Abstract Background: The Functional Index for Hand Osteoarthritis (FIHOA) is a simple, reliable, and reproducible specific instrument to evaluate hand OA that can be applied both in clinical practice and research protocols. In order to be used in Brazil, FIHOA has to be translated into Portuguese, culturally adapted and have the reliability of the translated FIHOA version tested, which is the purpose of this study. Methods: The FIHOA was translated into Brazilian Portuguese and administered to 68 patients with hand OA recruited between May 2019 and February 2020. The test-retest was applied to 32 patients and the reliability was assessed using Spearman’s correlation coefficient and intraclass correlation coefficient (ICC). The internal consistency reliability was evaluated using Cronbach’s alpha. External construction validity was assessed using the Spearman’s correlation test between FIHOA and pain, assessed with a Visual Analogue Scale (VAS), the Cochin Hand Functional Scale (CHFS) and Health Assessment Questionnaire (HAQ). Results: The 30 participants that initially answered the translated version of the FiHOA did not report difficulties in understanding or interpreting the translated version. The test-retest reliability for the total score was strong ( r =0.86; ICC = 0.89). Mean differences (1.37 ± 0.68) using Bland Altman’s analysis did not significantly differ from zero and no systematic bias was observed. Cronbach’s alpha was also high (0.89) suggesting a strong internal coherence in the test items. There were also correlations between FIHOA and the CHFS ( r =0.88), HAQ ( r = 0.64) and pain in the hands both at rest ( r =0.55) and in motion ( r =0.44). Conclusion: The translation of the FIHOA into Brazilian Portuguese proved a valid instrument for measuring the functional capacity of patients with hand OA who understand Brazilian Portuguese.

Abstract Background: Low back pain is particularly problematic among nursing professionals. Education is part of the rehabilitation process for low back pain and has been heavily studied. In parallel, gestural behaviors play an important role during the evaluation of the low back pain, especially while performing the activities of daily living. The aim of the present study was to evaluate gesture behavior and knowledge on LBP among nurses with and without LBP and correlate these factors with pain, physical functioning and quality of life. Methods: An observational, controlled, cross-sectional study was carried out in 120 female nurses: 60 with LBP and 60 without LBP. The two groups were matched for age. The measures used for the evaluation were the Gesture Behavior Test, LBP Knowledge Questionnaire, Numerical Pain Scale for LBP, Roland Morris Disability Questionnaire and the Short Form-36 (SF-36) to assess quality of life. Results: Mean age in both groups was 31 years. In the group with LBP, the mean Numerical Pain Scale score was 5.6 cm and the mean score on the Roland Morris questionnaire was 2.7. No statistically differences between groups were found regarding the scores of the LBP Knowledge Questionnaire or Gesture Behavior Test (p = 0.531 and p = 0.292, respectively). Statistically lower scores were found in the group with LBP for the following SF-36 domains: physical functioning (p <0.001),physical role (p = 0.015), pain (p = 0.001), general health perceptions (p = 0.015), vitality (p < 0.001) and mental health (p = 0.001). Conclusions: No differences were found when comparing nurses with or without LBP regarding gesture behavior or knowledge on LBP. Nurses with LBP showed a decrease in some domains of quality of life.

RESUMO CONTEXTO E OBJETIVO: A espondilite anquilosante (EA) gera inflamação e dor em enteses, articulações periféricas e coluna vertebral. A educação na EA pode melhorar a incapacidade dos pacientes. Assim, é importante avaliar o conhecimento do paciente. Não há na literatura instrumento que avalie o conhecimento da EA na língua portuguesa. O objetivo foi traduzir para a língua portuguesa brasileira, realizar a adaptação cultural e testar a confiabilidade do questionário Ankylosing Spondylitis: What do you know? e relacionar os resultados com outros fatores. TIPO DE ESTUDO E LOCAL: Artigo original de validação de questionário realizado na Universidade Federal de São Paulo (Unifesp). MÉTODOS: Para tradução e adaptação cultural, foi utilizada a metodologia de Guilleman. Depois da primeira fase, a confiabilidade foi testada em 30 pacientes. Correlações entre esses escores e outros fatores foram avaliadas. RESULTADOS: Na avaliação interobservador, o coeficiente de correlação de Pearson e o alpha de Cronbach foram de 0,831 e 0,895, respectivamente. Na avaliação intra-observador, o coeficiente de correlação intraclasse e o alpha de Cronbach foram de 0,79 e 0,883, respectivamente. Nesta etapa, foram encontradas correlações entre etnia e escolaridade e a área de conhecimento A, e entre idade e a área D; entre o escore total e escores das áreas A e B e "aspectos sociais" do SF-36 e entre a área D e "dor", "vitalidade" e "aspectos emocionais" do SF-36. CONCLUSÃO: Foi criada a versão brasileira do questionário "Ankylosing Spondylitis: What do you know?", que é reprodutível e se correlaciona com escolaridade, etnia e os domínios "aspectos sociais" e "aspectos emocionais" do SF-36.

