Abstract This research aimed to investigate the association between the skin temperature variation of the skin identified by thermography and serum CK values in healthy subjects based on a systematic review with meta-analysis. A systematic literature search was performed in June 2021 in the SCOPUS, MEDLINE, and Web of Science databases (2000 to 2021). MeSH and DeCS platforms were used to find the descriptors in English referring to the terms “thermography” and “creatine kinase” with their synonyms (nine and 13, respectively) to find studies, following the PIRT strategy: Participants (healthy subjects); Index Test (thermography); Reference Test (CK collection); Target Condition (having analyzed the results of the Index and Reference Test). A meta-analysis was performed to calculate the association between variables. A total of 483 files were retrieved from the databases, and 13 were selected for analysis (five met the criteria for meta-analysis). Considering the 13 studies reviewed, there is a general balance in obtaining results of CK increase along with skin temperature versus studies that didn’t observe any association between the measures. However, the meta-analysis showed no significant association between the variables analyzed (r= –0.05; p= 0.06; 95%CI –0.11 – 0.00). This result suggests that the result of one test cannot estimate the result of the other. It was concluded that there is no good association between CK levels and thermography results; it’s recommended the use of thermal images in addition to other evaluation methods in order to assist in the determination of special differential diagnoses of musculoskeletal injuries.

RESUMO As pressões respiratórias máximas (PImáx e PEmáx) avaliam o índice de força dos músculos respiratórios. Essas medidas são relevantes para a avaliação da força muscular respiratória e para o monitoramento clínico. O objetivo deste estudo foi avaliar os artigos que sugerem equações preditivas de PImáx e PEmáx para a população brasileira. Foram incluídos estudos que estabeleceram equações de predição para PImáx e PEmáx da população brasileira saudável, com idades entre 4 e 90 anos e de ambos os sexos, que mediam as pressões respiratórias máximas na posição sentada. Uma pesquisa foi realizada, em março de 2020, nas bases de dados MEDLINE, LILACS, Cochrane, SciELO, CINAHL, Web of Science e SCOPUS, sem filtros de tempo ou idioma. Os descritores utilizados foram “força muscular”, “equações” e “músculos respiratórios preditivos”, com seus respectivos sinônimos. Dos 3.920 estudos encontrados nas bases de dados, 963 eram duplicados e 2.779 foram excluídos, 178 tiveram seus textos analisados integralmente e apenas 9 atendiam aos critérios de inclusão. As variáveis utilizadas nas equações preditivas de força muscular ventilatória analisadas nesta revisão foram: idade, peso e estatura. No entanto, os estudos mostraram fragilidades metodológicas, como falta de validação cruzada da equação, exclusão de outliers e familiarização do PImáx e PEmáx.

ABSTRACT Maximal inspiratory and expiratory pressures (MIP and MEP) assess the strength index of the respiratory muscles. These measures are relevant to assess respiratory muscle strength and for clinical monitoring. This study evaluates papers that suggest predictive equations of MIP and MEP for the Brazilian population. We included studies that established prediction equations for MIP and MEP for the healthy Brazilian population, aged from 4 to 90 years old, both men and women and that had the maximum respiratory pressures measured in a sitting position. A search was carried out in March 2020 on MEDLINE, LILACS, Cochrane, SciELO, CINAHL, Web of Science, and SCOPUS databases, without date or language filters. The descriptors used were “muscle strength,” “equations,” “predictive respiratory muscles” and their respective synonyms. Out of the 3,920 studies found in databases, 963 were duplicates, 2,779 were excluded, 178 had their full texts analyzed, and only 9 met the inclusion criteria. The predictive equations of ventilatory muscle strength analyzed in this review used age, weight, and stature as variables. However, the studies showed methodological weaknesses, such as lack of cross-validation of the equation, exclusion of outliers, and lack of familiarization of MIP and MEP.

