Evidence map on burnout syndrome in higher education teachers and its relationship with ergonomic and biopsychosocial factors: a scoping review.

Objectives. This study aimed to map the evidence on burnout syndrome in higher education teachers and its relationship with ergonomic and biopsychosocial factors. Methods. We performed a scoping review of articles published up to 2021, extracting the location, study design, sample characteristics and assessment methods, and investigated ergonomic and biopsychosocial factors. Results. Eighteen studies were found in 12 countries, and most used a cross-sectional design (n = 17/18, 94%). The Maslach burnout inventory was the most used assessment method (n = 9, 50%). There is a consensus that burnout syndrome in higher education teachers requires more attention, as it can be related to physical, mental and social factors. Conclusions. In the professional environment, physical ergonomic characteristics or those related to work organization deserve greater attention, as well as psychosocial factors, as they are strongly associated with burnout syndrome.

Falta de conhecimento sobre os fatores de risco não ocupacionais da dor lombar entre profissionais de saúde ocupacional brasileiros: um estudo observacional transversal / Lack of knowledge about non-occupational low back pain risk factors among brazilian occupational health professionals: a cross-sectional observational study

INTRODUÇÃO: A dor lombar possui alta prevalência, sendo uma das principais causas de incapacidade no Brasil e no mundo. A dor lombar apresenta etiologia multifatorial, sendo extremamente comum em trabalhadores. OBJETIVOS: Verificar o conhecimento sobre os fatores de risco para dor lombar, crenças e atitudes sobre o manejo da dor lombar entre profissionais de saúde (fisioterapeutas e ergonomistas) atuantes na área ocupacional. MATERIAIS E MÉTODOS: Foi realizado um estudo observacional transversal com 81 profissionais de saúde ocupacional brasileiros. Os participantes preencheram um questionário eletrônico composto por dados profissionais, sociodemográficos, itens sobre fatores de risco para dor lombar e a Brazilian version of the Pain Attitudes and Beliefs Scale for Physiotherapists. Conhecimentos, crenças e atitudes foram analisados por meio do teste do qui-quadrado para fatores de risco para dor lombar e um modelo de regressão linear para crenças e atitudes dos profissionais de saúde. RESULTADOS: Obesidade (7,4%), ficar sentado mais de 2 horas (8,6%), atividade física (9,9%), falta de apoio psicossocial no trabalho (11,1%) e consumo de álcool (37,0%), apresentaram os menores índices de conhecimento sobre fatores de risco da dor lombar pelos profissionais. Itens sobre saúde geral apresentaram o menor conhecimento. Uma orientação biomédica e psicossocial equilibrada de crenças e atitudes sobre o manejo da dor lombar foi observada. CONCLUSÃO: Profissionais de saúde ocupacional brasileiros carecem de conhecimento sobre os fatores de risco não ocupacionais da dor lombar, especialmente o estado geral de saúde. Esses profissionais também possuem conceitos biomédicos e psicossociais equilibrados no manejo da dor lombar.

INTRODUCTION: Low back pain (LBP) is highly prevalent and is one of the main causes of disability in Brazil and around the world. LBP presents a multifactorial etiology, being extremely common in workers. OBJECTIVE: This study aimed to verify the knowledge about the LBP risk factors, beliefs and attitudes about the management of LBP among health professionals (physiotherapists and ergonomists) working in the occupational area. MATERIALS AND METHODS: A cross-sectional observational study was conducted with 81 Brazilian occupational health professionals. Participants completed an electronic questionnaire comprising professional data, sociodemographics, items about LBP risk factors, and the Brazilian version of the Pain Attitudes and Beliefs Scale for Physiotherapists. Knowledge, beliefs and attitudes were analyzed using the chi-square test for LBP risk factors and the linear regression model for health professionals' beliefs and attitudes. RESULTS: Obesity (7.4%), sitting for more than 2 hours (8.6%), physical activity (9.9%), lack of psychosocial support at work (11.1%) and consuming alcohol (37.0%) presented the lowest rate of knowledge about LBP risk factors by professionals. Items about general health showed the lowest knowledge. A balanced biomedical and psychosocial orientation of beliefs and attitudes about managing LBP was observed. CONCLUSION: Brazilian occupational health professionals lack knowledge about non-occupational LBP risk factors, especially general health status. These professionals also have balanced biomedical and psychosocial concepts in managing LBP.

Hybrid maneuver for benign paroxysmal positional vertigo in individuals with limited neck mobility: Case series.