ABSTRACT CONTEXT AND OBJECTIVE: Ankylosing spondylitis (AS) generates inflammation and pain in entheses, peripheral joints and the spine. Education regarding AS can improve patients' disability. Thus, it is important to assess patients' knowledge. There is no instrument in the literature for assessing knowledge of AS in Portuguese. The aim here was to translate to the Brazilian Portuguese language, culturally adapt and test the reliability of the questionnaire "Ankylosing Spondylitis: What do you know?" and to correlate the findings with other factors. DESIGN AND SETTING: Original article regarding validation of questionnaire, produced at the Federal University of Sao Paulo (Unifesp). METHODS: For translation and cultural adaptation, Guilleman methodology was used. After the first phase, the reliability was tested on 30 patients. Correlations between these scores and other factors were examined. RESULTS: In the interobserver assessment, the Pearson correlation coefficient and Cronbach's alpha were 0.831 and 0.895, respectively. In the intraobserver evaluation, the intraclass correlation coefficient and Cronbach's alpha were 0.79 and 0.883, respectively. At this stage, the score for area of knowledge A showed correlations with ethnicity and education; the score for area D, with age; the total score and scores for areas A and B with "social aspects" of SF-36; and the score for area D with "pain", "vitality" and "emotional aspects" of SF-36. CONCLUSION: The Brazilian version of the questionnaire "Ankylosing Spondylitis: What do you know?" was created. It is reproducible and correlates with education level, ethnicity and the SF-36 domains "social aspects" and "emotional aspects".

RESUMO CONTEXTO E OBJETIVO Apesar de existirem questionários de ombro validados para o Brasil, nenhum deles é voltado para a população com doenças reumáticas. Acreditamos que o Oxford Shoulder Score (OSS) possa ser útil nessa população. O objetivo deste estudo foi traduzir, adaptar à cultura brasileira e testar a reprodutibilidade do OSS. TIPO DE ESTUDO E LOCAL Estudo de validação realizado nos ambulatórios da universidade. MÉTODOS Foi realizada a tradução para o português por dois professores de inglês e depois a retradução para o inglês por dois professores nativos da língua inglesa. Essas traduções foram revisadas por um comitê para estabelecer a versão do OSS-Brasil, que foi aplicada em 30 pacientes com artrite reumatoide (AR) e dor no ombro para testar a adaptação cultural. A validade e a reprodutibilidade foram testadas em outros 30 pacientes com AR e dor no ombro de ambos os gêneros com idade entre 18 a 65 anos. Foram analisadas a consistência interna e a reprodutibilidade. Foram avaliados os seguintes instrumentos: OSS-Brasil; escala numérica de dor no ombro; DASH; HAQ e SF-36. RESULTADOS A consistência interna foi 0,957 e a reprodutibilidade intra-avaliador e interavaliador foi 0,917 e 0,861, respectivamente. Foi observado alto nível de correlação do OSS-Brasil com HAQ (-0,663), DASH (-0,731) e os domínios do SF-36: capacidade funcional (0,589); aspectos físicos (0,507); dor (0,624); estado geral de saúde (0,444); vitalidade (0,634); saúde mental (0,578). CONCLUSÃO O OSS-Brasil foi traduzido e adaptado com sucesso, com boa consistência interna, confiabilidade e validade de construção.