RESUMEN Las presiones inspiratoria y espiratoria máximas (PImáx y PEmáx) evalúan el índice de fuerza muscular respiratoria. Estas medidas son importantes en la evaluación de la fuerza muscular respiratoria y el seguimiento clínico. El objetivo de este estudio fue evaluar los artículos proponen ecuaciones predictivas para PImáx y PEmáx a la población brasileña. Se incluyeron estudios que establecieron ecuaciones predictivas para PImáx y PEmáx a la población brasileña sana de ambos sexos, de entre 4 y 90 años de edad, y que miden las presiones respiratorias máximas en posición sentada. Se realizó, en marzo de 2020, una búsqueda en las bases de datos MEDLINE, LILACS, Cochrane, SciELO, CINAHL, Web of Science y SCOPUS, sin año de publicación específico ni idioma. Los descriptores utilizados fueron “fuerza muscular”, “ecuaciones” y “músculos respiratorios predictivos” y sus respectivos sinónimos. De los 3.920 estudios encontrados, 963 eran duplicados y se excluyeron 2.779, así se analizaron 178 textos en su totalidad y solo 9 cumplieron con los criterios de inclusión. Las variables edad, peso y talla fueron las que habían sido utilizadas en las ecuaciones predictivas de fuerza muscular respiratoria analizadas por esta revisión. Sin embargo, los estudios apuntaron limitaciones metodológicas, como falta de validación cruzada de la ecuación, exclusión de outliers y familiaridad de la PImáx y PEmáx.

Abstract Aims: The present study is a review focused on analyzing the physical, psychological, and demographic factors that lead recruits to be dismissed or to request their dismissal during basic military training periods. Methods: This study is a systematic review of cohort studies. The following databases were searched in June 2019 and updated in July 2020: Embase, LILACS, CINAHL, Cochrane, MEDLINE, SCOPUS, SPORTDiscus, Web of Science, and Science Direct databases. The MeSH descriptors military personnel, risk factors, and discharge were used to elaborate the search equations. Reference lists were explored to find studies that examined the association between physical, psychological, and demographic factors that lead recruits to be discharged. The following data were extracted from the studies: profile of the participants, sample size, type of risk factors, the duration of follow-up, and the results of the statistical analysis carried out in the studies included. The risk of bias was analyzed with the Newcastle-Ottawa Scale for cohort studies. Results: A total of 531 titles were retrieved from the databases, and eight articles met the eligibility criteria. The results showed the factors associated with discharge, in descending order: musculoskeletal injuries and other medical questions, depressive and behavioural disorders, performance in physical fitness tests, and others. Factors such as educational level, alcohol use, history of suicide attempt, and imprisonments were not associated with an increased risk of being discharged. Conclusion: Musculoskeletal injuries, depression, running performance, previous physical exercise practice, and demographic factors were associated with an increased risk of being discharged.

Abstract Aims: To investigate the inter-and intra-rater agreement of the Dynamic Movement Assessment (DMA™) risk classification. Method: In this study, after the anthropometric measurements were made, 17 female soccer athletes were filmed performing the six DMA™ tests (full squat, step-up, single-leg squat, jump test, test plank, and side plank). Both, major and secondary deviations, were observed during the tests. Two experienced health professionals performed video analysis using Kinovea 8.15.0 (inter-rater agreement). To assess the intra-rater agreement, the same video analysis was performed two months later. Participants were rated from 0 to 21 points and at low, medium, moderate, and high risk of developing musculoskeletal injuries. To assess the reliability of the assessment of movement patterns of DMA, the intraclass correlation coefficient (ICC) was performed with a 2-way random-effects model with an absolute agreement (inter-rater) and a 2-way mixed-effects model and consistency (intra-rater). Weighted Kappa Agreement Analysis (kw) was performed with linear weights to assess the level of agreement related to the risk classification of DMA (high, moderate, medium, or minimum). The Analysis was performed with StatsDirect v.3 and SPSS (23.0). Results: Comparing the number of points between the inter-and intra-rater, the ICC was 0.91 (95% CI = 0.74-0.97) and 0.84 (95% CI = 0.59-0.94), respectively, with kw = 0.46 (P = 0.02) intra -rater and kw = 0.46 (P = 0.006) inter-rater (Table 9). Conclusion: DMA has excellent inter-and intra-rater reliability to evaluate movement patterns and classify the risk of musculoskeletal injuries.