INTRODUCTION: Mobility limitation of the cervical spine compromises the adequate execution of the canalith repositioning maneuver (CRM) in cases of posterior semicircular canal benign paroxysmal positional vertigo (PSC-BPPV-GEO). Thus, novel therapeutic options are required for such individuals. OBJECTIVES: This study describes the effects of a change in the biomechanical position for the execution of the CRM on symptoms of dizziness and mobility limitation regarding flexion-extension of the cervical spine in older people with unilateral PSC-BPPV-GEO. METHODS: A quasi-experimental viability study was conducted with 15 older adults (11 women; mean age: 72.2 ± 8.1 years). Treatment consisted of a hybrid CRM. The participants were evaluated before and after the intervention using the modified Dix & Hallpike test, Dizziness Handicap Inventory (DHI) and a visual analog scale (VAS) for vertigo. RESULTS: The modified Dix & Hallpike test was negative in all cases after the execution of the hybrid CRM. A significant reduction was found for dizziness measured using the DHI (mean difference: -39.3 ± 9.4, p < 0.001) and VAS (mean difference: -2.9 ± 0.8, p = 0.04) after the intervention. CONCLUSION: The hybrid CRM proved executable and satisfactory for resolving symptoms of dizziness in older adults with PSC-BPPV. The present findings are promising and randomized controlled clinical trials should be conducted to evaluate the effectiveness of the hybrid CRM in this population.

Prediction models for physical function in COVID-19 survivors.

BACKGROUND: The burden of caring for patients who have survived COVID-19 will be enormous in the coming years, especially with respect to physical function. Physical function has been routinely assessed using the Post-COVID-19 Functional Status (PCFS) scale. AIM: This study built prediction models for the PCFS scale using sociodemographic data, clinical findings, lung function, and muscle strength. METHOD: Two hundred and one patients with post-COVID-19 syndrome (PCS) completed the PCFS scale to assess physical function. Their levels of general fatigue were also assessed using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale, handgrip strength (HGS), and spirometry. RESULTS: The number of participants who scored 0 (none), 1 (negligible), 2 (slight), 3 (moderate), and 4 (severe) on the PCFS scale was 25 (12%), 40 (20%), 39 (19%), 49 (24%), and 48 (24%), respectively. The PCFS scale was significantly correlated with the following variables: FACIT-F score (r = -0.424, P < 0.001), HGS (r = -0.339, P < 0.001), previous hospitalization (r = 0.226, P = 0.001), body mass index (r = 0.163, P = 0.021), and sex (r = -0.153, P = 0.030). The regression model with the highest coefficient of regression (R = 0.559) included the following variables: age, sex, body mass index, FACIT-F, HGS, and previous hospitalization. CONCLUSIONS: Worse general fatigue and HGS are associated with more severe physical function impairments in PCS patients. Furthermore, a history of prior hospitalization results in worse physical function. Thus, prediction models for the PCFS scale that incorporate objective measures enable a better assessment of the physical function of these patients, thus helping in the selection of candidates for a program of physical reconditioning.

Hospital admission is associated with disability and late musculoskeletal pain in individuals with long COVID.

Background: The acute clinical repercussions of SARS-CoV-2 infection have been widely studied. However, the possible late repercussions of long COVID have not yet been well defined in the literature. Objectives: To identify the presence of pain and musculoskeletal disability in patients with Long COVID and also to identify predictive factors for pain intensity in this population. Methods: In this cross-sectional and retrospective observational study individuals with Long COVID symptoms were included. It was collected musculoskeletal disability measures, data from patient-related outcome measures and variables from a COVID-19 outpatient service database. Associations and sub-group analyses were performed considering the variables pain, disability and hospitalization. Linear regression was performed to identify predictive factors for pain intensity in Long COVID patients. Results: We evaluated 195 patients and most of them (57%) presented musculoskeletal pain in one area of the body. Pain sub-group presented worse disability indices and worse clinical course during hospitalization. Hospitalized patients presented worse disability indices comparing to non-hospitalized. Significant correlations were found between pain and days of non-invasive oxygen support (r = 0.21; p = 0.003); days in intensive care unit (r = 0.22; p = 0.002) and days in invasive mechanical ventilation (r = 0.35; p = 0.001). Hospitalized individuals showed a higher chance of presenting late musculoskeletal pain (OR = 1.42: 95%CI 1.09-2.04). Days in intensive care unit (ß = 0,234: P = 0,001) and days in invasive mechanical ventilation (ß = 0.764: P = 0.001) were predictors of pain intensity [F(2,192) = 18.559; R2 = 0.231; p = 0.001]. Conclusion: Individuals with Long COVID presented musculoskeletal pain and disability. Hospitalized patients showed a greater chance of having musculoskeletal pain. Days in intensive care unit and days in invasive mechanical ventilation were predictors of late musculoskeletal pain intensity.

Factors associated with mortality in mechanically ventilated patients with severe acute respiratory syndrome due to COVID-19 evolution.

