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1.
Neural Plast ; 2020: 8961493, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32256559

RESUMO

Parkinson's disease (PD) is a neurodegenerative disorder for which there is currently only symptomatic treatment. During the last decade, there has been an increased interest in investigating physical exercise as a neuroprotective mechanism in PD. Animal studies have suggested that exercise may in fact induce neuroplastic changes, but evidence in humans is still scarce. A handful of reviews have previously reported on exercise-induced neuroplasticity in humans with PD, but few have been systematic, or have mixed studies on both animals and humans, or focused on one neuroplastic outcome only. Here, we provide a systematic review and metasynthesis of the published studies on humans in this research field where we have also included different methods of evaluating neuroplasticity. Our results indicate that various forms of physical exercise may lead to changes in various markers of neuroplasticity. A narrative synthesis suggests that brain function and structure can be altered in a positive direction after an exercise period, whereas a meta-analysis on neurochemical adaptations after exercise points in disparate directions. Finally, a GRADE analysis showed that the current overall level of evidence for exercise-induced neuroplasticity in people with PD is very low. Our results demonstrate that even though the results in this area point in a positive direction, researchers need to provide studies of higher quality using more rigorous methodology.

2.
J Rehabil Med ; 52(2): jrm00019, 2020 02 27.
Artigo em Inglês | MEDLINE | ID: mdl-31995224

RESUMO

OBJECTIVE: To investigate prognostic factors for physical and emotional functioning following interdisciplinary multimodal pain rehabilitation, by targeting patients' baseline characteristics and health measures. METHODS: A prospective cohort of 2,876 patients from 38 specialist clinics across Sweden, who were completing interdisciplinary multimodal pain rehabilitation programmes, was followed through the Swedish Quality Registry for Pain Rehabilitation, from initial assessment to 12-month follow-up. Using logistic regression, baseline data were regressed to predict improvement in Physical functioning and Emotional functioning, fused by principal component analyses using the 36-item Short Form Health Survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS). RESULTS: Employment status emerged as having the largest effect sizes in both Physical functioning and Emotional functioning; Working: odds ratio (OR) 2.05 (95% confidence interval (95% CI) 1.64-2.56) and OR 1.59 (95% CI 1.27-1.98), respectively. Strong beliefs in restored health, better initial emotional health, lower levels of pain and pain interference, and younger age all predicted Physical functioning. European origin, higher levels of general activity, and sense of life control all predicted Emotional functioning. Worse initial physical and emotional health predicted the corresponding dependent outcomes. CONCLUSION: Employment was consistently found to be an important prognostic factor, suggesting the significance of avoiding delay in interdisciplinary multimodal pain rehabilitation. A positive treatment expectancy was of importance. In general, multidimensional measures indicated that better initial status was more favourable; however, inconsistency implies a complex prognostic picture.


Assuntos
Dor Crônica/reabilitação , Emoções/fisiologia , Adolescente , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Sistema de Registros , Suécia , Fatores de Tempo , Adulto Jovem
3.
Scand J Med Sci Sports ; 30(3): 572-582, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31743494

RESUMO

The ActiGraph has a high ability to measure physical activity; however, it lacks an accurate posture classification to measure sedentary behavior. The aim of the present study was to develop an ActiGraph (waist-worn, 30 Hz) posture classification to detect prolonged sitting bouts, and to compare the classification to proprietary ActiGraph data. The activPAL, a highly valid posture classification device, served as reference criterion. Both sensors were worn by 38 office workers over a median duration of 9 days. An automated feature selection extracted the relevant signal information for a minute-based posture classification. The machine learning algorithm with optimal feature number to predict the time in prolonged sitting bouts (≥5 and ≥10 minutes) was searched and compared to the activPAL using Bland-Altman statistics. The comparison included optimized and frequently used cut-points (100 and 150 counts per minute (cpm), with and without low-frequency-extension (LFE) filtering). The new algorithm predicted the time in prolonged sitting bouts most accurate (bias ≤ 7 minutes/d). Of all proprietary ActiGraph methods, only 150 cpm without LFE predicted the time in prolonged sitting bouts non-significantly different from the activPAL (bias ≤ 18 minutes/d). However, the frequently used 100 cpm with LFE accurately predicted total sitting time (bias ≤ 7 minutes/d). To study the health effects of ActiGraph measured prolonged sitting, we recommend using the new algorithm. In case a cut-point is used, we recommend 150 cpm without LFE to measure prolonged sitting and 100 cpm with LFE to measure total sitting time. However, both cpm cut-points are not recommended for a detailed bout analysis.