Abstract Aims: To analyze the effects of physical therapy procedures in reducing acute pain in runners. A second aim was to investigate the impact of weather conditions on the number of physical therapy visits during the Ultramarathon Rio24 h. Methods: This retrospective study was performed at the Physical Education Center Admiral Adalberto Nunes (CEFAN). Medical records were analyzed. The participants were athletes that were attended by the Physical therapy team during three editions of the Ultramarathon Rio24 h. The variation in the Visual Analog Scale score (VAS) before and after each treatment were analyzed. After the evaluation procedure, another professional had decided the best procedure for the assessed athlete: massotherapy, cryotherapy by immersion, or stretching. An ANOVA was performed to assess which procedures produce pain reduction immediately after the procedure. Results: A total of 1,995 care services (228 in women) were performed in 602 athletes (84 women). Analyzing the treatments that used only one modality (n = 512 visits), the final pain decreased significantly over the initial pain for the three treatments. It was verified that massotherapy, cryotherapy, and stretching promote significant intragroup differences, with no intergroup differences. The environmental conditions were not associated with the number of visits. Conclusion: Massotherapy, cryotherapy, and stretching are effective treatments for acute pain reduction during ultramarathons. The weather conditions are not associated with the number of physical therapy visits.

Abstract Aim: To Verify the effects of hydrogymnastics on functional autonomy in elderly women. Method: In November 2018, a systematic review of the literature was performed in the databases MEDLINE, SciELO, LILACS, PEDro, Cochrane, Web of Science, SPORTDiscus, SCOPUS e CINAHL. Two independent researchers selected randomized clinical trials, which evaluated the effects of hydrogymnastics over healthy elderly women performance on functional tests performance on functional tests. From each study they selected the number of participants in both experimental and control groups (EG and CG), age, intervention protocol, mean and standard deviation before and after the intervention for the following variables: legs and biceps muscular strength, posterior muscle chain extensibility, and agility - all of which compose the functional autonomy on Rikli and Jones test. We analyzed the methodological quality and the risk of bias through the Jadad Scale and the Cochrane tool respectively. We performed the data analysis through the random effects model and the mean difference between CG and EG. The analysis of the publication bias was done with Egger Test. Results: We found a total of 887 studies in the aforementioned databases, and five randomized clinical trials were included in the present meta-analysis. In spite of the evidence level is very low, the hydrogymnastics promoted an increase in agility and leg muscle strength in elderly women.

Resumo Introdução: Pouca pesquisa foi realizada sobre os efeitos do treinamento de resistência muscular (TR) em adultos idosos hipertensos. Objetivo: O objetivo da presente metanálise foi verificar a eficácia da TR, de forma crônica, na pressão arterial sistólica (PAS) e diastólica (PAD) de idosos com hipertensão controlada. Método: Várias bases de dados da literatura foram exploradas para encontrar estudos que examinaram ensaios clínicos controlados e randomizados que avaliaram os efeitos do TR em idosos hipertensos por um período de mais de 10 semanas. Foi analisado o perfil dos participantes, o tamanho da amostra, o protocolo de intervenção e os resultados da PAS e PAD. A Escala PEDro e a ferramenta Cochrane foram utilizadas para analisar a qualidade metodológica dos estudos e o risco de viés, respectivamente. O programa RevMan5.3 foi usado para analisar os resultados na PAS e PAD após a intervenção TR e nos grupos de controle. Resultados: A metanálise de cinco estudos incluiu que, considerando os 96 indivíduos hipertensos submetidos à TR e 104 sujeitos de controle hipertensos, a prática regular de TR por 12 a 16 semanas, três vezes por semana, com três séries de 8 a 12 repetições em uma intensidade de 60% a 80% do teste de uma repetição máxima (1-RM), reduziram significativamente a PAS em 7,26 mmHg (IC 95% = -9,16 - 5,37) e PAD por 4,84 mmHg (IC 95% = -5,89 - 3,79). Conclusão: O treinamento resistido muscular foi eficaz na redução crônica da pressão arterial de idosos hipertensos controlados, podendo diminuir a necessidade de medicação anti-hipertensiva. Estes resultados implicam uma maior sobrevivência para esta população, bem como uma possível diminuição da necessidade de medicamentos inerentes à hipertensão.

