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Background: The current study aimed to describe the trends in gender, ethnicity, and education inequalities of types of leisure-time physical activity (LTPA) practiced by Brazilian adults from 2006 to 2019. Methods: We used data from 2006 to 2019 of the Brazilian Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey, which is an annual survey with a representative sample of adults (≥ 18y) living in state capital cities. The types of LTPA considered were walking, running, strength/gymnastics, sports, other LTPA, and no LTPA participation. Gender (women or men), ethnicity (white, black, brown, or yellow/indigenous), and years of formal education were also self-reported. We used relative frequencies and their respective 95% confidence intervals to analyze trends. The absolute and relative differences between the proportions were used to assess the inequalities. Results: We observed increases in inequalities related to gender and education (running and strength/gymnastics), while gender inequalities for sports, other types, and no LTPA participation decreased. There were persistent inequalities related to gender (walking) and education (sports, other types, and no LTPA participation). Considering ethnicity, we noted increases in inequality for strength/gymnastics, where white adults were more active than black and brown adults. In addition, white adults reported more access to LTPA than brown adults over the years analyzed. Conclusion: Women, black and brown people, and subjects with less schooling were the most unfavored groups. While some inequalities persisted over the years, others increased, such as ethnicity and education inequalities for strength/gymnastics. [ABSTRACT FROM AUTHOR]

Quarantine periods change routines and behaviors with potential impact on different health outcomes. To determine the association between changes in physical activity and sedentary behaviors with changes in back pain during the COVID-19 pandemic quarantine among Brazilian adults. This was a nationwide survey through online questionnaires using data from 43,062 adults (≥ 18 years of age). Information on back pain was assessed using questions about episodes of back pain and worsening symptoms during the quarantine. The pattern of movement behaviors adopted before and during the pandemic were considered for physical inactivity (< 150 min/week of activity), high TV-viewing (≥ 4 h/d), and high computer/tablet use (≥ 4 h/d). Covariates included sex, age group, academic achievement, skin color, working status during the quarantine, and adherence to the quarantine. Logistic regression models were used for statistical analyses (weighted for national representativity). Becoming inactive (OR=1.76, 95% CI: 1.32, 2.37), with high TV-viewing (OR=1.35, 95% CI: 1.14, 1.61) and high computer/tablet use (OR=1.39, 95% CI: 1.11, 1.73) during the pandemic were associated with a higher incidence of back pain. The incidence of physical inactivity was also associated with increased back pain (OR=2.71, 95%CI: 1.64, 4.48). We conclude that increased physical inactivity and sedentary behaviors due to the COVID-19 pandemic quarantine are associated with the incidence and worsening symptoms of back pain among Brazilian adults. [ABSTRACT FROM AUTHOR]

Background: Active transportation is a crucial sort of physical activity for developing sustainable environments and provides essential health benefits. This is particularly important in Latin American countries because they present the highest burden of non-communicable diseases relative to other worldwide regions. This study aimed to examine the patterns of active transportation and its association with sociodemographic inequities in Latin American countries. Methods: This cross-sectional study was conducted in eight countries. Participants (n = 8547, 18–65 years) self-reported their active transportation (walking, cycling, and total) using the International Physical Activity Questionnaire. Sex, age, ethnicity, socioeconomic level, education level, public and private transport use, and transport mode were used as sociodemographic inequities. Results: Participants spent a total of 19.9, 3.1, and 23.3 min/day with walking, cycling, and total active transportation, respectively. Mixed and other ethnicity (Asian, Indigenous, Gypsy, and other), high socioeconomic level as well as middle and high education level presented higher walking than Caucasian, low socioeconomic and education level. Private transport mode and use of ≥ 6 days/week of private transport showed lower walking than public transport mode and ≤ 2 days/week of private transport. Use of ≥ 3 days/week of public transport use presented higher walking than ≤ 2 days/week of public transport. Men had higher cycling for active transportation than women. Use of ≥ 3 days/week of public transport use presented higher cycling than ≤ 2 days/week of public transport. ≥6 days/week showed lower cycling than ≤ 2 days/week of private transport use. Men (b: 5.57: 95 %CI: 3.89;7.26), black (3.77: 0.23;7.31), mixed (3.20: 1.39;5.00) and other ethnicity (7.30: 2.55;12.04), had higher total active transportation than women and Caucasian. Private transport mode (-7.03: -11.65;-2.41) and ≥ 6 days/week of private transport use (-4.80: -6.91;-0.31) showed lower total active transportation than public transport mode and ≤ 2 days/week of private transport use. Use of 3–5 (5.10: 1.35;8.85) and ≥ 6 days/week (8.90: 3.07;14.73) of public transport use presented higher total active transportation than ≤ 2 days/week of public transport use. Differences among countries were observed. Conclusions: Sociodemographic inequities are associated differently with active transportation across Latin American countries. Interventions and policies that target the promotion of active policies transportation essential to consider sociodemographic inequities. Trial registration: ClinicalTrials.Gov NCT02226627. Retrospectively registered on August 27, 2014. [ABSTRACT FROM AUTHOR]

