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Análise da incapacidade ancorada no modelo biopsicossocial e sua relação com determinantes sociais da saúde na pessoa idosa com dor lombar

Wed, 01 Jan 2025 00:00:00 GMT

Título: Análise da incapacidade ancorada no modelo biopsicossocial e sua relação com determinantes sociais da saúde na pessoa idosa com dor lombar Autor(es): Braga, Camila Ceron Cossa Abstract: Disability resulting from low back pain (LBP) in older adults reflects the impact on the functioning of this population. Despite this, studies in this area do not explore whether social determinants of health (SDH) influence the protection or increase of disability, and patient-reported outcome measures (PROMs) are unclear in reflecting functioning. This dissertation aims to investigate whether social determinants of health (SDH) influence disability in older adults twelve months after the episode, as well as to identify whether PROMs cover LD-related disability/functioning in the context of aging. In product 1, a systematic review was conducted of disability in older adults with chronic DL, assessing whether the PROMs used to obtain these results are consistent with the ICF structure and the related Geriatric Core Set. A search was conducted in the main health databases, such as PubMed, Embase, Lilacs, and the Virtual Health Library (VHL). Of the 24 studies included, eight PROMs were identified to assess disability in older adults with DL. The main and additional concepts of the PROMs were linked to identify the corresponding International Classification of Functioning, Disability, and Health (ICF) codes, which were then compared with the Geriatric Core Set codes. This product showed that the PROMs that assess disability in older adults with DL do not reflect functioning in the aging scenario. We concluded that further studies are needed to create appropriate PROMs to assess disability in older adults with DL. In product 2, a longitudinal study was conducted using data from the “Back Complaints in the Elders” database in Brazil, BACE-Brasil, to investigate the association between DSS and disability in older adults with acute DL twelve months after the onset of the episode. The independent variables analyzed were DSS and the dependent variable was the Roland-Morris Disability Questionnaire (RMDQ), which assesses disability resulting from LDS at baseline and twelve months after the episode. We revealed, through multivariate logistic regression, these higher income and education levels, as well as darker skin color, were associated with lower disability rates.These findings increased the chance of disability reduction by 1.26, 1.04, 2.1, and 2.4 times, respectively. Health professionals should take these socioeconomic variables into account to better understand the process of recovery from disability in aging. Finally, researchers need to develop PROMs that reflect functioning to cover aspects of aging in disability resulting from DL in older adults, and clinicians must understand that variables such as low income, low education, and skin color influence disability recovery in older adults with DL. Tipo: Dissertação

Criação e validação de conteúdo de instrumento de avaliação do engajamento de crianças nas aulas de Educação Física Escolar

Wed, 01 Jan 2025 00:00:00 GMT

Título: Criação e validação de conteúdo de instrumento de avaliação do engajamento de crianças nas aulas de Educação Física Escolar Autor(es): Marques, Lara Almeida Abstract: The literature indicates that most instruments for assessing student engagement in Physical Education (PE) classes are self-report questionnaires, typically applied to older children. Therefore, this study aimed to develop and validate the content of an observational instrument to assess engagement among elementary school children, both with and without disabilities. The instrument was constructed in four stages: (i) development of the first version, (ii) pilot study, (iii) relevance analysis, and (iv) restructuring. Content validation, data analysis, and verification of reliability and trustworthiness were conducted by a panel of five expert judges. A pilot study was then carried out with 15 students, of both sexes, from two private schools in Fortaleza, Ceará. Results indicated that the criterion of Language Clarity generated the greatest divergence among expert judges, particularly within the behavioral dimension of engagement. In terms of student participation, 10 students demonstrated adequate active engagement, while 5 students scored between 2.2 and 2.4, suggesting the need for improvements. In conclusion, the instrument proved to be effective in assessing engagement in PE contexts and may support health and education professionals in monitoring children across diverse social environments, contributing to a better understanding of individual social participation, an essential component of child development. Tipo: Dissertação

Tradução, adaptação transcultural e validação do questionário Oslo Sports Research Trauma Center - Patella (OSTRC-P) para o português brasileiro