ABSTRACT CONTEXT AND OBJECTIVE Although shoulder questionnaires validated for Brazil do exist, none of them are aimed at populations with rheumatic disease. We believe that the Oxford Shoulder Score (OSS) may be useful in this population. The objective of this study was to translate the OSS, adapt it to Brazilian culture and test its reproducibility. DESIGN AND SETTING Validation study conducted in university outpatient clinics. METHODS The OSS was translated into Portuguese by two English teachers and was then retranslated into English by two native English teachers. These translations were reviewed by a committee to establish the version of OSS-Brazil to be administered to 30 patients with rheumatoid arthritis (RA) and shoulder pain, in order to test the cultural adaptation. The validity and reproducibility was tested among another 30 patients with RA and shoulder pain, of both genders and aged 18 to 65 years. The internal consistency and reproducibility were analyzed. The following instruments were evaluated: OSS-Brazil; a numerical scale for shoulder pain; DASH; HAQ and SF-36. RESULTS The internal consistency was 0.957 and the intra and inter-rater reproducibility was 0.917 and 0.861, respectively. A high level of correlation was found between OSS-Brazil and the following: HAQ (-0.663), DASH (-0.731) and the SF-36 domains of functional capacity (0.589), physical aspects (0.507), pain (0.624), general state of health (0.444), vitality (0.634) and mental health (0.578). CONCLUSION OSS-Brazil was successfully translated and adapted, and this version exhibited good internal consistency, reliability and construct validity.

RESUMO Introdução O pé e o tornozelo na artrite reumatoide passam por sinovite altamente destrutiva, com perda de força muscular. Objetivo Avaliar a força muscular do tornozelo de pacientes com artrite reumatoide com base em parâmetros da dinamometria isocinética. Materiais e métodos Foram estudados 30 pacientes com diagnóstico de artrite reumatoide. O estudo envolveu 30 indivíduos saudáveis (grupo controle) pareados por idade, sexo, etnia, índice de massa corporal e dominância de membro inferior. Todos os indivíduos foram submetidos a avaliação da flexão dorsal, flexão plantar, inversão e eversão com o dinamômetro isocinético Cybex Norm. As variáveis foram comparadas entre os grupos artrite reumatoide e controle e entre os tornozelos direito e esquerdo. Foi determinada a relação de força muscular flexores dorsais/flexores plantares e inversores/eversores. Resultados Os pacientes com artrite reumatoide tiveram resultados estatisticamente piores no teste de dinamometria isocinética para todos os movimentos do tornozelo. A relação de força muscular entre flexores dorsais e flexores plantares foi diferente nos dois grupos. Não foram observadas diferenças significativas na relação entre inversores e eversores. Nos dois grupos, os músculos flexores plantares eram estatisticamente mais fortes do que os flexores dorsais. Conclusão Os pacientes com artrite reumatoide têm pior desempenho na dinamometria isocinética em todos os movimentos do tornozelo do que os indivíduos do grupo controle. Foram observados resultados semelhantes no teste isocinético para o lado direito e esquerdo, em ambos os grupos, com poucas exceções. A avaliação isocinética não representou risco adicional, como dor importante ou atividade inflamatória, em pacientes com artrite reumatoide.

ABSTRACT Introduction The foot and ankle in rheumatoid arthritis undergo highly destructive synovitis with loss of muscle strength. Objective To evaluate the muscle strength of ankles in patients with rheumatoid arthritis based on isokinetic dynamometry parameters. Materials and methods Thirty patients with a diagnosis of rheumatoid arthritis involving the ankle(s) and 30 healthy subjects (control group) matched for age, gender, race, body mass index and lower limb dominance were studied. Dorsiflexion, plantar flexion, inversion and eversion were evaluated in all subjects on an isokinetic Cybex Norm dynamometer. The variables were compared between the rheumatoid arthritis and control groups and between the right and left ankles, and the dorsiflexor/plantar flexor and invertor/evertor muscle strength ratio was determined. Results Patients with rheumatoid arthritis performed statistically worse in the isokinetic dynamometry test for all ankle movements. The muscle strength ratio between dorsiflexors and plantar flexors was different in the two groups. No significant differences were observed in the invertor and evertor ratios. In the two groups the plantar flexor musculature was statistically stronger than dorsiflexors. Conclusion We conclude that patients with rheumatoid arthritis perform worse in isokinetic dynamometry regarding all ankle movements than control subjects, with similar isokinetic test results being observed for the right and left side in both groups, with few exceptions. Isokinetic evaluation posed no additional risk such as important pain or inflammatory activity to patients with rheumatoid arthritis.