Is patient education effective as a standalone intervention or combined with other interventions for people with knee osteoarthritis? Systematic review of randomised controlled trials. MEDLINE, EMBASE, SPORTDiscus, CINAHL and Web of Science were searched from inception to April 2020. The Cochrane Risk of Bias tool was used for included studies, and Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was used to interpret certainty of results. People with knee osteoarthritis. Any patient education intervention compared with any non-pharmacological comparator. Primary outcomes were self-reported pain and function. Twenty-nine trials involving 4,107 participants were included, informing low to very-low certainty evidence. Nineteen of 28 (68%) pooled comparisons were not statistically significant. Patient education was superior to usual care for pain (SMD −0.35, 95% CI −0.56 to −0.14) and function in the short term (−0.31, 95% CI −0.62 to 0.00), but inferior to exercise therapy for pain in the short term (0.77, 95% CI 0.07 to 1.47). Combining patient education with exercise therapy produced superior outcomes compared with patient education alone for pain in the short term (0.44, 95% CI 0.19 to 0.69) and function in the short (0.81, 95% CI 0.54 to 1.08) and medium term (0.39, 95% CI 0.15 to 0.62). When using the Western Ontario and McMaster Universities Osteoarthritis Index for these comparisons, clinically important differences indicated that patient education was inferior to exercise therapy for pain in the short term (MD 1.56, 95% CI 0.14 to 2.98) and the combination of patient education and exercise therapy for function in the short term (8.94, 95% CI 6.05 to 11.82). Although patient education produced statistically superior short-term pain and function outcomes compared with usual care, differences were small and may not be clinically important. Patient education should not be provided as a standalone treatment and should be combined with exercise therapy to provide statistically superior and clinically important short-term improvements in function compared with education alone. PROSPERO CRD42019122004. [ABSTRACT FROM AUTHOR]

Background This study examined the joint associations of leisure time physical activity and television (TV) viewing time with the prevalence of chronic diseases among Brazilian adults. Methods Data from the Brazilian Health Survey, a nationally representative survey conducted in 2013 (n  = 60 202; ≥18 years), were used. Time spent in TV viewing and leisure physical activity, physician diagnoses of diabetes, hypertension and heart disease and information on co-variables (chronological age, education, ethnicity, candies/sweets consumption, sodium intake and tobacco smoking) were collected via interview. Descriptive statistics (mean and 95% confidence interval) and logistic regression models were used for etiological analyses. Results Physical activity attenuated but did not eliminate the risk associated with high TV viewing for at least one chronic disease in the general population [odds ratio [OR]: 1.29 (1.11–1.50)] and among women [OR: 1.31 (1.09–1.60)], adults [OR: 1.24 (1.05–1.46)] and older adults [OR: 1.63 (1.05–2.53)]. On the other hand, physical activity eliminated the risk associated with high TV viewing for at least one chronic disease among men [OR: 1.24 (0.98–1.58)]. Conclusions We conclude that physical activity can attenuate but not eliminate the negative effects of high TV viewing on chronic disease among subgroups of Brazilian adults. [ABSTRACT FROM AUTHOR]

