Cross-cultural adaptation, reliability and validation of the Gillette Functional Assessment Questionnaire (FAQ) into Brazilian Portuguese in patients with cerebral palsy.

BACKGROUND: The purpose of this study was to translate, cross-culturally adapt and validate the Gillette Functional Assessment Questionnaire (FAQ) into Brazilian Portuguese. METHODS: The translation and cross-cultural adaptation was carried out in accordance with international recommendations. The FAQ was applied to a sample of 102 patients diagnosed with cerebral palsy (CP). Construct validity was assessed using Spearman's correlation coefficient (rho), and the FAQ score was correlated with the Functional Mobility Scale (FMS) and Gross Motor Function Classification Scale (GMFCS). A subsample of 50 patients was used to assess reliability using intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimum detectable difference (MDD). Ceiling and floor effects were also evaluated. RESULTS: The Brazilian version of the FAQ showed excellent test-retest reliability by the assessment of the physiotherapist (ICC = 0.99) and respondent (ICC = 0.97), as well as excellent inter-examiner reliability (ICC = 0.94). The SEM was 0.23 (physiotherapist), 0.47 (respondent) and 0.64 (inter-examiner), while the MDD was 0.64 (physiotherapist), 1.29 (respondent) and 1.76 (inter-examiner). The classification of gross motor function showed a high correlation with the FAQ applied by the physiotherapist (rho = -0.89) and by the respondent (rho = -0.87). The FMS-5 m was highly correlated with the FAQ applied by the physiotherapist and the respondent (rho = 0.88 and rho = 0.87, respectively). The FMS-50 and FMS-500 presented very high correlation with the FAQ applied by the physiotherapist (rho = 0.91 for both) and high correlation with the FAQ applied by the respondent (rho = 0.89 and rho = 0.88, respectively). The Brazilian version of the FAQ did not present the ceiling and floor effects. CONCLUSION: The FAQ presented adequate psychometric properties in patients with CP, indicating that it is possible to use it as a measure of functional gait mobility in Brazil.

Structural validity of the Brazilian version of the Shoulder Pain and Disability Index in patients with chronic shoulder pain.

BACKGROUND: The Shoulder Pain and Disability Index (SPADI) is a measuring instrument for pain and disability in patients with shoulder dysfunction. However, its structure is controversial (ie, 1 or 2 domains). PURPOSE: To investigate the structural validity of the Brazilian version of the SPADI in patients with chronic shoulder pain. STUDY DESIGN: Cross-sectional study. METHODS: Brazilian Portuguese speakers of both genders aged 18 years or older with shoulder pain for at least 90 days (chronic) were included in this study. The structure of the SPADI was assessed by means of exploratory factor analysis with the implementation of parallel analysis and by confirmatory factor analysis. For the latter, the following goodness-of-fit indices were considered: root mean square error of approximation with 90% confidence interval, comparative fit index, Tucker-Lewis index, standardized root mean square residual, and chi-square/degrees of freedom. RESULTS: A total of 103 participants were included in the study. The original version of the SPADI with 2 domains and 13 items showed high covariance between domains (0.98), suggesting one-dimensionality. After exploratory factor analysis with the implementation of parallel analysis, one-dimensionality was found in the SPADI. Comparing models with 1 and 2 domains by means of confirmatory factor analysis, both presented adequate values (chi-square/degrees of freedom < 3; comparative fit index and Tucker-Lewis index > 0.90; root mean square error of approximation and standardized root mean square residual < 0.08). However, the model with one domain is more suitable for presenting lower values of Akaike information criterion (3308.713) and Bayesian information criterion (3377.216). CONCLUSION: The Brazilian version of the SPADI has a one-dimensional structure with 13 items ("shoulder impairment" construct), in contrast to the version with 2 domains.

Translation, cross-cultural adaptation and validation of the Upper Limb Functional Index (ULFI) into Brazilian Portuguese in patients with chronic upper limb musculoskeletal disorders.

