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In addition to pain, specific low back pain is frequently accompanied by restricted range of motion (ROM) during gait. To compare the behavior of kinematic and spatiotemporal gait parameters, pain, functional status, and self-efficacy, in patients with a diagnosis of herniated disk or lumbar stenosis undergoing surgery, in the pre- and postoperative periods of 1 and 6 months (PO6). Seven participants and 11 control subjects were assessed. A kinematics system comprising 10 optoelectronic cameras was used to assess gait. The Roland-Morris questionnaire, pain intensity, and self-efficacy, over three periods, were used. The ROM of the pelvis, hip, and knee of the hernia group presented an increase after surgery and the stenosis group presented a reduction of values in the hip. During the stance phase, the pelvis and hip ROM of both groups remained smaller than the control group. There was improvement in pain in individuals with hernia and stenosis (effect size = 0.6 and 0.8, respectively) in the three analyzed moments; for functional status there was improvement in the first postoperative period (ES = 0.4) compared to the preoperative in those individuals with hernia; and those with stenosis had improvement at PO6 when compared to the time before the surgery (ES = 0.2). Surgical intervention modifies the spatiotemporal parameters, the ROM of the pelvis, hip, and knee in the total gait cycle, primarily in the sagittal plane, and causes alterations, particularly in the hip joint, in these individuals during the support phase. [ABSTRACT FROM AUTHOR]

Introduction: Congenital Generalized Lipodystrophy (CGL) is a rare autosomal recessive disease caused by mutations in genes responsible for the formation and development of adipocytes. Bone abnormalities are described. However, there is a scarcity of data. Objective: To describe bone characteristics in a large CGL1 and 2 case series. Methods: Cross-sectional study that assessed bone radiological features of CGL patients of a reference hospital in Fortaleza (CE), Brazil. Patients underwent clinical and bone mineral metabolism evaluation, radiographs of the axial and appendicular skeleton and bone mineral density (BMD) assessment by DEXA (dual energy X-ray absorptiometry). Results: Nineteen patients were included, fourteen were CGL1 and 5, CGL2. Median age was 20 years (8-42) and 58% were women. Median BMI and percentage of body fat were, respectively, 21 Kg/m² (16-24), and 10.5% (7.6- 15). The median leptin concentration was 1 ng/mL (0.1-3.3). Diabetes mellitus and dyslipidemia were present in 79% and 63% of patients, respectively. Median calcium and phosphate were normal in almost all patients (95%). Median parathyroid hormone and 25-OH-vitamin D were 23 pg/mL (7-75) and 28 ng/mL (18-43). Osteolytic lesions, osteosclerosis and pseudo-osteopoikylosis, were present in 74%, 42% and 32% of patients, respectively. Lytic lesions were found predominantly in the extremities of long bones, bilaterally and symmetrically, spine was spared. Osteosclerosis was present in axial and appendicular skeleton. Pseudo-osteopoikilosis was found symmetrically in epiphyses of femur and humerus, in addition to the pelvis. BMD Z-score greater than +2.5 SD was observed in 13 patients (68.4%). BMD was higher in CGL1 compared to CGL2 in lumbar spine and total body in adults. No associations were found between high BMD and HOMA-IR (p=0.686), DM (p=0.750), osteosclerosis (p=0.127) or pseudo-osteopoikilosis (p=0.342), and, between pain and bone lesions. Fractures were found in 3 patients. Conclusion: Bone manifestations are prevalent, heterogeneous, and silent in CGL1 and CGL2. Osteolytic lesions are the most common, followed by osteosclerosis and pseudo-osteopoikilosis. Bone mass is high in most cases. There was no pain complaint related to bone lesions. Thus, systematic assessment of bone manifestations in CGL is essential. Studies are needed to better understand its pathogenesis and clinical consequences. [ABSTRACT FROM AUTHOR]

All known Pleistocene South American fossil ursids belong to Arctotherium , an extinct genus of tremarctine bears. Its occurrence encompasses many countries in Central and South America, with findings mainly from Argentina. In Brazil, the genus is recorded in eight states, highlighting Rio Grande do Sul due to its provenance from fluvial deposits. In contrast, all other Brazilian records come from caves or fossil tanks. The Arctotherium material from Rio Grande do Sul comes from the Passo do Juquiry site, located on the banks of the Quaraí River, which marks the frontier between Brazil and Uruguay. The fossils are MCN-PV 1940/A-K, a set of postcranial bones: first to sixth lumbar vertebrae, sacrum, left scapula, left humerus, right portion of the pelvic girdle, and left femur. The anatomic description of these bones confirmed their belonging to Arctotherium sp. due to their size, the form of the vertebral processes, the presence of the entepicondylar foramen of the humerus, and the morphology of the trochlea and capitulum. Body mass estimates resulted in values mostly above 400 kg. The first absolute age from Passo do Juquiry indicated 40,000 years BP. The stratigraphic framework of the outcrop conformed to a floodplain fines facies association, a succession of mudstones with carbonate nodules on top. This facies association has lithological correlations to the Brazilian Touro Passo Formation, the Uruguayan Sopas Formation, and the Argentinean Toropí/Yupoí Formation. While having similar features, the ages of the lithologically correlated facies associations do not always line up, indicating that the evolution of the Uruguay River basin throughout the Late Pleistocene followed a pattern, but not synchronously. The presence of carbonate levels suggests that the climate during the time of deposition was drier than the present one, with the carbonate-less middle layer representing a more humid period. [ABSTRACT FROM AUTHOR]

The capybara (Hydrochoerus hydrochaeris) is currently the largest known representative of the Rodentia order. It is an important herbivorous animal from the zootechnical point of view, found in different countries in South America, mainly in Brazil, where it can be found in all its States. The study of the anatomy of the lumbosacral plexus and medullary cone of the species could contribute to the development of comparative anatomy, and to adoption of future clinical and surgical procedures in the species. The present study proposed to conduct an exploration of the nerves of the lumbosacral plexus in capybara to highlight their relationship with the adjacent muscle tissues. Four adult capybaras, two males and two females, were used for dissection of the muscles innervated by the nerves that make up the lumbosacral plexus. The results allowed to verify that the lumbosacral plexus is formed by ventral roots originating in the six lumbar vertebrae and the three sacral vertebrae. The medullary cone was found between L6 and S1 in the sixth lumbar vertebra (L6) and the first sacral vertebra (S1). The identification and the recognition of these nerves in capybaras are important to improve the assessment of possible injuries caused by inadequate management, accidental mechanical shocks, or peripheral nervous system disorders. Additionally, the study included the topographic analysis of the medullary cone, essential for improving the anesthetic techniques by epidural route. The expansion of this type of research with capybaras can be useful for developing management techniques that preserve the species health and well-being. [ABSTRACT FROM AUTHOR]

The morphology and physiology of the Lontra longicaudis is not well understood, making it sometimes difficult to understand its anatomy or behavior. A descriptive anatomical study of the spinal cord of neotropical river otters is presented. It was conducted at the Wild Animal Research Laboratory at the Federal University of Santa Catarina, Brazil. Three female otters were used, two cubs and one adult, from the Instituto Ekko Brasil (IEB) — Otter Project. To analyze the spinal cord and its components, measurements of body length and epiaxial musculature and vertebral arches were registered from the cervicothoracic transition to the base of the tail. The conus medullaris reached the fourth lumbar vertebra. In one animal, it reached the fifth lumbar vertebra. At the level of the sixth lumbar vertebra, no spinal cord segments were observed. In neotropical river otters, the space between the sacrum and the first caudal (sacrococcygeal) vertebra can be used for epidural anesthesia injection. Practitioners should consider this description when considering injection sides for epidural anesthesia. [ABSTRACT FROM AUTHOR]

