Effects of Transcranial Direct Current Stimulation for Treatment of Primary Dysmenorrhea: Preliminary Results of a Randomized Sham-Controlled Trial.

OBJECTIVE: The aim of this trial was to investigate the effects of five consecutive sessions of anodal transcranial direct current stimulation (tDCS) over the motor cortex (M1) on pain, mood, and physical performance in patients with primary dysmenorrhea (PDM). DESIGN: This is a double-blind randomized controlled trial. SUBJECTS: Twenty-two participants with PDM according to the No. 345-PDM Consensus Guideline were included. METHODS: Eleven active treatment and 11 sham stimulation patients received five applications over a one-week period. The primary outcome measures were pain evaluated by numeric rating scale (NRS) and McGill Questionnaire score. Secondary outcomes measures were responses to the Positive and Negative Affect Schedule (PANAS), Hamilton Anxiety Scale (HAM-A), grip strength, and six-minute walk test (6MWT). Baseline data were performed during the first menstrual cycle, and during the second menstrual cycle, participants were conducted to tDCS treatment, and postintervention data were collected. RESULTS: The intervention provided significant improvements on NRS in active tDCS, shown as an interaction between group intervention vs pre/postintervention vs days of menstrual cycle (Wald x2 = 10.54, P = 0.005), main effect of days of menstrual cycle (Wald x2 = 25.42, P < 0.001), and pre/postintervention (Wald x2 = 6.97, P = 0.008). McGill showed an interaction effect between pre/postintervention and group of stimulation (Wald x2 = 18.45, P = 0.001), with a large reduction in active tDCS (P < 0.001, d = 0.75). Psychological and functional outcomes did not differ between groups or pre/postintervention. CONCLUSIONS: tDCS could provide pain relief in subjects with PDM. These results provide some preliminary evidence for the potential role of tDCS as a contributor to the management of symptoms of PDM.

Klapp method effect on idiopathic scoliosis in adolescents: blind randomized controlled clinical trial.

[Purpose] To estimate the effect of Klapp method on idiopathic scoliosis in school students. [Subjects and Methods] A single-blind randomized clinical trial with 22 students randomly divided into intervention group (n=12) and inactive control group (n=10). Exercise protocol consisted of Klapp method, 20 sessions, three times a week for intervention group, and inactivity for control group. Dorsal muscle strength was measured by dynamometer; body asymmetries and gibbosity angles were measured by biophotogrammetry. Data were obtained by Generalized Estimated Equation, with 5% significance level. Clinical impact for dependent variables was estimated by "d" Cohen. [Results] There was no change in intragroup analysis and intergroup for all postural symmetry variables. However, it was detected intergroup difference in extensor muscle strength and intergroup difference with marginal significance of gibbosity angles. Regarding extensor muscle strength, intervention group produced average improvement of 7.0 kgf compared to control group. Gibbosity angles progressed less in intervention group, with 5.71° average delay compared to control group. [Conclusion] Klapp method was effective for gibbosity stabilization and it improves spine extensor muscle strength.

Factors associated with scoliosis in schoolchildren: a cross-sectional population-based study.

BACKGROUND: The present study aimed to investigate the prevalence of scoliosis and to analyze the factors associated with scoliosis in schoolchildren aged between 7 and 17 years. METHODS: This is a cross-sectional and quantitative study with stratified random selection of public school students in the city of Santa Cruz, Brazil. The presence of scoliosis was examined, as well as the flexibility of the posterior muscle chain, socioeconomic characteristics, anthropometry, lifestyle habits, sexual maturation, and ergonomics of school furniture. In order to identify factors associated with scoliosis, the variables were divided in biological, socioeconomic, lifestyle, and ergonomic factors, and crude and adjusted prevalence ratios (PRs) were estimated by means of Poisson regression analysis. RESULTS: Two hundred and twelve pupils participated in this study (mean age 11.61 years, 58% female). The prevalence of scoliosis was 58.1% (n = 123) and associated with female sex (PR 2.54; 95% CI, 1.33-4.86) and age between 13 and 15 years (PR 5.35; 95% CI, 2.17-13.21). Sleeping in a hammock was inversely associated with scoliosis (PR 0.44; 95% CI, 0.23-0.81). CONCLUSIONS: Scoliosis seems to be positively associated with female sex and age between 13 and 15 years, whereas the habit of sleeping in a hammock is negatively associated with the onset of scoliosis.