Background: Characteristics of the neighborhood built environment are associated with physical activity (PA). However, few studies with representative samples have examined environmental correlates of domain-specific PA in Latin America. We examined the associations of the perceived neighborhood built environment with domain-specific PA in a large sample of adults from eight Latin American countries. Methods: This study examined data from 8185 adults (aged 18–65 years) from eight Latin American countries. The Neighbourhood Environment Walkability Survey - Abbreviated (NEWS-A) scale was used to assess perceptions of land use mix–diversity, land use mix-access, street connectivity, walking/cycling facilities, aesthetics, safety from traffic, and safety from crime. Perceived proximity from home to public open spaces (metropolitan parks, playgrounds, public squares) and to shopping centers was also measured. Transport-related and leisure-time PA were assessed using the long form of the International Physical Activity Questionnaire. Both logistic and linear regression models were estimated on pooled data. Results: Perceptions of higher land use mix-access (OR: 1.40; 95% CI: 1.22,1.61), the existence of many alternative routes in the neighbourhood (1.12; 1.04,1.20), slow speed of traffic (1.19; 1.03,1.35) and few drivers exceeding the speed limits (1.09; 1.03,1.15) were associated with greater odds of reporting at least 10 min/week of transport-related PA. Perceptions of higher levels of land use mix-diversity, better aesthetics and greater safety from crime, the presence of crosswalks and pedestrian signals, and greater proximity of shopping centers were associated with more min/week of transport-related PA. Perceptions of higher land use mix-diversity (1.12; 1.05,1.20), higher land use mix-access (1.27; 1.13,1.43), more walking/cycling facilities (1.18; 1.09,1.28), and better aesthetics (1.10; 1.02,1.18) were associated with greater odds of engaging in at least 10 min/week of leisure-time PA versus none. Perceptions of higher land use mix-diversity were associated with more min/week of leisure PA. Conclusions: Different perceived neighborhood built environment characteristics were associated with domain-specific PA among adults from Latin America countries. Interventions designed to modify perceptions of the neighbourhood built environment might influence initiation or maintenance of domain-specific PA. Trial registration: ClinicalTrials. Gov NCT02226627. Retrospectively registered on August 27, 2014. [ABSTRACT FROM AUTHOR]

Background Our aim was to investigate the association between physical activity and alcohol consumption, as well as the sociodemographic and behavioral patterns of this association in a representative sample of Brazilian adults. Methods Data from the Brazilian Health Survey (PNS), a nationally representative survey conducted in 2013 (n = 60 202; age≥18 years), were used. Time spent in leisure physical activity, alcohol consumption as well as sociodemographic (chronological age, educational status and skin color) and associated behavioral factors (TV viewing and tobacco smoking) were collected via interview. Logistic regression models were used for the main analyses. Results Prevalence of weekly and almost daily alcohol consumption were 29.5% and 6.7% for men and 12.0% and 1.0% for women respectively. Adults with weekly alcohol consumption were more likely to be classified as physically active [young: men=OR:1.20 (CI 95%:1.02–1.39), women= OR:2.33 (CI 95%:1.92–2.82); middle-aged: men= OR:1.46 (CI 95%: 1.17–1.82), women= OR:1.75 (CI 95%:1.38–2.22); older: men= OR:1.83 (CI 95%:1.27–2.66), women= OR:2.11 (CI 95%: s1.26–3.52)], when compared to adults with no alcohol consumption. Almost daily alcohol consumption was associated with lower physical activity among young and middle-aged adults but with higher physical activity among older adults of both sexes and young women. Conclusions Weekly alcohol consumption was associated with a higher level of physical activity among young, middle aged and older adults. [ABSTRACT FROM AUTHOR]

