Background Traumatic upper plexus injury affects daily living activities performance and participation of individuals. Physical therapy treatment has a fundamental role on functional recovery, but it is still an unexplored and challenging field. Aim To develop a protocol to evaluate the efficacy of Proprioceptive Neuromuscular Facilitation (PNF) compared to conventional physiotherapy (CPT group) on functionality and quality of life. Methods A committee was formed by four physical therapists to develop the treatment protocol. A Delphi study was carried out in order to quantify the level of agreement. A protocol for a randomized controlled trial was proposed to evaluate the effectiveness of the protocol in improving functionality and quality of life, according Consolidated Standards of Reporting Trials. Participants will be randomly assigned (1:1) to PNF or CPT group and two weekly sessions will be carried out for 12 months postsurgery, with a three‐month follow‐up. The main outcome measurements are: upper limb functionality, quality of life, range of motion, muscle strength, tactile sensitivity, and pain, which will be assessed at baseline, on the 6th, 9th, and 12th months postsurgery. Result A PNF protocol was developed for traumatic upper brachial plexus injury, consisting of 11 illustrated exercises, three for immediate postoperative and eight for postoperative. Biomechanical objectives, observations, positions of patients and therapists and PNF principles, procedures and techniques have been described. An 80% agreement on all items in the first round of the Delphi study was achieved. Conclusion A protocol based on the PNF‐concept was developed with the aim of improving the functionality and quality of life of individuals undergoing nerve transfer after traumatic injury to the upper plexus. The detailed description of a physical therapy treatment protocol through an appropriate method will allow its use in clinical practice and in future studies with this population.

Objective To assess the effect of pelvic patterns of proprioceptive neuromuscular facilitation (PNF‐concept) on pelvic floor muscles (PFM) recruitment, as well as the electromyographic activity of muscles synergic to the pelvic floor in healthy women. Methods Observational study conducted with 31 women aged between 18 and 35 years, with mean age of 23.3 ± 3.2 (22.1–24.4). PFM activity was monitored by surface electromyography during the combination of isotonics technique of four pelvic patterns of PNF‐concept (i.e., anterior elevation, posterior depression, anterior depression, and posterior elevation). The electromyographic signal was analyzed using root mean square amplitude. Two‐way repeated measures analysis of variance was performed to analyze differences in PFM activity between types of contraction (i.e., concentric, isometric, and eccentric) and the four pelvic patterns. Results PFM activity did not differ among the four pelvic pattens. However, PFM activity was significantly different between the combination of isotonics technique and baseline, F(1.6, 48.2) = 71.5; p < 0.000, with a large effect size (partial ƞ² = 0.705). Concentric (22.4 µV ± 1.1), isometric (17.3 µV ± 0.6), and eccentric (15 µV ± 0.5) contractions of combination of isotonics technique increased PFM activity compared with baseline (10.8 µV ± 0.4) in all pelvic patterns. By analyzing the electromyographic activity of the muscles synergistic to the pelvic floor, there is effect of the interaction of the type of contraction, the pelvic pattern of the PNF concept, and the synergistic muscles on the myoelectric activity of the external anal sphincter, F(3.2, 96.5) = 5.6; p < 0.000, with a large magnitude of effect (partial ƞ² = 0.15). In the anterior elevation pattern, the muscles synergistic to the pelvic floor present synergy in phase with the PFM, and in the posterior patterns there was a decrease in the activity level of all synergistic muscles, without changing the activity level of the PFM. Conclusion PFM activity did not differ among the four pelvic patterns of PNF‐concept. Nonetheless, the combination of isotonics technique showed a significant effect on PFM compared with baseline, with greater PFM activity during concentric contraction. Pelvic patterns of PNF‐concept may be used to increase PFM recruitment in young healthy women.

Objective: Identification of changes in functionality of women with migraine according to the International Classification of Functioning, Disability, and Health (ICF). Method: This is a qualitative study conducted in the format of focus group interviews, which included women between 18 and 55 years old diagnosed with migraine based on the criteria of the International Headache Society. The women were divided into groups with averages of two to four people and, guided by a moderator, they were encouraged to talk about the influence of migraine on performing the tasks to which they are exposed daily, taking into account the environment in which they are inserted. The categories that reached the 30% agreement cutoff point in the groups were approved. Results: There were 10 rounds of interviews, each with a focus group with an average of two to four people, totaling 29 women with a mean age of 35 years old (95% CI: 18 - 51). Eighteen categories were approved, four in the Body Function domain, four in the Body Structure domain, six categories in the Activity and Participation domain and four categories in the Environmental Factors domain. Conclusion: Women with migraine perceive lteration in functionality in all ICF domains, with the Activities and Participation domain presenting the most mentioned categories.

Objective: To identify which categories of the International Classification of Functioning, Disability, and Health (ICF) are compromised in patients with migraine from the perspective of health professionals. Methods: This is a cross-sectional study conducted at the headache outpatient clinic of the Clinical Hospital of Pernambuco, Oswaldo Cruz University Hospital and at the Motor Learning and Control Laboratory of the Federal University of Pernambuco. A five-section printed and online questionnaire based on ICF checkList 2.1 was used. Health professionals from different specialities who had experience in treating patients with migraine were invited. Professionals were instructed to complete the questionnaire and to choose, based on their clinical experience, which categories had the highest degree of impairment or the highest relationship with the clinical condition of migraine patients. A cut-off point of 70% for approval of categories was considered. Results: Sixteen professionals were enrolled in the survey. The questionnaire was compost by 106 categories, of which 32 reached the cutoff point of 70% to be considered approved. Among these categories, seven (21.8%) are part of the body functions component, five (15.6%) body structures, thirteen (40.6%) activities, and participation and seven (21.8%). of environmental factors. Conclusion: In the perception of health professionals, individuals with migraine present impairment in all domains of the ICF and the activity and participation domains presented the highest number of compromised categories.

Objective: To evaluate the electromyographic response of the transversus abdominis/internal oblique muscles (TrA/IO) during the execution of the four pelvic patterns of proprioceptive neuromuscular facilitation (PNF). Methods: Cross-sectional study. Were evaluated 21 women aged 18-38 years. The right TrA/IO complex, ipsilateral to the execution of a PNF combination of isotonics technique was monitored by surface electromyography. Three repetitions were performed with two-minute intervals between them in the four PNF pelvic patterns: anterior elevation, posterior depression, anterior depression, and posterior elevation. For the analysis of the electromyographic signal, a period of 500ms adjusted to the central value was extracted and the Root Mean Square amplitude was analyzed. Descriptive statistics and ANOVA test was used with a 95% confidence interval. Results: There was a higher TrA/IO activity in the concentric phase in the anterior elevation pattern (36.2 ± 32.3%) when compared to previous depression (19.5 μV ± 12.9), posterior elevation (16.1 μV ± 8.7), posterior depression 14.6μV ± 5.9). In addition, in the antero-elevation there is greater activation of the TrA/IO muscle complex when compared to the other patterns (p <0.01). Conclusion: The higher EMG response of the TrA/IO found in the anterior elevation pattern reveals its usefulness for clinical use.