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CONTEXT: The incidence and recurrence rate of hamstring strain injuries remain persistently high, with recurrent injuries leading to increased time lost during play and extended recovery periods compared with initial injury. Ultrasound imaging assesses important factors such as hamstring fascicle length (FL), pennation angle (PA), cross-sectional area (CSA), muscle thickness (MT), echo intensity (EI), and shear wave elastography (SWE), all impacting athletic performance. However, its reliability must be established before employing any measurement tool in research or clinical settings. OBJECTIVES: To determine the reliability and measurement error of ultrasound for assessing hamstring FL, PA, CSA, MT, EI, and SWE among healthy adults and athletes; to synthesize the information regarding the operationalization of ultrasound. EVIDENCE ACQUISITION: A systematic literature search was done from January 1990 to February 5, 2023, to identify reliability and validity studies of hamstring ultrasound assessment published in peer-reviewed journals with identifiable methodology of outcome measures. EVIDENCE SYNTHESIS: Intraclass correlation coefficient measurement of 14 included studies reported moderate to excellent intrarater, interrater, and test-retest reliabilities of FL, PA, and MT regardless of the site of muscle testing, probe size, and setting, state of muscle, and use of different techniques in the extrapolation of FL. Good to excellent test-retest reliability rates for all hamstring anatomic CSA along midmuscle and different percentages of thigh length using panoramic imaging. Good intrarater reliability of EI regardless of gender and orientation of the probe but with excellent intrarater reliability in transverse scan using maximum region of interest. Good intrarater, interrater, and interday repeatability on SWE with the muscle in a stretched position. CONCLUSION: Evidence from studies with a predominantly low risk of bias shows that ultrasound is a reliable tool to measure hamstring FL, PA, CSA, MT, EI, and SWE in healthy adults and athletes under various experimental conditions.
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Músculos Isquiossurais , Ultrassonografia , Humanos , Músculos Isquiossurais/diagnóstico por imagem , Músculos Isquiossurais/fisiologia , Músculos Isquiossurais/anatomia & histologia , Reprodutibilidade dos Testes , Atletas , Técnicas de Imagem por Elasticidade/métodos , AdultoRESUMO
Background: Myofascial pain syndrome (MPS) is described as pain that arise from myofascial trigger points (MTrPs) which is a hyperirritable spot within a taut band of skeletal muscle. A newer needling technique called the interfascial hydrodissection (IH), wherein anesthetic saline solution (ASS) is injected between the fascia of the muscles using ultrasound as guide. It is theorized that this technique blocks the nerve branches and improve gliding in between the muscle and fascia. Objective: To determine the short and long-term effects of interfascial hydrodissection using 2% Lidocaine and saline solution compared to dry needling with MPS of the upper trapezius on pain and quality of life using. Methods: This study is a single-blind randomized controlled trial where ultrasound guided IH with ASS was compared to dry needling (DN) of the MTrPs. Both groups were taught self-stretch exercises (SSE) to be done everyday after the procedure. Outcome measures were pain using the visual analogue scale (VAS) and quality of life assessment with EQ-5D-5l questionnaire. All participants were assessed by a blinded assessor before the intervention, immediately after, 10 and 30â min, one week, two weeks, four weeks, three months, and six months after the procedure. Data Analysis: Two-way mixed ANOVA and follow-up independent T-test were conducted for the outcome measures across several time points between the 2 groups. Results: A total of 46 participants with two dropouts were all included during the final analysis. Both groups demonstrated significant differences in VAS scores between baseline and the different time points, the IH + SSE group demonstrated the more significant effect size at as compared to the DN + SSE group. For EQ-5D-5l, no statistical differences were seen in all dimensions but there was a larger effect size for usual activities, pain/discomfort and anxiety/depression. Conclusion: Interfascial hydrodissection is a technique that can manage both short and long term symptoms of MPS. This could be utilized as an alternative management for those with chronic MPS of the upper trapezius. Philippine Health Research Registry ID: PHRR221003-005034.
