Peripheral muscle oxygenation, pain, and disability indices in individuals with and without nonspecific neck pain, before and after myofascial reorganization®: A double-blind randomized controlled trial.

To investigate whether myofascial reorganization® in the trapezius muscle (MRT) improves peripheral muscle oxygenation and pain tolerance and decreases neck disability index (NDI) scores in individuals with and without nonspecific neck pain (NP) using a double-blind randomized controlled trial. Seventy-five subjects were equally and randomly assigned to three groups: the intervention groups (experimental [EG] and sham sSG]) and the control group (CG). Several inclusion criteria were applied to the intervention groups: male or female, aged 18-32 years, self-reported NP in the last 3 months without a defined cause; at least "soft" pain in session 1 of the NDI, and at least a score of 1 on the Visual Analogue Scale (VAS). The CG was required to have NDI and VAS scores of 0 at recruitment. Intervention: The EG underwent MRT for 10 min, once a week for 6 weeks. Patients with NP in the SG underwent classical massage for the same duration and frequency. Patients in the CG had no pain and underwent no intervention. Data collection was performed using the NDI Questionnaire, a pressure algometer for pain evaluation, and near-infrared spectroscopy for muscle oxygenation measurements. It was registered as NCT03882515 at ClinicalTrials.gov. The NDI score in both the EG (p<0.001) and SG (p<0.001) decreased after 6 weeks of intervention compared to the CG. The CG demonstrated a lower basal tissue saturation (TSI) index than the EG (p<0.001) and SG (p = 0.02). The EG demonstrated higher oxyhemoglobin values than the SG (p<0.001) and CG (p = 0.03). The CG had higher pain tolerance than the EG (p = 0.01) and SG (p<0.001) post-intervention. MRT increased trapezius muscle oxygenation after 6 weeks of intervention.

Submaximal Field Walking Tests Applied in the Cardiopulmonary Assessment in Congenital Heart Diseases: A Systematic Review.

INTRODUCTION: Submaximal field walking tests are easy to apply and low cost, but it is necessary to standardize their application, especially in the pediatric population. The feasibility and its use in patients with congenital heart disease have been studied. To verify which are the submaximal field walking tests applied in the cardiopulmonary assessment of children and adolescents with CHD and to verify if they are being performed as recommended by the standardization protocols/guidelines. METHODS: Literature review through a search in six electronic databases, structured in PICO format, without date restrictions. Looking for studies that used submaximal field walking tests in children and adolescents with congenital heart disease aged 5 to 18 years. Methodological quality, effectiveness and safety and risk of bias were assessed. RESULTS: Five studies met the eligibility criteria with a sample of 160 individuals with congenital heart disease, and all used the six-minute walk test. Note that different methodologies and modifications are used. Only the clinical trial showed good methodological quality.Four studies had low risk of bias and one study had moderate risk. CONCLUSION: Although the six-minute walk test is the only test used as a field test found in our research, there is no standardization in the application of the test, making it difficult to compare the results. In this sense, reducing the limitations and heterogeneity in the application of the test will enable more concrete outcomes and facilitate their reproduction in clinical practice.

Whole-body vibration exercise in the management of cardiovascular diseases: A systematic review.

BACKGROUND: Cardiovascular diseases (CVDs) are an important public health problem, representing about 45% of deaths in the world. Its management is linked to medications, changes in lifestyle, and physical exercise, with the whole-body vibration exercises (WBV) being a promising therapeutic resource. This study aims to investigate the effects of WBV in isolation or associated with other types of exercises in the management of CVDs. METHODS: A systematic review following the PRISMA guidelines and registered on the PROSPERO platform was carried out. The search took place in the databases PubMed, Cochrane, PEDro, Lilacs, and Science Direct, from the beginning of the databases until January 2021. Descriptors related to WBV and CVD were used. The selected studies were assessed for quality, risk of bias, and level of evidence. RESULTS: In all, 84 studies were identified, and of these, three were included. The intervention protocols used were analyzed, in addition to the effects of WBV on hemodynamic, cardiovascular, vascular/arterial, and muscle parameters. CONCLUSION: The use of different WBV protocols, in isolation, in the improvement of the parameters mentioned above in individuals with CVD is plausible, with significant responses acutely or chronically and can be considered as a safe and effective training resource.

