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RationalePulmonary rehabilitation is an effective treatment for people with chronic respiratory disease but is delivered to MethodsA multicentre randomised controlled trial with assessor blinding, powered for equivalence was undertaken. Individuals with a chronic respiratory disease referred to pulmonary rehabilitation at four participating sites (one rural) were eligible and randomised using concealed allocation to pulmonary rehabilitation or telerehabilitation. Both programmes were two times per week for 8 weeks. The primary outcome was change in Chronic Respiratory Disease Questionnaire Dyspnoea (CRQ-D) domain at end-rehabilitation, with a prespecified equivalence margin of 2.5 points. Follow-up was at 12 months. Secondary outcomes included exercise capacity, health-related quality of life, symptoms, self-efficacy and psychological well-being.Results142 participants were randomised to pulmonary rehabilitation or telerehabilitation with 96% and 97% included in the intention-to-treat analysis, respectively. There were no significant differences between groups for any outcome at either time point. Both groups achieved meaningful improvement in dyspnoea and exercise capacity at end-rehabilitation. However, we were unable to confirm equivalence of telerehabilitation for the primary outcome ΔCRQ-D at end-rehabilitation (mean difference (MD) (95% CI) −1 point (−3 to 1)), and inferiority of telerehabilitation could not be excluded at either time point (12-month follow-up: MD −1 point (95% CI −4 to 1)). At end-rehabilitation, telerehabilitation demonstrated equivalence for 6-minute walk distance (MD −6 m, 95% CI −26 to 15) with possibly superiority of telerehabilitation at 12 months (MD 14 m, 95% CI −10 to 38).Conclusiontelerehabilitation may not be equivalent to centre-based pulmonary rehabilitation for all outcomes, but is safe and achieves clinically meaningful benefits. When centre-based pulmonary rehabilitation is not available, telerehabilitation may provide an alternative programme model.Trial registration numberACtelerehabilitationN12616000360415.

Little is known regarding community participation in individuals with chronic obstructive pulmonary disease (COPD). The aim of this study was to explore community participation in individuals with COPD and to determine whether there is an association between community participation and activity-related outcome variables commonly collected during pulmonary rehabilitation assessment. We also sought to investigate which of these variables might influence community participation in people with COPD. Ninety-nine individuals with COPD were enrolled (67 ± 9 years, FEV1: 55 ± 22% predicted). We assessed community participation (Community Participation Indicator (CPI) and European Social Survey (ESS) for formal and informal community participation), daily physical activity levels (activity monitor), exercise capacity (6-minute walk test), breathlessness (Modified Medical Research Council, MMRC scale), self-efficacy (Pulmonary Rehabilitation Adapted Index of Self-Efficacy) and anxiety and depression (Hospital Anxiety and Depression Scale). Higher levels of community participation on the CPI were associated with older age and greater levels of physical activity (total, light and moderate-to-vigorous) (all rs = 0.30, p

BACKGROUND: Social media is established as a communication channel that is useful to disseminate scientific information. While social media can disseminate high quality information, it can also facilitate the spread of false or misleading information. Furthermore, social media is considered a self-promotion environment that can have several aspects related to personal marketing. OBJECTIVE: To systematically search and review social media posts verifying whether the posts about physical therapy interventions reported sources of information; the presence of aspects suggesting conflicts of interest (COI); whether information was presented to facilitate knowledge acquisition; the reach of information posted; and the use and quality of the cited scientific references. METHODS: Searches were performed on Instagram and Twitter using #reabilitação for Portuguese posts, and #rehabilitation for English posts. The inclusion criteria were posts including terms related to physical therapy and presenting interventions along with their purposes. The searches and screening processes were performed by at least two independent researchers. RESULTS: Of 1,145 pre-selected posts, 632 posts were included, of which 14% cited references as source of information, 57% presented potential COI, and 9% facilitated knowledge acquisition. The posts received the mean ± SD of 88 ± 593 likes and profiles had a mean of 5,162 ± 37,240 followers. Considering the posts that cited references, most posts presented consistent information (51%) and 6% presented only positives outcomes (selection bias). Many references were of poor methodological quality (39%). CONCLUSION: The present study enlightens the fact that most posts on Instagram and Twitter regarding physical therapy interventions did not report or use sources to support the information disseminated. Also, most posts were not created to facilitate knowledge acquisition. REGISTRATION NUMBER: PROSPERO register database (CRD42021276941).

