The PRE program was effective in reducing pain and improving function, some quality of life domains and strength in women with OA of the knee.

Rheumatoid arthritis (RA) is an aggressive articular autoimmune disease that causes deformities and disability. The temporomandibular joint (TMJ) might be affected by this disease. Few controlled studies have evaluated bite force (BF) and oro-facial manifestations of this disease. To characterise oro-facial alterations in patients with RA, correlate these results with clinical and disease activity parameters and correlate BF with hand strength (HS). A cross-sectional study of 150 women was performed, (75 RA patients (RA group) and 75 healthy individuals (control group). The presence of articular sounds, pain on palpation of masseter, temporal and TMJ lateral pole, changes in occlusion, range of mandibular motion, measurement of BF in the incisor and molar regions and assessment of HS were evaluated. In relation to oro-facial evaluation there were statistical differences between the groups. There was correlation between BF and HS, in the RA group, this correlation was consistent in patients with natural teeth. Patients with RA had lower scores (P < 0·05) in the HAQ, DASH and OHIP-14 questionnaires than the control group. Inverse correlations were found between BF and HAQ, but not between BF and DAS-28, DASH and OHIP-14 questionnaires in the RA group. The women with RA presented more signs and symptoms in the oro-facial region and had a lower BF than the women in the control group. BF was inversely correlated with the overall function (evaluated by the HAQ) in the patients with RA, and there were correlations between BF and HS in the RA patients and in the control group.

OBJECTIVE:To translate, to perform a cultural adaptation of and to test the reproducibility of the Cochin Hand Functional Scale questionnaire for Brazil.METHODS:First, the Cochin Hand Functional Scale questionnaire was translated into Portuguese and was then back-translated into French. These translations were reviewed by a committee to establish a Brazilian version of the questionnaire to be tested. The validity and reproducibility of the Cochin Hand Functional Scale questionnaire was evaluated. Patients of both sexes, who were aged 18 to 60 years and presented with rheumatoid arthritis affecting their hands, were interviewed. The patients were initially interviewed by two observers and were later interviewed by a single rater. First, the Visual Analogue Scale for hand pain, the Arm, Shoulder and Hand Disability questionnaire and the Health Assessment Questionnaire were administered. The third administration of the Cochin Hand Functional Scale was performed fifteen days after the first administration. Ninety patients were assessed in the present study.RESULTS:Two questions were modified as a result of the assessment of cultural equivalence. The Cronbach's alpha value for this assessment was 0.93. The intraclass intraobserver and interobserver correlation coefficients were 0.76 and 0.96, respectively. The Spearman's coefficient indicated that there was a low level of correlation between the Cochin Hand Functional Scale and the Visual Analogue Scale for pain (0.46) and that there was a moderate level of correlation of the Cochin Scale with the Health Assessment Questionnaire (0.66) and with the Disability of the Arm, Shoulder and Hand questionnaire (0.63). The average administration time for the Cochin Scale was three minutes.CONCLUSION:The Brazilian version of the Cochin Hand Functional Scale was successfully translated and adapted, and this version exhibited good internal consistency, reliability and construct validity.

Osteoarthritis of the knee (KOA) is a chronic degenerative musculoskeletal disease associated with functional disability and chronic pain. Currently, physical modalities, such as ultrasound and Laser therapies, are usually prescribed in rehabilitation scenarios as an adjunctive treatment of symptomatic KOA. These therapies have demonstrated great potential to reduce pain and improve the functional capacity of patients with this disease.Thus, the purpose of this case report was to show the effects of prototype equipment specially developed to perform the combined application of therapeutic ultrasound and laser therapy in the symptoms of knee osteoarthritis.The present case reports the use of a prototype of equipment developed to perform the combined application of ultrasound and laser therapy. A 63-year-old woman with KOA for 12 years with painful complaints and worsening of functional capacity was submitted to 12 sessions using the prototype. After treatment, she observed a 95% reduction in pain and a decrease in the WOMAC questionnaire indexes related to pain, morning stiffness, and disability. In addition, to a 50% improvement in the sit and put test.Like this, a single case study shows the efficacy of the combined US and laser therapy on pain and function in the treatment of the symptomatic KOA. The results analyzed, as well as the patient's report make it possible to show the effectiveness in the conjugated treatment and the new equipment.

Background Rheumatoid arthritis (RA) can affect any synovial joint. Unlike the hand, ever so valued in the physical examination of patients with RA, the joints in the area of the jaw and neck may also be affected in this disease and have their involvement usually underdiagnosed. There are few studies evaluating the incidence of orofacial alteration in the examination as well as the correlation between bite force (BF) and clinical and functional parameters in these patients. Objectives The aim of our study was to compare the orofacial evaluation of women with RA with a control group, correlating orofacial function parameters with clinical disease activity in RA patients and hand strength in RA patients and control subjects. Methods We conducted a cross-sectional study with 150 women: half of them (n=75) were RA patients and the others (n=75) consisted the control group. The two groups were paired by age. All individuals we evaluated in relation to: pain duringmandibular function; TMJ pain at rest; TMJ sounds; tiredness during mastication; complaint of changes in the occlusion pattern; vertical range of motion of the mandible; reports chewing fatigue;reports of bruxism; reports of feeling morning stiffness in the TMJ; pain in TMJ lateral pole; BF of three regions: incisors and molars; assess the pinch (key,tip, palmar) and grip strenght; DASH and HAQ questionnaires; DAS 28 and OHIP14 questionnaire (Oral Health Impact Profile). Results The mean age (±SD) of the RA group was 49.2 years (±9.4) and 47.4 (±10.0) of the control group (p=0.244). Duration of disease of the RA group was 12.66 years (±9,32). Only 2 (2.6%) patients in the RA group reported TMJ pain at rest and during function; it was observed in RA and control group respectively: sounds in 36 (48.0%), 11 (14.6%); mouth opening in 44.13 mm (± 6.95), 46.48 mm (± 6.09); chewing fatigue in12 (16.0%), 5 (6.6%); pain inlateral pole TMJ in 29 (38.6%), 6 (8%); sleep bruxism in 21 (28.0%), 19 (25.3%); wakefulness bruxism in 13 (17.3%), 13 (17.3%); changes in the occlusion pattern in 7 (9.3%),1 (1.3%). The mean BF values of the RA and control groups in the three regions (incisors, right molars and left molars) were respectively: Incisor 92.8N (± 53.8), 126.5N (± 59.8), p=0.002; right molars 154.7N (± 104.4), 252.7N (± 149.7), p<0.001; 170.3N left molars (± 121.0), 249.2N (± 155.7), p=0.002. p<0.001; In RA group, there was no correlation between the BF and OHIP-14, DASH and DAS-28,was correlation and incisor force and key pinch (r=0.317,p=0.006), palmar pinch (r=0,317,p=0.006), and HAQ (r =- 0,488, p=0.0001);molar force and key pinch (r=0,275,p=0.032) and HAQ (r=-0.256,p=0.045). Conclusions We found women with RA have lower BF and more signs and symptoms in the orofacial region when compared to healthy ones. There was correlation between the BF and functional parametersand pinch strength in these patients. Disclosure of Interest None Declared