Scientific evidence indicates that workers in the health sector are commonly exposed to work-related musculoskeletal pain. Objectives: We aimed to identify the relationship between the presence and intensity of musculoskeletal pain in the neck and lumbar regions reported by Primary Health Care (PHC) workers with workloads and occupational risks, analyze musculoskeletal pain in the presence and absence of self-reported mental disorders based on a medical diagnosis, and identify workers' strategies to manage pain. Method: This cross-sectional study addressed 338 health professionals working in PHC outpatient services in the extreme South of Brazil. One questionnaire addressed sociodemographic questions concerning occupation, occupational risks, and mental disorders. The Nordic Musculoskeletal Questionnaire was used to assess self-reported musculoskeletal pain. The National Aeronautics and Space Administration Task Load Index (NASA-TLX) measured the workload. A descriptive and inferential analysis was performed using SPSS version 21.0. Results: Most (55.3%) participants reported neck and (64.5%) lower back pain in the previous 12 months, and 22.5% and 30.5% reported intense neck and lower back pain, respectively, in the previous 12 months. The results showed different independent associations with increased musculoskeletal pain among health workers. Dentists presented the highest prevalence of neck pain, while female workers presented the highest prevalence of lower back pain. Furthermore, the perception of ergonomic risk and virtually all self-reported mental disorders (except panic syndrome for neck pain) were associated with pain in the neck and lower back regions and a higher frustration level (mental demand). Additionally, professionals with graduate degrees, nurses, and professionals working the longest in PHC services reported seeking complementary therapies more frequently, while physicians and those with self-reported mental disorders self-medicated more frequently. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Physiotherapy Research / Revista Pesquisa em Fisioterapia is the property of Journal of Physiotherapy Research / Revista Pesquisa em Fisioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The purpose of this study was to assess the influence of sex and body mass index (BMI) on the thoracic kyphosis and lumbar lordosis of adolescents and to assess the reliability and agreement of the flexicurve method for these measurements. The study included 217 adolescents of both sexes, aged between 11 and 15 years, who were students from municipal schools in the city of São José dos Campos in São Paulo. The measurement of thoracic kyphosis and lumbar lordosis angles was performed using the flexicurve method. Descriptive analysis of the data, analysis of covariance for comparison between groups (by BMI and sex), assessment of reliability, and intrarater agreement were analyzed. There was a significant difference between the groups by BMI and sex only for lumbar lordosis. The obese group had greater lumbar angles for both sexes (female sex: 32.6° ± 7.8° [eutrophic]; 37.7° ± 7.3° [obese]; male sex: 25.3° ± 7.3° [eutrophic]; 32.2° ± 7.3° [obese]). In the comparison between the sexes, the greatest lumbar angles were found in the female sex (female sex: 32.6° ± 7.8°; male sex: 25.3° ± 7.3°) among the eutrophic. Excellent intrarater reliability was found for thoracic kyphosis (intraclass correlation coefficient, 0.86) and moderate for lumbar lordosis (intraclass correlation coefficient, 0.72). Sex and BMI were associated with lumbar lordosis in adolescents and were greater in individuals with obesity and female individuals. The flexicurve method was reliable and accurate for the assessment of thoracic kyphosis and lumbar lordosis in adolescents. [ABSTRACT FROM AUTHOR]

The study aimed to develop and validate a cut-off for daily postures to discriminate workers with low back pain. The self-reported episode of low back pain in the last year and during the previous week and the total spent time in occupational postures of 529 workers were used to screen workers who more likely would report low back pain. The receiver operating characteristics curve verified the ability of daily time in each posture in discriminating workers with low back pain in a training sample. Then, the chi-squared test and measurements of the diagnostic accuracy were performed in the testing sample. The daily time spent in a given posture was not able to accurately discriminate against workers with low back pain. Total time spent walking was the only daily posture that discriminated workers with low back pain in the last year in the testing sample, albeit with low accuracy. Practitioner Summary: The daily time spent in a given posture was not able to accurately distinguish workers with low back pain. Total spent time in walking presented modest diagnostic accuracy and should be interpreted cautiously. The spent time in a particular posture did not detect workers with LBP in the last week. [ABSTRACT FROM AUTHOR]

Summary: It is of great importance to investigate any potential detrimental effect on bone health in young adults with 21-hydroxylase enzyme deficiency undergoing glucocorticoid replacement therapy. This study demonstrated normal bone health in well-controlled patients. Additionally, glucocorticoid dose may play an important role in the mineral density of femoral neck region. Purpose: To compare regional bone mineral densities (BMDs) and bone statuses of young adults with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase enzyme (21OHase) deficiency with a control group. The duration and dose of glucocorticoid therapy and relative skeletal muscle index (an indicator of sarcopenia) were also analyzed as parameters to predict bone health. Methods: This case–control study included 23 patients (7 male and 16 female) and 20 controls (8 male and 12 female) matched by age range (18 to 31 years). Dual energy X-ray absorptiometry and phalangeal quantitative ultrasound (QUS) were used to estimate BMD and bone status, respectively. Results: No difference was observed between patients and controls (of both sexes) in absolute values of BMD and Z-scores for the total body, lumbar spine, and femoral neck; or the bone status (estimated by phalangeal QUS). Multiple linear regression analysis demonstrated that relative skeletal muscle index independently correlated with BMD of the entire body (β: 0.67, P = 0.007), the lumbar spine (β: 0.73, P = 0.005), and the femoral neck (β: 0.67, P = 0.007). However, the dose of glucocorticoids (β: − 0.38, P = 0.028) independently correlated with BMD in the femoral neck region alone. Conclusion: No signs of change in bone health were observed in patients with CAH when compared to the reference group. Additionally, a marker of sarcopenia was demonstrated to have a role in mineral density mechanisms in all analyzed bone sites. Only the femoral neck BMD seemed to be significantly dependent on glucocorticoid dose. [ABSTRACT FROM AUTHOR]

The lumbar spine is a region of great mobility and undergoes functional adaptations. Physiotherapy seeks the development and application of techniques, aimed at the health of the individual, through several tools, among them, manual therapy based on massage therapy. Thus, the aim of this study was to analyze the effects of massage therapy on the lumbar square in higher education students. It is a quasi-experimental study, composed of 15 academics, between 18 and 35 years of age, from the physiotherapy course of a university center located in Porto Alegre / RS. The study took place during ten meetings and the massage therapy interventions took place twice a week, from the second to the ninth meeting for 20 minutes. For an evaluation before and after the intervention period, an anamnesis form was applied, the international physical activity questionnaire - IPAQ (International Physical Activity Questionnaire), goniometer of lateral inclination of the lumbar spine, Schöber test and ultrasonography of the lumbar square muscle. Participants in the study were individuals with a mean age of 27.26 ± 5.04 years and 80% of the sample had a low level of physical activity. In the active goniometry there was a decrease in the values in comparison to the basal phase, however in the Schöber test an increase in the lumbar mobility was observed (p≤0.05). Muscle quality by ultrasonography showed an increase in echogenicity acutely (p = 0.01), however at the end of the intervention these results decreased and were not significant (p = 0.26). In conclusion, massage therapy has been shown to sharply improve lumbar echogenicity and mobility in the chronic phase, however, further studies are needed. [ABSTRACT FROM AUTHOR]