Acute exacerbations are associated with disease progression, hospital admission and death in people with chronic obstructive pulmonary disease (COPD). The detrimental outcomes associated with acute exacerbations highlights a need to understand the time course of recovery following acute exacerbation of COPD (AECOPD) so that effective and timely interventions can be provided. The aim of this narrative review was to describe the natural recovery in physiology, symptoms and function following AECOPD. Substantial recovery of lung function and airway inflammation occurs in the first week after onset of an AECOPD, whilst systemic inflammatory markers may take up to two weeks to recover. Symptoms generally improve over the first 14 days, however marked variation is evident between studies and individuals. There are limited data regarding the time course of recovery for functional capacity, quality of life and strength. In a small number of patients (

Purpose Early pulmonary rehabilitation (PR) has beneficial impacts on people with chronic obstructive pulmonary disease (COPD) when delivered after an exacerbation; however, program characteristics are diverse. This systematic review aimed to determine the impact of PR program characteristics (mode, length, commencement, frequency, location, and supervision) on clinical outcomes following an exacerbation of COPD. Methods Studies were screened from Medline, Medline in progress, Embase, CINAHL, SCOPUS, CENTRAL, and PEDro. Included studies were randomized controlled trials of early PR after an exacerbation of COPD (commenced during hospital stay or ≤4 wk of hospital discharge). The primary outcomes were hospital readmissions and mortality. Results Thirty studies were included. Exercise training alone was delivered in 43% of studies. Program duration varied from length of inpatient stay to 12 wk. The interventions commenced as early as ≤24 hr of hospitalization for acute exacerbation, and up to 2 wk after discharge. Early PR was compared to usual care, and no studies made a direct comparison of the program characteristics of interest. Program characteristics associated with reduced risk of hospital admission were commencement after hospital discharge, duration longer than 3 wk, and programs that included exercise training and education (relative risk of readmission range 0.6-0.79); however, it was not possible to determine which of these characteristics made the most important contribution. Mortality risk did not vary according to PR program characteristics. Conclusion Programs >3 wk, started after hospital discharge or including an educational component in addition to exercise, were most effective at reducing hospital readmissions.

Bruna Wageck,1 Narelle S Cox,1– 3 Christine F McDonald,3– 5 Angela T Burge,1– 3,6 Ajay Mahal,7 Catherine J Hill,3,8 Annemarie L Lee,2,3,6 Rosemary Moore,3,8 Caroline Nicolson,9,10 Paul O’Halloran,11 Aroub Lahham,1– 3 Rebecca Gillies,1,8 Anne E Holland1– 3,6 1La Trobe University, Melbourne, Australia; 2Monash University, Melbourne, Australia; 3Institute for Breathing and Sleep, Melbourne, Australia; 4Department of Respiratory and Sleep Medicine, Austin Health, Melbourne, Australia; 5Department of Medicine, The University of Melbourne, Melbourne, Australia; 6Department of Physiotherapy, Alfred Health, Melbourne, Australia; 7The Nossal Institute of Global Health, The University of Melbourne, Melbourne, Australia; 8Department of Physiotherapy, Austin Health, Melbourne, Australia; 9Department of Pulmonary Hypertension, Alfred Health, Melbourne, Australia; 10Physiotherapy Department, Monash University, Melbourne, Australia; 11Department of Public Health, La Trobe University, Melbourne, AustraliaCorrespondence: Anne E HollandMonash University, Central Clinical School, Level 6, Alfred Centre, 99 Commercial Road, Melbourne, VIC 3004, AustraliaTel +61 3 99030214Email a.holland@alfred.org.auBackground: Pulmonary rehabilitation is an effective treatment for people with chronic obstructive pulmonary disease (COPD), but its benefits are poorly maintained. The aim of this study was to evaluate the impact of COPD exacerbations in the year following pulmonary rehabilitation on outcomes at 12 months.Methods: This was a secondary analysis from a trial of home versus hospital-based rehabilitation in COPD, with 12 months of follow-up. Moderate and severe exacerbations were identified using administrative data (prescriptions) and hospital records (admissions) respectively. The impact of exacerbations at 12 months following pulmonary rehabilitation was evaluated for quality of life (Chronic Respiratory Questionnaire, CRQ), dyspnea (modified Medical Research Council, mMRC), exercise capacity (6-minute walk distance, 6MWD) and objectively measured physical activity (moderate-to-vigorous physical activity, MVPA).Results: A total of 166 participants were included, with mean age (SD) 69 (9) years and forced expiratory volume in one second (FEV1) 49 (19)% predicted. Moderate exacerbations occurred in 68% and severe exacerbations in 34% of participants. Experiencing a severe exacerbation was an independent predictor of worse 12-month outcomes for CRQ (total, fatigue and emotional function domains), mMRC, 6MWD and MVPA (all p< 0.05). Participants who completed pulmonary rehabilitation were less likely to have a severe exacerbation (29% vs 48%, p=0.02). Severe exacerbations were more likely in those with worse baseline CRQ total (odds ratio 0.97, 95% CI 0.95 to 0.99) and FEV1%predicted (0.98, 95% CI 0.96 to 0.99).Conclusion: Severe exacerbations occur frequently following pulmonary rehabilitation and predict worse 12-month outcomes. Strategies to maintain the benefits of pulmonary rehabilitation should address exacerbation prevention and management.Keywords: COPD, exacerbations, pulmonary rehabilitation, long term maintenance, predictors

