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BACKGROUND: Pressure pain threshold (PPT) is decreased in several musculoskeletal disorders, giving indirect evidence regarding pain status. Despite the fact that PPT has been already proven to be reliable in patients with acute conditions, there is great variability of methods and results observed within studies, and only a few evidences confirming its reliability in chronic conditions. OBJECTIVE: The objective of this study was to determine the test-retest reliability of PPT in the neck and low back regions to discriminate individuals with neck or low back pain from healthy individuals. Additionally, one secondary aim was to establish the minimum detectable change (MDC) and the standard error of measurement for future clinical studies and interventions. METHODS: In this reliability study, 74 individuals (15 individuals from the neck pain and 17 from the neck control group; 21 individuals from the low back pain and 21 from the low back control group). PPT was measured in the neck region (suboccipital, trapezius and supraspinal muscles) and in the lower back region (paraspinal muscles in the levels of L1, L3 and L5). Intrarater reliability was assessed using intraclass correlation coeficient and Bland-Altman. RESULTS: Excellent intra-rater reliability was observed for both (ICC of 0.874 for the neck pain versus ICC of 0.895 in neck control group; ICC of 0.932 for the low back pain group versus ICC of 0.839 for the control group). A small bias was observed for all groups (-0.08 for the neck pain group versus 0.10 in the control group; and 0.32 in low back pain group versus 0.44 in the control group). Minimum detectable change of 0.63 kgf of neck pain and 1.21 kgf of low back pain was calculated. It was found difference in PPT between pain and control groups (p< 0.05). CONCLUSION: It may be suggested that the protocol with PPT is reliable and able to discriminate individuals with and without neck and low back pain with a minor measurement error. Therefore, this method may be used to detect possible progress after interventions in patients with neck or low back pain.

Relation of plantar pressure and range of movement of the lower limbs with the risk of falls in older women Relação da pressão plantar e amplitude de movimento de membros inferiores com o risco de quedas em idosasRelación entre la presión plantar y la amplitud de los movimientos de los miembros inferiores y el riesgo de caídas en adultos mayores

ResumoA necessidade de uma ampliação da base teórico-empírica do conceito de estabilização central, por ser uma realidade no arsenal terapêutico, principalmente no âmbito da Terapia Manual e Fisioterapia Desportiva, torna urgente a elaboração de um artigo que traga os métodos de treinamento da estabilização central. Como a lombalgia afeta ou afetará 80% das pessoas de todo o mundo, este método terapêutico mostrou-se eficaz em vários estudos. Para este artigo de revisão, foram utilizados artigos de 1987 a 2008, pesquisados em vários bancos de dados (Scielo, Bireme, Cochrane), além do acervo pessoal. Observou-se que apesar deste assunto estar em ascensão dentro da Fisioterapia, faltam estudos de base aleatória com variáveis controladas, para que mais exercícios usados empiricamente sejam finalmente aceitos cientificamente. Portanto, a estabilização central é um excelente método terapêutico usado em várias situações clínicas, desde o início de um tratamento até a finalização do mesmo. Porém, sugere-se a realização de outros estudos a respeito da estabilização central buscando compreender o comportamento deste tipo de treinamento. Palavras-chave: Estabilização central. Terapia manual. Fisioterapia. AbstractWith the need for the theoretical-empirical basis expansion of the core stability concept, already in progress in the therapeutic repertoire, mainly within the scope of Manual Therapy and Sports Physiotherapy, the demand of work that could bring, the methods of training for core stability was observed. As the low back pain affects or will affect 80% of people all over the world, this therapeutic method has shown effective results in several studies. In this article, several studies were collected from different databases (Scielo, Bireme, Cochrane) as well as from our personal archive, in the period from 1987 to 2008. Despite the increase of this subject in Physiotherapy, there is a lack of randomized studies with controlled variables, which could enable exercises that are used empirically to be finally accepted scientifically. Therefore, core stability is an excellent therapeutic method used in several clinical situations, from beginning to the end of a treatment. However, more studies about the core stability training method are suggested.

Treatment with condroitin/glucosamin contributes to a lower decline in physical component while it had no influence on mental component of health-related quality of life in older adults with ostheoartritis.

Background: Low intensity laser therapy has been used to accelerate the ulcers healing due to its healing, anti-inflammatory, analgesic and anti-edematous effects. Contaminations by bacteria or fungi on these ulcers commonly happen, constituting a major complication of healing, but there is no consensus about laser therapy bactericidal or fungicidal effect. Aim: To analyze the effects of different times of appliantion using the 808nm and 660nm lasers on cultures of different bacterial species and fungi in vitro. Method: Photon Lase III -DMC was used, with the wavelengths of 660 and 808nm and 30mW, 60mW and 100mW of power, with different exposure time to laser irradiation. Fifteen Petri plates were prepared, 12 plates containing Gram-positive (3 Staphylococcus aureus plates, 3 nterococcus plates) and gram negative bacterias (3 Escherichia coli, 3 Klebsiella pneumonia plates) and 3 Petri plates with the fungi Candida albicans. Plates were randomly divided into 3 groups with 5 plates each group. Plates of Group 1 were irradiated with 660 nm laser at nine different points (A, A 1 , A 2 /B, B 1 , B 2 /C, C 1 , C 2 ), and points A/B/C reciebed only one application, points A 1 ,B 1 ,C 1 received 2 applications and points A 2 ,B 2 ,C 2 received 3 applications. Plates from group 2 where irradiated with 660nm also in nine diferente points, following the same criterea of group 1, while plate of group 3 where used as control, without irradiation. Groups 1 and 2 were irradiated with 144 J/cm² dose at point A (irradiation time of 2 minutes and 15 seconds), point B (irradiation time of 1 minute 7 seconds) and at point C (40 seconds). After the irradiations the plates were incubated for 24 hours. The cultures were visually examined to check the presence or not of the inhibition zone. In all the groups, no zone of inhibition nor growth were observed. Conclusion: Low intensity laser therapy (808nm and 660nm) did not produce bactericidal and/or bacteriostatic effects, and even no bio-stimulant effect on the bacteria.

Introduction: Population aging brings physical changes of its own age. Along with these changes occur in most cases, the

Com o envelhecimento ocorrem complicações que afetam a funcionalidade e a independência dos indivíduos, muitas vezes sendo necessário o acompanhamento contínuo por profissionais da saúde, entre eles o fisioterapeuta. Diante disso, objetivou-se verificar a sobrevida, a funcionalidade e a ocorrência de comorbidades em indivíduos idosos acompanhados pelo serviço de Fisioterapia domiciliar. Um estudo com delineamento transversal foi realizado com 121participantes de um Serviço de Atenção Domiciliar, utilizando a Karnofsky Performance Scale para verificar a funcionalidade, e o Índice de Comorbidades de Charlson para avaliar as multimorbidades. Constatou-se que aproximadamente metade dos participantes apresentou cronicidade funcional, com condição potencialmente incapacitante, com piora dos índices de funcionalidade em indivíduos que sofreram alguma intercorrência. Os resultados demonstraram também que o acesso à Fisioterapia aumentou a taxa de sobrevida dos idosos e que o acompanhamento fisioterapêutico mais frequente possibilitou que a funcionalidade se mantivesse.