OBJECTIVE: The purpose of this study was to translate, cross-culturally adapt, and validate the Upper Limb Functional Index (ULFI) into Brazilian Portuguese (ULFI-Br). METHODS: The translation and cross-cultural adaptation of the ULFI was performed according to international recommendations. The ULFI-Br was applied to 190 patients with chronic upper limb musculoskeletal disorders to verify structural validity. The QuickDASH, the SF-36 and a Numerical Pain Scale (NPS) were completed by 180 patients to assess construct validity using the Spearman correlation (ρ). The internal structure of the ULFI-Br was evaluated by exploratory and confirmatory factor analysis with fit indices chi-square/degrees of freedom (DF), Root Mean Square Error of Approximation (RMSEA), Comparative Fit Index (CFI) and Tucker Lewis Index (TLI). A subsample of 51 patients was used to assess test-retest reliability using the intra-class correlation coefficient (ICC), standard error of measurement (SEM) and minimum detectable change at the 90th percentile (MDC90). Internal consistency was assessed by Cronbach's alpha (α). Floor and ceiling effects were also assessed. RESULTS: Factor analysis identified an uni-dimensional structure with acceptable fit indices (RMSEA = 0.063, CFI = 0.918, TLI = 0.910). The ULFI-Br showed excellent reliability (ICC = 0.909) and adequate internal consistency (α = 0.897). The SEM was 6.11% and the MDC90 was 14.26%. The ULFI-Br demonstrated high correlation with the QuickDASH (ρ = -0.721), and moderate to low correlation with other questionnaires. There were no floor or ceiling effects. CONCLUSION: The ULFI-Br showed adequate measurement properties in patients with chronic upper limb musculoskeletal disorders indicating its suitability for use as a measure of upper limb functional status in Brazil.

Assessment of the Reliability of the Leg Lateral Reach Test to Measure Thoraco-Lumbo-Pelvic Rotation in Individuals With Chronic Low Back Pain.

PURPOSE: The purpose of this study was to evaluate the intrarater and interrater reliability of the Leg Lateral Reach Test (LLRT) to measure the mobility of the thoraco-lumbo-pelvic segment in individuals with nonspecific chronic low back and the correlations among pain intensity, kinesiophobia, and LLRT scores. METHODS: Thirty participants with nonspecific chronic low back pain were selected. The main variables were LLRT, pain intensity (measured with the Numeric Pain Rating Scale) and kinesiophobia (Tampa Scale of Kinesiophobia). The reliability of the LLRT was evaluated by means of intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimum detectable change. RESULTS: Most participants were women (83.3%), young adults (mean = 30.86; standard deviation = 8.56), with overweight and nonspecific chronic low back for more than 59 months of duration. In the intrarater analysis, we observed reliability values ranging from substantial to excellent (ICC ≥ .889; SEM ≤ 7.97%). In the interrater analysis, we observed excellent reliability (ICC ≥ .947; SEM ≤ 5.62%). There was a weak and positive correlation between pain and LLRT, and no correlation between kinesiophobia and LLRT. CONCLUSION: LLRT is a reliable test to measure thoraco-lumbo-pelvic rotation in individuals with nonspecific chronic low back pain.

Brazilian version of the Self-Estimated Functional Inability because of Pain questionnaire for musculoskeletal injuries relating to dance and sport: translation and cross-cultural adaptation.

BACKGROUND: Self-Estimated Functional Inability because of Pain (SEFIP) is a questionnaire specifically designed to measure musculoskeletal pain or discomfort. OBJECTIVE: To perform translation and cross-cultural adaptation of the SEFIP for dancers (SEFIP-dance), for use in Brazilian Portuguese. In addition, as a secondary objective, we adapted the translated version of SEFIP-dance for use among athletes or exercise practitioners (SEFIP-sport). DESIGN AND SETTING: Questionnaire translation and cross-cultural adaptation study conducted at a public university. METHODS: The Brazilian version of the SEFIP-dance questionnaire was developed following the processes of translation (involving two translators with Brazilian Portuguese as their mother tongue and fluency in English), backtranslation (involving two translators with English as their mother tongue and fluency in Brazilian Portuguese), committee review and pre-testing. SEFIP-sport was developed following the processes of content and face validation. RESULTS: SEFIP-dance was applied to 30 dancers, of mean age 22.38 years (standard deviation [SD] = 3.41), among whom 14 were men (46.66%). The participants understood 100% of the SEFIP-dance items and alternatives. SEFIP-sport was applied to 30 athletes or physical exercise practitioners, of mean age 25.09 years (SD = 8.93), among whom 25 were men (86.33%). The participants understood 100% of the -SEFIP-sport items and alternatives. CONCLUSION: The Brazilian Portuguese versions of SEFIP-dance, translated and cross-culturally adapted for dancers, and SEFIP-sport, adapted for athletes or physical exercise practitioners, were shown to have adequate levels of understanding.