• Crepitus is not associated with higher odds of having total knee replacement. • Crepitus is associated with decreased quadriceps strength in patients with KOA. • Crepitus does not affect physical function and quality of life of patients with KOA. To investigate whether the presence of knee crepitus is associated with the occurrence of total knee replacement (TKR), quality of life and deficits in physical function at long-term. Setting – This observational study uses longitudinal data (up to 4-year follow-up) from the Osteoarthritis Initiative (OAI). Participants – 4566 participants. Main Outcome Measure(s) – Logistic regression models were used to test if baseline knee crepitus is associated with the occurrence of TKR. Linear mixed models with adjustment for confounding variables (age, gender, BMI and Kellgren–Lawrence grade) were used to test the association between baseline knee crepitus and longitudinal changes in the pain, self-reported physical function, quality of life and performance-based function. The presence of knee crepitus at baseline does not predict the occurrence of TKR at 36 months (p = 0.58 and 0.67 for right and left knees, respectively). The crepitus group presented a slightly knee extension strength decline from baseline to 48 months (p = 0.03 for the right and 0.01 for the left knee; between group difference = 2% for both right [95%CI = −0.12; −0.01] and left knees [95%CI = −0.13; −0.02]). The presence of knee crepitus is not associated with the occurrence of TKR in the following three years. Knee crepitus is associated with slightly declines in knee extension strength, but this does not seem to affect physical function and quality of life at long-term. [ABSTRACT FROM AUTHOR]

Aim Examine the association between child and adolescent physical activity maintenance categories and metabolic profile in adolescence. Methods This cross-sectional study was conducted with 1152 adolescents (57.4% female) aged 10–16 years from Londrina, Brazil. Physical activity was self-reported in childhood (7–10 years old, retrospective data) and adolescence through questionnaires. Cardiorespiratory fitness (20 m shuttle-run test), body fat (skinfolds), waist circumference, blood pressure (automatic instrument) and blood variables (fasting glucose, HDL-cholesterol and triglycerides) were measured at adolescence. Results Frequency of physical activity in childhood and adolescence was 50.3 and 17.2%, respectively, and only 25.7% of boys and 10.9% of girls were active at both ages. Adolescents who were physically active in childhood alone were less likely [OR = 0.71 (95% CI: 0.52–0.97)] to present low cardiorespiratory fitness in adolescence compared to those who were non-active in childhood. Regardless of controlled, actives in childhood and adolescence were less likely to present low cardiorespiratory fitness [OR = 0.50 (95% CI: 0.34–0.73)], high blood pressure [OR = 0.52 (95% CI: 0.32–0.85)] and high metabolic risk score [OR = 0.44 (95% CI: 0.22–0.90)] compared to the non-actives at both ages. Conclusions Actives through childhood to adolescence are less likely to present low cardiorespiratory fitness, high blood pressure and high metabolic risk. [ABSTRACT FROM AUTHOR]

Objective. Compare pressure pain thresholds (PPTs) at the knee and a site remote to the knee in female adults with patellofemoral pain (PFP) to pain-free controls before and after a patellofemoral joint (PFJ) loading protocol designed to aggravate symptoms. Design. Cross-sectional study. Setting. Participants were recruited via advertisements in fitness centers, public places for physical activity and universities. Subjects. Thirty-eight females with patellofemoral pain, and 33 female pain-free controls. Methods. All participant performed a novel PFJ loading protocol involving stair negotiation with an extra load equivalent 35% of body mass. PPTs and current knee pain (measured on a visual analogue scale) was assessed before and after the loading protocol. PPTs were measured at four sites around the knee and one remote site on the upper contralateral limb. Results. Females with PFP demonstrated significantly lower PPTs locally and remote to the knee, both before and after the PFJ loading protocol when compared to control group. Following the loading protocol, PPTs at knee were significantly reduced by 0.54 kgf (95%CI = 0.33; 0.74) for quadriceps tendon, 0.38 kgf (95%CI = 0.14; 0.63) for medial patella, and 0.44 kgf (95%CI = 0.18; 0.69) for lateral patella. No significant change in PPT remote to the knee was observed - 0.10 kgf (95%CI = 20.04; 0.24). Conclusions. Female adults with PFP have local and widespread hyperalgesia compared to pain free controls. A novel loading protocol designed to aggravate symptoms, lowers the PPTs locally at the knee but has no effect on PPT on the upper contralateral limb. This suggests widespread hyperalgesia is not affected by acute symptom aggravation. [ABSTRACT FROM AUTHOR]

