Objective: To explore the relationship between ankle dorsiflexion range of motion (ROM) and hip and knee muscle strength between patients with a history of patellar dislocation (PD) to healthy controls. Design: Case-control study. Setting: Orthopaedical specialty outpatient clinic at a tertiary hospital. Participants: 88 individuals were recruited; 44 individuals aged 16 years or older, of both sexes, with a history of at least one episode of atraumatic unilateral or bilateral PD requiring emergency care (14 males; 30 females; mean age 20 years) and 44 healthy (control) individuals (11 males; 33 females; mean age 21 years) matched for age, weight and height to PD cases. Intervention: Assessment of hip and knee strength and ankle dorsiflexion ROM. Outcome measures: Ankle dorsiflexion ROM was assessed through the lunge test with a goniometer. Hip and knee muscle strength was evaluated through isometric hand-held dynamometry. Differences between healthy and control individuals were assessed using Student T-Tests and Mann-Whitney U Test. Results: PD individuals presented with a reduced ankle dorsiflexion ROM (mean difference (MD): 9°; effect size (ES): 1.39; p<0.001) and generalised hip and knee weakness (MD range: 4.74 kgf to 31.4 kgf; ES range: 0.52 to 2.35; p<0.05) compared to healthy subjects. Conclusion: Individuals with a history of PD have reduced ankle dorsiflexion ROM and hip and knee muscle strength compared to healthy controls.
BACKGROUND: The Norwich Patellar Instability (NPI) score is a tool for evaluating the impact of patellofemoral instability on joint function. It has not been translated or culturally adapted for the Brazilian population before. OBJECTIVE: This study had the aims of translating and culturally adapting the NPI score for use in Brazilian Portuguese and subsequently assessing its validity for this population. DESIGN AND SETTING: Translation, cross-cultural adaptation and validation study conducted at the State Public Servants' Institute of São Paulo, Brazil. METHODS: Sixty patients of both sexes (aged 16-40 years) with diagnoses of patellar dislocation were recruited. The translation and cultural adaptation were undertaken through translation into Brazilian Portuguese and back-translation to English by an independent translator. Face validity was assessed by a committee of experts and by 20 patients. Concurrent validity was assessed through comparing the Brazilian Portuguese NPI score with the Brazilian Portuguese versions of the Lysholm knee score and the Kujala patellofemoral disorder score among the other 40 patients. Correlation analysis between the three scores was performed using Pearson correlation coefficients with significance levels of P < 0.05. RESULTS: The Brazilian Portuguese version of the NPI score showed moderate correlation with the Brazilian Portuguese versions of the Lysholm score (r = -0.56; 95% confidence interval, CI: -0.74 to -0.30; P < 0.01) and Kujala score (r = -0.57; 95% CI: -0.75 to -0.31; P < 0.01). CONCLUSION: The Brazilian Portuguese version of the NPI score is a validated tool for assessing patient-reported patellar instability for the Brazilian population.
OBJECTIVE: To evaluate the influence of the body mass index (BMI) on the functional assessment of patients who underwent revision total knee arthroplasty (RTKA). METHODS: Thirty patients who un-derwent RTKA between January 2008 and January 2012 were retrospectively assessed using the WOMAC questionnaire. The patients were divided into three groups according to the BMI ca-tegories defined by the World Health Organization (WHO): Group I with normal BMI (18-24.9 Kg/m2), with eight patients; Group II, overweight (BMI 25-29.9 Kg/m2), with 15 patients, and Group III obesity with BMI ≥ 30 Kg/m2, with seven patients. The post-ope-rative function scores obtained through the WOMAC questionnaire were compared with the BMI of each group. The statistical analysis between BMI and WOMAC scores was performed with the Spe-arman correlation test. RESULTS: The average functional WOMAC score for individuals in Group I was 16.7; in Group II it was 47.7; and in Group III it was 69.9, with a statistically significant differen-ce between groups I, II and III (p< 0.0001). CONCLUSION: Patients with BMI > 25 Kg/m2 had a worse functional evaluation through WOMAC scores when compared to patients with normal BMI after RTKA. Level of Evidence III, Tranversal Retrospective Study.
Introduction: Patellofemoral Pain Syndrome is characterized by retro-patellar and peripatellar pain during squatting, kneeling and running whose intensity can be related to Body Mass Index (BMI). Objective: To evaluate the relationship between overweight, pain and function in women with Patellofemoral Pain Syndrome (PFPS). Method: Cross-sectional observational study of fifty-four women with PFPS assessed in the period between January and December 2015, in the physiotherapy outpatient clinic of a tertiary hospital in the city of São Paulo. To verify the variables of pain at rest, at effort and function, the Numerical Pain Rating Scale (NPRS) and the Kujala Anterior Knee Pain Scale (AKPS) were used. The participants were divided into two groups, according to the BMI categories defined by the World Health Organization (WHO): Group 1, composed of women with normal BMI (18-24.9 kg/m²), with 36 patients, and group 2 composed of overweight women (25-29.9 k/m²), with 18 patients. Comparison between groups of pain at rest and effort and AKPS were performed using Student's t-test and Mann-Witney with statistical significance p < 0,05. Results: There was no statistically significant difference between groups for the pain at rest and effort and for AKPS. Conclusion: BMI does not impact pain intensity and function in women with PFPS.
Background: The Activity Scale for Kids (ASK) assesses the physical disability of children (5 to 15 years old) with neurological, orthopaedic or rheumatic diseases. The objective of this study was to translate and cross-culturally adapt the ASK for Brazilian Portuguese and assess the validity and reliability of the instrument.Methods: A total of 67 children and adolescents with musculoskeletal, neurological or rheumatic diseases participated in the study. We evaluated the comprehension of the pre-final version of the questionnaire in 24 participants and reliability and validity in the other 43 participants. The translation and adaptation of ASK to Brazilian Portuguese followed guidelines from previous studies. The validity of the Brazilian Portuguese version of the ASK was verified through Spearman's correlation with the Pediatric Quality of Life Inventory™ Version 4.0 (PedQL). Intraclass correlation coefficient verified inter-and intra-evaluator reliability, while internal consistency was assessed using Cronbach's alpha. Scores were used to assess the standard error of the mean and minimal detectable change.
Results:The Brazilian Portuguese version of the ASK presented excellent reliability, internal consistency, agreement and moderate correlation with PedsQL (0.522, P < 0.001) between ASK performance and PedsQL; 0.537, P < 0.001 between ASK capacity and PedsQL.
Conclusion:The Brazilian Portuguese version of the ASK has good validity and reliability and may be used by professionals and researchers to assess the functioning of children and adolescents with disabilities. K E Y W O R D S adolescent, patient reported outcome measures, paediatrics, questionnaire 1 | INTRODUCTION Disability is a broad term that includes activity limitations and restrictions of a person and refers to the interaction between the health condition, the environment and personal aspects. The global estimate of children and adolescents with disabilities is approximately 150 million (World Health Organization & World Bank, 2011), with Brazil having approximately 12.4 million people; 4.4% are children and adolescents (from 0 to 17 years old), and 1.0% present physical disabilities (Malta et al., 2016). Physical Disabilities in children and adolescents occur mainly due to non-transmissible chronic diseases, such as rheumatic, neurological
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