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In the last years, shoulder injuries have represented an increasing health problem in soccer players. The goalkeepers are more exposed to shoulder disorders than other field players. Injury prevention exercises for upper limbs were cited in few studies involving throwing athletes, but we know that goalkeepers need a specific program. The purpose of this study is to describe the development of an adapted Fédération Internationale de Football Association (FIFA) 11+ program, namely the FIFA 11+ shoulder, which targets the prevention of shoulder injuries in soccer goalkeepers. The FIFA 11+ shoulder program is structured into three parts: general warming-up exercises, exercises to improve strength and balance of the shoulder, elbow, wrist, and finger muscles, and advanced exercises for core stability and muscle control. The exercises were selected based on recommendations from studies demonstrating high electromyographic activity.

Introduction: Shoulder instability is a common problem that usually affects patients on their second or third decades of life and athletes who practice throwing or contact sports. Its consequences are pain, decrease of activity level and general decrease in the quality of life. Many treatments have been used to the different types of instability; however, there are few instruments of evaluation that prove their efficacy. In order to apply evaluation measures in health used and developed for another idiom, it is necessary to do the transcultural equivalency, being unnecessary the creation and validation of another instrument that evaluates the condition under interest. The objective of this study was to do the translation and cultural adaptation of the WOSI scale (The Western Ontario Shoulder Instability Index) to Brazilian Portuguese. Materials and methods: The applied protocol consisted of: 1) Preparation, 2) Translation, 3) Back-Translation, 4) Cognitive Interrogatory and 5) Information Report. After the conclusion of the translation and back-translation, the versions were sent to the original WOSI authors who approved the continuation of the study. The Portuguese version was applied in 35 patients with shoulder instability to verify the instrument's level of comprehension. The final Brazilian WOSI version was concluded after reaching less than 15% of "no comprehension" in each item. To analyze the variables, descriptive statistics was applied. Results: To obtain the cultural equivalency, modifications and terms alterations suggested by the patients for the items "no comprehension" were done. Conclusion: After the translation and cultural adaptation of the scale, the WOSI Portuguese version was accomplished.

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Smoking and physical inactivity are important preventable causes of disability and early death worldwide. Reduced exercise tolerance has been described in smokers, even in those who do not fulfill the extant physiological criteria for chronic obstructive pulmonary disease (COPD) and are not particularly sedentary. In this context, it is widely accepted that exercise capacity depends on complex cardio-pulmonary interactions which support oxygen (O 2 ) delivery to muscle mitochondria. Although peripheral muscular factors, O 2 transport disturbances (including the effects of increased carboxyhemoglobin) and autonomic nervous system unbalance have been emphasized, other derangements have been more recently described, including early microscopic emphysema, pulmonary microvascular disease, ventilatory and gas exchange inefficiency, and left ventricular diastolic dysfunction. Using an integrative physiological approach, the present review summarizes the recent advances in knowledge on the effects of smoking on the lung-heart-muscle axis under the stress of exercise. Special attention is given to the mechanisms connecting physiological abnormalities such as early cardio-pulmonary derangements, inadequate oxygen delivery and utilization, and generalized bioenergetic disturbances at the muscular level with the negative sensations (sense of heightened muscle effort and breathlessness) that may decrease the tolerance of smokers to physical exercise. A deeper understanding of the systemic effects of smoking in subjects who did not (yet) show evidences of COPD and ischemic heart disease – two devastating smoking related diseases – might prove instrumental to fight their ever-growing burden.

rEsumoIntrodução: A discinesia escapular é definida como uma alteração da posição escapular, tanto dinâmica quanto estática, resultante de desequilíbrios da musculatura periescapular secundários à fadiga, trauma ou lesão neurológica. O SICK Scapula avalia e caracteriza as alterações escapulares estaticamente, variando de 0 a 20 pontos (0 = melhor possível). No exame, a escápula é avaliada em três aspectos: dor objetiva, dor subjetiva e mau posicionamento escapular. Objetivo: Comparar o SICK Scapula entre jogadores de handebol sintomáticos e assintomáticos. Métodos: A amostra foi composta por 57 atletas de handebol divididos em dois grupos, de acordo com a presença de dor no ombro: grupo assintomático (GA) (N = 27) e grupo sintomático (GS) (N = 30). O SICK Scapula foi avaliado entre os atletas, tanto em relação à sua pontuação final como às subescalas. O GS apresentou maior pontuação no SICK Scapula em relação ao GA (8 ± 2,3 vs 2,7 ± 1,8; p<0,001). Resultados: Nas subescalas, os GA e GS também apresentaram diferenças significantes quanto à dor subjetiva (0 vs. 1,73 ± 0,83; p < 0,001), dor objetiva (0,41 ± 0,64 vs. 2,5 ±0,86; p < 0,001) e mau posicionamento escapular (2,3 ± 1,9 vs. 3,7 ± 1,5; p = 0,002). Conclusão: Os atletas de handebol com dor relacionada ao arremesso apresentam maior pontuação com relação à dor e às alterações de posicionamento escapular, segundo avaliação pelo SICK Scapula, em comparação com os que não apresentam sintomatologia.Palavras-chave: dor de ombro, escápula, discinesias, medicina esportiva, atletas. (AG) (N = 27) and symptomatic group (SG) (N = 30). The SICK Scapula score has been reported among athletes, both in relation to the total score and its subscales. The GS had a significantly higher score than the GA (8±2.3 vs. 2.7±1.8; p<0.001). Results: In the subscales, GA and SG also showed significant differences in subjective pain (0 vs. 1.73±0.83, p<0.001), objective pain (0.41±0.64 vs. 2.5±0.86, p<0.001) and scapular malposition (2.3±1.9 vs. 3.7±1.5, p=0.002 AbstrACt Introduction: The scapular dyskinesia is defined as a change in scapular position

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