Wed, 01 Jan 2025 00:00:00 GMT

Título: Tradução, adaptação transcultural e validação do questionário Oslo Sports Research Trauma Center - Patella (OSTRC-P) para o português brasileiro Autor(es): Façanha, Caian Guimarães Lima Abstract: Patellar tendinopathy is a musculoskeletal condition characterized by chronic pain in the patellar tendon, with a high prevalence among athletes involved in sports requiring repetitive jumping, such as volleyball and basketball, as well as in individuals engaged in physical activity. In Brazil, the lack of validated questionnaires for early screening of this condition hinders the identification of its initial stages, potentially resulting in delayed diagnoses, invasive treatments, and high costs to the healthcare system. To address this gap, this study aimed to translate, cross-culturally adapt, and validate the Brazilian version of the Oslo Sports Trauma Research Center – Patella (OSTRC-P) questionnaire, originally developed to assess functional impairments associated with patellar tendinopathy. The cross-cultural adaptation process followed international COSMIN guidelines, involving independent translation by two bilingual professionals, synthesis of the translated versions, back-translation into English, and review by a committee of experts in sports and orthopedic physiotherapy. After semantic and cultural adjustments—such as replacing specific terms (e.g., "experienced pain" with "felt pain")—the pre-final version was pre-tested with participants from the target population to assess item clarity.For psychometric validation, 105 physically active individuals were recruited and divided into three groups: Control (asymptomatic), Risk (engaged in high-impact sports without symptoms), and Tendinopathy (clinically diagnosed based on pain upon palpation of the patellar tendon—intensity ≥3 on the Numeric Pain Rating Scale—and a VISA-P score <80). Participants completed the OSTRC-P-Br, the Victorian Institute of Sport Assessment–Patella (VISA-P), and the Lower Extremity Functional Scale (LEFS) at two time points, 15 minutes apart. The Delphi committee reached consensus after three review rounds, with over 90% agreement on the adapted items. In the pre-test, 98% of participants reported clear understanding of the items. During validation, the OSTRC-P-Br demonstrated high internal consistency (Cronbach’s alpha = 0.88; 95% CI 0.84–0.91), excellent inter-rater reliability (ICC = 0.955; 95% CI 0.92–0.98), and significant inverse correlations with the VISA-P (rho = –0.825; p < 0.001) and LEFS (rho = –0.659; p < 0.001), supporting its construct validity.In diagnostic analysis, the OSTRC-P-Br demonstrated high accuracy, with a sensitivity of 90% and a specificity of 91.4%, showing excellent discriminatory power for detecting patellar tendinopathy and ruling out false positives. A floor effect was observed in the control group, which had fixed scores (0.0 ± 0.0), while no ceiling effect was found in the other groups. The tendinopathy group showed significantly higher mean scores (38.0 ± 22.0) compared to the Control (0.0 ± 0.0) and Risk (0.0 ± 9.5) groups. These findings support the conclusion that the OSTRC-P-Br is a valid, reliable, and culturally adapted instrument for early screening of dysfunctions related to patellar tendinopathy in the Brazilian context. Its use in clinical practice may facilitate early detection and timely intervention, helping prevent chronic complications. Additionally, the questionnaire contributes to the standardization of epidemiological studies and the generation of internationally comparable data, thereby strengthening prevention and management strategies for patellar tendinopathy in Brazil. Tipo: Dissertação

Associação entre suporte social e incapacidade em indivíduos com dor lombar crônica: um estudo transversal

Wed, 01 Jan 2025 00:00:00 GMT

Título: Associação entre suporte social e incapacidade em indivíduos com dor lombar crônica: um estudo transversal Autor(es): Pinheiro, Luana de Carvalho Abstract: Previous estimates from the Global Burden of Disease for low back pain confirm that the condition is the leading cause of disability in most countries. The biopsychosocial model reinforces the experience of pain and disability as multidimensional and dynamic interactions and is strongly recommended to guide the assessment and management of chronic low back pain. The objective of the present study is to analyze the association between social support and the level of disability in individuals with chronic low back pain. This is a cross-sectional observational study. The research was conducted at CDFAM between July 2024 and April 2025. Adults aged 18 to 60 years of both sexes were eligible to participate. Recruitment was carried out by convenience sampling through active search in the waiting room and printed materials disclosing the study objective and the researcher’s contact information. Participants underwent face-to-face data collection interviews, lasting approximately 40 minutes, using the following instruments: sociodemographic and lifestyle questionnaire, Numerical Pain Rating Scale, 36-item World Health Organization Disability Assessment Schedule (WHODAS 2.0), Medical Outcomes Study-Social Support Survey (MOS- SSS), and the short version of the International Physical Activity Questionnaire (IPAQ-SF). Data were analyzed using Jamovi software through a multiple linear regression model to identify the association between disability and social support. In the model, disability was the dependent variable, social support was the predictor variable, and age, sex, years of education, number of comorbidities, and pain intensity were the adjustment variables. The study was approved by the Research Ethics Committee (approval number: 6.902.189). A total of 120 individuals with chronic low back pain receiving care at the Primary Health Care Unit CDFAM (mean age = 46.02 ± 9.76, 81.7% female) participated in the study. The unadjusted model revealed that social support was negatively associated with disability (R2 = 0.15, β = -0.32, p < 0.001), indicating that higher levels of social support were associated with lower levels of disability. This association remained significant in the adjusted model (R2 = 0.35, β = -0.17, p < 0.018), which explained 35.3% of the variance in disability. This is one of the first studies to directly investigate the association between perceived social support and functional disability in individuals with chronic low back pain. The findings highlight the significant role of social support in the variability of disability levels in this population, emphasizing the importance of addressing social factors, particularly perceived social support, in the clinical assessment and management of chronic low back pain. Tipo: Dissertação