OBJECTIVES: To evaluate the factors associated with mortality in mechanically ventilated patients with acute respiratory distress syndrome due to COVID-19. METHODS: This was a retrospective, multicenter cohort study that included 425 mechanically ventilated adult patients with COVID-19 admitted to 4 intensive care units. Clinical data comprising the SOFA score, laboratory data and mechanical characteristics of the respiratory system were collected in a standardized way immediately after the start of invasive mechanical ventilation. The risk factors for death were analyzed using Cox regression to estimate the risk ratios and their respective 95%CIs. RESULTS: Body mass index (RR 1.17; 95%CI 1.11 - 1.20; p < 0.001), SOFA score (RR 1.39; 95%CI 1.31 - 1.49; p < 0.001) and driving pressure (RR 1.24; 95%CI 1.21 - 1.29; p < 0.001) were considered independent factors associated with mortality in mechanically ventilated patients with acute respiratory distress syndrome due to COVID-19. Respiratory system compliance (RR 0.92; 95%CI 0.90 - 0.93; p < 0.001) was associated with lower mortality. The comparative analysis of the survival curves indicated that patients with respiratory system compliance (< 30mL/cmH2O), a higher SOFA score (> 5 points) and higher driving pressure (> 14cmH2O) were more significantly associated with the outcome of death at 28 days and 60 days. CONCLUSION: Patients with a body mass index > 32kg/m2, respiratory system compliance < 30mL/cmH2O, driving pressure > 14cmH2O and SOFA score > 5.8 immediately after the initiation of invasive ventilatory support had worse outcomes, and independent risk factors were associated with higher mortality in this population.

Anterior component of Y-Balance test is correlated to ankle dorsiflexion range of motion in futsal players: A cross-sectional study.

BACKGROUND AND PURPOSE: Restricted dorsiflexion range of motion (DFROM) could impact dynamic balance in sports. This study aimed to investigate the relationship between dorsiflexion range of motion and the Y-Balance Test (YBT) in elite futsal players. METHODS: Sixty-one asymptomatic male futsal players (mean age 26.57 (5.64) years, a mean body mass index of 25.40 (2.69) kg/m2 ) were included. DFROM was measured by the weight-bearing lunge test (WBLT). DFROM data were obtained using smartphone-based motion capture. The Pearson correlation coefficient verified the correlation between the variables. RESULTS: Dominant and nondominant leg ankle DFROM was significantly correlated with the anterior component of YBT (r = 0.27 and 0.51, respectively). The posteromedial component and the composite score of the YBT were also significantly correlated with nondominant leg ankle DFROM (r = 0.31 and 0.34, respectively)]. The other measures were not statistically significant. DFROM explained between 7% and 24% of the variation of the distances reached in the YBT. CONCLUSION: Dorsiflexion range of motion measured by weight bearing lunge test is positively correlated with dynamic balance in futsal players.

Sleep quality and polysomnographic changes in patients with chronic pain with and without central sensitization signs.

BACKGROUND: Insufficient sleep is common nowadays and it can be associated with chronic pain. OBJECTIVE: To describe the main polysomnographic findings in patients with chronic musculoskeletal pain and to estimate the association between sleep quality, polysomnography variables and chronic musculoskeletal pain. METHODS: This cross-sectional research analyzed a database from polysomnography type 1 exams results and then collected data via an electronic form from these patients. The form collected sociodemographic data and presented clinical questionnaires for measuring sleep quality, sleepiness, pain intensity and central sensitization signs. Pearson's correlation coefficient and odds ratio were used to estimate the associations. RESULTS: The mean age of the respondents was 55.1 (SD 13.4) years. The mean score of the Central Sensitization Inventory showed signs of central sensitization (50.1; SD 13.4) in the participants. Most patients (86%) had 1 or more nocturnal awakenings, 90% had one or more episodes of sleep apnea, 47% had Rapid Eye Movement sleep phase latency greater than 70-120 min and the mean sleep efficiency among all participants was 81.6%. The Pittsburgh Sleep Quality Index score was correlated with the CSI score (r = 0.55; 95% CI: 0.45, 0.61). People with central sensitization signs have 2.6 times more chance to present sleep episodes of blood oxygen saturation below 90% (OR = 2.62; 95% CI:1.23, 6.47). CONCLUSION: Most people with central sensitization signs had poor sleep quality, night waking episodes and specific disturbances in sleep phases. The findings showed association between central sensitization, sleep quality, nocturnal awakening, and changes in blood oxygen saturation during sleep.

Cardiorespiratory Response to Six-Minute Step Test in Post COVID-19 Patients-A Cross Sectional Study.

BACKGROUND AND PURPOSE: New coronavirus disease 2019 (COVID-19) can cause persistent symptoms and physical weakness that can lead to a limitation in activities of daily living (ADL). There is a lack of evidence about the performance in the six-minute step test (6MST) of post-COVID-19 patients and healthy subjects. The aim of this study is to investigate the cardiorespiratory response induced by the 6MST in post-COVID-19 patients and compare it with the response of the six-minute walk test (6MWT). METHODS: This cross-sectional study was conducted on 34 post-COVID-19 patients and 33 healthy subjects. The assessment was performed at one month from a non-severe SARS-CoV-2 infection. Both groups were assessed by using the 6MST, 6MWT, and the pulmonary function test (PFT). Post COVID functional status (PCFS) scale was used for the post-COVID-19 group to assess functional status. Physiological responses; heart rate (HR), respiratory rate (RR), oxygen saturation (SpO2), blood pressure (BP), and Borg scale for fatigue and dyspnea were recorded before and after the 6MST and 6MWT. RESULTS: the performance of the post-COVID-19 group was worse than the healthy group in both tests. In 6MWT, the distance walked by the post-COVID-19 group (423 ± 7) was 94 m less than the healthy group, and the number of climbed steps in the 6MST (121 ± 4) was 34 steps less than the healthy group. Both results were statistically significant (p < 0.001). There was a moderate positive correlation between the 6MST and 6MWT in walked distance versus steps number (r = 0.5, p < 0.001). In addition, there was a moderate correlation between the two tests in the post (HR, RR, SpO2, systolic blood pressure SBP, diastolic blood pressure DBP, dyspnea, and fatigue) with p < 0.001. CONCLUSIONS: Six-minute step tests produced similar cardiorespiratory responses when compared to a 6MWT. The 6MST can be used as an assessment tool for COVID-19 patients to evaluate their functional capacity and ADL.