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Background: The recent COVID-19 pandemic has forced various workforce industries to work from home. The work-from-home set-up has exposed some workers to some office-related work, typically not included in their jobs, consequently exposing them to an increased risk for developing musculoskeletal pain. Methods: We will search PubMed, MEDLINE, and CINAHL for observational studies published between May 2020-June 2021. This review will include published peer-reviewed studies in the English language. We will include studies that recruited adults aged 20-65 from any work industry reporting on outcomes related to musculoskeletal functions (i.e., pain, disorder, condition, etc.). Two independent reviewers will screen the search results. Two independent reviewers will accomplish risk of bias assessment using the JBI-MAStARI critical appraisal tools. Likewise, data extraction will be performed by one reviewer and verified by a second reviewer. Pooled prevalence estimates will be generated using Revman V.5.2.1, where Forest plots will be generated to determine overall estimates of random-effects and confidence intervals. To quantify heterogeneity, we will index the I 2 and X 2 p-value. A narrative synthesis summarised into tables and themes will likewise be used to summarize the extracted data. Discussion: A rapid review methodology was chosen to rapidly synthesize the available literature on the prevalence of musculoskeletal pain associated with work-from-home conditions during the COVID-19 pandemic, which is essential in informing health programs and policies that address both the public and private industry sectors. Systematic review registration: This is registered in the PROSPERO Registry (CRD42021266097).
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OBJECTIVES: To determine the most important motor impairments that are predictors of gait velocity and spatiotemporal symmetrical ratio in patients with stroke. DESIGN: Cross-sectional, descriptive analysis study. SETTING: Human performance laboratory of the University of Santo Tomas. PARTICIPANTS: Individuals with chronic stroke (N=55; 34 men, 21 women) who are community dwellers. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The gait velocity and spatiotemporal symmetrical ratio (step length; step, stance, swing, single-leg support, and double-leg support stance times) was determined using Vicon motion capture. We also calculated motor impairment of the leg and foot using Brunnstrom's stages of motor recovery, evaluated muscle strength using the scoring system described by Collin and Wade, and assessed spasticity using by the modified Ashworth Scale. RESULTS: Regression analysis showed that plantarflexor strength is a predictor of gait velocity and all temporospatial symmetry ratio. Knee flexor and extensor strength are predictors in single-leg support time and double-leg support time symmetry ratio, respectively. On the other hand, hip adductor and quadriceps spasticity are predictors of swing time and step length symmetry ratio. CONCLUSION: Different motor impairments are predictors of stroke gait abnormality. Interventions should be focused on these motor impairments to allow for optimal gait rehabilitation results.
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OBJECTIVES: To determine the diagnostic capacity of ultrasound (US) in detecting carpal tunnel syndrome (CTS). METHODS: Volunteer adults with and without CTS symptoms were recruited from offices in metropolitan Manila, where employees' work was hand/wrist intensive. Carpal tunnel syndrome was independently diagnosed by a reference standard (positive findings on a physical examination and nerve conduction studies). Blinded US measurements were taken of the median nerve (cross-sectional area, hypervascularity, wrist-to-forearm ratio, wrist-forearm difference, swelling ratio, flattening ratio, and palmar bowing of the flexor retinaculum) at the carpal tunnel inlet and carpal tunnel outlet (CTO). RESULTS: A total of 117 eligible consenting participants (234 hands) were included, with 54 hands (23.1%) with a diagnosis of CTS. There were no anthropometric differences between arms with and without CTS. Men and women older than 33 years were 5 times more likely to report CTS than younger people. A CTO wrist-forearm difference of greater than 0.03 cm had the strongest association with CTS (odds ratio, 4.7; 95% confidence interval, 1.4-15.9), with an area under the curve of 0.58 (sensitivity, 94.4%; specificity, 21.7%). The area under the curve increased to 0.59 when the next strongest measurement (CTO hypervascularity of 1+: odds ratio, 3.8; 95% confidence interval, 1.8-8.1) was included (sensitivity, 98.1%; specificity, 27.7%). Adding further US parameters did not improve the diagnostic capacity of US for CTS. Diagnostic capacity was independent of age and the duration of CTS symptoms. CONCLUSIONS: Combining US findings for the CTO wrist-forearm difference and hypervascularity provides a sensitive, alternative diagnostic tool for CTS.