Background: Pulmonary rehabilitation is an effective treatment for people with chronic respiratory disease, but is delivered to Aims: To compare the efficacy of home-based telerehabilitation (TR) and centre-based pulmonary rehabilitation (PR) in people with chronic respiratory disease. Methods: Assessor blinded, multi-centre RCT, powered for equivalence. Participants were randomised to centre-based PR or home-based TR. Both programs were 2 sessions/week for 8 weeks. Telerehabilitation used a stationary cycle and group videoconferencing to enable social interaction and real time monitoring. The primary outcome was change in chronic respiratory disease questionnaire dyspnea domain (CRQ-D) at end rehabilitation, with a pre-specified equivalence margin of 2.5 points. Results: We randomised 142 participants to PR (n=72) or TR (n=72). Both groups had clinically important improvements in CRQ-D following rehabilitation (TR mean (95%CI) 4 (2 to 5) vs PR 5 (3 to 7)), however equivalence of TR was not confirmed (mean difference between groups (MD) -1 point (-3 to 1)), with similar findings at 12 month followup (MD -1 point (-4 to 1)). The 6-minute walk distance (6MWD) was equivalent at end rehabilitation (MD -6 metres (-26 to 15) and at 12 months superiority of TR could not be excluded (MD 14 metres (-10 to 38). The proportion of participants who completed ≥70% of prescribed sessions was high (84% TR vs 79% PR). Conclusions: Home-based TR achieved clinically important gains in health-related quality of life, but equivalence to centre-based PR was not confirmed.

Pulmonary rehabilitation is an effective therapeutic intervention for people with chronic respiratory disease. However, fewer than 5% of eligible individuals receive pulmonary rehabilitation on an annual basis, largely due to limited availability of services and difficulties associated with travel and transport. The Rehabilitation Exercise At Home (REAcH) study is an assessor-blinded, multi-centre, randomised controlled equivalence trial designed to compare the efficacy of home-based telerehabilitation and traditional centre-based pulmonary rehabilitation in people with chronic respiratory disease. Participants will undertake an 8-week group-based pulmonary rehabilitation program of twice-weekly supervised exercise training, either in-person at a centre-based pulmonary rehabilitation program or remotely from their home via the Internet. Supervised exercise training sessions will include 30 min of aerobic exercise (cycle and/or walking training). Individualised education and self-management training will be delivered. All participants will be prescribed a home exercise program of walking and strengthening activities. Outcomes will be assessed by a blinded assessor at baseline, after completion of the intervention, and 12-months post intervention. The primary outcome is change in dyspnea score as measured by the Chronic Respiratory Questionnaire – dyspnea domain (CRQ-D). Secondary outcomes will evaluate the efficacy of telerehabilitation on 6-min walk distance, endurance cycle time during a constant work rate test, physical activity and quality of life. Adherence to pulmonary rehabilitation between the two models will be compared. A full economic analysis from a societal perspective will be undertaken to determine the cost-effectiveness of telerehabilitation compared to centre-based pulmonary rehabilitation. Alternative models of pulmonary rehabilitation are required to improve both equity of access and patient-related outcomes. This trial will establish whether telerehabilitation can achieve equivalent improvement in outcomes compared to traditional centre-based pulmonary rehabilitation. If efficacious and cost-effective, the proposed telerehabilitation model is designed to be rapidly deployed into clinical practice. Clinical trial registered with the Australian and New Zealand Clinical Trials Register at ( ACTRN12616000360415 ). Registered 21 March 2016.

