Effect of compression by elastic bandages on pain and function in individuals with knee osteoarthritis: protocol of a randomised controlled clinical trial.

INTRODUCTION: Although compression is used to control pain in knee osteoarthritis (KOA), its clinical application is poorly supported, and there is a lack of scientific evidence to support its clinical use. As a low-cost and accessible protocol, compression using elastic bands could be a non-pharmacological intervention to reduce pain and improve physical function in individuals with KOA. This study aims to evaluate the effects of compression on pain and function in individuals with KOA. METHODS AND ANALYSIS: A randomised controlled clinical trial will be conducted. Individuals with KOA (n=90; both sexes; between 40 and 75 years old) will be allocated to three groups (n=30/group): compression (compression by the elastic bandage on the affected knee, once a day for 20 min, on four consecutive days); sham (same protocol, but the elastic band is placed around the affected knee without compression) and control (no intervention). The individuals in the three groups will be evaluated 1 day before the first intervention, 1 day after the last intervention, and at the 12th and 24th weeks after the end of the intervention. Pain intensity by the Visual Analogue Scale and pain scale from Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) will be the primary outcomes. The secondary variables will be physical function assessed by the WOMAC questionnaire and physical tests (step test; 30 s sit and stand test; 40 m accelerated walk test). The Global Rating of Change Scale (GRC) will also be applied to quantify the volunteers' perceived change. ETHICS AND DISSEMINATION: The project was approved by the Human Research Ethics Committee of the Federal University of São Carlos, São Paulo, Brazil (3955692). The results will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT04724902.

Prognostic value of key variables from cardiopulmonary exercise testing in patients with COPD: 42-month follow-up.

AIM: To identify better predictors of early death in patients with chronic obstructive pulmonary disease (COPD) using potential predictors derived from key measures obtained from cardiopulmonary exercise testing (CPET). METHODS: This is a prospective, cohort study with 42-month follow-up in 126 COPD patients. Every patient completed the clinical evaluation, followed by a pulmonary function test and CPET. CPET was performed on a cycle ergometer with electromagnetic braking and ventilatory expired analysis was measured breath-by-breath using a computer-based system. Peak oxygen consumption (V̇O2, mlO2. kg-1. min-1), minute ventilation/carbon dioxide production and the, minute ventilation (V̇E, L/min), and the V̇E/carbon dioxide production (V̇E/V̇CO2) slope were obtained from CPET. RESULTS: 48 (38%) patients died during the 42-month follow-up. Kaplan Meier analysis revealed a V̇E/V̇CO2 slope ≥30, peak V̇E ≤ 25.7L/min and peak V̇O2 ≤ 13.8 mlO2. kg-1. min-1were strong predictors of mortality in COPD patients. Cox regression revealed that the V̇O2 peak ≤13.8 mlO2. kg-1. min-1 (CI 95% 0.08-0.93), V̇E/V̇CO2 slope ≥30 (CI 95% 0.07-0.94), V̇E peak ≤25.7 L/min (CI 95% 0.01-0.15), Sex (CI 95% 0.04-0.55) and Age (CI 95% 1.03-1.2) were the main predictors of mortality risk. CONCLUSION: Diminished exercise capacity and peak ventilation as well as ventilatory inefficiency are independent prognostic markers. Similar to patients with heart failure, CPET may be a valuable clinical assessment in the COPD population.

Ankle strength impairments associated with knee osteoarthritis.