Abstract Introduction: Little research has been done on the effects of muscle-resistance training (RT) in hypertensive older adults. Objective: The aim of this meta-analysis was to verify the efficacy of RT, on a chronic basis, on the systolic (SBP) and diastolic blood pressure (DBP) of hypertensive older adults. Method: Several literature databases were explored to find studies on controlled and randomized trials that evaluated the effects of RT in hypertensive older adults for more than 10 weeks. Profile of the participants, sample size, intervention protocol, and results of SBP and DBP were analyzed. The PEDro scale and the Cochrane tool were used to analyze the methodological quality of the studies and the risk of bias, respectively. The RevMan5.3 program was used to analyze the results on the SBP and DBP after the RT intervention and in the control groups. Results: The meta-analysis of five studies considering 96 hypertensive individuals who underwent RT and 104 hypertensive control subjects showed that the regular practice of RT from 12 to 16 weeks, three times a week, with three sets from 8 to 12 repetitions at an intensity of 60% to 80% of one-repetition maximum (1-RM), significantly reduced SBP by 7.26 mmHg (95%CI = -9.16 - 5.37) and DBP by 4.84 mmHg (95%CI = -5.89 - 3.79). Conclusion: The muscle-resistance training was effective in reducing, chronically, the blood pressure of hypertensive older adults. It can also decrease the need for medication inherent to hypertension.

Resumen Introducción: Poca investigación se realizó sobre los efectos del entrenamiento de resistencia muscular (ER) en adultos mayores hipertensos. Objectivo: El objetivo del presente metanálisis fue verificar la eficacia del ET, de forma crónica, en la presión arterial sistólica (PAS) y diastólica (PAD) de ancianos con hipertensión controlada. Método: Varias bases de datos de la literatura se exploraron para encontrar estudios que examinaron ensayos clínicos controlados y aleatorizados que evaluaron los efectos del ER en ancianos hipertensos por un período de más de 10 semanas. Se analizó el perfil de los participantes, el tamaño de la muestra, el protocolo de intervención y los resultados de la PAS y PAD. La Escala PEDro y la herramienta Cochrane se utilizaron para analizar la calidad metodológica de los estudios y el riesgo de sesgos, respectivamente. El programa RevMan5.3 fue utilizado para analizar los resultados en la PAS y PAD después de la intervención ER y en los grupos de control. Resultados: El metanálisis de cinco estudios incluyó que, considerando los 96 individuos hipertensos sometidos a ET y 104 sujetos de control hipertensos, la práctica regular de ET por 12 a 16 semanas, tres veces por semana, con tres series de 8 a 12 repeticiones en una intensidad del 60% al 80% de una repetición máxima (1-RM), redujo significativamente la PAS en 7,26 mmHg (IC 95% = -9,16 - 5,37) y DBP por 4,84 mmHg (IC 95% = -5,89 - 3,79). Conclusión: El entrenamiento resistido muscular fue eficaz en la reducción de la presión arterial de ancianos hipertensos controlados, crónicamente, y puede disminuir la necesidad de medicación antihipertensiva.

