Proposal and test-retest reliability of a scale for cervical, thoracic, and lumbar spine pain in brazilian young people / Proposição e reprodutibilidade de uma escala de dor na coluna cervical, torácica e lombar em jovens brasileiros

ABSTRACT Objective: To propose and analyze the test-retest reliability of an instrument to verify the presence and intensity of pain in the cervical, thoracic and lumbar spine in Brazilian young people. Methods: This reliability study enrolled a sample of 458 participants (13 to 20 years). Two groups were formed for each sex according to the range of days for the test-retest (10±3 and 28±2 days). For analysis of spinal pain, a drawing of the human body with cervical, thoracic and lumbar spine areas delimited was presented. The following question was presented: during a normal day, do you feel pain in any of these regions of your spine? If so, what is the intensity from 0 to 10 (mark on the line)? The starting point, with the number 0, corresponded to no pain, and the number 10 to severe pain. The agreement of frequency and of intensity of pain was verified by Kappa test and Bland-Altman plot, respectively. Results: Intraclass correlation coefficients ranged from 0.71 (confidence interval of 95% - 95%CI - 0.59-0.79) to 0.94 (95%CI 0.90-0.96). The results concerning the agreement of pain scores showed the mean differences to be close to 0, and the largest mean difference was -0.40 (95%CI -5.14-4.34). The agreement in reported pain ranged from 72.2 (Kappa 0.43; 95%CI 0.28-0.58) to 90.1% (Kappa 0.76; 95%CI 0.60-0.92). Conclusions: This instrument was shown to be a reliable manner to verify the pain in different regions of the spine in Brazilian young people.

RESUMO Objetivo: Propor e analisar a reprodutibilidade de um instrumento para verificar a presença e a intensidade da dor na coluna cervical, torácica e lombar em jovens brasileiros. Métodos: Estudo de reprodutibilidade com uma amostra de 458 participantes (13 a 20 anos). Dois grupos foram formados para cada sexo de acordo com o intervalo de dias entre teste e reteste (10±3 e 28±2 dias). Para a análise da dor na coluna, foi apresentada a figura de um corpo humano com as áreas da coluna cervical, torácica e lombar delimitadas. A seguinte pergunta foi realizada: durante um dia comum, você sente dor em alguma dessas regiões da coluna? Se sim, qual é a intensidade de 0 a 10 (marque um traço)? A extremidade com o número 0 correspondia à ausência de dor e o número 10, à dor muito intensa. A concordância na frequência e intensidade da dor foi verificada por meio do teste Kappa e da plotagem de Bland-Altman, respectivamente. Resultados: Os coeficientes de correlação intraclasse variaram de 0,71 (intervalo de confiança de 95% - IC95% - 0,59-0,79) a 0,94 (IC95% 0,90-0,96). Os resultados relativos à concordância no escore de dor mostraram que as diferenças médias foram próximas de 0 e a maior diferença média foi de -0,40 (IC95% -5,14-4,34). A concordância no relato de dor variou de 72,2 (Kappa 0,43; IC95% 0,28-0,58) a 90,1% (Kappa 0,76; IC95% 0,60-0,92). Conclusões: O instrumento demonstrou ser uma forma reprodutível de verificar a dor em diferentes regiões da coluna vertebral em jovens brasileiros.

Biomechanical evaluation of walking and cycling in children.

Physical activity in children is important as it leads to healthy growth due to physiological benefits. However, a physiological benefit can be partially negated by excessive or unphysiological loads within the joints. To gain an initial understanding into this, the present study sought to compare joint loading between walking and cycling in children. With institutional ethical approval, 14 pre-pubertal children aged 8-12 walked on an instrumented treadmill and cycled on a stationary ergometer. Two methods were used to match physiological load. Cardiovascular loads between walking and cycling were matched using heart rate. Metabolic load was normalised by matching estimates of oxygen consumption. Joint reaction forces during cycling and walking as well as joint moments were derived using inverse dynamics. Peak compressive forces were greater on the knees and ankles during walking than during cycling. Peak shear peak forces at the knee and ankle were also significantly larger during walking than during cycling, independent of how physiological load was normalised. For both cycling conditions, ankle moments were significantly smaller during cycling than walking. No differences were found for knee moments. At equivalent physiological intensities, cycling results in less joint loading than walking. It can be speculated that for certain populations and under certain conditions cycling might be a more suitable mode of exercise than weight bearing activities to achieve a given metabolic load.