BACKGROUND: Knee Osteoarthritis seems to negatively impact ankle biomechanics. However, the effect of knee osteoarthritis on ankle muscle strength has not been clearly established. This study aimed to evaluate the ankle strength of the plantar flexors and dorsiflexors of patients with knee osteoarthritis in different degrees of severity. METHODS: Thirty-seven patients with knee osteoarthritis and 15 controls, subjected to clinical and radiographic analysis, were divided into three groups: control, mild, and moderate knee osteoarthritis. Participants answered a self-reported questionnaire and accomplished a muscle torque assessment of the ankle using the Biodex dynamometer in isometric, concentric and eccentric modes. FINDINGS: The mild osteoarthritis group (peak torque=26.85(SD 3.58)) was significantly weaker than the control (peak torque=41.75(SD 4.42)) in concentric plantar flexion (P<0.05). The control and mild osteoarthritis groups were not significantly different from the moderate osteoarthritis group (peak torque=36.12(SD 4.61)) in concentric plantar flexion. There were no significant differences for dorsiflexion among the groups; however the control and moderate osteoarthritis groups presented large and medium standardized mean differences. The mild osteoarthritis group was significantly lower than the control and moderate osteoarthritis groups in the concentric plantar flexion by concentric dorsiflexion torque ratio. INTERPRETATION: Ankle function exhibited impairments in patients with knee osteoarthritis, especially in the plantar flexion torque, in which the mild osteoarthritis group was weaker than the control. Interestingly, patients with moderate knee osteoarthritis showed results similar to the control group in plantar flexion torque. The results raise the possibility of a compensatory mechanism of the plantar flexors developed by patients in more advanced degrees to balance other muscle failures.

[Relationship between climate change and determinant factors of mortality among the elderly in the municipality of São Carlos (São Paulo, Brazil) over a period of ten years]. / Relação entre alterações climáticas e fatores determinantes da mortalidade de idosos no município de São Carlos (SP) em um período de dez anos.

The aim of this study was to identify the correlation between the number of deaths of elderly people and climate change in the district of São Carlos (SP) over a period of 10 years (1997-2006). Records of deaths were obtained from DATASUS for people aged over 60 who died between 1997 and 2006 in São Carlos. The average monthly maximum and minimum temperature data and relative air humidity in São Carlos were provided by the National Institute of Meteorology. The mortality coefficient of the district was calculated by gender and age and the resulting data were analyzed using t test, one-way ANOVA, the Bonferroni test and the Pearson correlation coefficient test. There were 8,304 deaths which predominantly occurred among males aged over 80, and diseases of the circulatory system were the main cause of death. There was a positive correlation between mortality by infectious disease and minimum humidity, and a negative correlation between mortality by infectious diseases and minimum temperatures, between mortality caused by respiratory disease and minimum humidity, between mortality caused by endocrine disease and minimum and maximum temperature. Thereby, it was possible to conclude that there was a correlation between climate change and mortality among elderly individuals in São Carlos.

Relação entre alterações climáticas e fatores determinantes da mortalidade de idosos no município de São Carlos (SP) em um período de dez anos / Relationship between climate change and determinant factors of mortality among the elderly in the municipality of São Carlos (São Paulo, Brazil) over a period of ten years

O objetivo desse estudo foi identificar as correlações existentes entre o número de óbitos de indivíduos idosos e as alterações climáticas no município de São Carlos (SP) em um período de 10 anos (1997-2006). Foram colhidas informações do registro de óbitos por meio do DATASUS, de pessoas com 60 anos ou mais, falecidas entre 1997 e 2006 no município. Os dados mensais da média das Temperaturas Máxima, Média e Mínima e da Umidade Relativa do Ar no município de São Carlos foram fornecidos pelo Instituto Nacional de Meteorologia. Calcularam-se os coeficientes de mortalidade do município, por sexo e faixa etária e os dados foram analisados com teste t, ANOVA de fator único, teste de Bonferroni e teste de Pearson. Ocorreram 8.304 óbitos, com predominância de indivíduos na faixa dos 80 anos ou mais, do sexo masculino. As doenças do aparelho circulatório foram as principais causas de óbito. Houve correlação positiva entre mortalidade por doenças infecciosas e Umidade Mínima e correlação negativa entre mortalidade por doenças infecciosas e Temperatura Mínima Mínima, entre mortalidade por doenças respiratórias e Umidade Mínima, entre mortalidade por doenças endócrinas e Temperatura Mínima Mínima e Temperatura Máxima Máxima. Dessa forma, foi possível concluir que houve relação entre o clima e a mortalidade de idosos em São Carlos.