INTRODUCTION: Systemic sclerosis is a relatively rare connective tissue disorder characterized by severe and progressive fibrosis of the skin. Due to the current lack of available information on this subject, the aim of the present study was to assess light touch sensations in the hands of patients with systemic sclerosis. METHODS: We completed a cross-sectional comparative study. Light touch sensations were evaluated in 30 individuals, including 15 patients with systemic sclerosis who exhibited changes in the dermis of their hands without loss of the distal phalanx and 15 subjects who did not exhibit changes in the upper limbs (control group). The groups were age- and sex-matched. Tactile sensory evaluations were performed using the Semmes-Weinstein monofilament test and the two-point discrimination test. RESULTS: Statistically significant differences were found between groups in the monofilament test. The study group had lower scores across all points of the hand when compared with the control group. Differences were also found when dominant and non-dominant hands were compared (p<0.05). Statistically significant differences were found between groups for a subset of the assessed points in the two-point discrimination test. CONCLUSIONS: The results of a monofilament test showed that tactile sensation, specifically light touch and deep pressure sensations, is altered in the hands of systemic sclerosis patients.

CONTEXTO E OBJETIVO:A esclerose sistêmica (ES) é uma doença autoimune caracterizada por anormalidades da vascularização, que podem gerar fibrose da pele e outros órgãos, podendo levar a disfunção. Assim, torna-se imprescindível a elaboração de instrumentos capazes de avaliar a função de indivíduos com ES. O objetivo deste estudo foi traduzir para o português, adaptar à cultura brasileira e testar a validade e confiabilidade do Scleroderma Health Assessment Questionnaire (SHAQ).TIPO DE ESTUDO E LOCAL:A validação do SHAQ seguiu uma metodologia aceita internacionalmente, e foi realizada nos ambulatórios da universidade.MÉTODOS:Foi realizada tradução e contra-tradução do instrumento. Na fase de adaptação cultural, o SHAQ foi aplicado a 20 pacientes. As questões que apresentaram mais de 20% de incompreensão foram modificadas e aplicadas em outros 20 pacientes. Para validade e confiabilidade, 20 pacientes foram entrevistados em dois momentos: no primeiro, por dois entrevistadores e após 14 dias por um deles. Foram aplicados o Health Assessment Questionnaire (HAQ), o Disabilities of the Arm, Shoulder and Hand (DASH) e o short form-36 (SF-36), para a validade externa.RESULTADOS:Na avaliação interobservador, o coeficiente de correlação de Pearson e o coeficiente de correlação intraclasse foram ambos de 0,967. Na avaliação intraobservador o coeficiente de correlação de Pearson foi de 0,735, e o coeficiente de correlação intraclasse foi de 0,687. Na validade externa, os escores do SHAQ foram associados estatisticamente com todos os instrumentos, exceto com o domínio estado geral de saúde do SF-36 e o escore relacionado ao trabalho (Q2) do DASH.CONCLUSÃO:A versão brasileira do SHAQ mostrou ser válida e confiável para a avaliação de função em pacientes com esclerose sistêmica difusa.

CONTEXT AND OBJECTIVE:Systemic sclerosis is an autoimmune disease characterized by abnormalities of vascularization that may cause fibrosis of the skin and other organs and lead to dysfunction. It is therefore essential to have tools capable of evaluating function in individuals with this condition. The aim of this study was to translate the Scleroderma Health Assessment Questionnaire (SHAQ) into Portuguese, adapt it to Brazilian culture and test its validity and reliability.DESIGN AND SETTING:The validation of SHAQ followed internationally accepted methodology, and was performed in university outpatient clinics.METHODS:SHAQ was translated into Portuguese and back-translated. In the cultural adaptation phase, it was applied to 20 outpatients. Items not understood by 20% of the patients were modified and applied to another 20 outpatients. Twenty patients were interviewed on two different occasions to determine the validity and reliability of the questionnaire: two interviewers on the first occasion and one interviewer 14 days later. To determine the external validity, comparisons were made with Health Assessment Questionnaire (HAQ), Disabilities of the Arm, Shoulder and Hand (DASH) and short form-36 (SF-36).RESULTS:In the interobserver evaluation, Pearson's correlation coefficient and the intraclass correlation coefficient were both 0.967. In the intraobserver evaluation, Pearson's correlation coefficient was 0.735 and the intraclass correlation coefficient was 0.687. Regarding external validity, SHAQ scores were statistically correlated with all measurements, except the general health domain of SF-36 and the work-related score (Q2) of DASH.CONCLUSION:The Brazilian version of SHAQ proved to be valid and reliable for assessing function in patients with diffuse systemic sclerosis.

