European Resuscitation Council Guidelines for Resuscitation.

Objective To assess the impact of daily cane use during gait in relation to pain, function, general health and energy expenditure among patients with knee osteoarthritis. Method Sixty-four patients were randomly assigned to an experimental group (EG) or control group (CG). The EG used a cane every day for 2 months, whereas the CG did not use a cane in this period. The first outcome was pain and the second were function (Lequesne and WOMAC), general health (SF-36) and energy expenditure (gas analysis during the 6-minute walk test (6MWT) with and without a cane). Evaluations were performed at baseline, 30 and 60 days. Results The groups were homogeneous for all parameters at baseline. Compared with the CG, the EG significantly improved pain (ES 0.18), function - Lequesne (ES 0.13), some domains of SF-36 (role physical, ES 0.07 and bodily pain, ES 0.08) and distance on the 6MWT with the cane (ES 0.16). At the end of the 6MWT with the cane, the EG significantly improved energy expenditure (ES 0.21), carbon dioxide production (ES 0.12) and metabolic equivalents (ES 0.15) compared with the CG. Conclusion A cane can be used to diminish pain, improve function and some aspects of quality of life in patients with knee osteoarthritis. The prescription of a cane should take into account the substantial increase in energy expenditure in the first month of use, whereas energy expenditure is no longer a factor for concern by the end of the second month due to adaptation to cane use. The trial was registered in clinicaltrials.gov (NCT00698412).

https://ard.bmj.com/content/annrheumdis/71/2/172.full.pdf

Impact of cane use on pain, function, general health and energy expenditure during gait in patients with knee osteoarthritis: a randomised controlled trial

OBJETIVOS: Traduzir e adaptar culturalmente o questionario Shoulder Pain and Disability Index (SPADI) para a Lingua Portuguesa do Brasil e avaliar sua confiabilidade. METODOS: A primeira etapa consistiu na traducao, sintese, retro-traducao, revisao pelo Comite, pre-teste e avaliacao dos documentos pelo comite e pelo autor do SPADI. A versao revisada pelo Comite foi aplicada a 90 individuos com disfuncao no ombro, com faixa etaria acima de 18 anos e niveis educacional e sociocultural variados. Os itens nao compreendidos por 20% ou mais dos pacientes foram reformulados e reaplicados ate alcancarem valores menores que esse. A segunda etapa consistiu de duas aplicacoes do SPADI a 32 pacientes com disfuncao de ombro, no intervalo de 2 a 7 dias. Os dados de traducao foram analisados descritivamente, a confiabilidade teste-reteste, pelo Coeficiente de Correlacao Intraclasse (ICC) e a consistencia interna, pelo Alpha de Cronbach. RESULTADOS: Algumas expressoes foram adaptadas a populacao brasileira, e os itens da escala de dor e incapacidade foram alterados para maior facilidade de leitura na Lingua Portuguesa. O pre-teste revelou a necessidade de se alterar apenas um item de dor e de se aplicar o questionario por entrevista, pois ele se repetiu tres vezes e, nas duas primeiras aplicacoes, com o questionario autoaplicado, os pacientes nao realizaram o relato referente a "semana passada" e utilizaram inadequadamente o item "Nao se aplica". A confiabilidade teste-reteste variou de 0,90 a 0,94, e a consistencia interna de 0,87 a 0,89. CONCLUSAO: Apos a traducao e adaptacao cultural, foi obtida uma versao confiavel do SPADI-Brasil.