The aim of this study was to identify the correlation between the number of deaths of elderly people and climate change in the district of São Carlos (SP) over a period of 10 years (1997-2006). Records of deaths were obtained from DATASUS for people aged over 60 who died between 1997 and 2006 in São Carlos. The average monthly maximum and minimum temperature data and relative air humidity in São Carlos were provided by the National Institute of Meteorology. The mortality coefficient of the district was calculated by gender and age and the resulting data were analyzed using t test, one-way ANOVA, the Bonferroni test and the Pearson correlation coefficient test. There were 8,304 deaths which predominantly occurred among males aged over 80, and diseases of the circulatory system were the main cause of death. There was a positive correlation between mortality by infectious disease and minimum humidity, and a negative correlation between mortality by infectious diseases and minimum temperatures, between mortality caused by respiratory disease and minimum humidity, between mortality caused by endocrine disease and minimum and maximum temperature. Thereby, it was possible to conclude that there was a correlation between climate change and mortality among elderly individuals in São Carlos.

Tradução e adaptação cultural para a língua portuguesa do questionário scoring of patellofemoral disorders: estudo preliminar / Translation and cross-cultural adaptation of the scoring of patellofemoral disorders into portuguese: preliminary study

OBJETIVO: Traduzir e adaptar culturalmente para língua portuguesa o questionário Scoring of Patellofemoral Disorders. MÉTODOS: 40 participantes foram selecionados entre fisioterapeutas e indivíduos leigos. O procedimento de tradução para língua portuguesa foi baseado em métodos padronizados. A escala original passou por 7 etapas até se obter a versão final em português da Escala de Desordens Patelofemorais. Em cada teste participaram 40 indivíduos, sendo 20 indivíduos leigos e 20 fisioterapeutas. O nível de não compreensão aceitável foi de até 10 por cento dos entrevistados. RESULTADOS: No 1º teste apenas as questões 3 não foram compreendidas por mais de 10 por cento dos participantes entrevistados, ocasionando a reaplicação do questionário. Já no 2° teste, apenas duas questões foram compreendidas por 90 por cento dos entrevistados e as demais questões compreendidas por mais de 90 por cento, não ocorrendo dúvidas entre os fisioterapeutas. Utilizou-se então a 2ª versão em português como versão final para a Escala de Desordens Patelofemorais. CONCLUSÃO: A escala Scoring of Patellofemoral Disorders foi traduzida e a adaptada culturalmente para língua portuguesa, tendo como título em português, Escala de Desordens Patelofemorais. Nível de Evidência II. Estudos diagnósticos, Investigação de um exame para diagnóstico.

OBJECTIVE: The aim of this study was to translate and culturally adapt the questionnaire Scoring of Patellofemoral Disorders for the Portuguese language.METHODS: 40 participants were selected, including physiotherapists and lay individuals. The process of translating the questionnaire into Portuguese was based on standardized methods. The original scale passed through seven stages, before reaching the final version in Portuguese. 40 subjects took part in each test: 20 lay individuals and 20 physiotherapists. The level acceptable of non-comprehension was up to 10% of the interviewees.RESULTS: In the first test, only three questions were not understood by more than 10% of the subjects interviewed, leading to a reapplication of the questionnaire. In the second test, only two questions were understood by 90% of the interviewees, while the remaining questions were understood by more than 90% of the interviewees, and there were no doubts among the physiotherapists. The 2nd version of the test was therefore selected as the final Portuguese version of Scoring of Patellofemoral Disorders.CONCLUSION: The Scoring of Patellofemoral Disorders scale was translated and adapted culturally for the Portuguese language, with title, in Portuguese, of Escala de Desordens Patelofemorais. Level of Evidence: Level II, development of diagnostic criteria on consecutive patients.

Immediate effects of the suboccipital muscle inhibition technique in subjects with short hamstring syndrome.