Assuntos
Actigrafia/instrumentação , Aprendizado de Máquina , Comportamento Sedentário , Postura Sentada , Adulto , Algoritmos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tempo
4.
Clin J Pain ; 35(2): 148-173, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30371517

RESUMO

OBJECTIVES: This systematic review aimed to identify and evaluate prognostic factors for long-term (≥6 mo) physical functioning in patients with chronic musculoskeletal pain following multidisciplinary rehabilitation (MDR). MATERIALS AND METHODS: Electronic searches conducted in MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science, and Cochrane CENTRAL revealed 25 original research reports, published 1983-2016, (n=9436). Potential prognostic factors relating to initial pain and physical and psychological functioning were synthesized qualitatively and quantitatively in random effects meta-analyses. The level of evidence (LoE) was evaluated with Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS: Pain-related factors (intensity and chronicity) were not associated with function/disability at long-term follow-up, odds ratio (OR)=0.84; 95% confidence interval (CI), 0.65-1.07 and OR=0.97; 95% CI, 0.93-1.00, respectively (moderate LoE). A better function at follow-up was predicted by Physical factors; higher levels of initial self-reported functioning, OR=1.07; 95% CI, 1.02-1.13 (low LoE), and Psychological factors; low initial levels of emotional distress, OR=0.77; 95% CI, 0.65-0.92, low levels of cognitive and behavioral risk factors, OR=0.85; 95% CI, 0.77-0.93 and high levels of protective cognitive and behavioral factors, OR=1.49; 95% CI, 1.17-1.90 (moderate LoE). DISCUSSION: While pain intensity and long-term chronicity did not predict physical functioning in chronic pain patients after MDR, poor pretreatment physical and psychological functioning influenced the prognosis negatively. Thus, treatment should further target and optimize these modifiable factors and an increased focus on positive, psychological protective factors may perhaps provide an opening for yet untapped clinical gains.


Assuntos
Dor Crônica/diagnóstico , Dor Crônica/reabilitação , Dor Musculoesquelética/diagnóstico , Dor Musculoesquelética/reabilitação , Dor Crônica/fisiopatologia , Humanos , Dor Musculoesquelética/fisiopatologia , Prognóstico
5.
BMJ Open ; 8(5): e018471, 2018 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-29730615

RESUMO

INTRODUCTION: Osteoarthritis (OA) of the knee is characterised by knee pain, disability and degenerative changes, and places a burden on societies all over the world. Exercise therapy is an often-used modality, but there is little evidence of what type of exercise dose is the most effective, indicating a need for controlled studies of the effect of different dosages. Thus, the aim of the study described in this protocol is to evaluate the effects of high-dose versus low-dose medical exercise therapy (MET) in patients with knee OA. METHODS AND ANALYSIS: This is a multicentre prospective randomised two-arm trial with blinded assessment and data analysis. We are planning to include 200 patients aged 45-85 years with symptomatic (pain and decreased functioning) and X-ray verified diagnosis of knee OA. Those eligible for participation will be randomly allocated to either high-dose (n=100) or low-dose (n=100) MET. All patients receive three supervised treatments each week for 12 weeks, giving a total of 36 MET sessions. The high-dose group exercises for 70-90 min compared with 20-30 min for the low-dose group. The high-dose group exercises for a longer time, and receives a greater number of exercises with more repetitions and sets. Background and outcome variables are recorded at inclusion, and outcome measures are collected after every sixth treatment, at the end of treatment, and at 6-month and 12-month follow-ups. Primary outcome is self-rated knee functioning and pain using the Knee Injury and Osteoarthritis Outcome Score (KOOS). The primary end point is at the end of treatment after 3 months, and secondary end points are at 6 months and 12 months after the end of treatment. ETHICS AND DISSEMINATION: This project has been approved by the Regional Research Ethics Committees in Stockholm, Sweden, and in Norway. Our results will be submitted to peer-reviewed journals and presented at national and international conferences. TRIAL REGISTRATION NUMBER: NCT02024126; Pre-results.


