CONTEXT AND OBJECTIVE: Systemic sclerosis is an autoimmune disease characterized by abnormalities of vascularization that may cause fibrosis of the skin and other organs and lead to dysfunction. It is therefore essential to have tools capable of evaluating function in individuals with this condition. The aim of this study was to translate the Scleroderma Health Assessment Questionnaire (SHAQ) into Portuguese, adapt it to Brazilian culture and test its validity and reliability. DESIGN AND SETTING: The validation of SHAQ followed internationally accepted methodology, and was performed in university outpatient clinics. METHODS: SHAQ was translated into Portuguese and back-translated. In the cultural adaptation phase, it was applied to 20 outpatients. Items not understood by 20% of the patients were modified and applied to another 20 outpatients. Twenty patients were interviewed on two different occasions to determine the validity and reliability of the questionnaire: two interviewers on the first occasion and one interviewer 14 days later. To determine the external validity, comparisons were made with Health Assessment Questionnaire (HAQ), Disabilities of the Arm, Shoulder and Hand (DASH) and short form-36 (SF-36). RESULTS: In the interobserver evaluation, Pearson's correlation coefficient and the intraclass correlation coefficient were both 0.967. In the intraobserver evaluation, Pearson's correlation coefficient was 0.735 and the intraclass correlation coefficient was 0.687. Regarding external validity, SHAQ scores were statistically correlated with all measurements, except the general health domain of SF-36 and the work-related score (Q2) of DASH. CONCLUSION: The Brazilian version of SHAQ proved to be valid and reliable for assessing function in patients with diffuse systemic sclerosis. RESUMO CONTEXTO E OBJETIVO:A esclerose sistêmica (ES) é uma doença autoimune caracterizada por anormalidades da vascularização, que podem gerar fibrose da pele e outros órgãos, podendo levar a disfunção. Assim, torna-se imprescindível a elaboração de instrumentos capazes de avaliar a função de indivíduos com ES. O objetivo deste estudo foi traduzir para o português, adaptar à cultura brasileira e testar a validade e confiabilidade do Scleroderma Health Assessment Questionnaire (SHAQ). TIPO DE ESTUDO E LOCAL:A validação do SHAQ seguiu uma metodologia aceita internacionalmente, e foi realizada nos ambulatórios da universidade. MÉTODOS: Foi realizada tradução e contra-tradução do instrumento. Na fase de adaptação cultural, o SHAQ foi aplicado a 20 pacientes.

Background Fibromyalgia (FM) is a chronic non-inflammatory syndrome characterized by diffuse pain throughout the body, sleep disorder, stiffness, fatigue, depression and other psychological problems. Patients with FM feel incapable of performing the majority of activities of daily living. Medication offers only short-term benefits. Thus, it is necessary to include other measures for treatment, such as physical activity and patient education. Art therapy combine the field of psychology with artistic activities, working with therapeutic and instructive aspects as well as the potential for personal growth contained in all forms of art. Objectives The aim of the present study was to assess the effectiveness of an art therapy program for the treatment of pain and improvements in both quality of life and body image of patients with fibromyalgia. Methods A randomized, controlled study with a blinded evaluator and 20-week follow-up period was carried out involving 80 patients with fibromyalgia. A visual analog scale (VAS) pain and sleep the six-minute walk test, Fibromyalgia Impact Questionnaire (FIQ), Medical Outcome Survey Short Form 36 (SF-36), Beck Depression Inventory and Body Dysmorphic Disorder Examination (BDDE) questionnaire were used for the assessments, which were performed at baseline and after 10, 20 (end of intervention) and 40 weeks. Results The art group achieved statistically significant improvements in VAS for pain (p=0.001), VAS for sleep (p=0.027), FIQ (p=0.001), Beck Depression Inventory (p=0.038) and the physical functioning (p=0.027), role-physical, (p<0.001), bodily pain (p=0.002), vitality (p=0.001), role-emotional (p=0.002) and mental health (p=0.010) subscales of the SF-36. Regarding body image no differences between groups was found over time. Conclusions Art therapy can be used in the treatment of fibromyalgia, leading to a reduction in pain and improvements in degree of depression and quality of life. References Valim V, Oliveira LM, Assis M, Barros TN, Feldman d, Natour J, et al. Aerobic fitness effects in fibromyalgia. J Rheumatol 2003; 30:1060-1069; E.H, Kowalski J, Theorell T, Anderberg U.M. Dance/movement therapy in fibromyalgia patients: Changes in self-figure drawings and their relation to verbal self-rating scales. Arts in Psychotherapy 2006; 33:11-25; SE, deHueck A., Voss S, Abbey SE. Six-Month and one-year followup of 23 weekks of aerobic exercise for individuals with fibromyalgia. Arthritis Care Res 2004; 51:890-98; AM, Komnaes HB, Forre O. The effects of 20 weeks of physical fitness training in female patients with fibromyalgia. Clin Exp Rheumatol 1992; 10(4):345-349. Disclosure of Interest None Declared