Estimating cardiopulmonary fitness with a new sampling technology in patients with rheumatoid arthritis-associated interstitial lung disease.

BACKGROUND AND OBJECTIVES: Although peak oxygen uptake (VO2peak ) is one of the most important measures in clinical practice, the high cost and time consumption have led to the search for simpler devices and the development of the estimating cardiopulmonary fitness (eCPF) equation. Since the lungs are one of the sites most affected by rheumatoid arthritis (RA), this study aimed to create a predictive equation for VO2peak obtained by simple sampling technology in women with RA-associated interstitial lung disease (RA-ILD). METHODS: This cross-sectional study evaluated 47 women with RA-ILD. The participants underwent the following evaluations: computed tomography (CT); evaluation of disease activity through the Clinical Disease Activity Index (CDAI); measurement of physical function using the Health Assessment Questionnaire disability index (HAQ-DI); pulmonary function testing, including spirometry, diffusing capacity for carbon monoxide (DlCO ), nitrogen single-breath washout (N2 SBW) test, and impulse oscillometry; and cardiopulmonary exercise testing (CPET) using FitMate™. RESULTS: VO2peak was correlated with age (r = -0.550, p < 0.0001), rheumatoid factor (r = -0.443, p = 0.002), anti-cyclic citrullinated peptide antibodies (r = -0.410, p = 0.004), CDAI (r = -0.462, p = 0.001), HAD-DI (r = -0.486, p = 0.0005), forced vital capacity (r = 0.491, p = 0.0004), DlCO (r = 0.621, p < 0.0001), phase III slope of N2 SBW (r = -0.647, p < 0.0001), resonance frequency (Fres , r = -0.717, p < 0.0001), integrated low-frequency reactance (r = -0.535, p = 0.0001), and the inhomogeneity of respiratory system resistance between 4 and 20 Hz (r = -0.631, p < 0.0001). In the CT examination, patients with extensive ILD had significantly lower VO2peak than patients with limited ILD (p < 0.0001). In the stepwise forward regression analysis, Fres , DlCO and age explained 61% of the VO2peak variability. CONCLUSIONS: As assessed by CPET, women with RA-ILD show reduced cardiopulmonary fitness, which can be explained at least in part by the presence of small airway disease, deterioration of pulmonary gas exchange, and advanced age. These associations of pulmonary variables with eCPF may be clinically important and support the use of the eCPF equation to improve patient outcomes.

Ambiente de trabalho seguro e sustentável: como a ergonomia de conscientização e participativa se aplica aos servidores públicos? / Safe, sustainable work environment: how awareness and participatory ergonomics can be applied to public servers? / Un entorno de trabajo seguro y sostenible: ¿cómo aplicar la sensibilización y la ergonomía participativa a los servidores públicos?

Introdução: As práticas ergonômicas de conscientização e de participação assumem importante papel na prevenção das doenças ocupacionais. Entretanto, os métodos utilizados pelos programas de prevenção das instituições e empresas visam a correção dos riscos ergonômicos, não observando o fator humano detentor da execução da tarefa. Objetivo: Analisar a utilização das Ergonomia de Conscientização e Participa- ção como programa de educação visando a prevenção primária e a conscientização dos riscos ergonômicos das lesões por esforço repetitivo (LER) e distúrbios osteomusculares relacionadas ao trabalho (DORT). Metodologia: Revisão crítica de literatura, sintetizando o embasamento teórico pertinente ao tema, com documentação técnica, normas, decretos, portarias e dados estatísticos atualizados de afastamento; formando, assim, à análise documental. Resultados e Discussão: Os dados estatísticos mostram a importância de uma mudança nos hábitos, nos programas e nas intervenções ergonômicas no ambiente laboral do trabalhador, visando minimizar os impactos socioeconômicos dos altos índices de afastamento para organizações, empresas privadas e, principalmente, serviços públicos de ensino superior devido a maior precariedade dos ambientes de trabalho. Práticas ergo- nômicas de conscientização e participação dos trabalhadores podem proporcionar uma melhora nos desconfortos do ambiente laboral. Ressalta-se a escassez de pesquisas que priorizem a relação custo-benefício e a eficácia a longo prazo na área de Ergonomia. Conclusões: Novas análises devem ser observadas para promover melhora da qualidade de vida do trabalhador, diminuição das perdas econômicas, contribuindo para um trabalho seguro, decente e sustentável como preconiza principalmente o Objetivo 8 da Agenda 2030 da Organização das Nações Unidas.