OBJECTIVE: The purpose of this study is to identify the effects of the suboccipital muscle inhibition technique in patients with short hamstring syndrome by means of tests designed to evaluate the elasticity of the hamstring muscles and pressure algometry of myofascial trigger points. METHODS: Randomized clinical trial (pre and postintervention). The study population comprised young adult students following their studies at the Physiotherapy School at the University of Extremadura (Spain) and footballers from an Extremadura Football Club with short hamstring syndrome. The sample (70 subjects = 47 male and 23 female) was randomly divided into a control group (n = 34) and an intervention group (n = 36). Mean sample age was 23.40 +/- 3.82 years. The control group was subjected to a placebo technique, whereas the intervention group was subjected to the suboccipital muscle inhibition technique. Pre and postintervention evaluation was used for the assessment of hamstring elasticity, and pressure algometry was also used (myofascial trigger points). Statistical analyses were performed using the SPSS 14.5 package (SPSS Inc, Chicago, Ill), comparing the sample between groups (Kolmorogov-Smirnov test, Student t test, 2-way analysis of variance [ANOVA], the chi(2) test). RESULTS: The distribution of the quantitative variables was normal, and the mean time doing physical activity per week was 2.82 +/- 4.03 hours. Two-way ANOVA afforded statistically significant results for the finger-floor test, straight leg raise test-left, straight leg raise test-right, left popliteal angle test (P values < .001), and right popliteal angle test (P = .005). For pressure algometry, only the right semimembranosus muscle afforded statistically significant differences (P = .021). CONCLUSIONS: According to the finger-floor distance test, the straight leg raise test, and the popliteal angle test, the suboccipital muscle inhibition technique modified the elasticity of the hamstring muscles for this group of subjects. The suboccipital muscle inhibition technique modifies the pressure algometry of the semimembranosus muscle but does not modify that of the semitendinosus muscle or biceps femoris.

Influência da prática regular de futebol sobre a elasticidade da cadeia muscular cinética reta posterior de jovens / Influence of the soccer practice on the elasticity of the posterior muscular chain in young men

No presente estudo foi realizada a avaliação da elasticidade da cadeia muscular cinética reta posterior (CRP) de jovens futebolistas (n = 100) pertencentes às categorias juvenil e amador (16 a 25 anos) de duas escolas de futebol da cidade de Salamanca (Espanha), estabelecendo uma comparação com os resultados obtidos em uma população (n = 37) de estudantes universitários (grupo controle), de idade cronológica similar, e que não praticavam o esporte regularmente. Foi avaliado o grau de elasticidade da musculatura isquiotibial e do tríceps sural de ambos os membros inferiores, utilizando-se o teste de elevação da perna estendida (EPR) e o método do zero. Para a medida da flexibilidade global da CRP foi utilizado o método sit and reach. Os dados foram analisados com o programa estatístico SPSS (análise descritiva, Test T- Student e coeficiente de Pearson). Os resultados revelam que, quando comparados com o grupo controle, os praticantes de futebol apresentaram elasticidade superior da musculatura isquiotibial e elasticidade inferior da musculatura do triceps sural. Em relação à elasticidade global não foram encontradas diferenças estatisticamente significativas.

This study evaluated the elasticity of the legs posterior muscular chain of soccer players (n = 100), youthful and amateur, of Salamanca City (Spain). Data were compared with ones of young colleges students (37) of similar age, that did not play soccer. The degree of elasticity of the hamstrings and triceps surae muscles was evaluated by means “straight leg rising” and “zero test”. For the measure of the global elasticity of the posterior muscular chain was used the “sit and reach” test. The data had been analyzed with statistical program SPSS 11.0 (descriptive analysis, test TStudent for independent samples and coefficient of Pearson). The results disclose that soccer practitioners had presented superior elasticity of the hamstrings muscles and inferior elasticity of the triceps surae muscles. The global elasticity did not present significant differences.