PROPOSAL AND TEST-RETEST RELIABILITY OF A SCALE FOR CERVICAL, THORACIC, AND LUMBAR SPINE PAIN IN BRAZILIAN YOUNG PEOPLE.

OBJECTIVE: To propose and analyze the test-retest reliability of an instrument to verify the presence and intensity of pain in the cervical, thoracic and lumbar spine in Brazilian young people. METHODS: This reliability study enrolled a sample of 458 participants (13 to 20 years). Two groups were formed for each sex according to the range of days for the test-retest (10±3 and 28±2 days). For analysis of spinal pain, a drawing of the human body with cervical, thoracic and lumbar spine areas delimited was presented. The following question was presented: during a normal day, do you feel pain in any of these regions of your spine? If so, what is the intensity from 0 to 10 (mark on the line)? The starting point, with the number 0, corresponded to no pain, and the number 10 to severe pain. The agreement of frequency and of intensity of pain was verified by Kappa test and Bland-Altman plot, respectively. RESULTS: Intraclass correlation coefficients ranged from 0.71 (confidence interval of 95% - 95%CI - 0.59-0.79) to 0.94 (95%CI 0.90-0.96). The results concerning the agreement of pain scores showed the mean differences to be close to 0, and the largest mean difference was -0.40 (95%CI -5.14-4.34). The agreement in reported pain ranged from 72.2 (Kappa 0.43; 95%CI 0.28-0.58) to 90.1% (Kappa 0.76; 95%CI 0.60-0.92). CONCLUSIONS: This instrument was shown to be a reliable manner to verify the pain in different regions of the spine in Brazilian young people.

Aulas de educação física e desfechos relacionados à saúde em estudantes brasileiros / Physical education classes and health outcomes in brazilian students

RESUMO Objetivo: O objetivo do presente estudo foi analisar a associação entre participação e atividade física durante as aulas de Educação Física com desfechos relacionados à saúde em estudantes brasileiros. Métodos: 681 estudantes brasileiros (50,5% do sexo feminino) com idades de 10 a 17 anos participaram desse estudo transversal. As variáveis independentes analisadas foram a participação e a atividade física durante as aulas de Educação Física, ambas estimadas por meio de um questionário autorrelatado. Os desfechos foram a aptidão cardiorrespiratória (teste de Shuttle Run de 20 m), força muscular (push-up test), sobrepeso e obesidade (índice de massa corporal) e pressão arterial elevada. A análise estatística foi realizada por meio da regressão de Poisson para estimar a razão de prevalência (RP) e os intervalos de confiança de 95% (IC95%) ajustados para as variáveis de confusão (idade, sexo, escolaridade dos pais, atividade física e comportamento sedentário), considerando a amostragem complexa. Resultados: A participação nas aulas de Educação física não se associou com nenhum dos desfechos estudados. Ser ativo durante as aulas de Educação física associou-se com o atendimento do critério de saúde para aptidão cardiorrespiratória (RP=1,34, IC95% 1,16-1,55) e força muscular (RP=1,36 IC95% 1,09-1,71). O mesmo não ocorreu para sobrepeso (RP=1,04, IC95% 0,95-1,14), obesidade (RP=1,02, IC95% 0,91-1,05) e pressão arterial elevada (RP=0,98, IC95% 0,90-1,06). Conclusões: Estudantes que relataram ser ativos nas aulas apresentaram maior probabilidade de atender aos critérios de saúde para aptidão cardiorrespiratória e força muscular. No entanto, as aulas tradicionalmente oferecidas no Brasil não protegem os estudantes do sobrepeso, obesidade ou pressão arterial elevada.