Purpose. To verify the influence of neural mobilization (NM) applied to the lower limbs on functional performance and dynamic balance in asymptomatic individuals. Methods. The total of 30 asymptomatic participants (15 women and 15 men; age, 30.1 ± 6.7 years; height, 1.70 ± 0.1 m; body mass, 73.1 ± 13.4 kg) were enrolled in this cross-over randomized controlled trial. The participants received NM of the femoral, sciatic, and tibial nerves, as well as static stretching (SS) of the following muscles: hamstring, lumbar, piriformis, hip adductors, hip flexors, quadriceps, and triceps surae. The order of applying NM and SS was randomly decided and the interventions were performed at least 48 hours apart. Functional performance was measured by performance in vertical jump (VJ) and dynamic balance was measured with the Star Excursion Balance Test (SEBT). Results. There were no differences between NM and SS for height (cm) in VJ (p = 0.16) or in the distance reached (%) in the SEBT, normalized by lower limb length (dominant limb: anterior, p = 0.35; posterolateral, p = 0.69; posteromedial, p = 0.50 / non-dominant limb: anterior, p = 0.68; posterolateral, p = 1.00; posteromedial, p = 0.77). Conclusions. NM did not exert any influence on functional performance or dynamic balance. Thereby, having no positive or negative impact on performance, NM can be used at any time of treatment.

Introduction: The risk of injuries related to physical activity and sports may increase if there is predisposition, inappropriate training and/or coach guidance, and absence of sports medicine follow-up. Objective: To assess the frequency of injuries in athletes treated at a physiotherapy center specialized in sports. Methods: For the data collection was carried out the survey of injuries in records of athletes treated in eight years of activities. The data collected included: characteristics of patients, sport, injury kind, injury characteristics and affected body part. Results: From 1090 patient/athlete records, the average age was 25 years old, the athletes were spread across 44 different sports modalities, being the great majority men (75%). The most common type of injury was joint injury, followed by muscular and bone injuries. Chronic injury was the most frequent (47%), while the most common body part injured was the knee, followed by ankle and shoulder. Among all the sports, soccer, futsal, and track and field presented the highest number of injured athletes, respectively. Conclusion: Soccer was the most common sport among the injured athletes, injury kind most frequent was joint injuries and knee was the body part most injured. Chronic injuries were the most common.

There is some evidence showing that people with functional ankle instability (FAI) can present changes in postural control during the landing phase of a jump. These studies also show preliminary results indicating possible changes during phases prior to landing. Therefore, the objective of this study was to investigate whether movement adjustments prior to a jump are different between people with and without FAI. Sixty participants with (n=30) and without (n=30) FAI participated in this study. The main outcome measures were the variability of range of motion in ankle inversion/eversion and dorsiflexion/plantarflexion; and variability of center of pressure for the directions anterior-posterior and medio-lateral during the pre-jump period for drop jump, vertical jump and during single-leg stance. The group with instability showed more variability of center of pressure in anterior-posterior direction (p=0.04) and variability of range of motion in ankle dorsiflexion/plantar flexion (p=0.04) compared to control in the single-leg stance test. For the within-group comparisons, the group with instability showed more variability of center of pressure in anterior-posterior direction in the drop jump higher than single-leg stance and vertical jump. The same pattern was seen for the control group. Thus, this study suggests that people with FAI have greater ankle range of motion variability and center of pressure variability in the anterior-posterior axis when compared to healthy individuals during single-leg stance. For those same two variables, preparation for a drop jump causes more postural instability when compared to the preparation for a vertical jump and to single-leg stance.