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

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

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

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

Analyzing Inbreeding and Estimating Its Related Deficiencies in Northeastern Brazil.

This cross-sectional study aimed to observe number of marriages between relatives in São Francisco Valley municipalities and correlations between degrees of kinship and susceptibility to genetic diseases. Three hundred and nine (309) consanguineous couples were interviewed in five municipalities. The data were analyzed using SPSS (version 22), Chi-square testing, and the generalized estimating equation (GEE). In Pariconha-AL for first cousins, the results revealed significantly higher numbers of disabled children than for third cousins ( p < 0.05). Of these, the prevalence for physical disability was significant ( χ 2 = 19.203, d f = 4, p = 0.001). In the cities of Glória-BA ( χ 2 = 11.652, d f = 3, p = 0.020) and OlhoD'água do Casado-AL ( χ 2 = 8.123, d f = 4, p = 0.044), physical disabilities were also significantly higher in children from unions of first-degree cousins than for other degrees of kinship. Visual impairment was more significant in first-degree cousins in Glória-BA ( χ 2 = 14.206, d f = 3 p = 0.007); yet among third-degree cousins, visual impairment in the municipality of Santa Brígida-BA was more prevalent ( χ 2 = 6.416, d f = 2 p = 0.040). Inbreeding, as revealed in the evaluated cities, reinforces the hypothesis for developing genetic diseases.

Dynamic knee valgus prevalence in children and its association with pain intensity, foot mobility, and sex- A cross-sectional study.

Introduction: Knee pain can impact the performance of activities and sports participation in children. Dynamic knee valgus is a movement pattern commonly related to health conditions that may be associated with sex and foot kinematics in children. Objective: To assess the prevalence of dynamic knee valgus and its relationship with foot mobility, sex, and knee pain in children. Method: A cross-sectional observational study was carried out with 144 children (10-18 years old). The pain level was investigated using the Visual Analog Pain Scale and categorized into no pain/minor pain (≤2 cm), moderate pain (3-4,9 cm), and severe pain (≥5.0 cm). Foot mobility was assessed using the adapted navicular drop test and categorized into poor/adequate foot mobility (0.0 cm-0.9 cm) and greater foot mobility (≥1.0 cm). The dynamic knee valgus presence was checked using the step-down test. The association analysis was performed using simple tabulation considering the cluster effect. The Prevalence Ratios and the respective confidence intervals (95%) were estimated from Multiple Poisson Regression with robust variance. A significance level of 5% was adopted. Results: The dynamic knee valgus prevalence was 26.3% and 26.9% in the right and left lower limbs, respectively. Females presented greater dynamic knee valgus frequency in the left lower limb than males. The dynamic knee valgus presence in males was associated with foot mobility in right (p = 0.001) (Prevalence Ratio: 9.33 Confidence Interval: 2.93-29.72) and left lower limbs (p = 0.003) (Prevalence Ratio: 6.25 Confidence Interval: 1.7-22.62). Conclusion: Male and female children showed different relationships of the analyzed factors, suggesting that characteristics related to sex may impact the aspects linked to dynamic knee in children.

Low health literacy and quality of life in patients with systemic arterial hypertension.

Purpose: Evaluate the level of health literacy and quality of life of patients with hypertension. Methods: A cross-sectional, observational study was carried out in the Northeast region of Brazil with 105 patients with hypertension through the SAHLPA-18, S-TOFHLA and MINICHAL tests. Results: For both literacy tests applied, it can be observed that about 60% of the interviewed patients did not present adequate health literacy. It was found that factors such as increasing age, lower economic class and lower education were associated with a lower level of health literacy. In the evaluation of the quality of life by the MINICHAL, 46.7% of the patients reported that hypertension interferes with quality of life. It was also possible to show that the time of diagnosis (p = 0.04) and the economic class (p = 0.008) influence the quality of life. Conclusion: Hypertension is a chronic condition that requires continuous treatment and has potential risks of evolving with fatal and non-fatal complications that can affect the patients' quality of life. The data presented reflect the difficulty in understanding and processing health information, which may directly impact on the therapeutic management of hypertension.