ABSTRACT Objective: To analyze the association between participation and physical activity during Physical Education classes with health outcomes in Brazilian students. Methods: 681 Brazilian students (50.5% female) aged 10 to 17 years participated in this cross-sectional study. Independent variables analyzed were participation and physical activity during Physical Education classes, both assessed using a self-report questionnaire. The outcomes were: cardiorespiratory fitness (20-meter Shuttle Run test), muscle strength (Push-up test), overweight and obesity (body mass index) and high blood pressure. Statistical analysis was conducted by Poisson regression to estimate the prevalence ratio (PR) and 95% confidence intervals (95%CI) adjusted for confounding variables (age, sex, parental education, physical activity and sedentary behavior), considering the complex sample design. Results: Participation in Physical Education classes was not associated with any of the studied variables. Being active during Physical Education classes was associated with achieving health related criteria for cardiorespiratory fitness (PR=1.34, 95%CI 1.16-1.55) and muscle strength (PR=1.36, 95%CI 1.09-1.71). The same did not occur for overweight (PR=1.04, 95%CI 0.95-1.14), obesity (PR=1.02, 95%CI 0.91-1.05), or high blood pressure (PR=0.98, 95%CI 0.90-1.06). Conclusions: Students who reported being active during classes presented a higher likelihood to achieve the health criteria for cardiorespiratory fitness and muscle strength. However, classes traditionally offered in Brazil do not protect students from overweight, obesity, or high blood pressure.

PHYSICAL EDUCATION CLASSES AND HEALTH OUTCOMES IN BRAZILIAN STUDENTS. / AULAS DE EDUCAÇÃO FÍSICA E DESFECHOS RELACIONADOS À SAÚDE EM ESTUDANTES BRASILEIROS.

OBJECTIVE: To analyze the association between participation and physical activity during Physical Education classes with health outcomes in Brazilian students. METHODS: 681 Brazilian students (50.5% female) aged 10 to 17 years participated in this cross-sectional study. Independent variables analyzed were participation and physical activity during Physical Education classes, both assessed using a self-report questionnaire. The outcomes were: cardiorespiratory fitness (20-meter Shuttle Run test), muscle strength (Push-up test), overweight and obesity (body mass index) and high blood pressure. Statistical analysis was conducted by Poisson regression to estimate the prevalence ratio (PR) and 95% confidence intervals (95%CI) adjusted for confounding variables (age, sex, parental education, physical activity and sedentary behavior), considering the complex sample design. RESULTS: Participation in Physical Education classes was not associated with any of the studied variables. Being active during Physical Education classes was associated with achieving health related criteria for cardiorespiratory fitness (PR=1.34, 95%CI 1.16-1.55) and muscle strength (PR=1.36, 95%CI 1.09-1.71). The same did not occur for overweight (PR=1.04, 95%CI 0.95-1.14), obesity (PR=1.02, 95%CI 0.91-1.05), or high blood pressure (PR=0.98, 95%CI 0.90-1.06). CONCLUSIONS: Students who reported being active during classes presented a higher likelihood to achieve the health criteria for cardiorespiratory fitness and muscle strength. However, classes traditionally offered in Brazil do not protect students from overweight, obesity, or high blood pressure.

OBJETIVO: O objetivo do presente estudo foi analisar a associação entre participação e atividade física durante as aulas de Educação Física com desfechos relacionados à saúde em estudantes brasileiros. MÉTODOS: 681 estudantes brasileiros (50,5% do sexo feminino) com idades de 10 a 17 anos participaram desse estudo transversal. As variáveis independentes analisadas foram a participação e a atividade física durante as aulas de Educação Física, ambas estimadas por meio de um questionário autorrelatado. Os desfechos foram a aptidão cardiorrespiratória (teste de Shuttle Run de 20 m), força muscular (push-up test), sobrepeso e obesidade (índice de massa corporal) e pressão arterial elevada. A análise estatística foi realizada por meio da regressão de Poisson para estimar a razão de prevalência (RP) e os intervalos de confiança de 95% (IC95%) ajustados para as variáveis de confusão (idade, sexo, escolaridade dos pais, atividade física e comportamento sedentário), considerando a amostragem complexa. RESULTADOS: A participação nas aulas de Educação física não se associou com nenhum dos desfechos estudados. Ser ativo durante as aulas de Educação física associou-se com o atendimento do critério de saúde para aptidão cardiorrespiratória (RP=1,34, IC95% 1,16-1,55) e força muscular (RP=1,36 IC95% 1,09-1,71). O mesmo não ocorreu para sobrepeso (RP=1,04, IC95% 0,95-1,14), obesidade (RP=1,02, IC95% 0,91-1,05) e pressão arterial elevada (RP=0,98, IC95% 0,90-1,06). CONCLUSÕES: Estudantes que relataram ser ativos nas aulas apresentaram maior probabilidade de atender aos critérios de saúde para aptidão cardiorrespiratória e força muscular. No entanto, as aulas tradicionalmente oferecidas no Brasil não protegem os estudantes do sobrepeso, obesidade ou pressão arterial elevada.

