Search

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]

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]

• 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]

• 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]

To investigate the potential influence of physical, psychological, and lifestyle factors on the association between TV-viewing and depressive symptoms among Brazilian adults. We used cross-sectional data from the Brazilian National Survey, conducted in 2013 with 60,202 adults (≥18 years). Information regarding exposure (TV-viewing), potential influencing factors (multimorbidity, mobility, self-rated health, tobacco use, alcohol consumption, sugar consumption, and physical activity) as well as elevated depressive symptoms (through PHQ-9 – score > 9) (outcome) was collected via interview-administered questionnaires. Data on covariates were self-reported. Body mass index was estimated through the assessment of body mass and stature. Mediation models were estimated through the Karlson-Holm-Breen method. Individuals who reported >5 h/d of TV viewing showed a higher prevalence of depressive symptoms than those with <5 h/d of TV viewing [8.1%(99%CI:7.6%–8.6%) vs 14.2%(99%CI:12.2%–16.6%)]. The association between TV-viewing and depressive symptoms was influenced by tobacco use (Overall: 7.22%; men: 4.46%, women: 8.59%), physical activity (men: 3.99%, women: 2.28%), mobility (overall: 11.31%, men: 10.85%, women: 11.03%), and multimorbidity (overall: 9.11%, men: 11.6%, women: 6.03%). Poor self-rated health influenced the association between TV-viewing and elevated depressive symptoms only among men (15.55%). Similarly, the association between >4 h/d of TV viewing and depressive symptoms was influenced by tobacco use (men: 6.8%, women: 11.7%), physical activity for women (5.5%), self-rated health for men (14.7%), mobility (men: 8.7%, women: 17.0%), and multimorbidity (men: 9.6%, women: 12.3%). Tobacco use, physical activity, mobility, multimorbidity, and self-rated health (men) mediate the relationship between high TV-viewing and elevated depressive symptoms. Longitudinal research is required to confirm/refute our data which may also be useful to contribute to public health interventions. [ABSTRACT FROM AUTHOR]

Hip muscle weakness and altered hip biomechanics during walking are often observed in people with femoroacetabular impingement syndrome, although little is known about biomechanics during higher impact tasks. The aim of our study was to explore relationships between hip muscle strength and hip biomechanics during running in people with femoroacetabular impingement syndrome, including exploring sex as an effect-modifier of this relationship. Forty-two adults with unilateral femoroacetabular impingement syndrome (20 females; age 18-50 years; alpha angle ≥60°) completed assessments of hip muscle strength and hip biomechanics during running. Strength was assessed using a hand-held dynamometer for the hip flexors, extensors, abductors, adductors, internal rotators, and external rotators. Hip biomechanics were assessed during overground running (3–3.5 m/s) using three-dimensional motion capture and a force plate. Linear models assessed the relationships between hip strength and hip biomechanics of the symptomatic limb, controlling for body mass and running velocity along with an interaction term (strength*sex). A significant negative relationship was observed between hip external rotator strength and hip frontal plane range of motion (i.e., excursion), independent of sex (estimate = −0.039, 95%CI −0.071 to −0.008, P = 0.02). Four sex-specific interactions were observed, with a significant positive relationship between hip external rotator strength and peak hip extension moment in women (estimate = −0.413, 95%CI −0.713 to −0.114, P = 0.01) but not in men. We found significant relationships between hip external rotator strength and stance phase running biomechanics, providing further understanding on two impaired physical measures that may inform exercise-based management strategies in femoroacetabular impingement syndrome. • Hip weakness and altered movement exist with femoroacetabular impingement syndrome. • Associations between muscle strength and running biomechanics were explored. • Stronger hip external rotators were associated with less hip frontal plane motion. • Significant sex-specific interactions were observed in some associations. • Our results may help to inform exercise-based management strategies. [ABSTRACT FROM AUTHOR]