Introduction: Ergonomic awareness and participation practices play an im- portant role in the prevention of occupational diseases. However, the methods used by institutions and companies' prevention programs aim to correct ergonomic risks and do not observe the human factor responsible for carrying out the task. Purpose: To analyze the use of Participation and Awareness Ergonomics as an education program aimed at raising awareness of ergonomic risks for the prevention of repetitive strain injuries (RSI) and work-related musculoskeletal disorders (WRMD). Methodology: Critical literature review, summarizing the theoretical basis relevant to the topic, with technical documen- tation, norms, decrees, ordinances, and updated statistical data on leave; thus forming the documental analysis. Results and discussion: Statistical data show the importance of changing habits, programs, and ergonomic interventions in the work environment of the worker, in order to minimize the socioeconomic impacts of the high removal rates of organizations, private companies, and, mainly, public higher education due to more pre- carious work environments. Ergonomic practices of awareness and participation of work- ers can improve the work environment's discomfort. The lack of research that prioritizes the cost-benefit ratio and long-term effectiveness in Ergonomics is highlighted. Conclu- sions: New studies must promote a significant improvement of the quality of life of work- ers, reduction of economic losses and, thus contribute to a safe environment, decent and sustainable, as advocated by Objective 8 of the United Nations 2030 Agenda.

Introducción: Las prácticas de sensibilización y participación ergonómicas desempeñan un papel importante en la prevención de las enfermedades profesionales. Sin embargo, los métodos utilizados por los programas de prevención de instituciones y em- presas tienen como objetivo corregir los riesgos ergonómicos y no observan el factor hu- mano responsable de la realización de la tarea. Propósito: Analizar el uso de la Ergonomía de Participación y Concienciación como programa educativo dirigido a la concienciación de los riesgos ergonómicos para la prevención de las lesiones por esfuerzos repetitivos (LER) y los trastornos musculoesqueléticos de origen laboral (TME). Metodología: Re- visión lit-eratura crítica, resumiendo la base teórica relevante al tema, con documentación técnica, normas, decretos, ordenanzas, y datos estadísticos actualizados sobre bajas la- borales; conformando así el análisis documental. Resultados y discusión: Los datos es- tadísticos demuestran la importancia del cambio de hábitos, programas e intervenciones ergonómicas en el ambiente de trabajo del trabajador, para minimizar los impactos soci- oeconómicos de los altos índices de desvinculación de organizaciones, empresas privadas y, principalmente, de la enseñanza superior pública, debido a la mayor precariedad de los ambientes de trabajo. Práticas ergonómicas de conscientização e par-ticipação dos tra- balhadores podem melhorar a incomodidade do ambiente de trabalho. Se destaca la falta de re-investigación que priorice la relación costo-beneficio y la eficacia a largo plazo en Ergonomía. Conclusiones: Nuevos estudios deben promover una mejora significativa de la calidad de vida de los trabajadores, la reducción de las pérdidas económicas y, así contribuir a un entorno seguro, digno y sostenible, como propugna el Objetivo 8 de la Agenda 2030 de las Na-ciones Unidas.

Relationship between the Widespread Pain Index and the PainMAP software for pain sites measurement in patients with Widespread Pain / Relação entre o Índice de Dor Espalhada e o software PainMAP para medida de localização da dor em pacientes com dor espalhada

ABSTRACT BACKGROUND AND OBJECTIVES: Identifying pain sites is essential to managing patients with Widespread Pain. Several instruments have been developed, including pain drawings, a grid system and computerized methods. However, it is not yet known whether the Widespread Pain Index matches an automated method (painMAP) for quantifying the number of pain areas. Therefore, this study aimed to identify the relationship between the Widespread Pain Index and the painMAP software to measure pain sites in participants with Widespread Pain. METHODS: A pre-planned secondary analysis of data collected from 311 patients with musculoskeletal pain was conducted. The Widespread Pain Index and the painMAP software assessed pain sites. Spearman's correlation coefficient investigated the correlation between the Widespread Pain Index and the painMAP software. RESULTS: A total of 98 participants with Widespread Pain were included in this study. Most participants were female (67; 83.7%), with a mean age of 57,7±11,5 years, mean height of 1.6 (0.1) meters and mean weight of 73.2 (11.8) kilograms. The mean pain intensity was 6.7 (2.0), and the pain duration was 92.3 (96.3) months. The mean number of pain sites in the Widespread Pain Index was 10.1 (3.7), and in the painMAP software, it was 11.7 (8.8). A weak positive correlation (rho = 0.26, 95% CI 0.45 to 0.04, p = 0.022) between the Widespread Pain Index and the painMAP software was found. CONCLUSION: The Widespread Pain Index and the painMAP software showed a weak correlation for assessing pain sites in participants with Widespread Pain.