Introduction: the sacrum is formed by the fusion of five vertebrae. It usually has four pairs of foramina that represents the exit point of the sacral nerves. A sacrum with five pairs of foramina is an anatomical variant resulting from sacralisation of a lumbar vertebra at the base of sacrum or sacralisation of coccygeal vertebra at the apex of the sacrum. Thus, the occurrence of these anatomical variants can develop complications such as lumbar pain, early degeneration of the intervertebral disc and lumbar spine diseases. The objective of the present study was to know the incidence and types of sacralisation of the fifth lumbar vertebra and the first coccygeal vertebra, and its clinical significance. Material and Methods: in the present study, 48 adult human sacrum were examined in the Human Anatomy Laboratory of the Federal University of Ceará and the Medical School Nova Esperança, Brazil. The sacralisation of the fifth lumbar vertebra and of first sacral vertebra was described according to the Singh classification. Results: about the 48 sacrum examined, 33 (68.75%) were normal and 15 (31.25%) presented sacralisation. Those with sacralisation of fifth lumbar vertebra were 12 cases (25.0%), all cases of Type I, and 3 cases of sacralisation first coccygeal vertebra (6.25%), all of Type III. Conclusion: the high numbers of sacralization of the lumbar vertebra diverging from data found in the literature. [ABSTRACT FROM AUTHOR]

BACKGROUND: In the adult population, the work environment and physical fitness levels are directly related to the onset of musculoskeletal pain, repetitive strain injuries, and decreased blood circulation. Although low levels of muscle strength and flexibility may lead to a higher prevalence of pain, specific anatomic regions are poorly addressed. OBJECTIVE: To investigate the prevalence of musculoskeletal pain and the association between strength or flexibility and pain in university staff. METHODS: The sample was composed of 110 members of staff from a university in Guarapuava-PR. Body mass and height values were obtained, from which the BMI was calculated. The pain evaluation was performed by means of a questionnaire, analyzing the intensity, frequency, and anatomical region. The subjects were then submitted to strength (right and left hand grip, lumbar traction, lower limb traction) and flexibility tests (sit and reach test). RESULTS: The anatomical region with the highest prevalence of pain was the lumbar region (43.4%). When the association between the presence of pain and flexibility was performed, only the lumbar traction presented significant results, with the weakest group demonstrating pain (OR: 3.47 [1.27 – 9.49]). CONCLUSION: The results demonstrate that low levels of strength in the lumbar region are associated with the presence of painful symptomatology. [ABSTRACT FROM AUTHOR]

In people with chronic low back pain, what is the average effect of directing manipulation at the most painful lumbar level compared with generic manipulation of the spine? Randomised controlled trial with concealed allocation, a blinded assessor and intention-to-treat analysis. 148 people with non-specific chronic low back pain with a minimum level of pain intensity of 3 points (measured from 0 to 10 on the Pain Numerical Rating Scale). All participants received 10 spinal manipulation sessions over a 4-week period. The experimental group received treatment to the most painful segment of the lower back. The control group received treatment to the thoracic spine. The primary outcome was pain intensity, measured at the end of the intervention (Week 4). Secondary outcomes were: pain intensity at Weeks 12 and 26; pressure pain threshold at Week 4; and global perceived change since onset and disability, both measured at Weeks 4, 12 and 26. Each group was randomly allocated 74 participants. Data were collected at all time points for 71 participants (96%) in the experimental group and 72 (97%) in the control group. There were no clinically important between-group differences for pain intensity, disability or global perceived effect at any time point. The estimate of the effect of directing manipulation at the most painful lumbar level, as compared with generic manipulation, on pain intensity was too small to be considered clinically important: MD 0 (95% CI −0.9 to 0.9) at Week 4 and −0.1 (95% CI −1.0 to 0.8) at Week 26. No clinically important differences were observed between directed manipulation and generic manipulation in people with chronic low back pain. NCT02883634. [ABSTRACT FROM AUTHOR]

Lumbar pain is a musculoskeletal disorder characterized by muscle stiffness, fatigue and discomfort, which is found in the lower lumbar spine. The aim of this study is to associate levels of pelvic loin rhythm with low back pain. This study was carried out through analytical research. The article included individuals from 18 to 40 years considered active, of both sexes, students of the University Center of Guanambi UniFG. The subjects underwent a dynamic evaluation of the pelvic loin rhythm. The study was presented to the Ethics Committee at Plataforma Brasil and to the Ethics Committee of the Italian University Institute of Rosario. This research has the number of opinion 1,904,520 and reference (CAAE: 61305616.5.0000.8068) according to the Brazil Platform committee. It was observed that 18% of the patients had acute lumbar pain, 28% subacute and 54% chronic and in relation to the pelvic lobe rhythm 19.8% of the individuals had a poor pelvic loin rhythm, 24.4% had a regular rhythm, 39.5% of the individuals observed a good pelvic loin rhythm, while 16.3% presented excellent pelvic loin rhythm. It has been found that there is a significant correlation between low back pain and pelvic loin rhythm. People with low back pain presented the most negative and regular patterns of pelvic loin rhythm, while individuals without low back pain presented excellent rhythms. [ABSTRACT FROM AUTHOR]

Background/aims: Chronic non-specific low back pain is one of the most prevalent and therapeutically challenging conditions that affect older people. The aim of this study was to verify the effects of a posture-focused self-management programme in pain and disability in older people in the community living with chronic non-specific low back pain. Methods: Attendees of two community centres for older people were selected and randomised into an experimental group (n=42) and a control group (n=31). The experimental group received a posture-focused self-management programme. The control group received simple advice with a self-care leaflet. Dependent variables were: pain intensity, functional capacity related to low back pain, and frequency of medication use for low back pain. Results: For intergroup analysis, a significant difference was observed for all variables (P≤0.001) with large effect size for pain intensity and functional capacity related to low back pain (effect size=0.65) and moderate effect for frequency of medication use for low back pain (effect size=0.46). Conclusions: The results of the posture-focused self-management programme demonstrate efficacy in reducing pain and disability in older people with chronic non-specific low back pain. [ABSTRACT FROM AUTHOR]

Background/aims: Despite electrostimulation being a common adjuvant therapy for non-specific low back pain, the use of Aussie current for muscle contraction is still underreported in the literature. The present study aimed to assess the use of Aussie current in the treatment of chronic, non-specific lumbar pain. Methods: Twenty-four young women with chronic non-specific low back pain were randomly assigned to the Aussie current group or control group. Pain (visual analogue scale and McGill Pain Questionnaire), function (Oswestry Disability Index), trunk muscle resistance (the time the participant remained in a predefined static position) and multifidus muscle thickness (ultrasound images) were analysed bilaterally before, at the end of and 30 days after completing the treatment protocol. The treatment group received 12 sessions of Aussie current over a period of 4 weeks. The electrodes were arranged laterally and bilaterally to the spinous processes of the first and fifth lumbar vertebrae. Results: There was a reduction in the pain profile for the Aussie group, as measured by a visual analogue scale and the McGill Pain Questionnaire. There was an increase in trunk muscle resistance and in muscle thickness in the Aussie group when compared to the control group. There were no changes in the Oswestry Disability Index in either group. Conclusions: Aussie current resulted in significant improvements in pain, endurance and muscle thickness in women with chronic, non-specific low back pain. [ABSTRACT FROM AUTHOR]