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Síndrome do Túnel Carpal/diagnóstico por imagem , Ultrassonografia/métodos , Adulto , Feminino , Humanos , Masculino , Nervo Mediano/diagnóstico por imagem , Filipinas , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
OBJECTIVE: The aim of this cross-sectional correlational study was to determine the association of pain with morphologic and inflammatory sonographic findings in patients with knee osteoarthritis. METHODS: A total of 113 participants with knee osteoarthritis were assessed using visual analog scale pain score and sonography. Ultrasound evaluation included morphologic changes (ie, articular cartilage degeneration, medial and lateral meniscal protrusion, and presence of osteophytes on the joint margins) and inflammatory changes (ie suprapatellar effusion and/or synovitis, Baker cyst, superficial and deep infrapatellar effusion, pes anserine tendinopathy, and Hoffa panniculitis). RESULTS: Cluster analysis via Ward's method grouped patients with minimal pain (visual analog scale score, 0-4) and with substantial pain (visual analog scale score, 5-10). Stepwise logistic regression yielded 5 variables that significantly explained the variation in the probability of perceived substantial pain at 10% level of significance: lateral cartilage clarity (LCC; P = .025), medial cartilage clarity (MCC; P = .20), medial cartilage thickness (MCT; P = .041), medial meniscus protrusion (MMP) (P = .029), and osteophytes at medial femoral margin (P = .082), with 63% overall prediction accuracy. When age and sex were added, 4 variables remained significant at a 10% level of significance: LCC, MCC, MCT, and MMP, with 65% overall prediction accuracy. The receiver operating characteristic curve of this model was 0.667. CONCLUSION: The study was able to demonstrate that morphologic abnormalities in the ultrasound parameters for LCC, MCC, MCT, and MMP were able to predict significant joint pain in knee osteoarthritis. There were no inflammatory changes that contributed to significant joint pain in this study.
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Artralgia/complicações , Artralgia/fisiopatologia , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/fisiopatologia , Osteoartrite do Joelho/complicações , Osteoartrite do Joelho/fisiopatologia , Idoso , Artralgia/diagnóstico , Protocolos Clínicos , Análise por Conglomerados , Estudos Transversais , Feminino , Humanos , Inflamação/complicações , Inflamação/diagnóstico por imagem , Inflamação/fisiopatologia , Masculino , Pessoa de Meia-Idade , Filipinas , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Ultrassonografia/métodosRESUMO
BACKGROUND: Electrophysiologic studies have been considered the "gold standard" in diagnosing carpal tunnel syndrome (CTS); however, reports of false-negative results, as well as discomfort for the patient during the procedure has paved the use of ultrasound, being a painless and cost-efficient tool, as an alternative means for its diagnosis. Various ultrasound parameters assessing the median nerve and wrist dimensions have been described, but description of landmarks to assess these in a reliable manner has been lacking. METHODOLOGY: A systematic search of different databases yielded data regarding ultrasound parameters for CTS diagnosis, the landmarks used, and presence of reliability testing. Based on this, three sonologists discussed the external and sonographic landmarks that will be used in measuring the median nerve measurements, bowing of the flexor retinaculum and the carpal tunnel dimensions. A pilot test with two consecutive healthy participants using the discussed ultrasound parameters was carried out, and results were subjected to inter- and intra-rater