Objective: Pulmonary rehabilitation (PR) improves function, reduces symptoms and decreases healthcare usage in people with chronic obstructive pulmonary disease (COPD) following an acute exacerbation (AECOPD). However, rehabilitation uptake rates are low. This study aimed to address barriers to uptake and completion of PR following AECOPD. Methods: An action research approach was used to reflect on study feasibility, and to plan and implement an improved protocol. Phase I tested the feasibility of home-based PR started early after AECOPD. Phase II used qualitative interviews to identified potential barriers to program uptake. Phase III re-tested the program with changes to recruitment and assessment strategies. Results: Phase I: From 97 screened patients, 26 were eligible and 10 (38%) started home-based PR. Eight participants undertook ≥70% of PR sessions, achieving clinically meaningful improvement in 6-minute walk distance (mean (SD) change 76 (60) m) and chronic respiratory disease questionnaire total score (15 (21) units). Phase II: Potential barriers to uptake of home-based PR included access issues, confidence to exercise, and lack of information about PR benefits. Phase III: From 77 screened patients, 23 were eligible and 5 (22%) started the program. Discussion: Home-based PR improved clinical outcomes, but program eligibility and uptake remain challenging. Efforts should be made to ensure PR program eligibility criteria are broad enough to accommodate patient needs, and new ways of engaging patients are needed to improve PR uptake after AECOPD.

Question: Does Kinesio Taping reduce swelling in athletes who have suffered an acute, lateral ankle sprain? Design: Randomised controlled trial with concealed allocation, intention-to-treat analysis and blinded assessment. Participants: Thirty-six athletes who participated regularly in one of seven different sports modalities and suffered an acute ankle sprain. Intervention: The experimental group received Kinesio Taping application for 3 days, which was designed to treat swelling. The control group received an inert Kinesio Taping application. Outcome measures: For the comparison between groups, the swelling was measured via volumetry, perimetry, relative volumetry and two analyses of the difference in volume and perimetry between ankles of each participant. Data were collected immediately after the 3 days of intervention and at follow-up, which was 15 days post intervention. Results: At 3 days after intervention, there were no differences between groups for swelling in volumetry (MD –2ml, 95% CI –28 to 32); perimetry (MD 0.2cm, 95% CI –0.6 to 1.0); relative volumetry (MD 0.0cm, 95% CI –0.1 to 0.1); and the other analyses. At day 15 follow-up, there were no significant between-group differences in outcomes. Conclusion: The application of Kinesio Taping, with the aim of stimulating the lymphatic system, is ineffective in decreasing acute swelling after an ankle sprain in athletes. Trial registration: Brazilian Registry of Clinical Trials, RBR-32sctf. [Nunes GS, Vargas VZ, Wageck B, dos Santos Hauphental DP, da Luz CM, de Noronha M (2015) Kinesio Taping does not decrease swelling in acute, lateral ankle sprain of athletes: a randomised trial. Journal of Physiotherapy 61: 28–33]

Question: Can massage therapy reduce pain and perceived fatigue in the quadriceps of athletes after a long-distance triathlon race (Ironman)? Design: Randomised, controlled trial with concealed allocation, intention-to-treat analysis and blinded outcome assessors. Participants: Seventy-four triathlon athletes who completed an entire Ironman triathlon race and whose main complaint was pain in the anterior portion of the thigh. Intervention: The experimental group received massage to the quadriceps, which was aimed at recovery after competition, and the control group rested in sitting. Outcome measures: The outcomes were pain and perceived fatigue, which were reported using a visual analogue scale, and pressure pain threshold at three points over the quadriceps muscle, which was assessed using digital pressure algometry. Results: The experimental group had significantly lower scores than the control group on the visual analogue scale for pain (MD –7mm, 95% CI –13 to –1) and for perceived fatigue (MD –15mm, 95% CI –21 to –9). There were no significant between-group differences for the pressure pain threshold at any of the assessment points. Conclusion: Massage therapy was more effective than no intervention on the post-race recovery from pain and perceived fatigue in long-distance triathlon athletes. Trial registration: Brazilian Registry of Clinical Trials, RBR-4n2sxr. [Nunes GS, Bender PU, de Menezes FS, Yamashitafuji I, Vargas VZ, Wageck B (2016 ) Massage therapy decreases pain and perceived fatigue after long-distance Ironman triathlon: a randomised trial. Journal of Physiotherapy 62: 83–87 ]