Objective. The objective of this study was to verify possible associations between bone mineral density (BMD) and breast cancer in recently diagnosed women in the Brazilian Mid-west region, considering the menopausal status of patients. Methods. A case-control study was conducted with 142 cases of breast cancer and 234 controls matched by for age, body mass index (BMI), and menopausal status (pre- and postmenopause), performed in a university hospital in the Brazilian Mid-west. Lumbar spine (L1–L4), femoral neck, and total femur BMD were measured by the dual-energy X-ray absorptiometry (DXA) method. For association, a logistic regression analysis was used. Results. Women in the highest lumbar spine BMD quartile presented had a higher chance of developing breast cancer (OR = 2.31; 1.02–5.25; p = 0.045), after adjusting for the confounding variables. Nonetheless, there were no statistically significant differences in the association between pre- and postmenopause in that quartile and breast cancer. Conclusions. High lumbar spine BMD was positively associated with breast cancer in the total sample. In evaluating the BMD of the femoral neck and total femur, such an association was not observed. [ABSTRACT FROM AUTHOR]

Football is consider a global sports phenomenon and there is a pleasure attached to the act of cheering. Such a feeling requires the understanding of the extent that this act may restrict the individual's enlightenment capacity as well as excite the violence. The present study aims to analyze the effectiveness of measuring single twists in classics in the state. During the period of the research, a data survey was carried out, referring to the main classics of the football teams of the A1 Series of the Campeonato Paulista and the Series A of the Brazilian Football Championship in 2015, 2016 and 2017, with a focus on identifying the levels of violence before and after the promulgation of the measure, which requires the presence of only one twist, in this case, the twist of the team principal of the classic. The results show that before the promulgation of the measure, there were 13 cases of violence because of the classics of São Paulo, and after the promulgation of the measure, there was a decrease for only 3 reported cases until the end of searches. In a conclusive way, there was a decrease in cases of violence in the classics analyzed after the promulgation of this measure, however, a short time after the promulgation of the measure, which makes - in a certain way - precipitated any statement regarding the effectiveness of this measure in the main classics of the state of São Paulo. [ABSTRACT FROM AUTHOR]

This study aimed to identify the musculoskeletal symptoms reported by athletes participating in a CrossFit® competition held in Fortaleza, Ceará, Brazil, in December 2016. The sample consisted of 195 athletes, being athletes of category RX, intermediate or scaled who sought the Physiotherapy service before, during or after the tests. The data were obtained through a questionnaire developed for the scientific investigation. The statistical analysis was performed through the association between the variables through the Pearson Chi-Square test with the Monte Carlo correction factor and the results confronted with the national and international literature on the current issue in question. It was observed that the mean age of the individuals was 30.63 ± 6.97 years, with a practice time of 15.56 ± 0.95 months, being the male and the scaled category prevalent. 34.4% of the participants sought the Physiotherapy service after finishing all the competitions. The body location with the presence of painful symptoms was: quadriceps (25.8%), followed by lumbar (13.1%) and shoulder (11.9%), with 42.6% of respondents reporting fatigue, followed by joint pain (30.8%). The majority had myofascial release preference, and 25.6% did not have any type of treatment before the competitions because they did not present symptoms, and those who had follow-up most often had electrothermo-photometric therapy (39%). It is noteworthy that most of the participants reported more acute and mild symptoms, most of them being posttest fatigue. It is important to involve the physiotherapist continuously in order to prevent, treat the acute phase and decrease the levels of injuries. This study provided data on the major sites and symptoms reported by CrossFit® athletes during a competition, as well as the major categories that need better approach and attention. [ABSTRACT FROM AUTHOR]

Objectives: to assess the action of ear acupuncture on disability and tissue temperature in people with chronic pain in the spinal column. Method: a clinical trial with a sample of 110 people, randomized into three groups: Treatment, Placebo and Control. The assessment instruments were the Rolland Morris Disability Questionnaire (RMDQ) and a thermographic camera, administered before the first treatment session, one week after and 15 days after (follow-up) the fifth session of ear acupuncture. In the analysis of the data, the Kruskal Wallis, Student-Newman Keuls and Wilcoxon tests were applied. Results: there was a significant reduction in disability in the Treatment and Placebo groups between the initial and final assessments (p<0.05) and between the initial assessments and follow-up (p<0.05). In the final assessment, the Treatment group presented improvement of disability when compared with the Placebo and Control groups (p<0.05). There was an increase in mean tissue temperature of the dorsal region between the initial and follow-up assessments in Treatment and Control groups (p<0.05), and between the final assessments and follow-up in the Treatment and Placebo groups (p<0.05). Conclusion: ear acupuncture was efficacious in reducing disability and increasing tissue temperature in people with chronic pain in the spinal column. Brazilian Register of Clinical Trials (RBR-5X69X2). [ABSTRACT FROM AUTHOR]

Copyright of Fisioterapia Brasil is the property of Atlantica Editora and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

It was our objective to correlate specific performance in the Special Judo Fitness Test (SJFT) and the maximum isometric handgrip (HGSMax), scapular traction (STSMax) and lumbar traction (LTSMax) strength tests in military judo athletes. Twenty-two military athletes from the judo team of the Brazilian Navy Almirante Alexandrino Instruction Centre, with average age of 26.14 ± 3.31 years old, and average body mass of 83.23 ± 14.14 kg participated in the study. Electronic dynamometry tests for HGSMax, STSMax and LTSMax were conducted. Then, after approximately 1 hour-interval, the SJFT protocol was applied. All variables were adjusted to the body mass of the athletes. Pearson correlation coefficient for statistical analysis was used. The results showed moderate negative correlation between the SJFT index and STSMax (r= -0.550, p= 0.008), strong negative correlations between the SJFT index and HGSMax (r= - 0.706, p< 0.001), SJFT index and LTSMax (r= -0.721; p= 0.001), besides the correlation between the sum of the three maximum isometric strength tests and the SJFT index (r= -0.786, p< 0.001). This study concludes that negative correlations occur between the SJFT index and maximum isometric handgrip, shoulder and lumbar traction strength and the sum of the three maximum isometric strength tests in military judokas. [ABSTRACT FROM AUTHOR]

Background/objectives: The aim of this study was to investigate the association between dietary patterns and bone mineral density (BMD) in postmenopausal women with osteoporosis.Subjects/methods: This cross-sectional study included 156 postmenopausal and osteoporotic Brazilian women aged over 45 years. BMD of lumbar spine, total femur (TF), femoral neck and of total body (TB), as well as body composition (fat and lean mass), was assessed by dual-energy X-ray absorptiometry. Body mass index and lifestyle information were also obtained. Dietary intake was assessed by using a 3-day food diary. Dietary patterns were obtained by principal component factor analysis. Adjusted multiple linear regression analysis was applied in order to evaluate the predictive effect of dietary patterns on BMD. Significance was set at P<0.05.Results: Five patterns were retained: 'healthy', 'red meat and refined cereals', 'low-fat dairy', 'sweet foods, coffee and tea' and 'Western'. The 'sweet foods, coffee and tea' pattern was inversely associated with TF BMD (β=-0.178; 95% CI: -0.039 to -0.000) and with TB BMD (β=-0.320; 95% CI: -0.059 to -0.017) even after adjusting for energy and calcium intake, lean mass, age and postmenopausal time.Conclusions: A concomitant excessive consumption of sweet foods and caffeinated beverages appears to exert a negative effect on BMD even when the skeleton already presents some demineralization. Food and beverage intake is a modifiable factor that should not be neglected in the treatment of individuals with osteoporosis. [ABSTRACT FROM AUTHOR]