reliability testing. Modifications were accordingly made on the acquisition of ultrasound image using external landmarks. The reliability testing proper was done with ten consecutive healthy participants. RESULTS: Based on the systematic review and the pilot study, external landmarks were used to locate the median nerve in the forearm, carpal tunnel inlet and outlet. For the forearm measurement, it was taken 10 cm proximal from the distal palmar crease. The distal palmar crease was the external landmark used for the carpal tunnel inlet, while for the carpal tunnel outlet; it was measured 1 cm distal to the distal palmar crease. Instead of using the inner edge of the hook of hamate and trapezium, the apices of these bones were used as the landmarks in measuring the carpal tunnel outlet dimensions. There was excellent intra-rater reliability (mid-forearm, carpal tunnel inlet and outlet) except for the following: cross-sectional area (CSA) of the median nerve at the carpal tunnel inlet and outlet; and bowing of the flexor retinaculum. All the parameters had an excellent inter-rater reliability measured at the three levels (intraclass correlation [ICC]: Of 0.77-0.99) except for CSA of the median nerve at the levels of the forearm (fair-to-good with ICC of 0.71) and the carpal tunnel inlet (fair-to-good reliability of ICC: 0.43). CONCLUSION: There was an improved inter- and intra-rater reliability when external landmarks were used instead of sonographic landmarks.
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It is of critical importance that findings from the wealth of clinical physical therapist research are transferred into clinical practice without unnecessary delays. There is a lack of knowledge about strategies that can be used to effectively implement physical therapist research findings and evidence-based practice (EBP) into everyday clinical practice in different national settings and contexts. The purpose of this article is to contribute to knowledge about effective strategies for implementing EBP that have been studied in different national physical therapy settings. The specific aims of this article are to share experiences and provide a current multinational perspective on different approaches and strategies for implementing EBP and to highlight important considerations and implications for both research and practice. Six research studies from various settings in 3 countries are described and synthesized. Key characteristics of the studies and intervention components are tabulated and mapped to the Cochrane Effective Practice and Organisation of Care taxonomy. Commonalities and differences are presented. The implementation strategies described were: a theory-based guideline implementation tailored to identified barriers and facilitators; a multifaceted EBP training package; journal clubs; a multifaceted strategy comprising contextualized procedures, protocols, and standardized resources; barrier identification, education, audit, feedback, and reminders; and contextualized guidelines. Commonalities were the use of a multifaceted approach, educational measures, and clinical guidelines. Key outcomes across the studies were improved attitudes and increased awareness, knowledge, skills, and confidence in EBP; better access to clinical practice guidelines and other EBP resources; identification of barriers that could be targeted in future implementation activities; earlier referrals; and use of recommended outcome measures. The article can serve as a template for other physical therapist researchers in designing implementation studies, as well as to inform policies and practice for health care managers and decision makers who are looking for ways to implement research findings in their organizations.