JUSTIFICATIVA E OBJETIVOS: A espondilite anquilosante (EA) é uma doença inflamatória, crônica, que acomete as articulações sacroilíacas, em graus variáveis a coluna vertebral e, em menor extensão as articulações periféricas. Dentre as formas de tratamento não medicamentoso, os grupos educacionais têm sido recomendados como importante coadjuvante no tratamento da doença. O objetivo deste estudo foi rever na literatura as evidências científicas sobre grupos educacionais para pacientes com EA. MÉTODO: A revisão foi realizada nas Bases de dados LILACS, Medline, Web of Science e PEDro. Os termos para busca sistemática foram extraídos dos Descritores em Ciências da Saúde (DeCS). RESULTADOS: Foram localizados nove artigos científicos no período de 1990 a 2012. Na seleção e análise dos estudos foram utilizados critérios de inclusão e exclusão, incluído artigos científicos que abordassem principalmente os grupos educacionais como forma de tratamento para os pacientes com EA. CONCLUSÃO: A literatura a respeito dos grupos educacionais como coadjuvante no tratamento desses pacientes é escassa. Futuros estudos mostrando os formatos dos grupos, duração, quantidade e conteúdos das aulas devem ser realizados, bem como a avaliação de sua efetividade.

BACKGROUND AND OBJECTIVES: Ankylosing spondylitis (AS) is a chronic inflammatory disease affecting sacroiliac joints, the spine in different degrees and in lesser extension peripheral joints. Among non-pharmacological treatments, educational groups have been recommended as major coadjuvants to treat this disease. This study aimed at reviewing the literature on scientific evidences of educational groups for AS patients. METHOD: The following databases were reviewed: LILACS, Medline, Web of Science and PEDro. Words for systematic search were extracted from Health Sciences Keywords (HSC). RESULTS: Nine scientific articles were found between 1990 and 2012. Inclusion and exclusion criteria were used to select and analyze studies, including scientific articles especially addressing educational groups as treatment approaches for AS patients. CONCLUSION: Literature on educational groups as coadjuvant to treat such patients is scarce. Further studies are needed to show group formats, number and content of classes, in addition to evaluating their effectiveness.

OBJECTIVES: To evaluate the difference in isokinetic strength of hip muscles between patients with knee osteoarthritis (OA) and matched healthy controls, and to establish the correlation between this isokinetic strength and pain and function in patients with knee OA. METHODS: 25 patients with a diagnosis of unilateral knee OA, 25 patients with bilateral knee OA, and 50 matched controls were evaluated using the visual analog scale for pain, knee Lequesne index, Western Ontario and McMaster Universities questionnaire and an isokinetic test. RESULTS: The groups were matched for age, gender and body mass index. The results of the isokinetic test revealed lower peak torque of the hip in patients with OA of the knee than in the control group for all movements studied. Strong correlations were found between the peak torque, visual analog scale and function. CONCLUSIONS: Patients with OA of the knee exhibit lower isokinetic strength in the hip muscles than healthy control subjects. Strengthening the muscles surrounding the hip joint may help to decrease pain in people with knee OA. Some correlations between pain/function and peak torque were found.