Questionário de autopercepção corporal de professores durante atividades escolares (P&Hscreen): desenvolvimento, validação e confiabilidade / Questionnaire on teachers' physical self-perception during school activities (P&Hscreen): development, validation, and reliability

Construir e validar um questionário para avaliar a autopercepção de professores sobre sua postura e a percepção dos hábitos posturais dos alunos em diferentes situações no ambiente escolar. Foram realizadas 7 etapas para a construção do questionário. A estratégia de validação de conteúdo foi julgada por um painel de especialistas e pelo Índice de Validade (VI). A confiabilidade teste-reteste foi realizada com professores e medida pelo Coeficiente de Correlação Intraclasse (ICC) e Coeficiente Kappa (KC). 11 especialistas com doutorado, experiência em educação e na área de postura participaram da validação de conteúdo e 40 professores participaram da confiabilidade teste-reteste. As medidas de VI foram todas acima de 0,81, e a média geral de ICC e KC foi de 0,94 e 0,91, respectivamente. Este questionário foi considerado válido, confiável e viável com linguagem compreensível para os professores. Pode ser recomendado para pesquisas em escolas e programas de educação postural, contribuindo para a prevenção de hábitos posturais inadequados e suas consequências.

To construct and validate a questionnaire for assessing teachers' self-perception of their posture, and their perception of students' posture habits in different situations in the school environment. 7-step were performed for the construction of the questionnaire. The content validation strategy was judged by a panel of experts and the Validity Index (VI). Test-retest reliability was performed with teachers and measured by the Intraclass Correlation Coefficient (ICC) and Kappa Coefficient (KC). Eleven experts with a doctorate, experience in education, and the field of posture participated in content validation and 40 teachers participated in test-retest reliability. VI measurements were all above 0.81, and the overall mean of ICC and KC were 0.94 and 0.91, respectively. This questionnaire was considered valid, reliable, and feasible with language understandable to teachers. It can be recommended for research in schools, and posture education programs, contributing to the prevention of inadequate posture habits and their consequences.

Trigger point dry needling increases masseter muscle oxygenation in patients with temporomandibular disorder.

BACKGROUND: Temporomandibular disorder (TMD) is an umbrella term encompassing various clinical complaints involving the temporomandibular joints, masticatory muscles, and/or associated orofacial structures. Myogenous TMDs are the most frequent cause of chronic orofacial pain. Musculoskeletal pain is commonly associated with myofascial trigger points (MTPs), for which dry needling (DN) is a routine treatment. OBJECTIVE: To investigate muscle oxygenation and pain immediately after DN application on an MTP in the masseter muscle of patients with myogenous TMDs. METHODOLOGY: Masseter muscle oxygen tissue saturation indices (TSI%) were assessed by near-infrared spectroscopy (NIRS) pre- and post-interventions by a randomized, controlled, double-blind, crossover DN/Sham clinical trial (primary outcome). Pain was investigated by the visual analog scale (VAS). In total, 32 individuals aged from 18 to 37 years who were diagnosed with myogenous TMD and myofascial trigger points in their masseter muscles participated in this study. Relative deltas for the studied variables were calculated. Data normality was tested using the Shapiro-Wilk test. According to their distribution, data were analyzed by two-way ANOVA and the Student's t-, and Mann-Whitney tests. Statistical analyses were performed using Prism® 5.0 (GraphPad, USA). RESULTS: We found a significant difference (2,108% vs. 0,142%) between masseter muscle TSI% deltas after the DN and Sham interventions, respectively (n=24). We only evaluated women since men refused to follow NIRS procedures. Pain increased immediately after DN (n=32, 8 men), in comparison to Sham delta VAS. CONCLUSION: These findings show an increase in tissue oxygen saturation in the evaluated sample immediately after the DN intervention on the MTP of patients' masseter muscle. Pain may have increased immediately after DN due to the needling procedure.

Does premature birth affect Brazilian parents' practices related to infant positioning?

OBJECTIVE: To verify whether the time spent in prone, supine, or seated positions differed between term and preterm infants; and to determine whether a single verbal guidance session for parents changed the time spent in different positions, and, consequently, the motor development scores, after one month in preterm infants. METHODS: Sixty-one infants from a full-term and preterm group from Brazil were included. Motor development was assessed by the Alberta Infant Motor Scale (AIMS) and the parents registered the time spent in each position on a 24-hour schedule. A month after verbal guidance, a second assessment was performed only on the preterm infants. RESULTS: The positioning times awake determined for the full-term and preterm parents were similar. Preterm infants spent more time in the prone sleeping position (2.1 vs. 0.8 h; p=0.037) than full-term infants. The AIMS percentile scores did not differ significantly between the groups. For preterm infants, the time spent in all positions did not change during the second assessment (n=18). CONCLUSIONS: The fact that some parents position their infants in the prone posture during sleeping periods reinforce the importance of parental education approaches for sudden infant death syndrome (SIDS) prevention during the first months of life. The verbal guidance provided to parents of preterm infants did not influence the AIMS percentile and time spent in various positions but increased preterm parents' confidence in placing their infants in a prone position to play.