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Prática Clínica Baseada em Evidências/métodos , Cooperação Internacional , Especialidade de Fisioterapia , Guias de Prática Clínica como Assunto , Pesquisa , Austrália , Tomada de Decisão Clínica/métodos , Prática Clínica Baseada em Evidências/organização & administração , Humanos , Filipinas , Especialidade de Fisioterapia/métodos , Especialidade de Fisioterapia/organização & administração , SuéciaRESUMO
BACKGROUND: Clinical practice guidelines need to be regularly updated with current literature in order to remain relevant. This paper reports on the approach taken by the Philippine Academy of Rehabilitation Medicine (PARM). This dovetails with its writing guide, which underpinned its foundational work in contextualizing guidelines for stroke and low back pain (LBP) in 2011. METHODS: Working groups of Filipino rehabilitation physicians and allied health practitioners met to reconsider and modify, where indicated, the 'typical' Filipino patient care pathways established in the foundation guidelines. New clinical guidelines on stroke and low back pain which had been published internationally in the last 3 years were identified using a search of electronic databases. The methodological quality of each guideline was assessed using the iCAHE Guideline Quality Checklist, and only those guidelines which provided full text references, evidence hierarchy and quality appraisal of the included literature, were included in the PARM update. Each of the PARM-endorsed recommendations was then reviewed, in light of new literature presented in the included clinical guidelines. A novel standard updating approach was developed based on the criteria reported by Johnston et al. (Int J Technol Assess Health Care 19(4):646-655, 2003) and then modified to incorporate wording from the foundational PARM writing guide. The new updating tool was debated, pilot-tested and agreed upon by the PARM working groups, before being applied to the guideline updating process. RESULTS: Ten new guidelines on stroke and eleven for low back pain were identified. Guideline quality scores were moderate to good, however not all guidelines comprehensively linked the evidence body underpinning recommendations with the literature. Consequently only five stroke and four low back pain guidelines were included. The modified PARM updating guide was applied by all working groups to ensure standardization of the wording of updated recommendations and the underpinning evidence bases. CONCLUSIONS: The updating tool provides a simple, standard and novel approach that incorporates evidence hierarchy and quality, and wordings of recommendations. It could be used efficiently by other guideline updaters particularly in developing countries, where resources for guideline development and updates are limited. When many people are involved in guideline writing, there is always the possibility of 'slippage' in use of wording and interpretation of evidence. The PARM updating tool provides a mechanism for maintaining a standard process for guideline updating processes that can be followed by clinicians with basic training in evidence-based practice principles.
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Dor Lombar/terapia , Manejo da Dor/métodos , Guias de Prática Clínica como Assunto , Reabilitação do Acidente Vascular Cerebral , Medicina Baseada em Evidências/métodos , Medicina Baseada em Evidências/normas , Humanos , Manejo da Dor/normas , Filipinas , Padrões de Prática Médica , Padrões de Referência , Reprodutibilidade dos TestesRESUMO
BACKGROUND: Stroke is one of the leading medical conditions in the Philippines. Over 500,000 Filipinos suffer from stroke annually. Provision of evidence-based medical and rehabilitation management for stroke patients has been a challenge due to existing environmental, social, and local health system issues. Thus, existing western guidelines on stroke rehabilitation were contextualized to draft recommendations relevant to the local Philippine setting. Prior to fully implementing the guidelines, an audit of current practice needs to be undertaken, thus the purpose of this audit protocol. METHODS: A clinical audit of current practices in stroke rehabilitation in the Philippines will be undertaken. A consensus list of data items to be captured was identified by the audit team during a 2-day meeting in 2012. These items, including patient demographics, type of stroke, time to referral for rehabilitation management, length of hospital stay, and other relevant descriptors of stroke management were included as part of the audit. Hospitals in the Philippines will be recruited to take part in the audit activity. Recruitment will be via the registry of the Philippine Academy of Rehabilitation Medicine, where 90% of physiatrists (medical doctors specialized in rehabilitation medicine) are active members and are affiliated with various hospitals in the Philippines. Data collectors will be identified and trained in the audit process. A pilot audit will be conducted to test the feasibility of the audit protocol, and refinements to the protocol will be undertaken as necessary. The comprehensive audit process will take place for a period of 3 months. Data will be encoded using MS Excel(®). Data will be reported as means and percentages as appropriate. Subgroup analysis will be undertaken to look into differences and variability of stroke patient descriptors and rehabilitation activities. CONCLUSION: This audit study is an ambitious project, but given the "need" to conduct the audit to identify "gaps" in current practice, and the value it can bring to serve as a platform for implementation of evidence-based stroke management in the Philippines to achieve best patient and health outcomes, the audit team is more than ready to take up the challenge.