INTRODUÇÃO: O treinamento resistido progressivo tem sido sugerido como uma modalidade terapêutica que tenta promover uma padronização da prescrição de exercícios em fisioterapia, além de otimizar os resultados da terapia. OBJETIVO: Revisar os estudos que utilizaram o treinamento resistido progressivo em doenças musculoesqueléticas crônicas e demonstrar a importância da inclusão deste tipo de treinamento na reabilitação destas doenças. FONTE DE DADOS: A pesquisa foi realizada através dos bancos de dados Pubmed, Medline e Lilacs sem restrições a datas e/ou idiomas. REVISÃO: Já se encontra bem fundamentada a importância da aplicação de exercícios terapêuticos em fisioterapia devido aos inúmeros benefícios atribuídos a esta modalidade terapêutica. Apesar de comprovadamente eficazes, os exercícios de alta intensidade ainda não são prescritos rotineiramente e esta prescrição geralmente não é feita de maneira padronizada, não nos permitindo chegar a um consenso quanto ao tipo de fortalecimento utilizado, o cálculo da carga e a sua progressão. O treinamento resistido progressivo é realizado através do aumento gradual de carga durante o período de treinamento. O número de repetições que cada indivíduo pode completar depende do cálculo da repetição máxima. CONCLUSÃO: Baseando-se nos achados desta revisão, recomenda-se o uso de exercícios resistidos progressivos como complemento dos exercícios tradicionais utilizados na reabilitação de doenças musculoesqueléticas crônicas para que seja possível padronizar os protocolos de atendimento, controlando e adequando individualmente a carga, e otimizar os resultados do treinamento. No entanto, vale ressaltar que novos estudos são necessários para que se chegue a conclusões mais fidedignas.

INTRODUCTION: Progressive resistance training has been suggested as a therapeutic modality that attempts to promote the standardization of the prescription of physical exercises in physical therapy, besides optimizing the results of the treatment. OBJECTIVE: To review studies that used progressive resistance training in chronic musculoskeletal diseases and to demonstrate the importance of including this type of training in the rehabilitation of those diseases. SOURCE OF THE DATA: Pubmed, Medline, and Lilacs databases were reviewed without restrictions of date and/or language. REVIEW: Due to the countless benefits attributed to this treatment modality, the importance of exercises in physical therapy has been well documented. Despite the proven efficacy, high-intensity exercises are not routinely prescribed, and this prescription is usually not standardized, which does not allow a consensus on the type of strengthening used, as well as load calculation and progression. Progressive resistance training implies the gradual increase in load during the training period. The number of repetitions that each individual can complete depends on the calculation of the maximal repetition. CONCLUSION: Based on the findings of this review, the use of progressive resistance training to complement traditional exercises used in rehabilitation of chronic musculoskeletal diseases is recommended in order to standardize treatment protocols, with adequate control of individual load, and to optimize training results. However, it should be emphasized that further studies are necessary for more reliable conclusions.

OBJECTIVE: To develop a Brazilian version of the gesture behavior test (GBT) for patients with chronic low back pain. METHODS: Translation of GBT into Portuguese was performed by a rheumatologist fluent in the language of origin (French) and skilled in the validation of questionnaires. This translated version was back-translated into French by a native-speaking teacher of the language. The two translators then created a final consensual version in Portuguese. Cultural adaptation was carried out by two rheumatologists, one educated patient and the native-speaking French teacher. Thirty patients with chronic low back pain and fifteen healthcare professionals involved in the education of patients with low back pain through back schools (gold-standard) were evaluated. Reproducibility was initially tested by two observers (inter-observer); the procedures were also videotaped for later evaluation by one of the observers (intra-observer). For construct validation, we compared patients' scores against the scores of the healthcare professionals. RESULTS: Modifications were made to the GBT for cultural reasons. The Spearman's correlation coefficient and the intra-class coefficient, which was employed to measure reproducibility, ranged between 0.87 and 0.99 and 0.94 to 0.99, respectively (p < 0.01). With regard to validation, the Mann-Whitney test revealed a significant difference (p < 0.01) between the averages for healthcare professionals (26.60; SD 2.79) and patients (16.30; SD 6.39). There was a positive correlation between the GBT score and the score on the Roland Morris Disability Questionnaire (r= 0.47). CONCLUSIONS: The Brazilian version of the GBT proved to be a reproducible and valid instrument. In addition, according to the questionnaire results, more disabled patients exhibited more protective gesture behavior related to low-back.