Postural education program for socially vulnerable adolescents protected by institutional care: case series / Programa de educação postural para adolescentes socialmente vulneráveis protegidos por cuidados institucionais

Introduction: Institutionalized young people may exhibit impaired development due to lack of support, correct guidance regarding their physiological changes, and knowledge about postural changes. Methods: This is a longitudinal observational case series study. Adolescents residing in shelters who could understand the entire protocol were invited to participate in the study. Ten meetings were held, once a week, with 8 theoretical-practical interventions and 2 pre and post-PEP evaluations. The evaluations were: static posture, dynamic balance, handgrip strength, self-esteem, quality of life, and a theoretical questionnaire on general knowledge. Results: From 18 adolescents, 11 (7 boys and 4 girls), with an average age of 14.8 (±1.3) years concluded the study. After the PEP intervention, a significant improvement was found in the knee angles (3.56º vs. 2.28º) and hip (-12.03º vs. -4.18º) in its plane lateral. The scores of the theoretical questionnaire were 4.75 vs. 11.63 and the handgrip strength was 22.91 vs. 28.54 kgf and 21.55 vs. 26.82 kgf for the right and left limbs. In the quality of life and self-esteem questionnaires, no statistically significant differences were obtained. Conclusion: PEP imparts benefits to socially vulnerable adolescents for postural angles, handgrip strength and theoretical knowledge. Self-esteem and quality of life did not change, probably due to their high vulnerability.

Introdução: Jovens institucionalizados podem apresentar comprometimento do desenvolvimento por falta de apoio, orientação correta quanto às suas alterações fisiológicas e conhecimento sobre alterações posturais. Métodos: Trata-se de um estudo observacional longitudinal de série de casos. Foram convidados a participar do estudo adolescentes residentes em abrigos que conseguissem compreender todo o protocolo. Foram realizados dez encontros, uma vez por semana, com 8 intervenções teórico-práticas e 2 avaliações pré e pós-PEP. (programa de educação postural). As avaliações foram: postura estática, equilíbrio dinâmico, força de preensão manual, autoestima, qualidade de vida e questionário teórico de conhecimentos gerais. Resultados: Dos 18 adolescentes, 11 (7 meninos e 4 meninas), com idade média de 14,8 (±1,3) anos, concluíram o estudo. Após a intervenção PEP, foi encontrada melhora significativa nos ângulos do joelho (3,56º vs. 2,28º) e quadril (-12,03º vs. -4,18º) no seu plano lateral. As pontuações do questionário teórico foram 4,75 vs. 11,63 e a força de preensão manual foi 22,91 vs. 28,54 kgf e 21,55 vs. 26,82 kgf para os membros direito e esquerdo. Nos questionários de qualidade de vida e autoestima não foram obtidas diferenças estatisticamente significativas. Conclusão: A PEP traz benefícios aos adolescentes em situação de vulnerabilidade social quanto aos ângulos posturais, força de preensão manual e conhecimento teórico. A autoestima e a qualidade de vida não se alteraram, provavelmente devido à sua elevada vulnerabilidade.

Peripheral muscle oxygenation and symptoms of stress in adolescents with and without temporomandibular disorder.

OBJECTIVE: To compare peripheral muscle oxygenation levels and the prevalence of psychological stress in adolescents with and without temporomandibular disorder (TMD). METHODS: A cross-sectional study was performed with adolescents submitted into two groups: those diagnosed with TMD (DG) and control (CG). Muscle oxygenation was measured by near-infrared spectroscopy in the masseter and upper trapezius muscles. Symptoms of stress were assessed by Lipp's Stress Symptom Inventory for Adults or Child Stress Scale. A Student t-test was used for intergroup comparisons and association between categorical variables by chi-square test, phi coefficient of correlation, odds ratio, and two-way ANOVA. RESULTS: Fifty-three adolescents were evaluated and a significant reduction was observed in the oxyhemoglobin level in the masseter muscle at rest (p = 0.04) and contraction (p = 0.02). A greater total hemoglobin level was found in the upper trapezius muscle at rest in DG (p = 0.03), with a significant difference in the tissue saturation index during contraction (p = 0.05) intergroup. Individuals in the DG were 4.523 times more likely to exhibit signs and symptoms of stress than in CG. CONCLUSION: Adolescents from DG showed reduced masseter oxyhemoglobin values at rest and during contraction and showed more signs and symptoms of stress than healthy controls. In the upper trapezius, DG showed higher values of total circulating hemoglobin, essential for greater blood flow and efficient maximum voluntary contraction. CLINICAL RELEVANCE: Changes in tissue oxygenation and stress in adolescents with TMD prompted the earlier treatment of this population to prevent disease progression into adulthood.