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INTRODUCTION: Despite reports on the association of radial nerve (RN) size and lateral epicondylalgia (LE), Filipino normative values on RN size in healthy elbows are not established. An association with upper extremity anthropometric measurements is likewise not reported. METHODS: Musculoskeletal ultrasound measurements of the RN at the level of the lateral epicondyle (RN-LE), posterior interosseous nerve at the level of the radial head and supinator (PIN-RH and PIN-sup), and superficial RN (SRN) in the elbows of healthy Filipinos were made in Manila from January-September 2011. RESULTS: A total of 198 elbows of 99 healthy participants aged 43 years (range, 33-48 years) [median(IQR)] were investigated. Men have larger PIN-RH, PIN-sup, and SRN compared with women. Arm length was associated with PIN-RH, PIN-sup, and SRN (P < 0.05). Activities and elbow circumference measurements (at 2 levels) were associated with PIN-RH. CONCLUSIONS: RN reference values can now be used for comparison in elbows with LE.
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Sistema Musculoesquelético , Nervo Radial/fisiologia , Extremidade Superior/inervação , Adulto , Antropometria , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Sistema Musculoesquelético/diagnóstico por imagem , Nervo Radial/diagnóstico por imagem , Valores de Referência , Reprodutibilidade dos Testes , Ultrassonografia , Adulto JovemRESUMO
The study aimed to assess the association between childhood obesity and snacking. A total of 396 students in grades 4 to 6 enrolled in an elementary school in the Philippines were the participants in this study. Demographic profile; anthropometric measures of height, weight, body mass index; and information about snacking were gathered. Obese group had statistically more servings of sweetened drinks and low-quality snacks. Female obese subjects have statistically more servings at nighttime and greater total snack servings. For the whole cohort, the odds ratio of being overweight with high total snack servings was 2.12 (95% confidence interval = 1.25-3.62) whereas the odds ratio of being obese with calories obtained from snacking was 2.08 (95% confidence interval = 1.01-4.26). Nighttime snacks and bad-quality foods should be minimized. Moreover, reducing food portions at any snack time will protect children from being overweight.
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Índice de Massa Corporal , Comportamento Alimentar , Lanches , Antropometria , Peso Corporal , Criança , Pré-Escolar , Estudos de Coortes , Ingestão de Energia , Feminino , Humanos , Masculino , Obesidade , Sobrepeso , Filipinas , Fatores de RiscoRESUMO
BACKGROUND: The World Health Organization recognizes depression as one of the most burdensome diseases in the world. Among cancer patients, depression is significantly associated with shorter survival, independent of the influence of biomedical prognostic factors. Although cancer is the third leading cause of morbidity and mortality among Filipinos, little is known about depressive symptoms and their influence on health-related quality of life in this population. We assessed the prevalence of, and factors associated with, depressive symptoms and their influence on health-related quality of life in Filipino patients with cancer. METHODS: The Patient Health Questionnaire (PHQ)-8 and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 were administered to all inpatients and outpatients, age >=18 years presenting for cancer treatment. RESULTS: Twenty-two percent (n=53/247) were categorized as depressed, using a PHQ-8 cutoff of ≥10. Depressed patients scored lower on cognitive, emotional, role, physical, and social functioning than those who scored PHQ<10 (all P<0.001). Depression varied by disease status, performance status and marital status (all P<0.001). However, only performance status (OR [odds ratio]=2.20; 95% CI=1.60, 3.00) and disease status (OR=2.4; 95% CI=1.13, 5.22) were significantly associated with depression in the multivariable model. CONCLUSIONS: Depression is prevalent in Filipino cancer patients. The findings provide empirical support for the development of mental health services in this understudied population. This study, the first to assess the prevalence of and factors associated with depression in Filipino cancer patients, needs further validation.