RESUMO A Dynamic Movement Assessment (DMATM) e o Functional Movement Screening (FMSTM) são ferramentas utilizadas para classificar o risco de lesões musculoesqueléticas em indivíduos que praticam exercícios físicos. O objetivo da presente revisão sistemática foi avaliar a associação de DMATM e FMSTM com o risco de lesões musculoesqueléticas em diferentes atividades físicas, categorizando por análise. Uma pesquisa sem filtros de idioma ou de tempo foi realizada em novembro de 2016 nas bases de dados MEDLINE, Google Scholar, SciELO, SCOPUS, SPORTDiscus, CINAHL e BVS, utilizando as palavras-chave: “predição de lesão”, “risco de lesão”, “sensibilidade”, “especificidade”, “functional movement screening” e “dynamic movement assessment”. Foram incluídos estudos prospectivos que analisaram a associação entre DMATM e FMSTM com o risco de lesões musculoesqueléticas em atividades físicas. Foram extraídos dos estudos: perfil dos participantes, tamanho da amostra, critérios de classificação da lesão, tempo de seguimento e os resultados apresentados, subdivididos pelo tipo de análise estatística. O risco de viés foi realizado com a Escala Newcastle-Ottawa para estudos de coorte. Não foi encontrado nenhum estudo sobre a DMATM. Foram incluídos 20 estudos, que analisaram um ou mais dos seguintes indicadores: acurácia diagnóstica (VPP, VPN e AUC), razão de chances (OR) ou risco relativo (RR). O FMSTM apresentou sensibilidade=12-99%; especificidade=38-97%; VPP=25-91%; VPN=28-85%; AUC=0,42-0,68; OR=0.53-54.5; e RR=0,16-5,44. O FMSTM apresentou-se como um método preditor de lesões musculoesqueléticas. Entretanto, devido às limitações metodológicas dos estudos, seu uso indiscriminado deve ser evitado.

ABSTRACT Dynamic Movement AssessmentTM (DMATM) and Functional Movement ScreeningTM (FMSTM) are tools to predict the risk of musculoskeletal injuries in individuals who practice physical activities. This systematic review aimed to evaluate the association of DMATM and FMSTM with the risk of musculoskeletal injuries, in different physical activities, categorizing by analysis. A research without language or time filters was carried out in November 2016 in MEDLINE, Google Scholar, SciELO, SCOPUS, SPORTDiscus, CINAHL and BVS databases using the keywords: “injury prediction”, “injury risk”, “sensitivity”, “specificity”, “functional movement screening”, and “dynamic movement assessment”. Prospective studies that analyzed the association between DMATM and FMSTM with the risk of musculoskeletal injuries in physical activities were included. The data extracted from the studies were: participant’s profile, sample size, injury’s classification criteria, follow-up time, and the results presented, subdivided by the type of statistical analysis. The risk of bias was performed with Newcastle-Ottawa Scale for cohort studies. No study with DMATM was found. A total of 20 FMSTM studies analyzing one or more of the following indicators were included: diagnostic accuracy (PPV, NPV and AUC), odds ratios (OR) or relative risk (RR). FMSTM showed a sensitivity=12 to 99%; specificity=38 to 97%; PPV=25 to 91%; NPV=28 to 85%; AUC=0.42 to 0.68; OR=0.53 to 54.5; and RR=0.16-5.44. The FMSTM has proven to be a predictor of musculoskeletal injuries. However, due to methodological limitations, its indiscriminate usage should be avoided.