Trigger point dry needling increases masseter muscle oxygenation in patients with temporomandibular disorder

Abstract Background: Temporomandibular disorder (TMD) is an umbrella term encompassing various clinical complaints involving the temporomandibular joints, masticatory muscles, and/or associated orofacial structures. Myogenous TMDs are the most frequent cause of chronic orofacial pain. Musculoskeletal pain is commonly associated with myofascial trigger points (MTPs), for which dry needling (DN) is a routine treatment. Objective: To investigate muscle oxygenation and pain immediately after DN application on an MTP in the masseter muscle of patients with myogenous TMDs. Methodology: Masseter muscle oxygen tissue saturation indices (TSI%) were assessed by near-infrared spectroscopy (NIRS) pre- and post-interventions by a randomized, controlled, double-blind, crossover DN/Sham clinical trial (primary outcome). Pain was investigated by the visual analog scale (VAS). In total, 32 individuals aged from 18 to 37 years who were diagnosed with myogenous TMD and myofascial trigger points in their masseter muscles participated in this study. Relative deltas for the studied variables were calculated. Data normality was tested using the Shapiro-Wilk test. According to their distribution, data were analyzed by two-way ANOVA and the Student's t-, and Mann-Whitney tests. Statistical analyses were performed using Prism® 5.0 (GraphPad, USA). Results: We found a significant difference (2,108% vs. 0,142%) between masseter muscle TSI% deltas after the DN and Sham interventions, respectively (n=24). We only evaluated women since men refused to follow NIRS procedures. Pain increased immediately after DN (n=32, 8 men), in comparison to Sham delta VAS. Conclusion: These findings show an increase in tissue oxygen saturation in the evaluated sample immediately after the DN intervention on the MTP of patients' masseter muscle. Pain may have increased immediately after DN due to the needling procedure.

Does premature birth affect Brazilian parents' practices related to infant positioning? / A prematuridade afeta as práticas maternas brasileiras relacionadas ao posicionamento de lactentes?

Abstract Objective: To verify whether the time spent in prone, supine, or seated positions differed between term and preterm infants; and to determine whether a single verbal guidance session for parents changed the time spent in different positions, and, consequently, the motor development scores, after one month in preterm infants. Methods: Sixty-one infants from a full-term and preterm group from Brazil were included. Motor development was assessed by the Alberta Infant Motor Scale (AIMS) and the parents registered the time spent in each position on a 24-hour schedule. A month after verbal guidance, a second assessment was performed only on the preterm infants. Results: The positioning times awake determined for the full-term and preterm parents were similar. Preterm infants spent more time in the prone sleeping position (2.1 vs. 0.8 h; p=0.037) than full-term infants. The AIMS percentile scores did not differ significantly between the groups. For preterm infants, the time spent in all positions did not change during the second assessment (n=18). Conclusions: The fact that some parents position their infants in the prone posture during sleeping periods reinforce the importance of parental education approaches for sudden infant death syndrome (SIDS) prevention during the first months of life. The verbal guidance provided to parents of preterm infants did not influence the AIMS percentile and time spent in various positions but increased preterm parents' confidence in placing their infants in a prone position to play.

RESUMO Objetivo: Verificar se o tempo nas posições prono, supino ou sentado difere entre lactentes a termo e pré-termo; bem como determinar se uma única sessão de orientação verbal aos pais alterou o tempo despendido nas diferentes posições e, consequentemente, o escore de desenvolvimento motor, após um mês em lactentes pré-termo. Métodos: Foram incluídos 61 lactentes brasileiros nos grupos a termo e pré-termo. O desenvolvimento motor foi avaliado pela Alberta Infant Motor Scale (AIMS), e os pais registraram o tempo despendido em cada posição em uma linha do tempo de 24 horas. Um mês após a orientação verbal, uma segunda avaliação foi realizada apenas nos lactentes pré-termo. Resultados: O tempo de posicionamento acordado determinado pelos pais de lactentes a termo e pré-termo foi semelhante. Os lactentes pré-termo passaram mais tempo dormindo na posição prona (2,2 vs. 0,8 h; p=0,037) do que os lactentes a termo. Os escores de percentil AIMS não diferiram significativamente entre os grupos. Para lactentes pré-termo, o tempo despendido em todas as posições não se modificou durante a segunda avaliação (n=18). Conclusões: O fato de alguns pais posicionarem os lactentes em decúbito ventral durante os períodos de sono reforça a importância das abordagens educativas parentais para a prevenção da síndrome da morte súbita do lactente (SMSL) durante os primeiros meses de vida. A orientação verbal fornecida aos pais de prematuros não influenciou o percentil da AIMS e o tempo de permanência em várias posições, mas aumentou a confiança dos pais de lactentes prematuros em utilizar a posição prona para brincar.