OBJECTIVE: The objective of this study was to develop and validate a questionnaire on specific knowledge about low back pain entitled "The Low Back Pain Knowledge Questionnaire". INTRODUCTION: There is a need for instruments to assess patient knowledge regarding chronic illness. Such methods can contribute to the education of patients. METHODS: The Low Back Pain Knowledge Questionnaire was developed through five focus groups. The questionnaire was distributed to 50 patients to assess their comprehension of the terms. To assess the reproducibility, 20 patients were surveyed by two different interviewers on the same day and twice by a single interviewer with a one-to-two week interval. For the construct validation, the Low Back Pain Knowledge Questionnaire was given to 20 healthcare professionals with knowledge on low back pain and 20 patients to determine whether the questionnaire would discriminate between the two different populations. To assess the sensitivity of the questionnaire to changes in the knowledge level of the patients, it was given to 60 patients who were randomly assigned to the Intervention Group and the Control Group. The Intervention Group answered the questionnaire both before and after attending a chronic back pain educational program (back school), whereas the Control Group answered the questionnaire twice with an interval of one month and no educational intervention. RESULTS: The focus groups generated a questionnaire with 16 items. The Spearman's correlation coefficient and the intra-class correlation coefficients ranged from 0.61 to 0.95 in the assessments of the intra-observer and inter-observer reproducibility (p< 0.01). In the construct validation, the healthcare professionals and patients showed statistically different scores (p< 0.001). In the phase regarding the sensitivity to change, the Intervention Group exhibited a significant increase in their specific knowledge over the Control Group (p< 0.001). CONCLUSION: The Low Back Pain Knowledge Questionnaire was validated and proved to be reproducible, valid and sensitive to changes in patient knowledge.

OBJETIVO: Avaliar o equilíbrio funcional e a qualidade de vida em pacientes com espondilite anquilosante. TIPO DE ESTUDO: Corte transversal. MÉTODOS: Foram avaliados 60 indivíduos, sendo 30 com espondilite anquilosante (EA) e 30 saudáveis, por meio da versão brasileira da escala de equilíbrio de Berg, questionário SF-36 para avaliação da qualidade de vida e escala visual analógica da dor (EVA). RESULTADOS: O escore da escala de Berg foi, respectivamente, para os grupos EA e controle de 48,83 e 55,5, com diferença estatisticamente significante. Houve correlação positiva entre a escala de Berg e a de EVA (r = 0,469) e entre esta escala e o domínio referente à capacidade funcional do SF-36 (r = 0,648). A EVA teve correlação negativa com o SF-36 nos seguintes domínios: capacidade funcional (r = -0,753), aspecto físico (r = -0,612), estado geral de saúde (r = -0,607), dor (r = -0,827) e vitalidade (r = -0,532). CONCLUSÃO: Os pacientes com EA possuem pior equilíbrio funcional, pior qualidade de vida e mais dor que indivíduos saudáveis. O pior equilíbrio correlacionou-se com pior capacidade funcional e dor.

OBJECTIVE: To assess functional balance and quality of life among patients with ankylosing spondylitis. TYPE OF STUDY: Cross-sectional. METHODS: Sixty individuals were evaluated: 30 with ankylosing spondylitis (AS) and 30 healthy individuals - using the Brazilian version of the Berg Balance Scale, SF-36 questionnaire for the assessment of quality of life and a visual analogue scale (VAS) for pain. RESULTS: The score of the scale of Berg was respectively for groups EA and control of 48.83 and 55.5 with statistically significant difference. There was a positive correlation between the Berg Scale and the VAS (r = 0,469) and between this scale and the functional capacity domain of the SF-36 (r = 0,648). There was a negative correlation between the VAS and following domains of the SF-36: functional capacity (r = -0,753), physical aspects (r = -0,612), overall health (r = -0,607), pain (r = -0,827) and vitality (r = -0,532). CONCLUSION: Patients with AS exhibit worse functional balance, a poorer quality of life and more pain than healthy individuals. Poorer balance was correlated to pain and worse functional capacity.