Purpose/objective(s): Pelvic insufficiency fractures and decreased bone mineral density (BMD) can occur in women treated with radiotherapy (RT) for gynecologic cancers. The purpose of this study was to compare the magnitude of BMD changes inside and outside of the radiation field in patients treated with radiation +/- chemotherapy for cervical cancer.Materials/methods: In an IRB-approved prospective study, women (N = 78) with cervical cancer were assessed with serial tomographic scans and dual-energy x-ray absorptiometry (DXA) scans to evaluate the incidence of pelvic fractures (previously reported) and post-treatment BMD changes. Patients were treated with definitive RT or chemoradiation (CRT) at a single institution between 09/2008 and 07/2015. DXA scans were obtained at baseline (before CRT), 3 months, 1 year, and 2 years after completion of therapy. Serial BMD values at L1, L2, L3 and L4 were extracted from DXA reports. Patients with a pre-treatment history of pelvic fractures, bone metastases, or pelvic RT were excluded. The current analysis focused on a subset of 78 patients whose RT fields had upper borders below L1 and above L4, permitting a comparison of BMD changes in the field (L4) with those in a vertebral body outside the field (L1). Linear mixed models (LMM) were performed to examine the impact of radiotherapy on BMD change over time, and were adjusted for covariates (age, menopausal status, BMI, number of chemotherapy cycles).Results: The median age of 78 patients was 45.5 years (range 23-88); all received RT and 76/78 (97.5%) received concurrent CRT. Treatment was associated with a significant decline in BMD in all 4 lumbar vertebral bodies over time, P < 0.05 with nadir at 3 months (L4) and 1 year (L1). By pairwise comparisons at 3 months and 2 years after treatment, BMD in L4 (inside RT field, P = 0.037) significantly improved while BMD in L1 (outside RT field) did not significantly change. After controlling for covariates noted above, there was no significant difference in BMD between 3 months and 2 years. Levels of C-terminal telopeptide of type I collagen (P = 0.018), bone alkaline phosphatase (P < 0.001), and number of chemotherapy cycles (P = 0.031) were significant predictors of L1 BMD loss. A trend of higher BMD at all time points was found for patients who were premenopausal versus postmenopausal at study entry. At 1- and 2-years of follow-up, trends towards BMD at levels higher than baseline were seen for patients who received hormone replacement therapy (HRT) after RT.Conclusion: Significant BMD loss following radiation treatment in all lumbar vertebrae (both in and out of field) was observed. On multivariate analysis, in-field vertebral bodies experienced no additional significant BMD decline earlier than those out-of-field, suggesting multifactorial contributors to bone density loss. HRT may improve BMD recovery and emphasizes the need for HRT after radiotherapy in appropriate premenopausal women.Author Disclosure: J. Wu: None. D.S. Lakomy: None. B. Fellman: None. M.P. Salcedo: IGCS-International Gynecologic Cancer Society, Brazilian Federation of Gynecology and Obstetricians (FEBRASGO)/BRAZIL (Federação Brasileira de Ginecologia e Obstetricia, FEBRASGO). A. Sood: Consultant; Kiyatec, Astra Zeneca. Stock; BioPath. sponsored research; M-Trap. A. Jhingran: American Board of Radiology. A.H. Klopp: Research Grant; MD Anderson Cancer Center SPORE Grant. R.B. Iyer: None. C. Jimenez: None. L. Colbert: None. K. Schmeler: None. P.J. Eifel: Travel Expenses; National Cancer Center Network. Stock; Apple Computer. L.L. Lin: Employee; VA Hospital. Research Grant; AstraZeneca. Travel Expenses; AstraZeneca. [ABSTRACT FROM AUTHOR]

Background: Bone mineral density (BMD) loss among depot medroxyprogesterone acetate (DMPA) users is a controversial issue. Aspects under debate include whether the number of years of use has any effect on continuous BMD loss, whether this loss will stabilise over the years of use or if it will progress to low bone mass, osteoporosis and an increased fracture risk. The aim of this study was to compare the difference in osteoporosis and low bone mass between DMPA and copper intrauterine device (Cu-IUD) users. Methods: This was a cross-sectional study that evaluated BMD at the lumbar spine and femoral neck in 47 long-term DMPA users and 41 Cu-IUD users as control group. BMD was measured by dual-energy X-ray absorptiometry. The participants were 27 to 57 years of age, had used either DMPA or a Cu-IUD uninterruptedly for at least ten years, had initiated use of the method prior to 40 years of age and had follicle stimulating hormone values <40 mIU/mL. Results: Findings showed that 68.1% and 36.6% of the DMPA and Cu-IUD users, respectively, had low bone mass and 29.8% and 2.4% of DMPA and Cu-IUD users, respectively, had osteoporosis. BMD decreased as the number of years of DMPA use increased. Conclusion: Long-term DMPA use was associated with low bone mass and osteoporosis in women who had used the method for 10 years or more. DMPA users with longer time of use showed a greater bone mass loss. [ABSTRACT FROM AUTHOR]

The authors aim to evaluate the ability of spine surgeons to subjectively identify patients with psychological distress in a subset of lumbar fusion candidates, and the influence of such factors on surgical outcomes. From a cohort of 85 patients who had received a surgical indication for lumbar fusion and were subjectively evaluated for psychological distress, 60 were included in the study and underwent objective evaluation using the Distress Risk Assessment Method (DRAM) evaluation for depressive/distress symptoms, VAS and Oswestry scores pre- and postoperatively. Fifty-six patients were available with a minimum 6-month follow-up: 20 presented with normal DRAM scores, and 36 with abnormal DRAM (28 at risk; 4 distressed somatic; 4 distressed depressive). Although the group improved significantly with surgery regarding VAS and Oswestry, it was not the case for the DRAM score. The abnormal DRAM group had inferior VAS, Oswestry and satisfaction rates in comparison with the normal DRAM group. A significant number of patients in the at-risk group reduced their DRAM scores and were classified as normal patients at the end of the study. This study emphasizes the need for objective psychological screening on chronic low back pain patients and that although patients with abnormal DRAM scores benefit from surgery, they report inferior outcomes and satisfaction in comparison with the normal DRAM group. [ABSTRACT FROM AUTHOR]

Purpose: To investigate inter- and intra-observer agreement in the assessment of lumbar vertebral rotational (VR) asymmetry by a motion palpation test. Methods: For this prospective and descriptive test-retest study, 51 asymptomatic participants (40 women, 11 men; mean age 23.3 [SD 5.6] years) were recruited from the community. Each participant was assessed in two sessions by the same three observers, who assessed VR by means of a palpatory test for movement asymmetry. This test is performed by applying posteroanterior pressure in an alternating manner to the left and right transverse processes of a vertebra to determine motion asymmetry in the transverse plane and thus the vertebral position. Observers classified the vertebral position as neutral, rotation to the right, and rotation to the left; they were blinded to which participant was being assessed and to any previous results. Results: Intra- and inter-observer agreement was verified by the kappa coefficient (κ) and the weighted kappa coefficient (κw). Values of κ and κw varied from 0.07 (95% CI, -0.10 to 0.245) to 0.37 (95% CI, 0.11-0.63) for intra-observer agreement and from 0.12 (95% CI, -0.06 to 0.29) to 0.30 (95% CI, 0.08-0.52) for inter-observer agreement. Conclusion: The motion palpation test used to assess VR asymmetry has low agreement levels; therefore, its clinical significance for measuring vertebral position is questionable. [ABSTRACT FROM AUTHOR]