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Depressão/epidemiologia , Neoplasias/psicologia , Qualidade de Vida , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Filipinas/epidemiologia , Prevalência , Fatores de Risco , Inquéritos e QuestionáriosRESUMO
The objective of this study was to evaluate the effectiveness of extracorporeal shock wave therapy (ESWT) in treating chronic plantar fasciitis. An online database search was conducted for studies using ESWT in managing chronic plantar fasciitis. Eleven high-quality randomized controlled trials were included in the meta-analysis and showed that ESWT was more effective in reducing morning pain (weighted mean difference, -0.77 [95% confidence interval {CI}, -1.30 to -0.25]; odds ratio, 0.65 [95% CI, 0.42-1.00]). Moderate-intensity ESWT was more effective in decreasing overall and activity pain (weighted mean difference, -6.6 [95% CI, -6.74 to -6.46], and weighted mean difference, 0.47 (95% CI, 0.30-0.74). Both moderate- and high-intensity ESWT were more effective in improving functional outcome, with odds ratios of 0.51 (95% CI, 0.30-0.84) and 0.47 (95% CI, 0.29-0.75). The adverse effects that were seen more in ESWT were pain on the calcaneal area and calcaneal erythema. This study concludes that moderate- and high-intensity ESWT were effective in the treatment of chronic plantar fasciitis.
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Fasciíte Plantar/terapia , Ondas de Choque de Alta Energia/uso terapêutico , Adolescente , Idoso , Fasciíte Plantar/diagnóstico , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Resultado do Tratamento , Adulto JovemRESUMO
AIM: The objective of this study is are to examine the association of preadolescent obesity using body mass index (BMI) and waist circumference (WC) with health-related physical fitness components. METHODS: Grades 4 to 6 students in 2 private schools in Manila were included in this study. Height, weight, WC, and BMI were obtained. Physical fitness field tests were sit-and-reach test, 1-minute sit-ups, standing broad jump, 40-m sprint, and 20-m shuttle run. RESULTS: Obese subjects had poorer scores in the field tests except in the sit-and-reach test. BMI and WC were significantly negatively associated with all the physical fitness parameters, except for the 40-m sprint where positive correlation was observed, and in the sit-and-reach test where no correlation was seen. CONCLUSION: In the management of preadolescent overweight and obesity, exercise programs should therefore be designed toward enhancing these fitness parameters, while not sacrificing enjoyment and creativity.
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Índice de Massa Corporal , Aptidão Física/fisiologia , Circunferência da Cintura/fisiologia , Criança , Feminino , Humanos , Masculino , Obesidade/epidemiologia , Obesidade/fisiopatologia , Filipinas/epidemiologiaRESUMO
BACKGROUND: Childhood obesity has been inconsistently associated with decreased levels of physical activity and fitness. Moreover, little is known about this relationship among Filipino preteens. METHODS: This cross sectional study reports the association between childhood obesity, measures of physical activity, and fitness. Children aged 11 to 12 from randomly selected schools from San Juan, Metromanila were included. Outcome measures were body mass index, Filipino modified Physical Activity Questionnaire for Older children (F_PAQ-C), standing broad jump, 50 m sprint and 20 m multistage shuttle run. RESULTS: 380 children participated in the study. Obese children had significantly lower median scores in the F_PAQ-C compared with overweight children. Overweight children had lower scores in the standing broad jump, 50 m sprints and predicted VO2max as compared with children with normal BMI. There were modest associations between the 50 m sprint, predicted VO2max, and F_PAQ-C. CONCLUSION: Our study has showed that physical activity and fitness scores were strongly correlated with childhood obesity. If childhood physical fitness is a predictor of physical fitness in adulthood which is a risk factor in cardiovascular diseases, there is a strong possibility that the prevalence of cardiovascular disease in the Philippines will increase dramatically in the future.