Overweight and obesity are not associated to high blood pressure in young people sport practitioners. / O sobrepeso e a obesidade não estão associados com a pressão arterial elevada em jovens praticantes de esportes.

The aim of this study was to analyze the association between overweight and obesity with high blood pressure (HBP) according to sports practice in young people. Took part in this study 636 young people aged 10 to 17 years of Londrina, Parana State, Brazil. Sex, age, parental education, sedentary behavior, sports practice, nutritional status and blood pressure were analysed. Poisson regression was used to estimate the prevalence ratio (PR) and 95% confidence intervals. Overweight and obesity young people showed higher prevalence of HBP compared to eutrophics when analysed the total sample (25,7 e 29,5 vs 15,2%) and non sport practitioners (29,7 e 33,3 vs 15,1%), which did not occur with sports practitioners (17,1 e 18,2 vs 15,5%). Positive associations were found between overweight and obesity with HBP in total sample (PR = 1,60, 1,02-2,52 and 1,93, 1,15-3,25) and on non sport practitioners (RP = 1,80, 1,05-3,14 and 2,15, 1,10-4,16). For young people sports practitioners were not found associations between overweight and obesity with HBP (PR = 1,01, 0,36-2,82 and 1,09, 0,48-2,48). Weight excess was not associated with HBP in young people sports practitioners, suggesting cardiovascular protection in young people with overweight and obesity.

O objetivo do estudo foi analisar a associação entre o sobrepeso e a obesidade com a pressão arterial elevada (PAE), de acordo com a prática esportiva de jovens. Participaram do estudo 636 jovens de 10 a 17 anos da cidade de Londrina-PR. Foram analisadas as variáveis sexo, idade, escolaridade paterna, comportamento sedentário, prática esportiva, estado nutricional e pressão arterial. A regressão de Poisson foi utilizada para estimar a razão de prevalência (RP) e os intervalos de confiança de 95%. Jovens com sobrepeso e obesidade apresentaram maiores prevalências de PAE, comparados aos eutróficos, quando analisadas a amostra total (25,7 e 29,5 vs 15,2%) e os não praticantes de esportes (29,7 e 33,3 vs 15,1%), o mesmo não ocorrendo com os praticantes de esportes (17,1 e 18,2 vs 15,5%). Foram encontradas associações positivas entre o sobrepeso e a obesidade com a PAE na amostra total (RP = 1,60, 1,02-2,52 e 1,93, 1,15-3,25) e nos jovens não praticantes de esportes (RP = 1,80, 1,05-3,14 e 2,15, 1,10-4,16). Para os jovens praticantes de esportes não foram encontradas associações entre sobrepeso e obesidade com a PAE (RP = 1,01, 0,36-2,82 e 1,09, 0,48-2,48). O excesso de peso não se associou com a PAE em jovens praticantes de esportes, sugerindo proteção cardiovascular nos jovens com sobrepeso e obesidade.

O sobrepeso e a obesidade não estão associados com a pressão arterial elevada em jovens praticantes de esportes / Overweight and obesity are not associated to high blood pressure in young people sport practitioners

Resumo O objetivo do estudo foi analisar a associação entre o sobrepeso e a obesidade com a pressão arterial elevada (PAE), de acordo com a prática esportiva de jovens. Participaram do estudo 636 jovens de 10 a 17 anos da cidade de Londrina-PR. Foram analisadas as variáveis sexo, idade, escolaridade paterna, comportamento sedentário, prática esportiva, estado nutricional e pressão arterial. A regressão de Poisson foi utilizada para estimar a razão de prevalência (RP) e os intervalos de confiança de 95%. Jovens com sobrepeso e obesidade apresentaram maiores prevalências de PAE, comparados aos eutróficos, quando analisadas a amostra total (25,7 e 29,5 vs 15,2%) e os não praticantes de esportes (29,7 e 33,3 vs 15,1%), o mesmo não ocorrendo com os praticantes de esportes (17,1 e 18,2 vs 15,5%). Foram encontradas associações positivas entre o sobrepeso e a obesidade com a PAE na amostra total (RP = 1,60, 1,02-2,52 e 1,93, 1,15-3,25) e nos jovens não praticantes de esportes (RP = 1,80, 1,05-3,14 e 2,15, 1,10-4,16). Para os jovens praticantes de esportes não foram encontradas associações entre sobrepeso e obesidade com a PAE (RP = 1,01, 0,36-2,82 e 1,09, 0,48-2,48). O excesso de peso não se associou com a PAE em jovens praticantes de esportes, sugerindo proteção cardiovascular nos jovens com sobrepeso e obesidade.