Question: Does Kinesio Taping reduce pain and swelling, and increase muscle strength, function and knee-related health status in older people with knee osteoarthritis? Design: Randomised, controlled trial with concealed allocation, intention-to-treat analysis and blinded assessment. Participants: Seventy-six older people with knee osteoarthritis. Intervention: The experimental group received three simultaneous Kinesio Taping techniques to treat pain, strength and swelling. The control group received sham taping. All participants kept the taping on for 4 days. Outcome measures: The outcomes were: concentric muscle strength of knee extensors and flexors, measured by isokinetic dynamometry with an angular velocity of 60 deg/second normalised for body mass [(Nm/kg) x 100 (%)]; pressure pain threshold via digital pressure algometry (kgf/cm 2 ); lower-limb swelling via volumetry (l) and perimetry (cm); physical function via the Lysholm Knee Scoring Scale (0 = worst to 100=best); and knee-related health status via the Western Ontario and McMaster (WOMAC) osteoarthritis index (0=best to 96=worst). Outcomes were measured at Day 4 (end of the taping period) and Day 19 (follow-up) after the start of the treatment. Results: At Day 4, there were no significant between-group differences for knee extensor muscle strength (MD –1%, 95% CI –7 to 5), knee flexor muscle strength (MD 2%, 95% CI –3 to 7), the pressure pain threshold at any measured point, volumetry (MD 0.05 L, 95% CI –0.01 to 0.11), perimetry at any measured point, Lysholm score (MD –4 points, 95% CI –9 to 2), or WOMAC score (MD –2 points, 95% CI –8 to 4). The lack of significant between-group difference was also seen at the follow-up assessment on Day 19. Conclusion: The Kinesio Taping techniques investigated in this study provided no beneficial effects for older people with knee osteoarthritis on any of the assessed outcomes. Trial registration: Brazilian Registry of Clinical Trials, RBR-36r3t5. [Wageck B, Nunes GS, Bohlen NB, Santos GM, de Noronha M (2016) Kinesio Taping does not improve the symptoms or function of older people with knee osteoarthritis: a randomised trial. Journal of Physiotherapy 62: 153–158]

Introduction The Subjective Daily Assessment Scale (ESAD) is based on the visual analog scale (VAS) and assesses six parameters (pain, edema, heat, mobility, sensitivity, and confidence).Objective This study aimed to examine the association between the analyzed variables as assessed by the ESAD and physical therapy clinical discharge and return-to-play of injured athletes.Method Eighty-one patient records of athletes were analyzed; mean sample age was 23.9 ± 6.3 years. The athletes received treatment through the Sports Physical Therapy program of Santa Catarina State University, Brazil, between 2008 and 2011. Six parameters were ranked on a scale from 0 to 10, with 0 being the best possible condition and 10 the worst. Data analysis was conducted using stepwise Cox regression.Results At the time of the injury, the mean score for confidence was 5.82 ± 0.48, and at the time of return-to-play, it was 0.48 ± 1.1; the mean score for pain decreased from 3.7 ± 2.64 to 0.34 ± 0.83. However, due to the strong association between pain and confidence, only confidence remained in the final model. For each reduction in the value reported for confidence, the probability of return-to-play was 0.62 times greater.Conclusion The results showed that confidence was the best variable for predicting athlete return-to-play. ResumoIntrodução A Escala Subjetiva de Avaliação Diária (ESAD) é uma escala baseada na Escala Analógica Visual (EVA), que avalia seis parâmetros (dor, edema, calor, mobilidade, sensibilidade e confiança).Objetivo Este estudo tem como objetivo analisar a associação das variáveis analisadas a partir da ESAD com a liberação da fisioterapia.Método Foram utilizados 81 prontuários de atletas com média de idade de 23,9 ± 6,3 anos, que foram atendidos entre 2008 e 2011 no Projeto de Fisioterapia Desportiva da Udesc e que responderam a ESAD, classificando os seis parâmetros numa escala de 0 a 10, sendo que 0 significa a melhor condição e 10 a pior. Os dados foram analisados a partir da regressão de Cox, por meio do método stepwise.Resultados No momento da lesão, a confiança, em média, era de 5,82 ± 0,48 e, no momento do retorno ao esporte, passou para 0,48 ± 1,1, e a dor de 3,7 ± 2,64 foi para 0,34 ± 0,83, porém devido à forte associação entre dor e confiança, apenas a confiança permaneceu no modelo final. A cada diminuição do valor relatado na confiança a chance de retorno ao esporte aumenta 0,62 vezes.Conclusão Os resultados demonstraram que a confiança é a variável que melhor prediz a liberação do atleta.