Risk of Death in the Elderly with Excessive Daytime Sleepiness, Insomnia and Depression: Prospective Cohort Study in an Urban Population in Northeast Brazil. / Risco de Morte em Idosos com Sonolência Excessiva Diurna, Insônia e Depressão: Estudo de Coorte Prospectiva em População Urbana no Nordeste Brasileiro.

BACKGROUND: The close relationship between sleep regulation and cardiovascular events is one of the main focuses of research in contemporary medicine. Sleep habits and characteristics interfere with the cardiac rhythm and also with life expectancy, especially in the elderly. OBJECTIVE: To estimate the risk of death and cardiovascular events in community-dwelling elderly individuals complaining of insomnia and excessive daytime sleepiness over eight years of follow-up. METHOD: A prospective cohort was designed with 160 elderly, with the first wave occurring in 2009 and the second in 2017. Follow-up groups were determined by exposure or not to complaints of primary insomnia and excessive daytime sleepiness with or without snoring. The covariates gender, marital status, depression, hypertension and diabetes were controlled. The primary outcome was death and the secondary outcome was cardio-cerebrovascular events (CCV). Outcome risks were estimated by relative risk (RR) through Poisson regression, adopting α≤0.05. RESULTS: There were 40 (25.97%: 19.04-32.89) deaths over the period and 48 (30.76%: 23.52-38.01) CCV. Men had a higher risk (RR = 1.88; 1.01-3.50) of death. Depression (RR = 2.04; 1.06-3.89), insomnia severity (RR = 2.39; 1.52-4.56) and sleep latency between 16-30 minutes (RR = 3, 54; 1.26-9.94) and 31-60 minutes (RR = 2.23; 1.12-4.47) increased the risk of death independently in community-dwelling elderly. CCV were predicted only in the hypertensive and / or diabetic elderly (RR = 8.30; 1.98-34.82). CONCLUSION: Mortality in the elderly is influenced by the emotional state and difficulty in falling asleep, unlike CCVs, which are conditioned only by arterial and metabolic blood pressure conditions.

FUNDAMENTO: A íntima relação entre a regulação do sono e os eventos cardiovasculares é um dos principais focos de investigação na medicina contemporânea. Hábitos e características do sono interferem na ritmicidade cardíaca e também na expectativa de vida, principalmente em idosos. OBJETIVO: Estimar o risco de óbito e de eventos cardiovasculares em idosos comunitários que apresentam queixa de insônia e sonolência excessiva diurna ao longo de oito anos de seguimento. MÉTODO: Foi desenhada uma coorte prospectiva com 160 idosos, a primeira onda em 2009 e a segunda em 2017. Os grupos de seguimento foram determinados pela exposição ou não às queixas de insônia primária e a sonolência excessiva diurna, com ou sem ronco. As covariáveis sexo, estado conjugal, depressão, hipertensão e diabetes foram controladas. O desfecho primário foi o óbito e o secundário, os eventos cardiocerebrovasculares (ECV). As probabilidades dos desfechos foram estimadas pelo risco relativo (RR), através da regressão de Poisson, adotando-se α ≤ 0,05. RESULTADOS: Registraram-se 40 mortes no período (25,97%:19,04-32,89) e 48 ECVs (30,76%:23,52-38,01). Os homens apresentaram maior risco (RR = 1,88;1,01-3,50) de óbito. A depressão (RR = 2,04;1,06-3,89), a gravidade da insônia (RR = 2,39;1,52-4,56) e a latência do sono entre 16-30 minutos (RR = 3,54;1,26-9,94) e 31-60 minutos (RR = 2,23;1,12-4,47) aumentaram independentemente o risco de óbito em idosos comunitários. Os ECVs foram preditos apenas por idosos hipertensos e/ou diabéticos (RR = 8,30; 1,98-34,82). CONCLUSÃO: A mortalidade em idosos é influenciada pelo estado emocional e pela dificuldade de dormir, diferentemente dos ECVs, condicionados apenas pelas condições pressóricas arteriais e metabólicas.