/pdf/versao-brasileira-do-shoulder-pain-and-disability-index-4d118vtg8e.pdf

Versão Brasileira do Shoulder Pain and Disability Index: tradução, adaptação cultural e confiabilidade

The objective of this study was to evaluate whether women with knee osteoarthritis performing a rehabilitation programme consisting of low-load exercises combined with PVO exhibited the same results in changes in quadriceps strength, pain relief, and functional improvement when compared to women receiving a programme consisting of high-load exercises without PVO. Thirty-four women (mean age, 61 years) with a diagnosis of knee osteoarthritis were randomly assigned to a conventional or occlusion group. The women in the conventional group (n = 17) performed a 6-week quadriceps strengthening and stretching programme using a load around 70 % of the 1-repetition maximum (RM). The women in the occlusion group (n = 17) performed the same programme, however, only using a load around 30 % of the 1-RM, while PVO was induced. The PVO was achieved using a pressure cuff applied to the upper third of the thigh and inflated to 200 mmHg during the quadriceps exercise. An 11-point Numerical Pain Rating Scale (NPRS), the Lequesne questionnaire, the Timed-Up and Go (TUG) test, and muscle strength measurement using a hand-held dynamometer were used as outcome measures at baseline (pretreatment) and at the end of the 6-week of treatment. Pain, using the NPRS, was also assessed when performing the quadriceps exercises during the exercise sessions. At baseline, demographic, strength, pain, and functional assessment data were similar between groups. Patients from both the conventional and occlusion groups had a higher level of function (Lequesne and TUG test), less pain (NPRS), and higher quadriceps strength at the 6-week evaluation when compared to baseline (all P < 0.05). However, the between-group analysis showed no differences for all outcomes variables at posttreatment (n.s.). Patients in the occlusion group experienced less anterior knee discomfort during the treatment sessions than those in the high-load exercise group (P < 0.05). A rehabilitation programme that combined PVO to low-load exercise resulted in similar benefits in pain, function, and quadriceps strength than a programme using high-load conventional exercise in patients with knee osteoarthritis. However, the use of PVO combined with low-load exercise resulted in less anterior knee pain during the training sessions. I.

Exercises with partial vascular occlusion in patients with knee osteoarthritis: a randomized clinical trial.

Objectives: To translate and culturally adapt the Shoulder Pain and Disability Index (SPADI) into Brazilian-Portuguese and to assess its reliability. Methods: The first step was the translation, synthesis, back-translation, revision by the committee, pre-testing and evaluation of documents by the committee and the author of the SPADI. The revised version by the committee was applied to 90 subjects with shoulder dysfunction, aged over 18 years from different education and sociocultural levels. The items misunderstood by 20% or more of patients were reformulated and reapplied until they reach values lower than 20%. The second stage consisted of two applications of SPADI to 32 patients with shoulder dysfunction in a interval ranging from 2 to 7 days. The data from the translation were analyzed descriptively, the test-retest reliability by Intraclass Correlation Coefficient (ICC) and the internal consistency by Cronbach's Alpha. Results: Some expressions have been adapted to the Brazilian population and the items in the pain and disability subscales were changed for an easier reading in Portuguese Language. The pre-test revealed a need to change only one item of the pain domain and to administer the questionnaire by interview, since it was repeated three times and in the first two applications with self-reported questionnaire the patients had not been reporting their symptoms with regards to the past week and also they have not been properly used the item "Not Applicable". The test-retest reliability ranged from 0.90 to 0.94 and the internal consistency ranged from 0.87 to 0.89. Conclusion: After the translation and cultural adaptation, it was obtained a reliable version of SPADI-Brazil.

Versão brasileira do Shoulder Pain and Disability Index: tradução, adaptação cultural e