Context: The treatment of edema after a knee injury is usually 1 of the main objectives during rehabilitation. To assess the success of treatment, 2 methods are commonly used in clinical practice: volumetry and perimetry. Objective: To investigate the intra- and interassessor reliability of volumetry and perimetry to assess knee volume. Design: Cross-sectional. Setting: Laboratory. Participants: 45 health participants (26 women) with mean age of 22.4 ± 2.8 y. Main Outcome Measures: Knee volume was assessed by 3 assessors (A, B, and C) with 3 methods (lower-limb volumetry [LLV], knee volumetry [KV], and knee perimetry [KP]). Assessor A was the most-experienced assessor, and assessor C, the least experienced. LLV and KV were performed with participants in the orthostatic position, while KP was performed with participants in supine. Results: For the interassessor analysis, the ICC2,1 was high (.82) for KV and very high for LLV (.99) and KP (.99). For the intra-assessor analysis, ICC2,1 ranged from moderate to high for KV (.69-.83) and was very high for LLV (.99) and KP (.97-.99). Conclusion: KV, LLV, and KP are reliable methods, both intra- and interassessor, to measure knee volume.

Objective To investigate the applications and effects of neuromuscular electrical stimulation (NMES) in critically ill patients in ICU by means of a systematic review. Materials and methods Electronic searches were conducted in the databases Medline, CINAHL, Cochrane Central Register of Controlled Trials, Web of Science, Embase, ProQuest Health and Medical Complete, AMED, and PEDro. The PEDro score was used to assess the methodological quality of the eligible studies. Results The search yielded a total of 9759 titles and nine articles satisfied the eligibility criteria. These studies showed that NMES can maintain or increase muscle mass, strength and volume, reduce time in mechanical ventilation and weaning time, and increase muscle degradation in critically ill patients in ICU. Two studies allowed a meta-analysis of the effects of NMES on quadriceps femoris strength and it showed a significant effect in favor of NMES in the Medical Research Council (MRC) Scale (standardized mean difference 0.77 points; p = 0.02; 95% CI: 0.13–1.40). Conclusions The selected studies showed that NMES has good results when used for the maintenance of muscle mass and strength in critically ill patients in ICU. Future studies with high methodological quality should be conducted to provide more evidence for the use of NMES in an ICU setting.

Clinical measurement.To translate, adapt, and test the measurement properties of the Brazilian Portuguese version of the Victorian Institute of Sport Assessment-Patella (VISA-P) questionnaire.It is important to objectively measure symptoms and functional limitations related to patellar tendinopathy using outcome measures that have been validated in the language of the target population. Cross-cultural adaptations are also useful to enhance the understanding of the measurement properties of an assessment tool, regardless of the target language.The VISA-P questionnaire was translated into Brazilian Portuguese, culturally adapted, and titled VISA-P Brazil. It was then administered on 2 occasions with a 24- to 48-hour interval between them, and a third time after a month of physical therapy treatment. The following measurement properties were analyzed: internal consistency, test-retest reliability, agreement, construct validity, floor and ceiling effects, and responsiveness.The VISA-P Brazil had high internal consistency (Cronbach α = .76; if item deleted, Cronbach α = .69-.78), excellent reliability and agreement (intraclass correlation coefficient = 0.91; 95% confidence interval: 0.85, 0.95; standard error of measurement, 5.2 points; minimal detectable change at the 90% confidence level, 12.2 points), and good construct validity (Pearson r = 0.60 compared to Lysholm). No ceiling and floor effects were detected for the VISA-P Brazil, and the responsiveness, based on 32 patients receiving physical therapy intervention for 1 month, demonstrated a large effect size of 0.97 (95% confidence interval: 0.68, 1.25).The VISA-P Brazil is a reproducible and responsive tool and can be used in clinical practice and research to assess the severity of pain and disability of patients with patellar tendinopathy.