Assuntos
Terapia por Exercício/métodos , Osteoartrite do Joelho/reabilitação , Dor/etiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Articulação do Joelho/fisiopatologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto , Análise Multivariada , Noruega , Medição da Dor/métodos , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Suécia , Resultado do Tratamento
6.
BMC Res Notes ; 10(1): 687, 2017 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-29202861

RESUMO

OBJECTIVES: The McMaster Toronto Arthritis patient preference questionnaire (MACTAR) is a semi-structured interview consisting of a baseline and a follow-up interview. The MACTAR baseline is reliable and valid, however the reliability of the MACTAR follow-up is scarcely described. The aim of this study was to describe aspects of reliability and ability to detect changes of the Swedish MACTAR follow-up following acupuncture treatment in individuals with rheumatoid arthritis. RESULTS: The study was of Single Subject Experimental Design, with a 2-week non-interventional A-phase and a 6-week intervention B-phase. Eight individuals with RA, age 30-68 years, were included. MACTAR baseline was performed once followed by five assessments with MACTAR follow-up during the A-phase and another ten assessments during the B-phase. Reliability statistics were calculated for measurements 1-3 during the A-phase and the ability to detect effects of acupuncture treatment was tested by celeration lines in the B-phase. The MACTAR follow-up was highly reliable (ICC = 0.7-0.9, SEM = 2.3-4.3, and SDD = 6.2-11.7). Visual and statistical analyses indicated that the MACTAR follow-up could detect effects on individual- and group levels after acupuncture treatment, indicating that the MACTAR follow-up seems to be reliable and is able to detect effects of acupuncture treatment in RA.


Assuntos
Atividades Cotidianas/psicologia , Terapia por Acupuntura , Artrite Reumatoide/terapia , Preferência do Paciente/psicologia , Qualidade de Vida/psicologia , Adulto , Idoso , Análise de Variância , Artrite Reumatoide/fisiopatologia , Artrite Reumatoide/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Suécia , Resultado do Tratamento
7.
J Rehabil Med ; 49(7): 591-597, 2017 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-28657642

RESUMO

The aim of this study was to determine whether job strain, i.e. a combination of job demands and decision latitude (job control), and sleep disturbances among persons with occasional low-back pain are prognostic factors for developing troublesome low-back pain; and to determine whether sleep disturbances modify the potential association between job strain and troublesome low-back pain. A population-based cohort from the Stockholm Public Health Cohort surveys in 2006 and 2010 (= 25,167) included individuals with occasional low-back pain at baseline 2006 (= 6,413). Through logistic regression analyses, potential prognostic effects of job strain and sleep disturbances were studied. Stratified analyses were performed to assess modification of sleep disturbances on the potential association between job strain and troublesome low-back pain. Those exposed to job strain; active job (odds ratio (OR) 1.3, 95% confidence interval (95% CI) 1.1-1.6), or high strain (OR 1.5, 95% CI 0.9-2.4) and those exposed to severe sleep disturbances (OR 3.0, 95% CI 2.3-4.0), but not those exposed to passive jobs (OR 1.1, 95% CI 0.9-1.4) had higher odds of developing troublesome low-back pain. Sleep disturbances did not modify the association between job strain and troublesome low-back pain. These findings indicate that active job, high job strain and sleep disturbances are prognostic factors for troublesome low-back pain. The odds of developing troublesome low-back pain due to job strain were not modified by sleep disturbance.


Assuntos
Emprego/psicologia , Dor Lombar/epidemiologia , Dor Lombar/etiologia , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/etiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Fatores de Risco , Suécia/epidemiologia , Adulto Jovem
8.
Spine (Phila Pa 1976) ; 42(8): 586-594, 2017 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-28399072

RESUMO

STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: To determine the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) on pain reduction, overall improvement, and reported adverse effects in people with sciatica. SUMMARY OF BACKGROUND DATA: NSAIDs are one of the most frequently prescribed drugs for sciatica. METHODS: We updated a 2008 Cochrane Review through June 2015. Randomized controlled trials that compared NSAIDs with placebo, with other NSAIDs, or with other medication were included. Outcomes included pain using mean difference (MD, 95% confidence intervals [95% CI]). For global improvement and adverse effects risk ratios (RR, 95% CI) were used. We assessed level of evidence using the Grades of Recommendation, Assessment, Development and Evaluation approach. RESULTS: Ten trials were included (N = 1651). Nine out of 10 trials were assessed at high risk of bias. For pain reduction (visual analog scale, 0 to 100) NSAIDs were no more effective than placebo (MD -4.56, 95% CI -11.11 to 1.99, quality of evidence: very low). For global improvement NSAIDs were more effective than placebo (RR 1.14 [95% CI 1.03 to 1.27], low quality of evidence). One trial reported the effect of NSAIDs on disability with very low-quality evidence that NSAIDs are no more effective than placebo. There was low-quality evidence that the risk for adverse effects is higher for NSAID than placebo (RR 1.40, 95% CI 1.02 to 1.93). CONCLUSION: Our findings show very low-quality evidence that the efficacy of NSAIDs for pain reduction is comparable with that of placebo, low-quality evidence that NSAIDs is better than placebo for global improvement and low-quality evidence for higher risk of adverse effects using NSAIDs compared with placebo. The findings must be interpreted with caution, due to small study samples, inconsistent results, and a high risk of bias in the included trials. LEVEL OF EVIDENCE: 1.