Brazilian version of the Self-Estimated Functional Inability because of Pain questionnaire for musculoskeletal injuries relating to dance and sport: translation and cross-cultural adaptation

ABSTRACT BACKGROUND: Self-Estimated Functional Inability because of Pain (SEFIP) is a questionnaire specifically designed to measure musculoskeletal pain or discomfort. OBJECTIVE: To perform translation and cross-cultural adaptation of the SEFIP for dancers (SEFIP-dance), for use in Brazilian Portuguese. In addition, as a secondary objective, we adapted the translated version of SEFIP-dance for use among athletes or exercise practitioners (SEFIP-sport). DESIGN AND SETTING: Questionnaire translation and cross-cultural adaptation study conducted at a public university. METHODS: The Brazilian version of the SEFIP-dance questionnaire was developed following the processes of translation (involving two translators with Brazilian Portuguese as their mother tongue and fluency in English), backtranslation (involving two translators with English as their mother tongue and fluency in Brazilian Portuguese), committee review and pre-testing. SEFIP-sport was developed following the processes of content and face validation. RESULTS: SEFIP-dance was applied to 30 dancers, of mean age 22.38 years (standard deviation [SD] = 3.41), among whom 14 were men (46.66%). The participants understood 100% of the SEFIP-dance items and alternatives. SEFIP-sport was applied to 30 athletes or physical exercise practitioners, of mean age 25.09 years (SD = 8.93), among whom 25 were men (86.33%). The participants understood 100% of the ­SEFIP-sport items and alternatives. CONCLUSION: The Brazilian Portuguese versions of SEFIP-dance, translated and cross-culturally adapted for dancers, and SEFIP-sport, adapted for athletes or physical exercise practitioners, were shown to have adequate levels of understanding.

Ground reaction force in basketball cutting maneuvers with and without ankle bracing and taping

CONTEXT AND OBJECTIVE: In basketball, the most common injuries are ankle sprains. For this reason, players frequently use external ankle devices or taping as prophylactic and rehabilitation measures. The purpose of this study was to evaluate ground reaction force (GRF) responses in basketball players while performing typical cutting maneuvers with and without ankle bracing and ankle taping. DESIGN AND SETTING: Comparative study with experimental design of single-group repeated measurements, at Medical Rehabilitation Division, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo. METHODS: Vertical (Fy) and medial-lateral (Fz) GRF measurements were made under three conditions (taping, Aircast-type orthosis and basketball shoes alone), with analysis of peak forces at foot contact (Fymax1, Fzmax1, Fymax2 and Fzmax2), growth gradient (peak/time) (GG Fymax1, GG Fzmax1, GG Fymax2 and GG Fzmax2) and impulse after foot contact. RESULTS: Bracing significantly reduced Fymax2 and GG Fymax2. GG Fzmax1 was significantly higher for the sport shoe condition than for the taping condition. Taping increased Fy in relation to the sport shoe at foot contact, but over a longer time interval, without increasing excessive ankle loading. Fz reached a peak in less time, which might generate greater inversion/eversion loading on a player's foot. The Aircast exerted better shock-absorbing effect than did the other two conditions, since it generated less vertical force over longer time intervals and smaller medial-lateral forces in relation to taping. CONCLUSIONS: Ankle bracing and ankle taping action mechanisms are still unclear and therefore should be carefully prescribed. More studies are needed to clarify taping and bracing effects on sporting activities.

CONTEXTO E OBJETIVO: A lesão mais comum no basquetebol é a entorse de tornozelo. Assim, os atletas freqüentemente utilizam suportes externos como medidas profiláticas. O objetivo deste estudo é avaliar as respostas da força de reação do solo (FRS) durante a execução do movimento de cutting do basquetebol com e sem acessórios de tornozelo. TIPO DE ESTUDO E LOCAL: Estudo comparativo. Delineamento experimental de grupo único com medidas repetidas; Divisão de Medicina de Reabilitação, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Brasil. MÉTODOS: Foram colhidas as forças vertical (Fy) e médio-lateral (Fz) em três condições (bandagem, Aircast e calçado esportivo) e analisados os picos de força e de propulsão no contato com o solo (Fymax1, Fzmax1, Fymax2 e Fzmax2), o gradiente de crescimento (pico/tempo) (GC Fymax1, GC Fzmax1, GC Fymax2 e GC Fzmax2) e o impulso após o contato. RESULTADOS: Os acessórios reduziram significativamente Fymax2 e GC Fymax2. GC FZmax1 foi maior na situação com tênis quando comparado com bandagem. No momento do impacto, a bandagem aumentou a Fy em relação ao calçado, mas em um intervalo de tempo maior, não aumentando a carga articular. Fz atingiu um pico em menor tempo, podendo gerar maior carga eversora/inversora. O Aircast exerceu um melhor efeito de absorção de impacto, pois gera menor Fy em um maior intervalo de tempo. CONCLUSÕES: Apesar do uso freqüente deste tipo de recurso pelos atletas, seu mecanismo de ação ainda é confuso. Mais estudos são necessários para esclarecer seus efeitos nas atividades esportivas a longo prazo.