Effects of Physical Exercises Alone on the Functional Capacity of Individuals with Obesity and Knee Osteoarthritis: A Systematic Review.

The association between obesity and knee osteoarthritis (KOA) is reported in the literature. The inflammatory factors described in obesity associated with mechanical overload on the knee joint lead to KOA development and reduced functional capacity in these individuals. Most physical exercise (PE) protocols associate a diet program to improve the functional capacity of individuals with concomitant KOA and obesity. There is a lack of published protocols performing PE alone, which would be without an associated diet program in individuals with both clinical conditions. In this systematic review, the authors summarize the effects of the application of PE alone, describing each protocol and reporting the improvement in the function of people with these clinical conditions. This investigation was conducted according to the PRISMA guidelines and registered in PROSPERO. Five databases (MEDLINE/PubMed, PEDro, Scopus, CINAHL and Web of Science) were used up to July 2022 and ten studies, including 534 participants, met the inclusion criteria. The PEDro scale, Cochrane collaborations and ROBINS-I tools were used to evaluate the methodological quality and risk of bias. It was concluded that PE performed alone seems to provide an improvement in the functional capacity of these individuals even without an associated diet plan in the condition of obesity.

Canadian and Brazilian Percentile Ranks for the Alberta Infant Motor Scale.

Aim: To verify if there is a difference between the percentile ranks for Brazilian infants compared with norms for Canadian infants on the Alberta Infant Motor Scale (AIMS). Method: A cross-sectional study in which 322 Brazilian infants, 2 to 15 months old, were administered the AIMS. Percentile ranks were calculated using norms for Canadian infants and norms from two studies of Brazilian infants. The Friedman test compared the AIMS percentile ranks for the entire sample. For reliability analysis, the interclass correlation coefficient (ICC) was used. Bland Altman's analysis was applied to compare percentile ranks. Results: Of the 322 evaluations analyzed, there were significant differences (p<.001) between the three percentile ranks compared. The Canadian norms presented the lowest average rating. There was good reliability between the percentile ranks (ICC > 0.75) but low agreement (Bland Altman; p<.001). Conclusion: There are differences between the Brazilian and Canadian percentile ranks and between the Brazilian percentile ranks of 2014 and 2016, and these differences may influence identification of motor development.

Acute effects of myofascial reorganization on trapezius muscle oxygenation in individuals with nonspecific neck pain.

BACKGROUND AND PURPOSE: Nonspecific neck pain (NNP) is a common idiopathic disorder in the general population that affects the trapezius muscle (TM) and blood supply, thereby compromising the fascial system. Myofascial reorganization (MR) is a physical therapy technique that can influence the dynamics of local fluids reducing excessive muscle tension and capillary constriction, and increasing local blood flow. This study aimed to investigate whether MR improves peripheral muscle oxygenation. METHODS: This was a quasi-experimental study with an intentional non-probability sample. Fifty participants (women: 36, men: 14) with and without NNP were assigned to either the experimental group (EG: n = 25, with NNP, subjected to MR) or the control group (CG: without NNP, no MR intervention). TM oxygenation was measured using near-infrared spectroscopy (NIRS) before and after a single intervention. All participants were evaluated and reassessed after 10 min. RESULTS: The results revealed that immediately after 10 min of MR, the EG exhibited an increase in the oxyhemoglobin level of the medium fibers of the TM (0.72 ± 1.47 vs. -0.14 ± 1.33 mmol/dL, p = 0.01). In addition, functional disability (CG: 5.48 ± 5.58%/EG: 21.12 ± 7.73%) and neck pain were measured using the neck disability index. The pain pressure threshold (CG: 70.49 ± 32.29 kgf/EG: 51.08 ± 27.65 kgf) and pain intensity (CG: 0.76 ± 1.56/EG: 3.28 ± 2.35) were also measured. CONCLUSION: The findings indicate that application of MR for 10 min increases the tissue oxyhemoglobin level in the TM of the group with NNP compared to the CG without NNP.

The effectiveness of different electrical nerve stimulation protocols for treating adults with non-neurogenic overactive bladder: a systematic review and meta-analysis.