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Dor Lombar/tratamento farmacológico , Dor/tratamento farmacológico , Ciática/tratamento farmacológico , Anti-Inflamatórios não Esteroides/efeitos adversos , Humanos , Dor/diagnóstico , Medição da Dor , Ensaios Clínicos Controlados Aleatórios como Assunto
9.
Appl Ergon ; 65: 492-500, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28274467

RESUMO

There is a need for objective methods for upper arm elevation measurements for accurate and convenient risk assessments. The aims of this study were (i) to compare a newly developed iOS application (iOS) for measuring upper arm elevation and angular velocity with a reference optical tracking system (OTS), and (ii) to compare the accuracy of the iOS incorporating a gyroscope and an accelerometer with using only an accelerometer, which is standard for inclinometry. The iOS-OTS limits of agreement for static postures (9 subjects) were -4.6° and 4.8°. All root mean square differences in arm swings and two simulated work tasks were <6.0°, and all mean correlation coefficients were >0.98. The mean absolute iOS-OTS difference of median angular velocity was <13.1°/s, which was significantly lower than only using an accelerometer (<43.5°/s). The accuracy of this iOS application compares well to that of today's research methods and it can be useful for practical upper arm measurements.


Assuntos
Acelerometria/métodos , Braço/fisiologia , Aplicativos Móveis , Movimento , Postura/fisiologia , Adulto , Fenômenos Biomecânicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Smartphone , Adulto Jovem
10.
Appl Ergon ; 60: 1-11, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28166867

RESUMO

PURPOSE: Dynamic chairs have the potential to facilitate movements that could counteract health problems associated with sedentary office work. This study aimed to evaluate whether a dynamic chair can increase movements during desk-based office work. METHODS: Fifteen healthy subjects performed desk-based office work using a dynamic office chair and compared to three other conditions in a movement laboratory. In a field study, the dynamic office chair was studied during three working days using accelerometry. RESULTS: Equivocal results showed that the dynamic chair increased upper body and chair movements as compared to the conventional chair, but lesser movements were found compared to standing. No differences were found between the conditions in the field study. CONCLUSIONS: A dynamic chair may facilitate movements in static desk-based office tasks, but the results were not consistent for all outcome measures. Validation of measuring protocols for assessing movements during desk-based office work is warranted.


Assuntos
Decoração de Interiores e Mobiliário/instrumentação , Movimento/fisiologia , Saúde do Trabalhador , Acelerometria , Adulto , Ergonomia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Postura , Distribuição Aleatória , Análise e Desempenho de Tarefas , Tronco/fisiologia , Extremidade Superior/fisiologia , Local de Trabalho , Adulto Jovem
11.
Ergonomics ; 56(8): 1304-14, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23837402

RESUMO

UNLABELLED: The aim of this study was to compare the biomechanical characteristics of sitting on a stool without a backrest (so as to encourage active sitting), sitting on a conventional office chair and standing in healthy participants. Thirteen healthy participants performed a keyboard-writing task during four (stable and unstable) sitting conditions and standing. Body segment positions and posture, postural sway and muscle activity of neck and trunk muscles were assessed with a motion capture system, a force plate and surface electromyography. The results showed that body segment positions, postural sway and trunk muscle activity were relatively similar for the stools without backrests compared with standing. All sitting conditions showed lower vertical upper body alignment, less anterior pelvic tilt and larger hip angles, compared with standing (p = 0.000). Unexpectedly, the muscle activity levels and total postural sway, sway velocity and sway in M/L and A/P directions were lower (p = 0.000) for the conditions that encouraged active sitting and standing, compared with the conventional office chair conditions. PRACTITIONER SUMMARY: Thirteen healthy participants performed a keyboard-writing task during different sitting conditions and standing and were analysed regarding posture, postural sway and trunk muscle activity. Surprisingly, less postural sway and less muscle activity were observed during the conditions that encourage active sitting, compared with sitting on a conventional office chair.