Copyright of Revista Terapia Manual is the property of Revista Terapia Manual and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Terapia Manual is the property of Revista Terapia Manual and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background. Manual therapists typically advocate the need for a detailed clinical examination to decide which vertebral level should be manipulated in patients with low back pain. However, it is unclear whether spinal manipulation needs to be specific to a vertebral level. Objective. The purpose of this study was to analyze the immediate effects of a single, region-specific spinal manipulation defined during the clinical examination versus a single non-region-specific spinal manipulation (applied on an upper thoracic vertebra) in patients with chronic nonspecific low back pain for the outcome measures of pain intensity and pressure pain threshold at the time of the assessment. Design. This was a 2-arm, prospectively registered, randomized controlled trial with a blinded assessor. Setting. The study was conducted in an outpatient physical therapy clinic in Brazil. Patients. The study participants were 148 patients with chronic nonspecific low back pain (with pain duration of at least 12 weeks). Randomization. The randomization schedule was generated by an independent statistician and was concealed by using consecutively numbered, sealed, opaque envelopes. Interventions. A single high-velocity manipulation was administered to the upper thoracic region of the participants allocated to the non-region-specific manipulation group and to the painful lumbar levels of the participants allocated to the region-specific manipulation group. Measurements. Pain intensity was measured by a 0 to 10 numeric pain rating scale. Pressure pain threshold was measured using a pressure algometer. Limitations. It was not possible to blind the therapist and participants. Results. A total of 148 patients participated in the study (74 in each group). There was no loss to follow-up. Both groups improved in terms of immediate decrease of pain intensity; however, no between-group differences were observed. The between-group difference for pain intensity and pressure pain threshold were 0.50 points (95% confidence interval=-0.10 to 1.10) and -1.78 points (95% confidence interval =-6.40 to 2.82), respectively. No adverse reactions were observed. Conclusion. The immediate changes in pain intensity and pressure pain threshold after a single high-velocity manipulation do not differ by region-specific versus non-region-specific manipulation techniques in patients with chronic low back pain. [ABSTRACT FROM AUTHOR]

Background: Chronic low back pain (CLBP) is a highly disabling morbidity with high social, economic and individual effects. Demographic, occupational and behavioral changes that took place in Brazil over the last decade are related with an increasing burden of chronic conditions. Despite these changes, comparison studies on CLBP prevalence and associated factors, over time are scarce in the literature in general, and unknown in Brazil. The present study compared the CLBP prevalence in a medium sized city in Brazil between the years 2002 and 2010 and examined factors associated with prevalence in 2010. Methods: Two cross-sectional studies with similar methodology were conducted in a medium-sized city in southern Brazil, in 2002 and 2010. 3182 individuals were interviewed in the first study and 2732 in the second one, all adults aged twenty years or more. Those who reported pain for seven weeks or more in the last three months in the lumbar region where considered cases of CLBP. Results: The CLBP prevalence increased from 4.2% to 9.6% in 8 years. In most of the studied subgroups the CLBP prevalence has at least doubled and the increase was even larger among younger individuals with more years of education and higher economic status. Conclusions: Increase in CLBP prevalence is worrisome because it is a condition responsible for substantial social impact, besides being an important source of demand for health services. [ABSTRACT FROM AUTHOR]

Study design:Experimental trial based on the analytical study of radiographic standards of the sagittal spinal alignment in paraplegics in upright position under surface neuromuscular electrical stimulation (NMES).Objectives:To evaluate changes in radiographic standards of the sagittal spinal alignment of paraplegics under three different models of NMES used to optimize the global bipedal posture.Setting:The University Hospital Ambulatory (UNICAMP), Campinas, SP, Brazil.Methods:Ten paraplegic patients were selected. Each patient underwent three different models of NMES. The influence that each NMES model exerted over the sagittal balance of the spine was evaluated by lateral panoramic X-rays. Wilcoxon's test was used to compare the modifications observed in each NMES model in the group studied.Results:Using the femoral quadriceps muscles' NMES as the starting point, the inclusion of the gluteus maximus' NMES generated an increase of the lumbar lordosis and a decrease of the spinal tilt angle. These alterations resulted in partial improvement of the anterior sagittal imbalance. NMES of the paralyzed paravertebral lumbar muscles resulted in a more expressive increase on the lumbar lordosis, with no significant change on the spinal tilt. On the latter model, however, an improvement of 20% was observed in the global sagittal imbalance due to a posterior translation of the spine as pointed out by the decrease in the C7-HA horizontal distance.Conclusions:The proposed NMES models were able to partially amend the anterior sagittal imbalance of the paraplegic patients in bipedal posture. [ABSTRACT FROM AUTHOR]

Purpose: Adipocytes and osteoblasts were derived from a common progenitor, and canola oil intake may have an adipogenic and osteogenic effect. Thus, our objective was to evaluate the effect on adipocyte, lipid profile, glucose homeostasis, and bone of canola oil as main lipid source on the diet during development. Methods: After weaning, rats were divided into two groups ( n = 10 per group): control (S) and experimental (C) diets containing 7 mL/100 g soybean or canola oil, respectively. At 60 days, body composition, liver and intra-abdominal fat mass, adipocyte morphology, serum analysis, femur and lumbar vertebras density by dual-energy X-ray absorptiometry and computed tomography were determined. Differences were considered significant with P < 0.05. Results: C group showed the following: lower liver (−12%) and intra-abdominal fat mass (−19%) area of adipocyte (−60%), cholesterol (−33%), insulin (−22%), lower total body (−9%) and spine (−33%) bone mineral content and bone area (−7 and −24%, respectively), femur mass (−9%), width of the diaphysis (−6%), femur (−10%) and lumbar vertebrae bone mineral density (−9%), and radiodensity of femoral head (−8%). Conclusions: The lower intra-abdominal adiposity could have more beneficial effects in a short term, since it can be associated with a better insulin sensitivity and lipid profile, than the small reduction in femur and lumbar vertebra density. However, it has to be considered the incremental effect of this reduction along the aging process. [ABSTRACT FROM AUTHOR]

One of the most prevalent aspects is women with complaints of discomfort in the lumbar region for the use of high heeled shoe. Authors described that there may be a relation between attitude and the present discomfort, often associated with muscular fatigue and increase the forces of reaction soil during the use of such footwear. The purpose of this study was to evaluate possible changes postural associated with the use of different types of shoes and barefoot. Fifteen sedentary women were subjected to a static evaluation posture with the use of the software SAPO. Analysis of variance (ANOVA) repeated measures was used to investigate differences between the shoes in all variables postural analyzed. The results showed no significant difference in static position with the types of shoes and barefoot. It was concluded that the shoes did not interfere in static position. [ABSTRACT FROM AUTHOR]

Copyright of Cadernos de Terapia Ocupacional da UFSCar is the property of Cadernos de Terapia Ocupacional da UFSCar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The need for early identification of postural abnormalities without exposing patients to constant radiation has stimulated the development of instruments aiming to measure the spinal curvatures. Objective: To verify the validity, repeatability and reproducibility of angular measures of sagittal curvatures of the spine obtained using an adapted arcometer, by comparing them with Cobb angles of the respective curvatures obtained by using X-rays. Methods: 52 participants were submitted to two procedures designed to evaluate the thoracic and lumbar curvatures: (1) X-ray examination from which the Cobb angles (CA) of both curvatures were obtained, and (2) measuring the angles with the arcometer (AA). Two evaluators collected the data using the arcometer, with the rods placed at T1, T12, L1 and L5 spinous processes levels in a way as to permit linear measurements which, with aid of trigonometry, supplied the AA. Results: There was a very strong and significant correlation between AA and CA (r=0.94; p<0.01), with no-significant difference (p=0.32), for the thoracic curvature. There was a strong and significant correlation for the lumbar curvature (r=0.71; p<0.01) between AA and CA, with no-significant difference (p=0.30). There is a very strong correlation between intra-evaluator and inter-evaluator AA. Conclusion: It was possible to quantify reliably the thoracic and lumbar curvatures with the arcometer and it can thus be considered valid and reliable and for use in evaluating spinal curvatures in the sagittal plane. [ABSTRACT FROM AUTHOR]