RESUMO JUSTIFICATIVA E OBJETIVOS: A identificação dos locais de dor é um aspecto essencial no manejo de pacientes com Dor Espalhada. Vários instrumentos foram desenvolvidos, incluindo desenhos de dor, um sistema de grade e métodos computadorizados. No entanto, ainda não se sabe se o Índice de Dor Espalhada coincide com um método automatizado (painMAP) para quantificar o número de áreas de dor. Portanto, este estudo teve como objetivo identificar a relação entre o Índice de Dor Espalhada e o painMAP para medir as áreas doloridas em participantes com esse quadro de dor. MÉTODOS: Uma análise secundária pré-planejada de dados coletados de 311 pacientes com dor musculoesquelética foi realizada. O Índice de Dor Espalhada e o painMAP avaliaram as áreas de dor. O coeficiente de correlação de Spearman foi utilizado para investigar a correlação entre o Índice de Dor Espalhada e o software painMAP. RESULTADOS: Um total de 98 participantes com Dor Espalhada foram incluídos neste estudo. A maioria dos participantes era do sexo feminino (67;83,7%), com média de idade de 57,7±11,5 anos, média de altura de 1,6 (0,1) metros e média de peso de 73,2 (11,8) quilogramas. A média de intensidade da dor foi de 6,7 (2,0) e da duração da dor de 92,3 (96,3) meses. O número médio de áreas de dor no Índice de Dor Espalhada foi de 10,1(3,7) e no software painMAP foi de 11,7 (8,8). Uma correlação positiva fraca (rho=0,26, IC de 95% 0,45-0,04, p=0,022) entre o Índice de Dor Espalhada e o painMAP foi encontrada. CONCLUSÃO: O Índice de Dor Espalhada e o painMAP mostraram correlação positiva fraca para avaliar as áreas de dor em participantes com dor espalhada.

Agreement and predictive performance of fall risk assessment methods and factors associated with falls in hospitalized older adults: A longitudinal study.

Falls in hospitalized older adults are of concern and, despite the availability of fall risk assessment methods and knowledge about factors associated with falls, their validity and agreement remain poorly investigated. In a prospective study, we enrolled 102 hospitalized older adults (median [P25-P75]) 67 (64-73) years, 52 [51%] men, length of stay 20 [8-41] days). Fall risk was assessed at hospital admission using the Functional Independence Measure; Morse Fall Scale; St. Thomas's Risk Assessment Tool in Falling Elderly Inpatients; Johns Hopkins Fall Risk Assessment Tool; and polypharmacy. The St. Thomas's Risk Assessment Tool in Falling Elderly Inpatients method showed the highest predictive performance (accuracy 92%) for the identification of fallers during hospitalization. A slightly better-then-chance agreement was estimated between all methods (Light's κ = 0.120). Fall risk assessment methods and factors associated with falls should not be used interchangeably as their overall and pairwise agreement are fair at best.

Body sway and movement strategies for control of postural stability in people with spinocerebellar ataxia type 3: A cross-sectional study.

BACKGROUND: Postural instability with an excessive body sway is a disabling manifestation in spinocerebellar ataxia type 3. Whether the larger body sway reflects distinct movement strategies for postural control remains uncertain. This study compared the control of postural stability of people with spinocerebellar ataxia type 3 with healthy subjects using body sway and movement strategy analyses derived from bi- and three-dimensional posturography. METHODS: Twenty-three patients (7 men, 16 women, 47 ± 11 years) and 102 healthy participants (34 men, 68 women; 44 ± 22 years) underwent posturography while standing with eyes open/closed tasks. Postural stability was assessed using elliptical area and average velocity of body sway. Spatial patterns (single-, double-, or multi-centered) were derived from the number of high-density regions in the three-dimensional statokinesigram. FINDINGS: Repeated measures two-way analysis-of-variance showed a vision-by-group interaction effect for area (F1,122 = 28.831, P < 0.001, η2 = 0.037) and velocity (F1,123 = 59.367, P < 0.001, η2 = 0.073); sway area and velocity were higher in spinocerebellar ataxia type 3 and increased under eyes-closed condition, with a higher increase in the spinocerebellar ataxia type 3. A main effect for group (F1,123 = 11.702, P < 0.001, η2 = 0.061) but not vision (F1,123 = 2.257, P = 0.136, η2 = 0.005) was found for the number of high-density regions. Spatial patterns were different between groups under trials with eyes closed (χ22,125 = 7.46, P = 0.023) but not open (χ22,125 = 2.026, P = 0.363), with a shift from single- to double- or multi-centered spatial patterns. INTERPRETATION: Compared to healthy subjects, a larger body displacement and velocity in spinocerebellar ataxia type 3, mainly under visual constraints, are not related to the predominance of either ankle or hip movement strategies.

Which psychosocial factors are related to severe pain and functional limitation in patients with low back pain?: Psychosocial factors related to severe low back pain.