Assuntos
Músculos Abdominais/fisiologia , Músculos do Dorso/fisiologia , Músculos do Pescoço/fisiologia , Postura/fisiologia , Adolescente , Adulto , Fenômenos Biomecânicos , Terminais de Computador , Eletromiografia , Ergonomia , Feminino , Humanos , Decoração de Interiores e Mobiliário , Contração Isométrica , Masculino , Adulto Jovem
12.
Top Stroke Rehabil ; 19(1): 23-31, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22306625

RESUMO

PURPOSE: The objective was to evaluate the effect of weight-shift training on functional balance, weight distribution, and postural control measures during standing and forward reach tasks in subjects with chronic stroke. METHODS: Nine male subjects (mean age, 66 years; range, 60-75 years) who experienced a stroke 3 to 13 years previously participated in a 4-week training program consisting of static and dynamic balance exercises with visual feedback and gait training with wall support. Balance control was assessed before and after the intervention with clinical measures (Berg Balance Scale) and with a pressure platform for registering the center of pressure (CoP) during quiet stance (weight distribution, CoP sway area, and velocity), and during a forward reach task at shoulder and knee levels. Intervention effects were evaluated with the Wilcoxon matched-pairs test. RESULTS: After training, the group improved their Berg Balance Scale median score from 42 (range, 14-54) to 46 (20-55) (P = .01), CoP sway area [10.6 (5.0-31.4) to 3.0 (1.8-10.8) cm2; P = .01], and mean velocity [3.5 (2.4-8.0) to 1.7 (0.9-3.7) mm/s; P = .01] during quiet standing but not weight distribution (P = .59). During the forward reach tasks, most of the postural control measures such as movement time, CoP displacement, and CoP velocity were significantly (P < .05) improved after the training period for both the affected and nonaffected sides as compared to before the training period. CONCLUSION: A weight-shift training program improved balance control but not weight distribution in a group of chronic stroke subjects. Larger, randomized, and controlled studies are necessary.


Assuntos
Terapia por Exercício/métodos , Equilíbrio Postural/fisiologia , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/fisiopatologia , Levantamento de Peso/fisiologia , Idoso , Doença Crônica , Avaliação da Deficiência , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Pressão , Resultado do Tratamento , Caminhada
13.
Disabil Rehabil ; 34(5): 416-22, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-21988673

RESUMO

PURPOSE: To evaluate potential determinants of self-reported lumbopelvic pain 6 months postpartum for pregnant women with and without lumbopelvic pain. METHODS: Questionnaires were answered in weeks 19-21 of pregnancy and at 6 months postpartum. The Pain Catastrophizing Scale was used to assess exaggerated negative thoughts about pain experiences, the Fear-Avoidance Beliefs Questionnaire to assess beliefs about how physical activity affects back pain, the Visual Analogue Scale to assess pain intensity, the Disability Rating Index to assess physical ability, and the Nottingham Health Profile to assess health-related quality of life. A Cox proportional hazards model was used to analyse the data. RESULTS: Of the 273 women who answered at both occasions, 112 had lumbopelvic pain in pregnancy and 161 did not. For pregnant women with lumbopelvic pain a higher level of catastrophizing and a more restricted physical ability both doubled the risk for postpartum lumbopelvic pain. CONCLUSIONS: We conclude that catastrophizing and physical ability, in weeks 19-21 of pregnancy determine postpartum lumbopelvic pain, and hence that, women at risk might be identified by the use of a biopsychosocial approach in pregnancy. It seems important to take these results into consideration both when forming preventive strategies and in rehabilitation.