Background: Most lesions of the spine of athletes, which often are detected incidentally, do not cause important symptoms or make the athletes discontinue their physical activities. To better understand the significance of these lesions, new imaging studies have been conducted with asymptomatic athletes in several sports, aiming to detect potentially deleterious and disabling abnormalities.Purpose: To compare the magnetic resonance imaging (MRI) lumbar spine findings in a group of asymptomatic adolescent rowers and in a control group of adolescents matched according to age and sex who do not practice any regular physical activity. Study Design: Cohort study (prevalence); Level of evidence, 3.Methods: Our study evaluated 44 asymptomatic adolescent boys distributed in 2 groups of 22 rowers and 22 control subjects. All the examinations were performed using a 0.35-T open-field MRI unit and evaluated by 2 experienced radiologists blinded to the study groups. Each MRI scan was analyzed for the presence of disc degeneration/desiccation, herniated or bulging disc, pars interarticularis stress reaction, and spondylolysis. The Student t test and the Fisher exact test were used for statistical analyses.Results: Nine rowers (40.9%) had at least 1 abnormality detected by MRI in the lumbar spine, whereas only 2 participants (9.1%) in the control group had at least 1 MRI abnormality (P = .03). Seven disc changes (31.8%) and 6 pars abnormalities (27.3%) were found in the group of elite rowers. In the control group, 3 disc changes (13.6%) and no pars abnormalities were found in the MR scans. The comparison between groups showed statistically significant differences in stress reaction of the pars articularis.Conclusion: Disc disease and pars interarticularis stress reaction are prevalent abnormalities of the lumbar spine of high-performance rowers. [ABSTRACT FROM AUTHOR]

A 28-week resistance training with linear periodization was compared with an undulating model in 27 premenopausal women. In both groups, bone mineral density (BMD) was not changed but muscle strength increased, and there were changes in anthropometrical and muscle damage parameters, indicating that in this population, these models are similar concerning these variables. This study seeks to compare the effects of resistance training with undulating versus linear periodization on BMD, muscle strength, anthropometrical variables, and muscle damage parameters in premenopausal women. Twenty-seven females (39.6 ± 0.41 years, mean ± standard error), without osteopenia or osteoporosis and without calcium supplementation, were randomly assigned either to a linear periodization group (LPG, n = 14) or to an undulating periodization group (UPG, n = 13). The subjects were trained three times a week for 28 weeks. Lumbar spine and femoral neck BMDs were measured through dual-energy X-ray absorptiometry. Maximal and submaximal dynamic muscle strengths were measured through the 1-RM and 20-RM tests, respectively. Anthropometrical (body mass, skinfolds, and perimeters) and muscle damage parameters were assessed through serum creatine kinase (CK) and delayed-onset muscle soreness (DOMS). BMD remained unchanged in both groups, despite significant increases in maximal (LPG, 37–73%; UPG, 40–70%) and submaximal (LPG, 82–114%; UPG, 70–102%) muscle strength. The perimeter of the distal thigh was increased (about 1.7 cm) in both groups. CK and DOMS were greater in the first mesocycle than in the subsequent ones. After the 1st training session in each mesocycle, 24 and 48 h CK was increased as compared to pretraining values. The resistance training of 28 weeks increased muscle strength in both training groups with no difference in BMD or in the occurrence of muscle damage. [ABSTRACT FROM AUTHOR]

Background: Work-related musculoskeletal disorders are responsible for important amount of declining productivity among workers. Its economic impact is considered important because, in some aspects, such as sickness absence, it can cause increase in costs for employers. This paper aimed at identifying whether the activities that the hotel maids perform during working hours may lead to the development of musculoskeletal disorders. Methods: Cross-sectional study conducted in a hotel in the city of São Paulo, Brazil. Performed an ergonomic analysis of the job application with a checklist consisting of risk assessment of low back pain. Results: The maids are responsible for the cleaning of hotel rooms, including to lean in order to clean the bathroom. The activity is associated with ergonomic risk for poor posture, manual transport of loads and use of physical force in the upper limbs. This job presents a moderate risk of low back pain according to checklist for assessing the ergonomic situation. Conclusions: Negative ergonomic aspects are associated with the development or aggravation of musculoskeletal disorders in these workers. We suggest modification in work organisation. Another possibility is decreased the weight of the carts, keeping areas of replacement material on each floor. [ABSTRACT FROM AUTHOR]

Aim : To analyze the effects of body weight loss on bone mineral density (BMD) on hip (Hip BMD) and lumbar spine (Lumbar BMD) after six months of bariatric surgery. Bariatric surgery is an effective treatment for morbid obesity. Nonetheless, there are scant data on the effect of weight bearing on bone structure. Material and methods : Seventeen obese women aged 41.2 ± 11.3 yrs. who underwent Roux-en-Y gastric bypass (RYGB) were included. Body composition assessments were performed through dual-energy X-ray absorptiometry immediately before and after 6-months RYGB. Data collected pre- and post-RYGB included total body weight, body mass index (BMI), lean body mass (LM), fat mass (FM) and bone mineral content. The pre- (PRE) and post-operative (POST) results were compared. Results : Lumbar BMD POST presented a non-significant loss of 1.8% whereas Hip BMD POST showed a significant loss of 17.8%. The analysis demonstrated that BMI and LM PRE explained 26% and 49%, respectively, of Hip BMD PRE variability. In addition, LM POST explained 30% of hip BMD POST variability and was not significant for Lumbar BMD POST. Conclusions : Obesity and rapid weight loss showed direct influence in Hip BMD after six months of bariatric surgery. However, its effect on the lumbar spine area was smaller due to the higher capacity of the spine to dissipate loads through its curvature.

Objectives: To estimate the prevalence and characterize the occurrence of low back pain (LBP), posterior pelvic girdle pain (PPGP) and pubic symphysis pain (PSP) among pregnant women resident in Rio Grande, RS., Methods: This was a cross-sectional study of all postpartum women who gave birth in 2016. Two pictures were used to investigate the presence of LBP, PPGP and PSP, both isolated and combined. Multinomial logistic regression was used to evaluate the factors associated with each symptom., Results: LBP was reported by 42.2%, PSP by 4.9%, and PPGP by 2%, while LBP + PSP was reported by 9%, LBP and PPGP by 2.8% and PPGP + PSP by 1.1%, and pain in all three regions was reported by 3.9% of the sample. The more advanced the age of the pregnant women, the risk for LBP and of LBP combined with one of the pelvic girdle regions was reduced, while the risk for PPGP + PSP was increased. Depression during pregnancy increased the risk for all symptom combinations., Conclusion: This study provided a detailed description of the occurrence of the evaluated outcomes and its associated factors. Studies like this are rare in Brazil, especially a census with low rates of losses and refusals. The high prevalence of the evaluated symptoms suggests that it should be investigated routinely in prenatal care, taking into account the age of the pregnant women, depressive symptoms and those experiencing combined or intense pain.