Abstract The aim of this study was to analyze the association between overweight and obesity with high blood pressure (HBP) according to sports practice in young people. Took part in this study 636 young people aged 10 to 17 years of Londrina, Parana State, Brazil. Sex, age, parental education, sedentary behavior, sports practice, nutritional status and blood pressure were analysed. Poisson regression was used to estimate the prevalence ratio (PR) and 95% confidence intervals. Overweight and obesity young people showed higher prevalence of HBP compared to eutrophics when analysed the total sample (25,7 e 29,5 vs 15,2%) and non sport practitioners (29,7 e 33,3 vs 15,1%), which did not occur with sports practitioners (17,1 e 18,2 vs 15,5%). Positive associations were found between overweight and obesity with HBP in total sample (PR = 1,60, 1,02-2,52 and 1,93, 1,15-3,25) and on non sport practitioners (RP = 1,80, 1,05-3,14 and 2,15, 1,10-4,16). For young people sports practitioners were not found associations between overweight and obesity with HBP (PR = 1,01, 0,36-2,82 and 1,09, 0,48-2,48). Weight excess was not associated with HBP in young people sports practitioners, suggesting cardiovascular protection in young people with overweight and obesity.

Sedentary Behavior During School Recess in Southern Brazil.

The aim of this study was to assess sedentary behavior during school recess in Brazilian boys and girls. The study included 455 students (233 boys and 222 girls), aged 8 to 17 years, enrolled in a public school in the city of Londrina, Brazil. All data was collected using questionnaires. Logistic regression with odds ratio and confidence interval (95%) was used to measure the relationship between sedentary behavior and sex, age, weight, screen time, and economic status. There was a high prevalence (40.7%) of sedentary behavior in this sample, with girls (aged 8 to 17 years) more likely than boys (54.5% vs. 27.5%, respectively) and older students (13-17 years) more likely than younger students (8-12 years) to engage in sedentary behavior (49.6% vs. 30.1%, respectively). These findings, and their broad implications for health and for interventions to increase physical activity, are discussed in light of past literature.

Physical activity and screen time in children and adolescents in a medium size town in the South of Brazil / Atividade física e tempo de tela em jovens de uma cidade de médio porte do Sul do Brasil

Abstract Objective: To analyze the associations between sex and age with behaviour related to physical activity practice and sedentary behaviour in children and adolescents. Methods: A cross-sectional study with 480 (236 boys) subjects enrolled in a public school in the city of Londrina, in the south of Brazil, aged 8–17 years. Measures of physical activity, sports practice and screen times were obtained using the Physical Activity Questionnaire for Older Children. The Mann–Whitney U test was used to compare variables between boys and girls. The Chi squared test was used for categorical analysis and Poisson regression was used to identify prevalence. Results: Girls (69.6%; PR=1.05 [0.99–1.12]) spent more time with sedentary behaviour than boys (62.2%). Boys (80%; PR=0.95 [0.92–0.98]) were more physically active than girls (91%). Older students aged 13–17 showed a higher prevalence of physical inactivity (91.4%; PR=1.06 [1.02–1.10]) and time spent with sedentary behaviour of ≥2h/day (71.8%; PR=0.91 [0.85–0.97]) when compared to younger peers aged 8–12 (78.7 and 58.5%, respectively). Conclusions: The prevalence of physical inactivity was higher in girls. Older students spent more screen time in comparison to younger students.