Assuntos
Medo/psicologia , Dor Lombar/psicologia , Dor Pélvica/psicologia , Período Pós-Parto/psicologia , Complicações na Gravidez/psicologia , Catastrofização , Estudos Transversais , Avaliação da Deficiência , Feminino , Humanos , Atividade Motora , Medição da Dor , Dor Pélvica/fisiopatologia , Gravidez , Complicações na Gravidez/fisiopatologia , Segundo Trimestre da Gravidez , Modelos de Riscos Proporcionais , Qualidade de Vida/psicologia , Análise de Regressão , Fatores de Risco , Autorrelato , Fatores Socioeconômicos , Inquéritos e Questionários , Suécia
14.
Phys Ther ; 92(1): 49-57, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22016374

RESUMO

BACKGROUND: There is a lack of knowledge about the possible role of catastrophizing in lumbopelvic pain during and after pregnancy and in postpartum physical ability. OBJECTIVE: The aims of this study were to explore how catastrophizing fluctuates over time during and after pregnancy and to investigate the associations between catastrophizing and lumbopelvic pain and between catastrophizing and postpartum physical ability. DESIGN: A prospective questionnaire was used. METHODS: The Pain Catastrophizing Scale was used to assess exaggerated negative thoughts about pain experiences in weeks 19 to 21 and weeks 34 to 37 of pregnancy and at 6 months postpartum. The Disability Rating Index was used to assess physical ability at 6 months postpartum. The occurrence of lumbopelvic pain was reported by participants. Parametric and nonparametric tests were used for the analyses. RESULTS: A total of 242 of 324 women were categorized according to reported levels of catastrophizing. A majority of women (57.9%) reported not catastrophizing at all test occasions, whereas 10.3% reported catastrophizing at all occasions. For the remaining 31.8%, the levels of catastrophizing varied over time. Women who catastrophized at 1 or more of the occasions reported higher proportions of postpartum lumbopelvic pain and had more restricted postpartum physical ability than women who did not catastrophize. LIMITATIONS: The fact that some women did not complete the questionnaire at all test occasions might have reduced the generalizability of the results. CONCLUSIONS: The common idea that levels of catastrophizing are "stable" within personality should be reconsidered, because for 1 of 3 women, the levels of catastrophizing changed over time. A majority of women reported not catastrophizing. However, catastrophizing in relation to pregnancy seems to be associated with lumbopelvic pain and postpartum physical ability. The results indicated that the role of catastrophizing in this context should be studied further.


Assuntos
Dor nas Costas/psicologia , Catastrofização , Dor Pélvica/psicologia , Período Pós-Parto/psicologia , Gravidez/psicologia , Atividades Cotidianas , Adulto , Dor nas Costas/fisiopatologia , Distribuição de Qui-Quadrado , Avaliação da Deficiência , Feminino , Humanos , Método de Monte Carlo , Medição da Dor , Dor Pélvica/fisiopatologia , Estudos Prospectivos , Inquéritos e Questionários
15.
Physiother Res Int ; 12(1): 14-24, 2007 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-17432390

RESUMO

BACKGROUND AND PURPOSE: Fear-avoidance beliefs are important determinants for disability in patients with non-specific low-back pain (LBP). The association with self-reported level of physical activity is less known. The aim of the present study was to describe the level of physical activity in patients with chronic non-specific LBP and its relation to fear-avoidance beliefs and pain catastrophizing. METHOD: A cross-sectional study on 64 patients with chronic non-specific LBP in primary healthcare. The variables measured and the questionnaires used were: level of physical activity (six-graded scale); activity limitations (Roland Morris Disability Questionnare (RDQ)); fear-avoidance beliefs (Tampa Scale of Kinesiophobia (TSK) 13-item and sub-scales 'activity avoidance' and 'somatic focus'); and pain catastrophizing (Pain Catastrophizing Scale (PCS)). The level of physical activity was dichotomised into low and high physical activity. Individual median scores on the TSKandPCSscales were used to group the patients into different levels offear-avoidance beliefs and pain catastrophizing. Univariate logistic regressions were used to calculate odds ratios for having low physical activity. RESULTS: Patients with low physical activity had significantly higher scores in fear-avoidance beliefs and pain catastrophizing (p < 0.05). Odds ratios for low level of physical activity were between 4 and 8 (p < 0.05) for patients with high fear-avoidance beliefs or medium/high pain catastrophizing. CONCLUSIONS: This study indicates that it seems important for physiotherapists in primary care to measure levels of fear-avoidance beliefs or pain catastrophizing. In particular, the two subscales of the TSK could be of real value for clinicians when making treatment decisions concerning physical exercise therapy for patients with chronic LBP.


Assuntos
Atividades Cotidianas , Atitude Frente a Saúde , Medo , Dor Lombar/psicologia , Atividade Motora , Adulto , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
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