Objectives: This study aimed to determine whether estrogen deficiency is a sole risk factor for osteoporosis or is also associated with age, through indicators such as gender, age, and time since menopause. Methods: A cross-sectional study was conducted evaluating 938 postmenopausal women who underwent bone mineral densitometry. We collected the following data: age, ethnic group, body mass index, smoking, and time since menopause. These data were correlated to the presence of osteoporosis, according to the T -score of the femur and lumbar spine. Results: The prevalence of osteoporosis was 37.8%. Ethnic group ( p =  0.47) and smoking habits ( p =  0.19) were not associated with osteoporosis. In the group of women with osteoporosis, mean age was significantly higher ( p <  0.001), mean body mass index was significantly lower ( p <  0.001), and time since menopause was significantly higher ( p <  0.001) than in the group of women with no osteoporosis. After multivariate analysis was performed, the only variables that remained independently associated with osteoporosis were body mass index and time since menopause. Higher body mass index was a protective factor (odds ratio = 0.80 [95% confidence interval 0.76; 0.84], p <  0.001). Time since menopause represented a risk factor for osteoporosis (odds ratio = 1.04 [1.02; 1.06], p <  0.001). When divided into categories, the risk increased after 20 years of menopause and gradually every 5 years. Conclusion: Time since menopause and body mass index were the most important factors associated with osteoporosis, confirming that estrogen deficiency, and not age, is the major cause of the disease.

Objective: Identify the prevalence of low back disorders and associated risks, as well as the characteristics and ergonomic factors present in the work of nursing professionals. Methods: Systematic review based on the search of terms such as low back pain, professionals, hospital ergonomics, work organization, nursing found in national and international databases. Results: The prevalence of low back pain symptoms was between 14.7% and 72% and the main cause, that is, the transference of the patient from bed to chair, leaded to the profession abandonment as a main consequence. Conclusion: it was possible to conclude that the prevalence of low back injury is high among nursing professionals and its causes are related to occupational factors - physical or psychological, which are in many cases permanent and disabling. [ABSTRACT FROM AUTHOR]

Study Design: Retrospective cohort., Objectives: The aim of this study was to evaluate the correlation between the level and completeness of the injury with Functional Independence Measure (FIM) score and the validity and responsiveness of the FIM in Brazilian individuals with spinal cord injury admitted to rehabilitation., Setting: SARAH Network of Rehabilitation Hospitals, Brasília, Brazil., Methods: A total of 218 patients with spinal cord injury admitted for rehabilitation in 2006 was included in this study. The validity was assessed as the ability of the FIM to discriminate different levels of disability (cervical, thoracic and lumbar) at admission and the responsiveness was obtained by analyzing admission and discharge data for each of the three injury groups., Results: Total FIM score, motor FIM score and each of the 13 items were valid when comparing three groups and comparing groups two by two, except the items 'eating' and 'grooming' among paraplegics, and 'stairs' at cervical and thoracic levels. The scale was not responsive to the five cognitive items, 'stairs' and 'eating', among paraplegics, or 'grooming', 'bathing' and 'dressing upper body' in lumbar level patients. The patient difficulty in performing tasks can vary among populations. Therefore, the continuous evaluation process of psychometric characteristics is important to validate the use of the instrument in different contexts.

Introduction: Acupuncture has been progressively included in the practice of mainstream medicine in recent decades. The State of Sao Paulo Cancer Institute is a public hospital established in 2008 and its acupuncture service follows the experience and model of several oncology centres in the USA, aiming to optimise the treatment of symptoms such as postoperative pain, oncological pain, neuropathic pain, nausea, vomiting, xerostomia and fatigue induced by chemotherapy. This paper describes the population given acupuncture treatment and the effects of the intervention on symptom management., Methods: One hundred and eighty-three patients from our service were enrolled in the study. Baseline and final symptom intensity was recorded using a visual analogue score (VAS) ranging from 0 to 10 cm, with a higher score meaning higher symptom intensity., Results: Fifty-four (29.50%) were receiving active treatment with chemotherapy and/or radiotherapy, 29 (15.85%) were receiving hormone therapy and 100 (54.65%) were considered to be in remission. The main symptoms were: oncological pain in 44 (24.04%), chemotoxicity in 34 (18.6%), lumbar pain in 53 (28.96%) and chronic postoperative pain in 54 (28.4%). The mean (SD) initial symptom score was 7.04 (1.8), which was reduced to 2.56 (2.75) after treatment (p<0.001), an improvement of 63.6% in control of the symptoms. Further analysis of the data showed that the effect was similar in different indications for acupuncture treatment., Conclusions: Use of acupuncture may have improved symptom control in patients enrolled in this study.

Posture assessment during childhood and adolescence allows early detection of postural disorders and adoption of preventive measures. This study evaluated the occurrence of lumbar hyperlordosis and associated factors in 467 children and adolescents aged 10 to 16 years at a school in Porto Alegre, Rio Grande do Sul State, Brazil. Lumbar hyperlordosis was defined as increased lumbar curvature evaluated by photography. Prevalence of lumbar hyperlordosis was 78%. Factors positively associated with lumbar hyperlordosis were female gender (PR = 1.08; 95%CI: 1.03; 1.13), abdominal strength below the 20th percentile (PR = 1.10; 95%CI: 1.05; 1.15), and flexibility below the 20th percentile (PR = 1.07; 95%CI: 1.01; 1.12). Lumbar hyperlordois was negatively associated with lumbar mobility (PR = 0.90; 95%CI: 0.85; 0.96) and height (PR = 0.995; 95%CI: 0.99; 0.999). Effective strategies to improve physical fitness in schoolchildren are necessary, because low abdominal strength and low flexibility were associated with lumbar hyperlordosis.

The current study investigated the association between vitamin-D-receptor (VDR) genotypes with bone-mineral density (BMD) and its interaction with physical activity level (PAL). Individuals in a sample of 192 volunteers (67.84 +/- 5.23 years) underwent BMD evaluation and were genotyped for VDR ApaI, BsmI, FokI, and TaqI polymorphisms. Haplotypes were reconstructed through expectation-maximization algorithm, and regression-based haplotype-specific association tests were performed with studied phenotypes. None of the polymorphisms were associated with BMD at any site; however, haplotype was associated with femoral-neck and Ward's-triangle BMD. Interaction between PAL and VDR genotypes was significant for the FokI polymorphism at femoral-neck and Ward's-triangle BMD. The FokI T/T genotype was associated with higher BMD in active women. It was concluded that VDR haplotypes, but not genotypes, are associated with femoral-neck and Ward's-triangle BMD in postmenopausal women. Moreover, the results suggest that VDR FokI polymorphism might be a potential determinant of BMD response to physical activity.

In this prospective, cross-sectional study male adolescent tennis players (44) and nonathletic controls (32) were evaluated to determine the effects of physical activity, dietary nutrient intakes, sexual maturation, and body composition on bone-mineral density (BMD). Dietary nutrient intakes and physical activity expenditure were estimated by 4-d diaries. Total body composition, bone-mineral content (BMC), and BMD (L1-L4, femur, and nondominant forearm) were assessed by dual-energy X-ray absorptiometry. Tennis players had significantly greater lean body mass (mean [SEM] 50.6 [1.6] kg vs. 45.1 [1.7] kg, p = .022), trochanter BMD (1.0 [0.02] g/cm2 vs. 0.9 [0.03] g/cm2, p = .032), and dominant forearm BMC (173.7 [7.4] g vs. 146.5 [9.3] g) but lower BMD in the nondominant forearm (0.7 [0.02] g/cm2 vs. 0.8 [0.03] g/cm2, p = .028). Daily average calcium intake was below the recommendation in both groups. No correlation was found between BMD and calcium intake and exercise. Lean body mass was the best predictor of BMD and BMC for both tennis players and controls (R2 = .825, .628, and .693 for L1-L4, total femur, and nondominant forearm, respectively). Based on these results the authors conclude that lean body mass is the best predictor of BMD and BMC for both tennis players and others. Tennis exerts a site-specific effect, and training should focus on ways minimize this effect. Although calcium intake showed no effect on BMD, nutrition education for young athletes should focus on promoting a balanced diet, providing energy and nutrients in adequate amounts.