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.
Background Low back pain (LBP) is a major cause of physical limitations and absenteeism at work throughout the world1. A number of studies have demonstrated the effectiveness of therapeutic exercises on reducing pain symptoms and improving function in patients with chronic LBP.2-4 Global Postural Reeducation (GPR) technique, theoretically consists of a reestablishment of the balance in the myofascial tension of different chains of muscles. GPR is based on the notion that a shortened muscle creates compensations in other proximal or distal muscles.5 One systematic review assessed the use of GPR for different conditions of the musculoskeletal system and found only one RCT that demonstrated a significant improvement in functional capacity in patients with ankylosing spondylitis.5 However, there are no previous randomized, controlled, clinical trials assessing the effectiveness of GPR on chronic LBP. Objectives To assess the effectiveness of global postural reeducation (GPR) on pain, function, quality of life and depressive symptoms in patients with chronic LBP. Methods Sixty-one patients with chronic LBP were randomly allocated to either the GPR group or a control group. Patients in the GPR group underwent one weekly 60-minute session of GPR for a period of 12 weeks. The control group remained on the waiting list under clinical treatment, with no physical intervention. Pain, function capacity, quality of life and depressive symptoms were assessed using a visual analog scale (VAS), the Roland-Morris questionnaire (RMQ), the Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36) and the Beck Inventory, respectively. The evaluations were performed by a blinded examiner at baseline, three months and six months after the initial evaluation and the data were analysis using an intention to treat approach. Results The GPR group demonstrated significant improvements in pain (p<0.001) and function (p<0.001) as well as the domains: pain (p=0.047), emotional aspects (p=0.008), limitation in physical functioning (p=0.040), vitality (p=0.003) and mental health (p=0.034) of the SF-36. Conclusions Based on the findings, GPR proved to be effective regarding pain, function and some domains of quality of life in chronic LBP patients. References Lidgren L. The bone and joint decade 2000-2010. Bulletin of the World Health Organization 2003;81(9):629. Snook SH, Webster BS, McGorry RW, Fogleman MT, McCann KB. The Reduction of Chronic Nonspecific Low Back Pain through the Control of Early Lumbar Flexion. Spine 1998;23(23):2601-2607. Hsieh CYJ, Adams AH, Tobis J, Hong CZ, Danielson C, Platt K, Hoehler Fred, Reinsch S, Rubel A. Effectiveness of four conservative treatments for subacute Low Back Pain. Spine 2002;27(11):1142-1148. Mannion AF, Mutineer M, Taimela S, et al. A Randomized Clinical Trial of three active therapies for chronic low back pain. Spine 1999;24:2435-2448. Vanti C, Generali A, Ferrari S, Nava T, Tosarelli D, Pillastrini P. La Reeducation Posturale Globale in musculoskeletal diseases: scientific evidence and c...
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