BACKGROUND: Low back pain (LBP) is a global public health issue. Psychosocial factors are linked to LBP. However, there is a lack of knowledge about the relation of psychosocial factors to clinical outcomes of patients with severe LBP. OBJECTIVE: To investigate the relationship between specific psychosocial factors with severe pain and functional limitation of patients with LBP. METHODS: A cross-sectional study of 472 participants with LBP was conducted. Participants completed self-reported questionnaires, including psychosocial factors, characteristics of pain, and functional limitations. Two multivariable logistic regression models were performed with severe pain intensity (≥ 7 out of 10) and functional limitation (≥ 7 out of 10) (dependent variables) and 15 psychosocial factors (independent variables). RESULTS: One hundred twenty-five (26.5%) participants had severe LBP. Patients with catastrophising symptoms were 2.21 [95%Confidence Interval (CI): 1.30, 3.77] times more likely to have severe pain and 2.72 (95%CI: 1.75, 4.23) times more likely to have severe functional limitation than patients without catastrophising symptoms. Patients with maladaptive beliefs about rest were 2.75 (95%CI: 1.37, 5.52) times more likely to present with severe pain and 1.72 (95%CI: 1.04, 2.83) times more likely to have severe functional limitation. Patients with kinesiophobia were 3.34 (95%CI: 1.36, 8.24) times more likely to present with severe pain, and patients with social isolation were 1.98 (95%CI: 1.25, 3.14) times more likely to have severe functional limitation. CONCLUSION: Catastrophising, kinesiophobia, maladaptive beliefs about rest, and social isolation are related to unfavourable clinical outcomes of patients with LBP.

Cognitive functional therapy compared with core exercise and manual therapy in patients with chronic low back pain: randomised controlled trial.

ABSTRACT: Cognitive functional therapy (CFT) is a physiotherapy-led intervention that has evolved from an integration of foundational behavioral psychology and neuroscience within the physiotherapist practice directed at the multidimensional nature of chronic low back pain (CLBP). The current evidence about the comparative effectiveness of CFT for CLBP is still scarce. We aimed to investigate whether CFT is more effective than core training exercise and manual therapy (CORE-MT) in pain and disability in patients with CLBP. A total of 148 adults with CLBP were randomly assigned to receive 5 one-hour individualized sessions of either CFT (n = 74) or CORE-MT (n = 74) within a period of 8 weeks. Primary outcomes were pain intensity (numeric pain rating scale, 0-10) and disability (Oswestry Disability Index, 0-100) at 8 weeks. Patients were assessed preintervention, at 8 weeks and 6 and 12 months after the first treatment session. Altogether, 97.3% (n = 72) of patients in each intervention group completed the 8 weeks of the trial. Cognitive functional therapy was more effective than CORE-MT in disability at 8 weeks (MD = -4.75; 95% CI -8.38 to -1.11; P = 0.011, effect size= 0.55) but not in pain intensity (MD = -0.04; 95% CI -0.79 to 0.71; P = 0.916). Treatment with CFT reduced disability, but the difference was not clinically important compared with CORE-MT postintervention (short term) in patients with CLBP. There was no difference in pain intensity between interventions, and the treatment effect was not maintained in the mid-term and long-term follow-ups.

Challenges and Perspectives for Research on Work Ability in Professional Drivers: A Scoping Review.

To review studies on work ability (WA) and its relationship with the biopsychosocial factors of professional drivers. We performed a scoping review of articles published until 2021, extracting location, study design, sample characteristics, transport category, WA assessment methods, and health-related factors. Eighteen studies were found in different transport categories around the world. Most of the studies were cross-sectional (15/18, 83%), in a single branch of professional drivers, and the Work Ability Index (WAI) appears as the most common assessment instrument (7/18, 39%). The characteristics of work organization, lack of physical activity, comorbidities, and psychosocial and ergonomic factors are associated with musculoskeletal symptoms and stress in professional drivers. Comparisons of WA and related factors between studies and professional drivers are limited due to the multiplicity of assessment methods.

Concurrent validity of the inertial sensors for assessment of balance control during quiet standing in patients with chronic low back pain and asymptomatic individuals.

The objective was to investigate the concurrent validity of inertial sensors for measuring balance control in patients with chronic low back pain and asymptomatic individuals. Thirty-nine patients with chronic low back and 39 age- and sex-matched asymptomatic individuals were included. Balance control analysis was performed in quiet standing with two inertial sensors positioned at the lumbar region and the sternum and compared to the results of a force plate. The variables analysed with either device were Root Mean Square (RMS), index of smoothness (JERK), trajectory length (PATH) and area (AREA). Spearman's correlation coefficient investigated the correlation. Patients with chronic low back pain showed moderate correlation with the inertial sensor positioned on the lumbar for RMS (rs = 0.59; p < 0.01), PATH (rs = 0.42, p = 0.01) and AREA (rs = 0.59; p < 0.01) and weak correlation with the inertial sensor positioned on the sternum for PATH (rs = 0.36, p = 0.04). The asymptomatic group showed statistically significant correlations for RMS for the lumbar (rs = 0.38; p = 0.03) and sternum inertial sensor (rs = 0.42; p = 0.02). Inertial sensors showed weak to moderate correlations compared to data obtained from a force plate.

Postural control in football players with vision impairment: Effect of sports adaptation or visual input restriction?