OBJECTIVE: translation, validation and cultural adaptation of the algofunctional index of Lequesne for the Portuguese language. PATIENTS AND METHODS: the original questionnaire, published in English, was translated by three English professors, and after back translated by others three professors. Four physiotherapists had congregated and comparing the translations, they had elaborated the first version. This was applied to 11 patients with diagnosis of osteoarthritis (OA) of knees and/or hips, and this version was recognized fully by the patients, who had not reported understanding problems. This version, considered as definitive, was them applied to others 73 patients in the following form: a time for observer 1 (A1), in the same day for observer 2 (A2) and one week later for observer 1 or 2 (A3). Jointly it was collected data on age, sex and applied questionnaire Westerm Ontario and McMaster Universities WOMAC in its version validated for Portuguese language. RESULTS: for osteoarthritis of knees, the patients of the pre-test (10 of 11 evaluated) had average age of 63 years (DP=9.3) and 2 were men. Its average grade for the index of Lequesne was of 14.9 (DP=5.1). The patients, evaluated with the definitive version, in number of 42, had in average 67.5 years (DP=8.7), 5 were men. Its average for the index of Lequesne was for A1=11.9 (DP=5.0), for A2=12.1 (DP=6.4) and A3=11.3 (DP=7.9). The intraclass correlation between A1 and A2 was of 0.99 and between A1 and A3 was of 0,99. The Pearson coefficient between A1 and WOMAC pain was of 0.800, WOMAC stiffness was of 0.640 and WOMAC function was 0.828, all with statistical significance. For osteoarthritis of hips, the patients of the pre-test (3 of the 11 evaluated) had average age of 67 years (DP=9.18) and were all women. Its average grade for the index of Lequesne was of 11.2 (DP=5.86). The patients, evaluated with the definitive version, in number of 37, had in average 66.9 years (DP=9.01), 8 were men. Its average for the index of Lequesne was for A1=12.5 (DP=5.6) for A2=12,5 (DP=5.7) and A3=14.1 (DP=6.3). The intraclass correlation between A1 and A2 was of 0.99 and between A1 and A3 was of 0.98. The coefficient of Pearson between A1 and WOMAC pain was of 0.759, WOMAC rigidity was of 0.659 and WOMAC function was 0.851, all also with statistical significance. CONCLUSION: the version for the Portuguese language (Brazil) of the algofunctional index of Lequesne, for evaluation of osteoarthritis of knees and hips is validated for use in Brazilian population.

http://danielsimonn.com.br/recomendados/atividade-fisica-saude/artigo1.pdf

Tradução e validação cultural do questionário algofuncional de Lequesne para osteoartrite de joelhos e quadris para a língua portuguesa

Virtual Reality has been used by rehabilitation professionals as a way to keep patients motivated while performing neuroplasticity functional exercises. This work describes a virtual environment which uses the CyberForce/CyberGrasp/CyberGlove system to enable a functional rehabilitation setup. The user of the system is supposed to be individuals who have been affected by traumatology, degenerative or neurological injuries, through the simulation of everyday life procedures.

A Haptic Rehabilitation System

In this article, we extend our previous instrument [1], which helps trainees improve the precision of their compressions during Cardio-Pulmonary Resuscitation (CPR), by adding to it a 3D-printed component (http://acima.lncc. br/i&m) that further improves the precision of force angle measurements. Our instrument measures the force vector and frequency of CPR compressions performed by the trainee. CPR is a technique that allows a certified person to try to keep alive someone whose heartbeat and/or breathing has stopped. Through compressions applied to the thorax of the individual in need of help, one can maintain the blood flow and air intake until further help (and equipment) arrives. During CPR training, our 3D-prototype methodically attaches a standard CPR manikin to a Nintendo WiiTM Balance Board, enabling adequate balance of the instrument, and thus, obtaining more precise data out of the compressions performed. Results of our empirical evaluations show that with the 3D prototype, the measured parameters of force value, force direction and frequency have a standard uncertainty of 0.91 KgF, 0.25 Rad (14.35 degrees), and 0.15 Hz, respectively, while without our 3D prototype they have a standard uncertainty of 0.72 KgF, 0.44 Rad (25.25 degrees) and 0.12 Hz, respectively. Results prove that our 3D prototype contributes to increasing the precision of force angle measurement, since it holds the manikin firmly in place, while having negligible effect in force amount and frequency measurements.

Felipe C. Marx

Papers

Tradução e validação cultural do questionário algofuncional de Lequesne para osteoartrite de joelhos e quadris para a língua portuguesa

A Haptic Rehabilitation System

A 3D-printable instrument to improve force vector measurement in CPR training