Resumo Objetivo: Analisar a associação do sexo e idade com comportamentos relacionados à prática de atividades físicas e sedentarismo em crianças e adolescentes. Métodos: Estudo transversal com 480 (236 sexo masculino) estudantes de uma escola pública de Londrina, Paraná, Brasil, entre 8 e 17 anos. As medidas de atividade física, prática de esportes e quantidade de comportamentos sedentários foram obtidas mediante aplicação do Physical Activity Questionnaire for Older Children. O teste U de Mann-Whitney foi usado para comparar variáveis de rapazes e moças. O teste de qui-quadrado foi usado para variáveis categóricas e a regressão de Poisson para identificar prevalências. Resultados: Moças (69,6%; RP=1,05 [0,99-1,12]) dedicaram mais tempo ao comportamento sedentário quando comparadas com rapazes (62,2%). Rapazes (80%; RP=0,95 [0,92-0,98]) apresentaram maiores níveis de atividade física quando comparados com moças (91%). Estudantes mais velhos entre 13-17 anos (91,4%; RP=1,06 [1,02-1,10]) apresentaram maior prevalência de inatividade física e comportamento sedentário de ≥2h/dia (71,8%; RP=0,91 [0,85-0,97]) quando comparados com estudantes entre 8 e 12 anos (78,7 e 58,5%, respectivamente). Conclusões: A prevalência de inatividade física foi superior entre as moças. Estudantes mais velhos despenderam mais tempo em tela quando comparados com estudantes mais novos.

Physical activity and screen time in children and adolescents in a medium size town in the South of Brazil. / Atividade física e tempo de tela em jovens de uma cidade de médio porte do Sul do Brasil.

OBJECTIVE: To analyze the associations between sex and age with behaviour related to physical activity practice and sedentary behaviour in children and adolescents. METHODS: A cross-sectional study with 480 (236 boys) subjects enrolled in a public school in the city of Londrina, in the south of Brazil, aged 8-17 years. Measures of physical activity, sports practice and screen times were obtained using the Physical Activity Questionnaire for Older Children. The Mann-Whitney U test was used to compare variables between boys and girls. The Chi squared test was used for categorical analysis and Poisson regression was used to identify prevalence. RESULTS: Girls (69.6%; PR=1.05 [0.99-1.12]) spent more time with sedentary behaviour than boys (62.2%). Boys (80%; PR=0.95 [0.92-0.98]) were more physically active than girls (91%). Older students aged 13-17 showed a higher prevalence of physical inactivity (91.4%; PR=1.06 [1.02-1.10]) and time spent with sedentary behaviour of ≥2h/day (71.8%; PR=0.91 [0.85-0.97]) when compared to younger peers aged 8-12 (78.7 and 58.5%, respectively). CONCLUSIONS: The prevalence of physical inactivity was higher in girls. Older students spent more screen time in comparison to younger students.

[The association between socioeconomic indicators andadolescents'physical activity and health-related fitness]. / Associação entre indicadores socioeconômicos com a atividade física e aptidão física relacionada à saúde em adolescentes.

OBJECTIVE: This study was aimed at analysing the association between socioeconomic indicators and adolescents' physical activity and health-related fitness. METHODS: The study involved 716 adolescents from both genders whose age ranged from 10 to 18 years-old (46.8% male) who answered a questionnaire for estimating their habitual physical activity, socioeconomic status; two health-related physical fitness tests were also performed. The socioeconomic indicators analysed concerned their parents' educational level and the number of bathrooms, TVs, cars, housemaids, refrigerators and freezers in their homes. RESULTS: A positive association was found between paternal education (PR=1.61 (range 1.27-2.10) and 1.41 (1.10-1.83)) and housemaids (PR=1.97 (1.04-3.81) and 1.92 (1.05-3.52)) with recommended physical activity and leisure time physical activity, respectively. The number of cars (PR=1.48: 1.02-2.19) and freezers (PR=1.88: 1.12-3.18) was positively associated with leisure time physical activity and the number of TVs negatively so (PR=0.75: 0.63-0.89). The number of TVs (PR=0.80: 0.67-0.96) and cars (PR=0.70: 0.55-0.89) was negatively associated with cardiorespiratory fitness whilst paternal education (PR=1.17: 1.00-1.37) and the number of bathrooms in the home (PR=1.25: 1.02-1.54) were positively associated with muscular strength. CONCLUSION: Physical activity and health-related physical fitness were associated with socioeconomic status. However, such association depended on the socioeconomic indicator being analysed. Caution should be taken when analysing studies which use different socioeconomic indicators.