Ground reaction force in basketball cutting maneuvers with and without ankle bracing and taping.

CONTEXT AND OBJECTIVE: In basketball, the most common injuries are ankle sprains. For this reason, players frequently use external ankle devices or taping as prophylactic and rehabilitation measures. The purpose of this study was to evaluate ground reaction force (GRF) responses in basketball players while performing typical cutting maneuvers with and without ankle bracing and ankle taping. DESIGN AND SETTING: Comparative study with experimental design of single-group repeated measurements, at Medical Rehabilitation Division, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo. METHODS: Vertical (Fy) and medial-lateral (Fz) GRF measurements were made under three conditions (taping, Aircast-type orthosis and basketball shoes alone), with analysis of peak forces at foot contact (Fymax1, Fzmax1, Fymax2 and Fzmax2), growth gradient (peak/time) (GG Fymax1, GG Fzmax1, GG Fymax2 and GG Fzmax2) and impulse after foot contact. RESULTS: Bracing significantly reduced Fymax2 and GG Fymax2. GG Fzmax1 was significantly higher for the sport shoe condition than for the taping condition. Taping increased Fy in relation to the sport shoe at foot contact, but over a longer time interval, without increasing excessive ankle loading. Fz reached a peak in less time, which might generate greater inversion/eversion loading on a player's foot. The Aircast exerted better shock-absorbing effect than did the other two conditions, since it generated less vertical force over longer time intervals and smaller medial-lateral forces in relation to taping. CONCLUSIONS: Ankle bracing and ankle taping action mechanisms are still unclear and therefore should be carefully prescribed. More studies are needed to clarify taping and bracing effects on sporting activities.

Influência de implementos para o tornozelo nas respostas biomecânicas do salto e aterrissagem no basquete / Influence of ankle devices in the jump and landing biomechanical responses in basketball

FUNDAMENTOS E OBJETIVO: O segmento mais freqüentemente lesado no basquetebol é o tornozelo, sendo a entorse por inversão a lesão mais comum. Para evitá-la, é comum o uso de implementos. O objetivo deste estudo foi avaliar a força reação do solo (FRS) em jogadores de basquete durante execução do salto em três situações: uso de tênis, bandagem e tênis, e tênis e órtese tipo Aircast. MÉTODOS: Oito atletas foram analisados durante o salto, através de uma plataforma de força, nas três situações citadas, para análise das componentes vertical e horizontal médio-lateral da FRS. RESULTADOS E CONCLUSAO: Não houve diferença estatística significativa entre as três situações na componente vertical da FRS durante o salto, embora o uso de bandagem tenda a apresentar, na impulsão, maiores valores do pico de força vertical (3,10 ± 0,46PC; 3,01 ± 0,39PC; 3,03 ± 0,41PC) e do gradiente de crescimento (GC) (12,33 ± 12,21PC; 8,16 ± 3,89PC; 8,46 ± 3,85PC), e durante a aterrissagem, menores valores de pico de força vertical (5,18 ± 1,35PC; 5,56 ± 1,31PC; 5,49 ± 1,44PC) e do GC (88,83 ± 33,85PC; 95,63 ± 42,64PC; 94,53 ± 31,69PC). Durante a impulsão, a força medial do salto com Aircast foi significativamente menor que com tênis (p = 0,0249) e apresentou valor semelhante ao do uso da bandagem, enquanto a força lateral foi significativamente maior com a bandagem do que com tênis (p = 0,0485) e tendeu a ser maior do que o Aircast. Na aterrissagem o componente médio-lateral da FRS ficou inalterado nas três situações. Concluiu-se que a bandagem potencializou a força direcionada ao salto vertical durante a impulsão, porém não estabilizou tanto quanto o Aircast os movimentos de inversão e eversão do pé. Durante a aterrissagem, os implementos não foram efetivos para reduzir a força médio-lateral, mas com a bandagem, houve um tempo maior para absorção do impacto.