CONTEXTO E OBJETIVO: A busca pela melhoria da imagem corporal é a principal motivação dos pacientes que procuram um cirurgião plástico. O objetivo deste estudo foi traduzir para o português, adaptar à cultura brasileira, testar a validade de construção e a reprodutibilidade do Body Dysmorphic Disorder Examination (BDDE). TIPO DE ESTUDO E LOCAL: Estudo transversal, realizado no Departamento de Cirurgia Plástica da Universidade Federal de São Paulo. MÉTODOS: O estudo foi realizado em duas fases. Primeiramente, o instrumento foi traduzido e retro-traduzido. Essas traduções foram submetidas à revisão por um comitê multidisciplinar até que se construísse uma versão consensual em Português. Na segunda fase do estudo foram testadas a validade e reprodutibilidade do instrumento. Os pacientes foram entrevistados em duas ocasiões distintas. Na primeira, por dois entrevistadores e na segunda ocasião por apenas um deles. Na primeira ocasião também foram administrados o Body Shape Questionnaire (BSQ) e a Escala de Auto-Estima de Rosenberg. RESULTADOS: Durante a fase de adaptação, seis questões foram modificadas. A consistência interna do instrumento foi de 0,89. O coeficiente de reprodutibilidade inter-observador foi de 0,91 e o intra-observador foi de 0,87. Quanto à validade, pode-se afirmar que os questionários BDDE e Rosenberg não apresentam correlação (0,22), ao passo que entre BDDE e BSQ a associação existente é moderada (0,64). CONCLUSÕES: O BDDE foi traduzido e adaptado com sucesso, demonstrando ser válido e reprodutível.

CONTEXT AND OBJECTIVE: Body image improvement is considered to be the main reason for undergoing plastic surgery. The objective was to translate the Body Dysmorphic Disorder Examination (BDDE) into Brazilian Portuguese and to adapt and validate this questionnaire for use in Brazil. DESIGN AND SETTING: Cross-sectional survey, at the Department of Plastic Surgery of Universidade Federal de São Paulo. METHODS: The BDDE was first translated into Portuguese and then back-translated into English. These translations were then discussed by healthcare professionals in order to establish the final Brazilian version. In a second stage, the validity and reliability of the BDDE were assessed. For this, patients were initially interviewed by two interviewers and subsequently, by only one of these interviewers. On the first occasion, in addition to the BDDE, the body shape questionnaire (BSQ) and the Rosenberg self-esteem scale were also applied. These questionnaires were applied to 90 patients. RESULTS: Six questions were modified during the assessment of cultural equivalence. Cronbach's alpha was 0.89 and the intraclass correlation coefficients for interobserver and test-retest reliability were 0.91 and 0.87, respectively. Pearson's coefficient showed no correlation between the BDDE and the Rosenberg self-esteem scale (0.22), whereas there was a moderate correlation between the BDDE and the BSQ (0.64). CONCLUSIONS: The BDDE was successfully translated and adapted, with good internal consistency, reliability and construct validity.

OBJECTIVE: To compare the energy expenditure in patients with unilateral knee osteoarthritis while walking with canes of different lengths. METHODS: A quasi-experimental study (single-group) was carried out on thirty patients with unilateral knee osteoarthritis. An adjustable aluminum cane was used, and three different cane lengths were determined for each subject: C1 - length from the floor to the greater trochanter; C2 - length from the floor to the distal wrist crease; and C3 - length obtained by the formula: height x 0.45 + 0.87 m. Resting and walking heart rates were measured with a Polar hear rate meter. Walking speed was calculated by the time required for the patient to walk 10 m. Gait energy cost was estimated using the physiological cost index, and results were compared. RESULTS: The sample consisted of 25 women and five men (average age of 68 years). Statistically significant differences in physiological cost index measurements were observed between unassisted walking and assisted walking with a cane of any length (p<0.001), as well as between walking with a C2-length cane and unassisted walking, and walking with a C1-length cane and walking with a C3-length cane (p=0.001; p = 0.037; p=0.001; respectively). CONCLUSION: These data demonstrate that small alterations in the length of canes used for weight-bearing ambulation in patients with unilateral knee osteoarthritis increase the energy expenditure measured by the physiological cost index during walking. Further studies are needed for a more precise quantification of the increase in energy expenditure during cane-assisted gait and an assessment of the effectiveness of cane use in relieving pain and improving function in patients with knee osteoarthritis.