COVID-19 in Brazilian cities: Impact of social determinants, coverage and quality of primary health care.

BACKGROUND: Brazil, as many other countries, have been heavily affected by COVID-19. This study aimed to analyze the impact of Primary health care and the family health strategy (FHS) coverage, the scores of the National Program for Improving Primary Care Access and Quality (PMAQ), and socioeconomic and social indicators in the number of COVID-19 cases in Brazilian largest cities. METHODS: This is an ecological study, carried out through the analysis of secondary data on the population of all Brazilian main cities, based on the analysis of a 26-week epidemiological epidemic week series by COVID-19. Statistical analysis was performed using Generalized Linear Models with an Autoregressive work correlation matrix. RESULTS: It was shown that greater PHC coverage and greater FHS coverage together with an above average PMAQ score are associated with slower dissemination and lower burden of COVID-19. CONCLUSION: It is evident that cities with less social inequality and restrictions of social protection combined with social development have a milder pandemic scenario. It is necessary to act quickly on these conditions for COVID-19 dissemination by timely actions with high capillarity. Expanding access to PHC and social support strategies for the vulnerable are essential.

Primary health care and social isolation against COVID-19 in Northeastern Brazil: Ecological time-series study.

BACKGROUND: Brazil is witnessing a massive increase of corona virus disease (COVID-19). Its peculiar primary health care (PHC) system faces a burden due to the contagion occurring in the community environment. Then, the aim is to estimate the effect of the coverage of primary health care and social isolation on the evolution of confirmed cases and deaths by COVID-19, controlling sociodemographic, economic and health system aspects. METHODS: A time series design was designed with data on diagnosed cases of COVID-19 and their deaths as outcomes in the capital cities of the Northeast region of Brazil. Independent variables such as PHC coverage, hospital beds, social isolation, demographic density, Gini index and other indicators were analyzed. A Autoregressive Generalized Linear Model method was applied for model the relationship. RESULTS: We identified an exponential growth of cases (y = 0.00250.71x; p-value<0,001). However, there is a high variability in the occurrence of outcomes. PHC coverage≥75% (χ2 = 9.27; p-value = 0.01) and social isolation rate (χ2 = 365.99; p-value<0.001) proved to be mitigating factors for the spread of COVID-19 and its deaths. Capitals with hospital beds ≥ 3.2 per thousand inhabitants had fewer deaths (χ2 = 9.02; p-value = 0.003), but this was influenced by PHC coverage (χ2 = 30,87; p-value<0.001). CONCLUSIONS: PHC mitigates the occurrence of Covid-19 and its deaths in a region of social vulnerability in Brazil together with social isolation. However, it is not known until when the system will withstand the overload in view of the low adhesion to social isolation, the lack of support and appropriate direction from the government to its population.

Concordance between two instruments for health literacy assessment. / Concordância entre dois instrumentos para avaliação do letramento em saúde.

OBJETIVO: To determine agreement between the Short Test of Functional Health Literacy in Adults (S-TOFHLA) and the Short Assessment of Health Literacy for Portuguese-speaking Adults (SAHLPA-18) measurement instruments as a strategy for estimating concurrent validity. METHODS: This was a cross-sectional study conducted with users of the Brazilian National Health System. An agreement approach using a weighted Kappa test for qualitative data was applied in order to test for concurrent validity. RESULTS: 372 individuals participated. It was found that 66% and 62% of them did not have an adequate level of literacy according to SAHLPA-18 and S-TOFHLA, respectively. There was strong correlation between the instruments (p<0.001; r=0.60), although the 65.3% agreement of correct answers found was considered weak (Kappa=0.35; p<0.001). CONCLUSION: The SAHLPA-18 and S-TOFHLA instruments have different constructs and poor agreement. Use of different instruments is indicated in research intended to measure level of literacy, as is the development of instruments specific to health conditions that allow results close to the real context of individuals to be obtained.