INTRODUCTION AND HYPOTHESIS: Electrical nerve stimulation is a widely used treatment for overactive bladder but there is no consensus regarding the best placement of electrodes or protocols. We hypothesised that some non-implanted neurostimulation protocols would be more effective compared to others for treating urinary symptoms and improving quality of life among adults diagnosed with non-neurogenic overactive bladder. METHODS: A systematic review and meta-analyses of randomized clinical trials were performed in five electronic databases: PubMed/MEDLINE, Lilacs, CINAHL, Web of Science, and PEDro. The main outcome was urinary symptoms-frequency, nocturia, and urgency-and the secondary outcome quality of life. Some protocol characteristics were extracted, e.g., frequency, pulse width, intensity, intervention time, and electrode placement. RESULTS: Nine randomized controlled trials were included. Tibial neurostimulation showed better results than sacral neurostimulation for urge incontinence (mean difference = 1.25 episodes, 95% CI, 0.12-2.38, n = 73). On the pooled analysis, the different neurostimulation protocols-intravaginal, percutaneous tibial, and transcutaneous tibial nerve stimulation-demonstrated similar results for urinary frequency, nocturia, and urgency as well as quality of life. In general, effect sizes from meta-analyses were low to moderate. The best reported parameters for percutaneous tibial nerve stimulation were 20-Hz frequency and 200-µs width, once a week. CONCLUSIONS: There was evidence that tibial neurostimulation is more effective than sacral neurostimulation for urge incontinence symptoms among patients with non-neurogenic overactive bladder. Overall, there was no superiority of an electrical nerve stimulation electrode placement and protocol over others considering urinary symptoms and quality of life. Further studies with three-arm trials are necessary. This study was registered at PROSPERO: CRD4201810071.

Quality Assessment of Neonatal Pain Scales Translated and Validated to Brazilian Portuguese: A Systematic Review of Psychometric Properties.

OBJECTIVES: The objective of this systematic review was to identify and describe the psychometric properties of neonatal pain scales that were translated into Brazilian Portuguese and to verify the methodological quality of these translation, transcultural adaptations and validation. DESIGN: The present study is a systematic review. A systematic search in the literature included studies of development, validation, and transcultural adaptation of neonatal pain scales to Brazilian Portuguese. The instruments must have been developed for health care professionals to evaluate neonatal pain and stress in full-term and preterm newborns. DATA SOURCES: The search strategy was conducted in PubMed, Web of Science, Scopus, and Scielo databases following The PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). REVIEW /ANALYSIS METHODS: A total of 1,479 publications were identified and 5 fulfilled the inclusion criteria, with 4 instruments evaluated. For the methodological quality analysis of the measurement properties of the instruments the Consensus-based Standards for Health Measurement Instruments (COSMIN) Risk of Bias checklist was used. The psychometric properties verified were internal consistency, content validity, reliability, and construct validity. RESULTS: Three instruments reviewed were inadequate and one was doubtful. CONCLUSIONS: The neonatal pain scales wich were cross culturally adapted to Brazilian Portuguese were shown to be of low methodological quality based on COSMIM checklist. Caution should be considered for clinical decisions about pain management judgment coming from these instruments.

Association between mental health and physical activity levels in people with Parkinson's disease during the COVID-19 pandemic: an observational cross-sectional survey in Brazil.

Aims: (1) To evaluate mental health symptoms in people with Parkinson's (PwP) in self-isolation, before and during the COVID-19 pandemic, in Brazil; (2) to explore associations between mental health and physical activity levels. Methods: An observational cross-sectional survey using retrospective data. PwP from the Brazilian territory, both sexes, no age limit, in self-isolation due to COVID-19 pandemic, were invited to complete an online self-administered and validated questionnaire. Demographic data (sex, age, Brazilian state they lived in, levels of education, and household income), days in self-isolation, time of diagnosis, and symptoms that bothered most were reported. Self-reported levels of physical activity and mental health symptoms (depression, anxiety, fear, and thoughts of death), before and during the COVID-19 pandemic, were assessed. Results: The participants were 156 individuals with PD (64 ± 11 years), from both sexes (50% women; 50% men), resident in the 5 Brazilian regions. There was a worse on mental health symptoms over the time: anxiety [effect size = - 0.52; 95% CI (- 0.70; - 0.28); p < .001], fear [effect size = - 0.58; 95% CI (- 0.76; - 0.34); p < .001], and thoughts of death [effect size = - 0.43; 95% CI (- 072;-0.02); p = .001]. A lower physical activity level during the pandemic is related to increased probability of thoughts of death [crude OR = 1.84; 95% CI (0.98; 3.46); p = 0.05; adjusted OR = 2.98; 95% CI (- 0.01; 2.19); p = 0.05]. Anxiety, fear and depression were not associated with physical activity levels. Conclusions: Anxiety, fear and thoughts of death worsened during the COVID-19 pandemic in comparison with the period before COVID-19. Lower physical activity level during the pandemic was related to an increased probability of thoughts of death. Supplementary Information: The online version contains supplementary material available at 10.1007/s11332-021-00868-y.