Objective: To evaluate the effectiveness of sleep hygiene instructions for women with fi bromyalgia. Materials and methods: Seventy women with fi bromyalgia completed the study. The assessment comprised the Fibromyalgia Impact Questionnaire (FIQ), the Pittsburgh Sleep Quality Index (PSQI), and a general questionnaire with personal data and lifestyle information. All patients received information about the disease and a sleep diary, but only the experimental group received the sleep hygiene instructions. Patients were asked to practice sleep hygiene, and, after three months, they were reevaluated by use of the same questionnaires. Results: The mean age in the control group was 55.2 ± 7.12 years, and, in the experimental group, 53.5 ± 8.89 years (P = 0.392). The experimental group showed: a decrease in the pain Visual Analogue Scale values (P = 0.028), in fatigue (P = 0.021), and in the PSQI component 1 (P = 0.030); and a signifi cant reduction in the diffi culty falling asleep after waking up in the middle of the night (P = 0.031). The experimental group also showed an increase in the reporting percentage of "silent environment" (ranging from 42.9% to 68.6%), a decrease in the reporting percentage of "fairly quiet environment" (ranging from 40% to 22.9%), and a decrease in the reporting percentage of "noisy environment" (ranging from 17.1% to 8.6%). These changes facilitated falling asleep after waking up in the middle of the night. Conclusion: The sleep hygiene instructions allowed changing the patients' behavior, which resulted in pain and fatigue improvement, increased subjective quality of sleep, in addition to facilitating falling asleep after waking up in the middle of the night.

BACKGROUND AND OBJECTIVES: Ankylosing spondylitis (AS) is a chronic inflammatory disease affecting sacroiliac joints, the spine in different degrees and in lesser extension peripheral joints. Among non-pharmacological treatments, educational groups have been recommended as major coadjuvants to treat this disease. This study aimed at reviewing the literature on scientific evidences of educational groups for AS patients. METHOD: The following databases were reviewed: LILACS, Medline, Web of Science and PEDro. Words for systematic search were extracted from Health Sciences Keywords (HSC). RESULTS: Nine scientific articles were found between 1990 and 2012. Inclusion and exclusion criteria were used to select and analyze studies, including scientific articles especially addressing educational groups as treatment approaches for AS patients. CONCLUSION: Literature on educational groups as coadjuvant to treat such patients is scarce. Further studies are needed to show group formats, number and content of classes, in addition to evaluating their effectiveness.

CONTEXT AND OBJECTIVE: Ankylosing spondylitis (AS) generates inflammation and pain in entheses, peripheral joints and the spine. Education regarding AS can improve patients' disability. Thus, it is important to assess patients' knowledge. There is no instrument in the literature for assessing knowledge of AS in Portuguese. The aim here was to translate to the Brazilian Portuguese language, culturally adapt and test the reliability of the questionnaire "Ankylosing Spondylitis: What do you know?" and to correlate the findings with other factors. DESIGN AND SETTING: Original article regarding validation of questionnaire, produced at the Federal University of Sao Paulo (Unifesp). METHODS: For translation and cultural adaptation, Guilleman methodology was used. After the first phase, the reliability was tested on 30 patients. Correlations between these scores and other factors were examined. RESULTS: In the interobserver assessment, the Pearson correlation coefficient and Cronbach's alpha were 0.831 and 0.895, respectively. In the intraobserver evaluation, the intraclass correlation coefficient and Cronbach's alpha were 0.79 and 0.883, respectively. At this stage, the score for area of knowledge A showed correlations with ethnicity and education; the score for area D, with age; the total score and scores for areas A and B with "social aspects" of SF-36; and the score for area D with "pain", "vitality" and "emotional aspects" of SF-36. CONCLUSION: The Brazilian version of the questionnaire "Ankylosing Spondylitis: What do you know?" was created. It is reproducible and correlates with education level, ethnicity and the SF-36 domains "social aspects" and "emotional aspects". entre o escore total e escores das áreas A e B e "aspectos sociais" do SF-36 e entre a área D e "dor", "vitalidade" e "aspectos emocionais" do SF-36. CONCLUSÃO: Foi criada a versão brasileira do questionário "Ankylosing Spondylitis: What do you know?", que é reprodutível e se correlaciona com escolaridade, etnia e os domínios "aspectos sociais" e "aspectos emocionais" do SF-36. RESUMO