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Background: Physical inactivity and sedentary behavior are major concerns for public health. Although global initiatives have been successful in monitoring physical activity (PA) worldwide, there is no systematic action for the monitoring of correlates of these behaviors, especially in low- and middle-income countries. Here we describe the prevalence and distribution of PA domains and sitting time in population sub-groups of six south American countries. Methods: Data from the South American Physical Activity and Sedentary Behavior Network (SAPASEN) were used, which includes representative data from Argentina (n = 26,932), Brazil (n = 52,490), Chile (n = 3719), Ecuador (n = 19,851), Peru (n = 8820), and Suriname (n = 5170). Self-reported leisure time (≥150 min/week), (≥150 min/week), transport (≥10 min/week), and occupational PA total (≥10 min/week), as well as sitting time (≥4 h/day) were captured in each national survey. Sex, age, income, and educational status were exposures. Descriptive statistics and harmonized random effect meta-analyses were conducted. Results: The prevalence of PA during leisure (Argentina: 29.2% to Peru: 8.6%), transport (Peru: 69.7% to Ecuador: 8.8%), and occupation (Chile: 60.4 to Brazil 18.3%), and ≥4 h/day of sitting time (Peru: 78.8% to Brazil: 14.8%) differed widely between countries. Moreover, total PA ranged between 60.4% (Brazil) and 82.9% (Chile) among men, and between 49.4% (Ecuador) and 74.9% (Chile) among women. Women (low leisure and occupational PA) and those with a higher educational level (low transportation and occupational PA as well as high sitting time) were less active. Concerning total PA, men, young and middle-aged adults of high educational status (college or more) were, respectively, 47% [OR = 0.53 (95% CI = 0.36–0.78), I2 = 76.6%], 25% [OR = 0.75 (95% CI = 0.61-0.93), I2 = 30.4%] and 32% [OR = 0.68 (95% CI = 0.47-1.00), I2 = 80.3%] less likely to be active. Conclusions: PA and sitting time present great ranges and tend to vary across sex and educational status in South American countries. Country-specific exploration of trends and population-specific interventions may be warranted. [ABSTRACT FROM AUTHOR]

• Assessing the stability of the body may help to determine risk of injuries. • The Upper Body Test (UBT) presented good inter-day reliability. • Previous familiarization to the UBT is essential for the analysis. There are a limited number of tests for the assessment of shoulder and pelvic girdle stability. Reliable instruments are important to evaluate movement dysfunction at these joints in order to provide more objective parameters. To evaluate the inter-day reliability of the Upper Body Test in young adults. A reliability study was carried out with three assessments of the shoulder and pelvic girdle stability within 48-h intervals (Monday, Wednesday, and Friday). The OctoBalance® platform was used to perform the Upper Body Test in 31 active young adults (24.5 ± 8 years). Intraclass Correlation Coefficient (ICC 2,2) two-way mixed model, Coefficient of Variation, and Bland–Altman plots were used to verify the reliability of the test. The standard error of measurement (SEM) and the minimum detectable difference (MDD 95%) were calculated for clinical applicability. The Intraclass Correlation Coefficient ranged from 0.87 to 0.94 – Featuring a mean difference of 0.89 (95%CI = −0.19–1.97) to left and 0.95 (95%CI = −0.38–2.27) for the right side, with a low variation coefficient (3.31–5.91%) between the second and third days of assessment. There was a statistically significant difference between the first assessment day and the other test sessions. The Bland–Altman analyses revealed low bias with scores within the limits of agreement. Minimum detectable difference scores were between 4.02 and 5.10, and standard error of measurement between 1.75 and 2.72, depending on the movement side. The Upper Body Test presented good inter-day reliability for assessing the stability of the shoulder and pelvic girdle in young active healthy adults. [ABSTRACT FROM AUTHOR]