O desempenho e as respostas fisiológicas ao teste de elevação do calcanhar bipodal são influenciados pela cadência e posição dos tornozelos / Bilateral heel-rise test performance and physiological response are influenced by cadence and ankle position

INTRODUÇÃO: Diferentes protocolos do teste de elevação do calcanhar (TEC) têm sido utilizados, sendo necessário analisar o impacto das variações nas respostas do teste. OBJETIVO: Comparar o desempenho e respostas de oxigenação muscular (OM) e frequência cardíaca (FC) de adultos em diferentes protocolos do TEC bipodal. MATERIAIS E MÉTODOS: Este foi um estudo transversal do tipo cruzado. Trinta participantes (23,1±2,9 anos; 16 homens) realizaram quatro protocolos do TEC bipodal, variando cadenciamento (autocadenciado e cadenciado externamente) e posição dos tornozelos (neutra e dorsiflexão). Para a OM, analisamos a saturação tecidual de oxigênio (StO2 ) e variação da concentração de oxihemoglobina (∆[O2 Hb]) e calculamos a variação entre os menores valores e os valores finais (∆Nadir-Final) e área sob a curva (AUC). Para a FC, calculamos a variação dos valores iniciais e finais (∆FC) e constante de tempo (τ). O teste de Friedman foi utilizado para comparar as variáveis entre os protocolos. A ANOVA de dois fatores foi utilizada para identificar o impacto da cadência e/ou posição dos tornozelos. RESULTADOS: O número de repetições e o tempo de execução foram maiores nos protocolos em posição neutra e cadenciado externamente (p<0,001 para ambos). ∆Nadir-Final (StO2: p<0,001; ∆[O2Hb]: p=0,005) e AUC (StO2: p<0,001; ∆[O2Hb]: p<0,001) dea mbas as variáveis de OM foram maiores nos protocolos em posição neutra. Protocolos autocadenciados apresentaram maior aumento da FC e τ mais rápida (p=0,006 e p=0,046). CONCLUSÃO: O TEC realizado em posição neutra e cadenciamento externo gera maiores repetições e tempo de execução. A dorsiflexão promoveu menor reperfusão muscular e o autocadenciamento, maior e mais rápido aumento da FC.

INTRODUCTION: Different heel-rise test (HRT) protocols have been used, possibly leading to varied responses. It is necessary to analyse the impact of protocol variation on test responses. PURPOSE: To compare the performance, muscle oxygenation (MO), and heart rate (HR) responses of adults in bilateral HRT protocols. METHODS: This was a cross-sectional crossover study. Thirty participants (23.1±2.9 years; 16 men) performed four bilateral HRT protocols with varying cadence (self-cadenced; externally cadenced) and ankle position (neutral; dorsiflexion). For MO responses, we analysed tissue oxygen saturation (StO2) and oxyhemoglobin concentration variation (∆[O2Hb]) and calculated the variation between the smallest and final values (∆Nadir-Final) and the area under the curve (AUC). The variation between the initial and final HR values (∆HR) and the time constant (τ) were calculated. Friedman's test was used to compare the variables among the protocols. Two-way ANOVA was used to identify the impact of cadence and/or ankle position. RESULTS: The number of repetitions and execution time were higher in the neutral position and externally cadenced protocols (p<0.001 for both). ∆Nadir-Final (StO2: p<0.001;∆[O2Hb]: p=0.005) and AUC (StO2: p<0.001; ∆[O2Hb]: p<0.001) of both MO variables were higher in the neutral position protocols. Selfcadenced protocols presented higher HR increase and faster τ (p=0.006 and p=0.046). CONCLUSION: Bilateral HRT performed in a neutral position, and external cadence promotes more repetitions and a longer execution time. Dorsiflexion promotes lower muscle reperfusion, and self-cadence higher and faster HR increase.