RESUMEN Evaluación Dinámica del MovimientoTM (DMATM) y Detección del Movimiento Funcional ™ (FMS™) son herramientas para predecir el riesgo de lesiones musculoesqueléticas en individuos que practican actividades físicas. Esta revisión sistemática tuvo como objetivo evaluar la asociación de DMATM y FMSTM con el riesgo de lesiones musculoesqueléticas en diferentes actividades físicas y categorizarlas por análisis. En noviembre de 2016 se llevó a cabo una investigación sin filtros de idioma o de tiempo en las bases de datos MEDLINE, Google Scholar, SciELO, SCOPUS, SPORTDiscus, CINAHL y BVS, utilizando las palabras clave: predicción de lesiones, riesgo de lesiones, sensibilidad, especificidad, detección del movimiento funcional y evaluación dinámica de movimientos. Se incluyeron estudios prospectivos que analizaron la asociación entre DMATM y FMSTM con el riesgo de lesiones musculoesqueléticas en actividades físicas. Los datos extraídos de los estudios fueron: perfil del participante, tamaño de la muestra, criterios de clasificación de la lesión, tiempo de seguimiento y los resultados presentados, subdivididos por el tipo de análisis estadístico. El riesgo de sesgo se realizó con la Escala Newcastle-Ottawa para estudios de cohorte. No se encontró ningún estudio con DMATM. Se incluyeron un total de 20 estudios FMSTM que analizaron uno o más de los siguientes indicadores: precisión diagnóstica (VPP, VPN y ABC), odds ratios (OR) o riesgo relativo (RR). FMSTM mostró una sensibilidad = del 12 al 99%; especificidad = del 38 al 97%; VPP = del 25 al 91%; VPN = del 28 al 85%; ABC = 0,42 a 0,68; OR = 0,53 a 54,5; y RR = 0,16-5,44. El FMSTM ha demostrado ser un predictor de lesiones musculoesqueléticas. Sin embargo, debido a limitaciones metodológicas, se debe evitar su uso indiscriminado.

Resumo Introdução: O Teste de Agachamento Profundo (TAP) tem sido utilizado em avaliações pré-temporada de equipes esportivas e em cursos militares para classificar o risco de lesões musculoesqueléticas. Objetivo: Avaliar a associação do desempenho no TAP e o risco de lesões musculoesqueléticas. Métodos: Nesta revisão sistemática, uma pesquisa sem filtros de linguagem ou de tempo foi realizada nas bases de dados MEDLINE, SciELO, SCOPUS, SPORTDdiscuss, CINAHL e BVS com as seguintes palavras-título: predição de lesões, risco de lesão e agachamento profundo em dezembro de 2016. Perfil dos participantes, tamanho da amostra, classificação das lesões musculoesqueléticas, tempo de seguimento, desenho do estudo e os resultados foram extraídos dos estudos. A análise do risco de viés foi realizada com a Escala Newcastle-Ottawa. Resultados: Foram incluídos cinco estudos, utilizando diferentes análises, cujos resultados variaram. O odds ratio variou de 1,21 a 2,59 (IC 95% = 1,01-3,28); O risco relativo foi de 1,68 (IC 95% = 1,50 - 1,87), sensibilidade de 3 a 24%, especificidade de 90 a 99%, VPP de 42 a 63%, VPN de 72 a 75% e AUC de 51 a 58%. Conclusão: O TAP pode ser um teste cuja presença de disfunções de movimento é um preditor do risco de lesões musculoesqueléticas em indivíduos que praticam exercícios físicos. No entanto, devido às limitações metodológicas apresentadas, sugere-se cautela ao interpretar esses resultados. Registro PROSPERO: CRD4201706922.

Abstract Introduction: The Deep Squat Test has been applied in pre-season evaluations of sports teams and in military courses to predict the risk of musculoskeletal injuries. Objective: To evaluate the association of DS performance and the risk of musculoskeletal injuries. Methods: In this systematic review, a search without language or time filters was carried out in MEDLINE, SciELO, SCOPUS, SPORTDiscuss, CINAHL and BVS databases with the following title words: injury prediction, injury risk and deep squat in December 2016. Participants' profile, sample size, classification of musculoskeletal injuries, follow-up time, study design and results were extracted from the studies. Bias risk analysis was performed with the Newcastle-Ottawa Scale. Results: Five studies were included, using different analyzes, whose results varied. Odds ratio ranged from 1.21 to 2.59 (95% CI = 1.01 - 3.28); relative risk was 1.68 (95% CI = 1.50 - 1.87), sensitivity from 3 to 24%, specificity from 90 to 99%, PPV from 42 to 63%, NPV from 72 to 75% and AUC from 51 to 58%. Conclusion: The DS can be a test whose presence of movement dysfunctions is a predictor of the risk of musculoskeletal injuries in individuals who practice physical exercises. However, due to the methodological limitations presented, caution is suggested when interpreting such results. PROSPERO registration: CRD4201706922.