Urinary Incontinence in Physically Active Older Women of Northeast Brazil.

Low- and moderate-impact physical activity (PA) is associated with the prevention of urinary incontinence (UI). The objective of the cross-sectional study presented herein is to analyze the factors associated with UI in physically older active women who participate in senior community groups. The variable UI was measured by the International Consultation Incontinence Questionnaire Short Form (ICIQ-SF). Socioeconomic variables were also collected, along with data on life habits and clinical history. The multivariate analysis employed Poisson's Regression with robust variance for factors associated with UI. Of the 106 participants evaluated, 54.7% presented UI, of which stress incontinence was more frequent, with 40.6%. UI presented a statistically significant association with dizziness/loss of balance during Activities of Daily Living (ADL) (prevalence ratio-PR 1.48; 95% CI 1.06-2.07) and nocturia (PR 1.63; 95% CI 1.05-2.55). Despite PA being a protection factor, UI presented an elevated prevalence in the older population, and therefore, other biological, social, and cultural aspects could also contribute to the occurrence of UI in this age group. Moreover, physically active older women with UI presented nocturia and dizziness/loss of balance during ADL, regardless of education levels and the number of births. These findings can help improve multi-professional programs aimed at promoting, preventing, and managing UI in the public.

Dissemination of COVID-19 in inland cities of Northeastern Brazil.

BACKGROUND: SARS-CoV-2 causes the new coronavirus disease (COVID-19) and it is weakening all health systems. Therefore, the most vulnerable populations are exposed to harmful consequences, such as illness and death. Thus, this study aims to estimate the temporal effect of COVID-19 dissemination on social indicators of the Northeastern region of Brazil. METHODS: An ecological time-series study was developed with the following: diagnosed cases of COVID-19 in the largest inland cities of Northeast Brazil, Human Development Index (HDI), poverty incidence, and Gini coefficient. Cities with high HDI, poverty rate, and Gini presented a larger number of patients. RESULTS: It was observed by evaluating case trends that COVID-19 spreads unevenly in inland cities of the Northeastern region of Brazil. CONCLUSIONS: In this sense, we emphasize that regional health managers should support small cities with vulnerable population and social assistance.

Biopsychosocial inequality, active lifestyle and chronic health conditions: a cross-sectional National Health Survey 2013 in Brazil.

This study estimated the biopsychosocial factors related to active physical behavior in the Brazilian population with and without chronic non-transmissible disease (NCD). Cross-sectional study of the National Health Survey (NHS) in Brazil, with 60,202 individuals in 2013. Participants were randomly selected by complex sampling. The outcome was physically active behavior measured by performing a minimum of 150 min of physical exercise per week. The independent variables were social and psychological characteristics, lifestyle and health. Cox regression was applied to estimate the prevalence ratio (PR). There are 29,666 (48.3%; 95% CI 47.0-50.0) participants reported having NCD. Not being a smoker or alcoholic, living in an urban area (PR = 1.44; CI95% 1.23-1.68/PR = 1.38; CI95% 1.08-1.75), having informal social support (PR = 1.26; CI95% 1.10-1.44/PR = 1.19; CI95% 1.05-1.34), A social class (PR = 0.43; CI95% 0.25-0.73/PR = 0.46; CI95% 0.26-0.80), high schooling (PR = 0.34; CI95% 0.23-0.51/PR = 0.33; CI95% 0.24-0.46) as well as paid work (PR = 0.87; CI95% 0.78-0.96/PR = 0.89; CI95% 0.79-0.99) are more associated with active lifestyle in both groups. However, only in the group without NCD, the male sex (PR = 1.42; CI95% 1.28-1.57), no having some disability (PR = 1.31; CI95% 1.03-1.66) and having private health insurance (PR = 1.26; CI95% 1.13-1.41) were more associated with active behavior, while in the group with NCD, being elderly (PR = 1.22; CI95% 1.05-1.42), not be white (PR = 0.85; CI95% 0.77-0.95) and not having restful sleep (PR = 1.23; CI95% 1.08-1.40) are associated with active lifestyle. People with and without NCD in Brazil have very close active behavior, however, some biopsychosocial factors such as: sex, age, lifestyle, socioeconomic level are unevenly associated with the active lifestyle in the groups. Thus, therapeutic or preventive proposals as well as public policies for health promotion must observe these distinctions when elaborating their actions.

