The Brazilian-Portuguese version of the Upper Extremity Functional Index (UEFI): Translation, cross-cultural adaptation and measurement properties for Brazilian adults after a burn injury.

OBJECTIVES: To translate, cross-culturally adapt, validate, verify the reliability and estimate the minimal detectable change (MDC) of the UEFI to Brazilian Portuguese (UEFI-Br) for burns. METHODS: The study was carried out with 131 Brazilian burn cases at two time points, at discharge and at the first outpatient follow-up (15-21 days after discharge) in a Burn Treatment Center. The adaptation process of the UEFI was based on international recommendations. The Burn Specific Health Scale-Brief-Br (BSHS-B-Br) was also applied in order to analyze construct validity of the UEFI-Br and distribution-based methods were used to estimate its MDC. RESULTS: Intra- and inter-rater reliability were good with ICC of 0.986 (CI 95 %: 0.98-0.99) and 0.969 (CI 95 %: 0.955-0.979), respectively, at discharge and 0.997 (CI 95 %: 0.996-0.998) and 0.987 (CI 95 %: 0.981-0.991), respectively, at the first outpatient follow-up appointment. We found good internal consistency with Cronbach's α values of 0.987 and 0.996, respectively, at the two times. The SEM was 4.42 and 2.31 at the first and second time points, respectively. The UEFI-Br scores demonstrated strong correlation with the Burn Specific Health Scale-Brief-Br (BSHS-B-Br) function domain scores (r = 0.87-0.90). No significant correlation was found between UEFI-Br scores and participants' characteristics. The MDC of the UEFI-Br lies between 11 and 13 points. CONCLUSION: The Brazilian version of the UEFI-Br, a useful tool to assess upper limb function and disability, is a valid and reliable tool for use with Brazilian burn survivors. The MDC for the instrument was determined to be 11-13 points.

Instruments to assess function or functionality in adults after a burn injury: A systematic review.

INTRODUCTION: Assessment of functionality or function, through valid and reliable instruments, is essential during rehabilitation of adults after a burn injury. Currently, there is no consensus in the literature regarding the most appropriate tool that should be used to assess function or functionality; there is also no synthesis of the current studies published in this area. OBJECTIVES: To investigate and report the instruments used to assess function or functionality in adults after a burn injury; to identify the characteristics and evidence on their measurement properties; and to evaluate their clinical utility. METHODS: We systematically searched the literature via six electronic databases and via screening reference lists of relevant studies. The review was registered in PROSPERO (CRD42016048065) and reported according to the PRISMA statement. Studies in which function or functionality of upper and/or lower limbs of adults after a burn injury was assessed were included. Exclusion criteria comprised studies in pediatric populations and conference abstracts. RESULTS: Thirty-four studies were included. Twelve questionnaires and seven objective tests for function or functionality were identified. Three specific tools were found; four generic instruments have been validated in burns. Nine studies evaluated the instruments' measurement properties, presenting at least one property classified as 'fair' quality. Finally, 18 instruments demonstrated clinical utility. CONCLUSION: This systematic review demonstrated that most instruments used to assess function or functionality in adults with a burn injury have not been specifically developed for this population and had their measurement properties poorly studied. Conversely, almost all instruments had clinical utility.

Six-minute walk test in burned subjects: Applicability, reproducibility and performance at hospital discharge.

INTRODUCTION: Despite its clinical relevance in several populations, there is no evidence on applicability of the 6-min walk test (6MWT) in burned subjects. OBJECTIVES: To verify the applicability and reproducibility of the 6MWT in burned individuals and to analyze patients' performance in this test at hospital discharge. METHODS: In a cross-sectional study, burned individuals performed two 6MWT at hospital discharge, according to international standardization. In addition to walked distance, physiological and symptomatic variables were collected. Clinical history and demographic data were also recorded. RESULTS: One hundred individuals were evaluated (70 men, 10 [6-18]% total body surface area burned). There was excellent agreement between the two 6MWT (ICC = 0.97). However, 73% of subjects increased the walked distance in the second test (23 [-9-47]m or 5 [-2-10]%; P = 0.001). Considering the best 6MWT, the walked distance was 488 [396-718]m (80 [65-92]%pred), and 51% of the individuals had limited functional exercise capacity. Additionally, participants without lower limb involvement presented better 6MWT than others (P < 0.0001). CONCLUSION: The 6MWT was applicable, well tolerated and reproducible at hospital discharge in burned individuals. However, there was considerable learning effect between the first and second test. Finally, the reduced exercise capacity observed reinforces need for early rehabilitation in this population.

Prevalência de enteroparasitoses no Jardim Uniäo da Vitória, Londrina-PR / Enteroparasitosis prevalence in the Jardim Uniäo da Vitória, Londrina-PR

O Jardim Uniäo da Vitória, localizado na Regiäo Sul da cidade de Londrina, abrange uma populaçäo de 12.000habitantes segundo informaçöes extra-oficiais e apresenta condiçöes de vida precária. Näo possui esgoto e parte dele näo é atendido pelo sistema de abastecimento de água tratada. Levando-se em conta que a presença ou ausência de água tratada e esgoto nas moradias podem ser traduzidas como indicadores de saúde de uma populaçäo, os autores tiveram como objetivo estabelecer a prevalência de enteroparasitose na populaçäo do Jardim Uniäo da Vitória e relacionar os resultados obtidos com o saneamento básico observado. Através dos resultados obtidos em 62 amostras do sexo masculino e56 amostras do sexo feminino constatou-se que, 56,8 por cento apresentaram positividade, sendo este resultado compatível com as condiçöes de saneamento básico observados