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Exercício Físico/fisiologia , Obesidade/epidemiologia , Aptidão Física/fisiologia , Criança , Intervalos de Confiança , Estudos Transversais , Feminino , Humanos , Masculino , Razão de Chances , Sobrepeso/epidemiologia , Filipinas/epidemiologia , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To evaluate evidence on the effectiveness of topical nitroglycerin (NTG) in treating tendinopathies. DATA SOURCES: Systematic searches were conducted on ScienceDirect, Scirus, Highwire Press Stanford University, PubMed Central, Directory of Open Access Journals, Free Medical Journals, Free Full Text, Bioline International, Findarticles, BioMed Central, IndMed, OpenMD, QMed, Geneva Foundation for Medical Education and Research, Scientific Electronic Library Online, eMedicine/Medscape/Medline, Biomedical E-journals, Current Contents Connect, Journal of Medical Internet Research, Cochrane, Turning Research Into Practice, Ovid, and EBSCO databases. There were no restrictions regarding the language of publication. STUDY SELECTION: All clinical controlled trials or randomized controlled trials (RCTs) evaluating the effects of NTG for patients with acute, subacute, or chronic tendinopathies, whether the said intervention was placebo-controlled or controlled against a comparator intervention, were considered for inclusion. DATA EXTRACTION: A reviewer extracted data from included studies using a data extraction form by the Joanna Briggs Institute. DATA SYNTHESIS: Methodologic quality of studies was assessed by 2 independent reviewers through a critical appraisal form by the Alberta Heritage Foundation. Qualitative analyses of data were done using a rating system devised by Van Tulder and colleagues. Where possible, meta-analyses of data were performed. Seven clinically relevant and high-quality RCTs involving 446 subjects were identified and included in this review. Meta-analysis showed that NTG has a positive effect in pain reduction during activities of daily living in chronic tendinopathies, with an odds ratio of 4.44 (95% confidence interval [CI], 2.34-8.40), and in both acute and chronic phases combined, with an odds ratio of 4.86 (95% CI, 2.62-9.02). There is also qualitative, strong (Level 1) evidence that NTG is effective in enhancing tendon forces in the chronic phase. There is limited and/or conflicting evidence (Level 3) for other outcomes in the chronic phase and all outcomes in the acute phase. There is a significant between-group difference between NTG and control in the incidence of headache, with an odds ratio of 1.73 (95% CI, 1.01-2.97). No significant difference was observed in the occurrence of contact dermatitis, with an odds ratio of 2.12 (95% CI, .89-5.02). CONCLUSIONS: In chronic tendinopathies, there is strong evidence for NTG in relieving pain during activities of daily living, and increasing tendon strength. Further studies are needed to explore the role of this promising intervention in all phases of tendinopathies.
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Nitroglicerina/uso terapêutico , Tendinopatia/tratamento farmacológico , Vasodilatadores/uso terapêutico , Doença Aguda , Administração Cutânea , Doença Crônica , Ensaios Clínicos como Assunto , Humanos , Nitroglicerina/administração & dosagem , Nitroglicerina/efeitos adversos , Dor/tratamento farmacológico , Amplitude de Movimento Articular , Vasodilatadores/administração & dosagem , Vasodilatadores/efeitos adversosRESUMO
BACKGROUND: Over the past decade, childhood obesity has been recognized as an increasing health problem worldwide. It is a predictor of obesity during adulthood, which is strongly linked to chronic lifestyle diseases. PURPOSE: This paper aims to evaluate the effectiveness of school-based programs in the prevention and management of childhood obesity. METHODS: A comprehensive literature search was undertaken for RCTs and clinical controlled trials on school-based interventions that addressed childhood obesity, published between 1995 and 2007. The papers included for the meta-analysis were those in which ORs or standardized mean differences and their 95% CIs were reported or could be calculated from available data. RESULTS: Meta-analysis showed that the odds of participants' being overweight and obese in the school-based intervention programs compared with the control arm were significantly protective in the short term (OR=0.74, 95% CI=0.60, 0.92). Interventions that were conducted for more than 1 year had a higher OR of decreasing the prevalence of obesity. However, intervention programs were not effective in decreasing BMI compared with control treatments, with a weighted mean difference of -0.62 (95% CI=-1.39, 0.14). CONCLUSIONS: This meta-analysis showed that there was convincing evidence that school-based interventions are effective, at least short-term, in reducing the prevalence of childhood obesity. Longer-running programs were more effective than shorter programs.