Patellofemoral pain syndrome in children and adolescents: A cross-sectional study.

OBJECTIVES: To assess the prevalence and associated factors of Patellofemoral Pain Syndrome (PFPS) in children and adolescents. METHOD: A population-based cross-sectional study was conducted with children and adolescents aged 10 to 18 years, who presented a history of peripatellar and/or retropatellar pain, attending elementary or high school in urban public schools in Natal, Brazil. The sample size was calculated based on a minimum outcome prevalence of 22%. RESULTS: A prevalence of 24.7% of PFPS was found. There was a positive association of PFPS with active students (p < 0.01; PR: 2.5; CI: 1.4-4.5), low functional capacity (p < 0.01; PR: 8.0; CI: 5.0-12.8), and those classified as pubertal (p < 0.03; PR: 1.8; CI: 1.0-3.2). CONCLUSION: There was a considerable prevalence of PFPS in children and adolescents, as well as an association between the level of sexual maturation and adjustable determinants, such as the level of physical activity and low functional capacity in this group.

Effects of primary health care and socioeconomic aspects on the dispersion of COVID-19 in the Brazilian Northeast: Ecological study of the first pandemic wave.

BACKGROUND: The COVID-19 pandemic has had a negative impact on socioeconomic and public health conditions of the population. AIM: To measure the temporal evolution of COVID-19 cases in cities near the countryside outside metropolitan areas of northeastern Brazil and the impact of the primary care organization in its containment. METHODS: This is a time-series study, based on the first three months of COVID-19 incidence in northeastern Brazil. Secondary data were used, the outcome was number of COVID-19 cases. Independent variables were time, coverage and quality score of basic health services, and demographic, socioeconomic and social isolation variables. Generalizable Linear Models with first order autoregression were applied. RESULTS: COVID-19 spreads heterogeneously in cities near the countryside of Northeastern Brazilian cities, showing associations with the city size, socioeconomic and organizational indicators of services. The Family Health Strategy seems to mitigate the speed of progression and burden of the disease, in addition to measures such as social isolation and closure of commercial activities. CONCLUSION: The spread of COVID-19 reveals multiple related factors, which require coordinated intersectoral actions in order to mitigate its problems, especially in biologically and socially vulnerable populations.

Transcranial direct current stimulation combined with peripheral stimulation in chronic pain: a systematic review and meta-analysis.

INTRODUCTION: The combination of Transcranial Direct Current Stimulation (tDCS) with peripheral stimulation may optimize their effects and bring positive results in treatment of people with chronic pain. AREAS COVERED: A systematic review with meta-analysis of randomized and non-randomized trials was performed to investigate the combination of tDCS with peripheral stimulation in adults with chronic pain. The primary outcome was pain intensity. Six studies were included in this review (sample of 228 participants), which investigated the combination of tDCS and transcutaneous electrical nerve stimulation, peripheral electrical stimulation, breathing-controlled electrical stimulation and intramuscular electrical stimulation. The conditions studied were knee osteoarthritis, spinal cord injury, chronic low back pain, and neurogenic pain of the arms. Pain intensity, measured by visual analog scale or numerical rating scale, was reduced in all included studies when at least one of the interventions was active, regardless they were combined or alone, with or without tDCS. However, meta-analysis showed superiority of tDCS used in combination with peripheral stimulation. EXPERT OPINION: This systematic review and meta-analysis suggests positive effects of tDCS combined with peripheral stimulation in chronic pain conditions. However, the evidence of the primary outcome was classified as low quality due to the limited number of studies.

Aplicação da banda neuromuscular e seus efeitos na alteração da flexibilidade da coluna lombar / Application of the neuromuscular band and its effects on flexibility of the lumbar spine

Introdução: A utilização da banda neuromuscular tem se tornado cada vez mais presente como uma forma auxiliar no tratamento de diversas disfunções musculoesqueléticas. Objetivo: Avaliar se aplicação da banda neuromuscular na coluna lombar aumenta a sua flexibilidade em comparação com o grupo controle, na ausência de dor. Material e métodos: Estudo experimental do tipo ensaio clínico, controlado e randomizado. A amostra foi composta por 30 sujeitos saudáveis, do sexo masculino, com idade entre 18 e 30 anos, divididos em dois grupos, 15 no grupo experimental, que usou a banda neuromuscular, e 15 no grupo controle. A flexibilidade lombar foi medida pelo teste de sentar e alcançar (TSA), índice de Schober e goniometria para flexão anterior, laterais e extensão. Resultados: No grupo controle, foi observado um aumento significativo da distância alcançada no segundo TSA (p < 0,01). Não foram encontradas diferenças significativas nas demais variáveis. No grupo experimental, porém, não foram observadas diferenças significativas em nenhuma das variáveis, quando se comparou as avaliações que ocorreram antes e depois da aplicação da banda neuromuscular. Conclusão: O presente estudo conclui que a banda neuromuscular não foi capaz de melhorar a mobilidade e flexibilidade da coluna lombar, em nenhum dos testes de flexibilidade e para nenhum movimento da coluna avaliado. (AU)

Introduction: The use of the neuromuscular band has become increasingly present as an auxiliary form in the treatment of various musculoskeletal disorders. Objective: To evaluate if the application of the neuromuscular band in the lumbar spine increases its flexibility compared to a control group, in the absence of pain. Methods: Experimental study of clinical trial, controlled and randomized. The sample consisted of 30 healthy male subjects, aged between 18 and 30 years, divided into two groups, 15 in the experimental group, who used neuromuscular band, and 15 in the control group. Lumbar flexibility was measured by sit-and-reach test, Schober index and goniometry for anterior flexion, lateral and extension. Results: In the control group, a significant increase in the distance reached in the second SRT was observed (p < 0.01). No significant differences were found in the other variables. In the experimental group, however, no significant differences were observed in any of the variables, when comparing the evaluations that occurred before and after the application of the neuromuscular band. Conclusion: The present study concludes that the neuromuscular band was not able to improve the mobility and flexibility of the lumbar spine in any of the flexibility tests and for no movement of the spine evaluated.