Shoulder pain in adolescent athletes: prevalence, associated factors and its influence on upper limb function.

BACKGROUND: Sports that require the constant use of an upper limb demand the maximum kinetic chain efficiency in this segment. Immaturity of the musculoskeletal system, followed by failure in motor skills can expose adolescents to major reports of pain complaints, particularly for the shoulder. OBJECTIVE: To evaluate the prevalence of shoulder pain in adolescent athletes and identify possible factors associated with the complaint. METHOD: A total of 310 athletes, of both sexes and aged between 10 and 19 years old participated on this study. The subjects filled out a questionnaire with personal, sports and upper limb function (Quick-DASH) questions. We evaluated the height, body mass, shoulder rotation range and stability of the upper limb using the CKCUES-test. The association between pain and the variables was analyzed using multilevel modeling logistic regression. We used the Mann-Whitney test for comparing between pain and function. RESULTS: The prevalence of shoulder pain was 43.5%. Athletes between 15 and 19 years, handball and judo practitioners, are 1.86, 2.14 and 3.07 more likely to report shoulder pain, respectively, when compared with other sports and ages. Shoulder pain reduced function scores (p<0.001) and increased changes in the range of motion (p<0.04). CONCLUSION: Shoulder pain is highly prevalent and is associated especially with older adolescent athletes of handball and judo, and affects the levels of function and the range of the shoulder.

Reliability and validity of the Brazilian version of the Pittsburgh Sleep Quality Index in adolescents / Confiabilidade e validade da versão brasileira do Índice de Qualidade do Sono de Pittsburgh em adolescentes

Abstract Objective: To evaluate the reliability and validity of the Brazilian version of the Pittsburgh Sleep Quality Index. Methods: 309 adolescents, subdivided into a sample of 209 subjects, of whom 25 were reassessed, and another sample of 100 adolescents. Reliability was assessed using Cronbach's α-values, intraclass correlation coefficient, Standard Error of Measure, Minimum Detectable Change, and Bland-Altman plotting. Exploratory analysis of the questionnaire components was performed based on the sample of 209 adolescents. Confirmatory factor analysis was performed with a sample of 100 individuals. Results: The sample of 209 participants had a mean age of 14.38 (±1.94) years, comprising 80 (38.3%) girls and 129 (61.7%) boys. The sample of 100 adolescents had a mean age of 13.66 (±2.35) years, comprising 51 (51%) girls and 49 (49%) boys. The questionnaire obtained a Standard Error of Measure = 1.12 and Minimum Detectable Change = 3.10. Cronbach's α was 0.71 and the Intraclass Correlation Coefficient was 0.65 (95% CI: 0.21-0.85). The factor analysis showed that the best model of components was the one that consisted of two factors, excluding the component on the use of sleep medications. Conclusion: The questionnaire showed high internal consistency and moderate reliability. Furthermore, a model with two factors seems to be the most appropriate to evaluate the quality of sleep in adolescents.

Resumo Objetivo: Avaliar a confiabilidade e validade da versão brasileira do Índice de Qualidade do Sono de Pittsburgh. Métodos: Uma amostra de 309 adolescentes, subdivididos em uma de 209 indivíduos, dos quais 25 foram reavaliados, e outra de 100 adolescentes. A confiabilidade foi avaliada por meio dos valores de α de Cronbach, coeficiente de correlação intraclasse, erro padrão da medida, mínima mudança detectável e plotado gráfico Bland-Altman. A análise exploratória dos componentes do questionário foi feita com base na amostra de 209 adolescentes. A análise fatorial confirmatória foi feita com a amostra de 100 indivíduos. Resultados: A amostra de 209 participantes teve uma média de 14,38 (± 1,94) anos, 80 (38,3%) meninas e 129 (61,7%) meninos. A amostra composta por 100 adolescentes teve uma média de 13,66 (± 2,35) anos, 51 (51%) meninas e 49 (49%) meninos. O questionário obteve erro padrão da medida = 1,12 e mudança mínima detectável = 3,10. O α de Cronbach foi de 0,71 e coeficiente de correlação intraclasse de 0,65 (IC95% 0,21-0,85). As análises fatoriais apontaram como melhor modelo de componentes aquele composto por dois fatores, com exclusão do componente sobre uso de medicamentos para dormir. Conclusão: O questionário obteve elevada consistência interna e confiabilidade moderada. Além disso, um modelo de dois fatores parece ser o mais adequado para avaliar a qualidade do sono em adolescentes.

TEST-RETEST RELIABILITY OF THE CLOSED KINETIC CHAIN UPPER EXTREMITY STABILITY TEST (CKCUEST) IN ADOLESCENTS: RELIABILITY OF CKCUEST IN ADOLESCENTS.

BACKGROUND: The Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) has been proposed as an option to assess upper limb function and stability; however, there are few studies that support the use of this test in adolescents. PURPOSE: The purpose of the present study was to investigate the intersession reliability and agreement of three CKCUEST scores in adolescents and establish clinimetric values for this test. STUDY DESIGN: Test-retest reliability. METHODS: Twenty-five healthy adolescents of both sexes were evaluated. The subjects performed two CKCUEST with an interval of one week between the tests. An intraclass correlation coefficient (ICC3,3) two-way mixed model with a 95% interval of confidence was utilized to determine intersession reliability. A Bland-Altman graph was plotted to analyze the agreement between assessments. The presence of systematic error was evaluated by a one-sample t test. The difference between the evaluation and reevaluation was observed using a paired-sample t test. The level of significance was set at 0.05. Standard error of measurements and minimum detectable changes were calculated. RESULTS: The intersession reliability of the average touches score, normalized score, and power score were 0.68, 0.68 and 0.87, the standard error of measurement were 2.17, 1.35 and 6.49, and the minimal detectable change was 6.01, 3.74 and 17.98, respectively. The presence of systematic error (p < 0.014), the significant difference between the measurements (p < 0.05), and the analysis of the Bland-Altman graph infer that CKCUEST is a discordant test with moderate to excellent reliability when used with adolescents. CONCLUSION: The CKCUEST is a measurement with moderate to excellent reliability for adolescents. LEVEL OF EVIDENCE: 2b.

Reliability and validity of the Brazilian version of the Pittsburgh Sleep Quality Index in adolescents.

OBJECTIVE: To evaluate the reliability and validity of the Brazilian version of the Pittsburgh Sleep Quality Index. METHODS: 309 adolescents, subdivided into a sample of 209 subjects, of whom 25 were reassessed, and another sample of 100 adolescents. Reliability was assessed using Cronbach's α-values, intraclass correlation coefficient, Standard Error of Measure, Minimum Detectable Change, and Bland-Altman plotting. Exploratory analysis of the questionnaire components was performed based on the sample of 209 adolescents. Confirmatory factor analysis was performed with a sample of 100 individuals. RESULTS: The sample of 209 participants had a mean age of 14.38 (±1.94) years, comprising 80 (38.3%) girls and 129 (61.7%) boys. The sample of 100 adolescents had a mean age of 13.66 (±2.35) years, comprising 51 (51%) girls and 49 (49%) boys. The questionnaire obtained a Standard Error of Measure=1.12 and Minimum Detectable Change=3.10. Cronbach's α was 0.71 and the Intraclass Correlation Coefficient was 0.65 (95% CI: 0.21-0.85). The factor analysis showed that the best model of components was the one that consisted of two factors, excluding the component on the use of sleep medications. CONCLUSION: The questionnaire showed high internal consistency and moderate reliability. Furthermore, a model with two factors seems to be the most appropriate to evaluate the quality of sleep in adolescents.