Biopsychosocial factors associated to self-percepted sleep function in Brazilian elderly people: analysis of a national survey.

BACKGROUND: Sleep is a dimension of well-being and health. Non-restful sleep is related to health dysfunctions, especially in vulnerable populations, considering that related factors change contextually. Thus, the objective of the present study was to measure the magnitude of the reduction in sleep restorative function (SRF) and related biopsychosocial factors in Brazilian elderly. METHOD: Secondary data from the 2013 National Health Survey of cross-sectional design were analyzed. The sample consisted of individuals as from 60 years old. The outcome considered was the prevalence of reduced self-perceived sleep restorative function (SRF). Health and sleep characteristics, emotional behavior, lifestyle, social support, and urbanization were all investigated. The association with outcome was measured with the prevalence ratio (PR) and estimated with Cox regression, assuming α ≤ 0.05. RESULTS: SRF was reduced by 29.2% (95%CI 27.2 - 30.6%). It is related to depression (PR = 3.37; 95%CI 2.87 - 3.97), insomnia/sleepiness (PR = 2.45; 95%CI 2.14 - 2.79); behavioral oscillation (PR = 1.75; 95%CI 1.53 - 1.99), negative health perception (PR = 1.50; 95%CI 1.23 - 1.82), computer and internet (PR = 1.44; 95%CI 1.01 - 2.07) and functional difficulty (PR = 1.13; 95%CI 1.01 - 1.27). Living in urban areas (PR = 1.32; 95%CI 1.14 - 1.52) and having a chronic condition (PR = 1.58; 95%CI 1.11 - 2.40) were only associated to the worst situation of reduced SRF. CONCLUSION: The reduction in SRF affects one third of the elderly in Brazil and is closely related to biopsychosocial factors, requiring intersectoral public health promotion approaches.

Evaluation of pain, functional capacity and kinesiophobia in women in the chronic stage of chikungunya virus infection: A cross-sectional study in northeastern Brazil.

Arboviral diseases have been considered a global public health problem due to their growing territorial dispersion and impact on the population around the world. Individuals affected by the chikungunya virus go through an acute febrile illness associated with severe pain and long-lasting polyarthralgia. After the initial stage, infected individuals may progress to the chronic stage, which has an epidemic character and a high rate of disability and reduced mobility, impacting negatively on their quality of life. The aim of this study was to evaluate the relationship between pain, functional capacity, and kinesiophobia in individuals in the chronic stage of chikungunya virus infection. A cross-sectional study was conducted in the city of Natal, in Rio Grande do Norte, Brazil, between July and September 2018. The participants were 59 women in the chronic stage of chikungunya virus infection. Data were collected in at physical therapy outpatient clinic of the Federal University of Rio Grande do Norte (UFRN), using a socio-demographic questionnaire, the Visual Analogue Scale (VAS), the Nordic Musculoskeletal Questionnaire (NMQ), the Brief Pain Inventory (BPI), the Health Assessment Questionnaire (HAQ), and the Tampa Scale for Kinesiophobia (TSK). Descriptive statistics and bivariate analysis of the time data were conducted by simple regression. The participants' mean age was just over 50 years and average duration of virus infection was 21.54 months. Most participants had moderate to severe pain intensity that more frequent in the ankle and wrist joints. Functional capacity was low, and there was moderate fear of performing exercises and activities of daily living. Duration of infection was associated with increased pain intensity and loss of functional capacity. We can conclude that women in the chronic stage of chikungunya infection have significant pain, reduced functional capacity, and fear of performing common movements of daily living.