The effects of whole-body vibration on cognition: a systematic review / Os efeitos da vibração de corpo inteiro na cognição: uma revisão sistemática

Porpouse: To systematically review the mechanisms by WBV improves the ability to learn, think, memorize and all other processes involving cognition. Methods: The present study collected data from three databases using the keywords "whole-body-vibration" and "cognition". Randomized clinical trials focusing on the association of WBV and cognition were considered. The study was registered in the database of systematic reviews protocols PROSPERO. All included studies used healthy patients, exposed to WBV. The included articles were obtained regarding the risk of bias according to the Cochrane Collaboration criteria, level of evidence and strength of recommendation following the GRADE and Oxford classification. Results: Of the 89 articles published to the eligibility criteria, four were submitted to data extraction. Cognitive parameters were improved in relation to attention, memory or learning in almost all articles evaluated in this systematic review. Conclusion: Intervention with WBV would positive effects on individuals' cognitive ability, although further randomized investigations must be conducted. PROSPERO registration number: CRD42020203679

Objetivo: Revisar sistematicamente os mecanismos pelos quais a vibração de corpo inteiro (VCI) melhora a capacidade de aprender, pensar, memorizar e todos os outros processos que envolvem a cognição. Método: O presente estudo coletou dados de três bancos de dados usando as palavras-chave "vibração de corpo inteiro" e "cognição". Ensaios clínicos randomizados com foco na associação de WBV e cognição foram considerados. O estudo foi registrado no banco de dados de protocolos de revisões sistemáticas PROSPERO. Todos os estudos incluídos usaram pacientes saudáveis, expostos à VCI. Os artigos incluídos foram avaliados quanto ao risco de viés de acordo com os critérios da Colaboração Cochrane, nível de evidência e força de recomendação segundo a classificação GRADE e Oxford. Discussão e Resultados: Dos 89 artigos publicados, de acordo com os critérios de elegibilidade, quatro foram submetidos à extração de dados. Os parâmetros cognitivos, atenção, memória e aprendizagem demonstraram melhora em quase todos os artigos avaliados nesta revisão sistemática. Conclusão: A intervenção com VCI teria efeitos positivos na capacidade cognitiva dos indivíduos, embora mais ensaios clínicos randomizadas devam ser realizados para avaliação de tais parâmetros. Número de registro PROSPERO: CRD42020203679

Use of surface electromyography to evaluate effects of whole-body vibration exercises on neuromuscular activation and muscle strength in the elderly: a systematic review.

PURPOSE: Reduction of muscle strength and lean mass, increase in the risk of falls, higher mortality, and morbidity are observed in geriatric syndromes. Physical activity is an effective intervention in reducing signs and symptoms of geriatric syndromes. Whole-body vibration exercise (WBVE) is an intervention with low cost and has been effective. MATERIALS AND METHODS: The aim of this systematic review aimed to determine the effects of WBVE on neuromuscular activation and muscle strength in the elderly. Searches in PubMed, Embase, Science direct, and Scopus databases were conducted. Six studies, that analyzed the use of surface electromyography evaluating effects of WBVE on neuromuscular activation and muscle strength in the elderly, published in English, were included. RESULTS: Six studies were included. One hundred forty-six individuals participated in the studies and 24 were males (16.43%), with an average age of 74.20 ± 7.66 years. Five publications were defined as "fair" methodological in the PEDro scale, the risk of bias was high and the risk of bias for non-randomized studies was moderate/high. In general, increased strength muscle was reported in the studies. CONCLUSION: This systematic review suggests that WBVE might promote desirable neuromuscular responses in healthy elderly. However, it is necessary to perform further studies to reinforce the reported findings.IMPLICATIONS FOR REHABILITATIONThe reduction in lean mass and consequent reduction in muscle strength are present in healthy elderly people and the whole-body vibration exercise can reduce or alleviate these symptoms caused by the geriatric syndrome.Whole-body vibration exercise is a training modality that increases neuromuscular activation and muscle strength.Surface electromyography is a useful tool for the evaluation of the neuromuscular activation of the muscle fibers.

Predictors for Screen Time Exposure among Children between 3 and 5 Years Old in Southern Brazil.

BACKGROUND: The use of technology is an increasingly common practice among preschoolers. Little is known about the relationship between screen time exposure (STE) and aspects related to family and the environment. AIM: The aim is to characterize STE in Brazilian children aged between 3 and 5 years. Furthermore, the objective of this study is to associate the STE of children and of their parents with sociodemographic variables. METHODS: Children aged between 3 and 5 years from southern Brazil and their parents participated in this study. To investigate STE, the researchers developed a specific questionnaire. To compare STE between age groups, the Kruskal-Wallis test was performed, followed by Dunn's post hoc test. Spearman's correlation and linear regression were used to correlate the variables. RESULTS: Children (n = 237) spend an average of 3.7 ± 0.8 h/day in front of screens. The STE of children had a moderately positive correlation with the STE of their parents (r = 0.4; p-value < 0.001). Only the variables of the children's and parents' STE had a significant and positive association. The model is significant (F = 6164, p-value < 0.001) and the residuals of the model met the necessary assumptions, with normal distribution, constant variance and without the presence of outliers. CONCLUSION: Children in southern Brazil remain in front of screens four times longer than the recommended amount of time. It was also found that the STE of parents directly influences that of their children.