Abstract Aim: To assess the postural control performance of football 5-a-side (FFS) players, comparing them with sighted players. Methods: Eight FFS players and 7 sighted futsal players were included. Postural control tests included feet together stance (FTS) and single-leg stance (SLS) tasks, performed on rigid and foam surfaces. Sighted players performed the tests with open (EO) and closed (EC) eyes. Area of displacement (Area) and average velocity (Vavg) were calculated from the center of pressure time-series coordinates. Results: On both surfaces conditions, a significant difference between visually impaired football 5-a-side players and sighted EO players was observed during FTS (higher Vavg for visually impaired football 5-a-side players; p < 0.04) and SLS (higher Area and Vavg for visually impaired football 5-a-side players; p < 0.01). No differences between visually impaired football 5-a-side players and sighted EC players were found. Differences between sighted EO vs. sighted EC were observed during FTS on the foam surface, and in SLS on both surface conditions (p < 0.03). Conclusion: FFS players' postural control performance is similar to sighted players with EC but worse than sighted players with EO, suggesting their postural control performance can be simply explained in terms of visual restriction.

Pico de fluxo da tosse para predizer o resultado da extubação: uma revisão sistemática e metanálise / Cough peak flow to predict extubation outcome: a systematic review and meta-analysis

RESUMO Objetivo: Avaliar a utilidade do pico de fluxo da tosse para predizer o desfecho da extubação em pacientes que obtiveram sucesso no teste de respiração espontânea. Métodos: A busca cobriu as bases de dados científicos MEDLINE, Lilacs, Ibecs, Cinahl, SciELO, Cochrane, Scopus, Web of Science e literatura cinzenta. Utilizaram-se os critérios Quality Assessment of Diagnostic Accuracy Studies para avaliar a qualidade da metodologia e o risco de viés dos estudos. A heterogeneidade estatística da razão de verossimilhança (LR) e razão de chance diagnóstica (RCD) do diagnóstico foram avaliadas com utilização de gráficos em floresta, teste Q de Cochran e um gráfico crosshair summary Receiver Operating Characteristic, utilizando um modelo com múltiplos pontos de corte. Resultados: Inicialmente obteve-se, nas bases de dados, um total de 3.522 referências; dentre estas, selecionaram-se para análise qualitativa 12 estudos que incluíram 1.757 participantes. Muitos estudos apresentavam um risco de viés incerto em termos da seleção de pacientes e do fluxo e tempo. Dentre os 12 estudos incluídos, sete tinham alto risco e cinco risco incerto para o item padrão de referência. O desempenho diagnóstico do pico de fluxo da tosse para o resultado da extubação foi baixo a moderado quando se consideram os resultados de todos os estudos incluídos, com +LR de 1,360 (IC95% 1,240 - 1,530), -LR de 0,218 (IC95% 0,159 - 0,293) e razão de chance diagnóstica de 6,450 (IC95% 4,490 - 9,090). Uma análise de subgrupos que incluiu somente estudos com valores de corte entre 55 e 65 L/minuto demonstrou desempenho ligeiramente melhor, porém ainda moderado. Conclusão: A avaliação do pico de fluxo da tosse, considerando valor de corte entre 55 e 65 L/minuto, pode ser útil como medida complementar antes da extubação. São necessários estudos com melhor delineamento para elucidar o melhor método e equipamento para registrar o pico de fluxo da tosse, assim como o melhor ponto de corte.

Abstract Objective: This systematic review was designed to assess the usefulness of cough peak flow to predict the extubation outcome in subjects who passed a spontaneous breathing trial. Methods: The search covered the scientific databases MEDLINE, Lilacs, Ibecs, Cinahl, SciELO, Cochrane, Scopus, Web of Science and gray literature. The Quality Assessment of Diagnostic Accuracy Studies was used to assess the methodological quality and risk of study bias. The statistical heterogeneity of the likelihood (LR) and diagnostic odds ratios were evaluated using forest plots and Cochran's Q statistic, and a crosshair summary Receiver Operating Characteristic plot using the multiple cutoffs model was calculated. Results: We initially retrieved 3,522 references from the databases; among these, 12 studies including 1,757 subjects were selected for the qualitative analysis. Many studies presented an unclear risk of bias in the "patient selection" and "flow and time" criteria. Among the 12 included studies, seven presented "high risk" and five "unclear risk" for the item "reference standard." The diagnostic performance of the cough peak flow for the extubation outcome was low to moderate when we considered the results from all included studies, with a +LR of 1.360 (95%CI 1.240 - 1.530), -LR of 0.218 (95%CI 0.159 - 0.293) and a diagnostic odds ratio of 6.450 (95%CI 4.490 - 9.090). A subgroup analysis including only the studies with a cutoff between 55 and 65 L/minute showed a slightly better, although still moderate, performance. Conclusion: A cough peak flow assessment considering a cutoff between 55 and 65L/minute may be useful as a complementary measurement prior to extubation. Additional well-designed studies are necessary to identify the best method and equipment to record the cough peak flow as well as the best cutoff.