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Purpose: to assess the effects of supervised and unsupervised gamified exercise programs on physical activity level, sedentary behavior and quality of life in patients with non-communicable chronic diseases., Materials and Methods: Six database were searched. Methodological quality of included studies, the quality of reporting interventions and the quality of the applications were assessed using the PEDro, TIDieR and MARS, respectively., Results: Nine studies were included ( n  = 974; 60.2 ± 5.7 years). Three of them enrolled individuals with cancer, one with stroke, one with multiple sclerosis, one with COPD, two with Diabetes Mellitus, and one with knee and hip osteoarthritis. Gamification was performed via a smartphone application in three studies (MARS = 13.4 ± 9.75pts, ranging from 10.9 to 16.9pts). The intervention was supervised in six studies. The PEDro and TIDIeR scores were 5.5 ± 1.3 (ranging 0-8pts) and 16.11 ± 3.14 (ranging 10-20pts), respectively. Supervised gamified interventions increased the level of physical activity compared to usual supervised exercises. Quality of life was similar between groups. Unsupervised interventions were similar for all outcomes evaluated., Conclusions: Supervised gamified exercise programs seem to increase the level of physical activity compared to usual exercises in patients with chronic diseases. However, studies with better methodological qualities and subgroup analyzes are needed.

Purpose: This study examined the clinimetrics of the Brazilian-Portuguese translation of the Grade-4/5 Motor Activity Log (MAL 4/5), which assesses everyday use of the more affected upper-limb (UL) in stroke survivors with moderate/severe or severe motor impairment., Materials and Methods: The translated MAL 4/5 was administered to 47 stroke survivors with moderate/severe or severe UL motor impairment. Accelerometers were worn on participants' wrists for five days on average prior to the first assessment. Test-retest and inter-rater reliabilities were assessed using the intraclass correlation coefficient (ICC), internal consistency using Cronbach's α, and construct validity was tested with correlations with the accelerometry. The measurement error (SEM) and the minimal detectable change (MDC) were calculated., Results: MAL4/5-Brazil's test-retest reliability (AOU: ICC = 0.84; QOU: ICC = 0.90), inter-rater reliability (AOU: ICC = 0.83; QOU: ICC = 0.91), internal consistency (Cronbach's α = 0.91 and 0.95 for AOU and QOU scales, respectively), the SEM and MDC were 0.3 and 0.8 points for the AOU subscale and 0.2 and 0.5 points for the QOU subscale, respectively. The construct validity (AOU scale: r  = 0.67; QOU scale: r  = 0.76) was high., Conclusion: Grade-4/5 Motor Activity Log-Brazil is a reliable and valid instrument for assessing the more-affected UL use of stroke patients with moderate/severe or severe UL motor impairments.

Objective: Comparing the efficacy of electrical stimulation (ES) and pelvic floor muscles training (PFMT) on urinary incontinence (UI) symptoms, quality of life and sexual function on women with stress UI. Also, to analyze the influence of supervised and non-supervised PFMT., Methods: Systematic review of randomized trials involving adult women with stress UI. Studies' review was performed by two independent researchers on PubMed, EMBASE, PEDro, Cochrane Library, LILACS. The PEDro scale was used to evaluate the quality of included studies. The certainty of evidence was analyzed by the GRADE. A meta-analysis was performed., Results: Seven studies comprising 411 women with stress UI were included. Methodological quality ranged from 3 to 8 points. Treatment sessions varied from 5 to 45 min (PMFT) and 15 to 30 min (ES), from 4 weeks to 6 months. Studies varied regarding the type of electrical current and its characteristics. With very low certainty of evidence and severe risk of methodological bias, the meta-analysis showed that ES is not superior to supervised or unsupervised PFMT for any outcome., Conclusion: ES is not superior to PFMT for reducing urinary leakage or improving quality of life in women with stress UI.

Objective: We investigated the measurement properties of the incremental step test in subjects with moderate to severe asthma., Methods: Subjects with moderate to severe persistent asthma were recruited from a tertiary university hospital specializing in treating severe asthma. All subjects performed one cardiopulmonary exercise test (CPET) and two incremental step tests (IST) in random sequences. Pulmonary gas exchange was measured during all exercise tests. The measurement properties investigated were reliability by intraclass correlation coefficient (ICC), measurement error by the standard error of measurement and minimum detectable difference, construct validity by Pearson's correlation, and interpretability by the ceiling and floor effects., Results: Fifty subjects (38 females, mean [SD], age 43.7 [11.6] yr, % FEV 1 70 [14.3], BMI 28.5 [5.3] kg/m 2 ) completed the study. The peak oxygen uptake (peak VO 2 ) for the CPET was 27.6 [±6.8] ml/kg/min, for the first IST was 22.3 [±5.3] ml/kg/min and for the second IST was 23.3 [±5.3] ml/kg/min. The IST presented excellent reliability (ICC=0.93, CI95% 0.88-0.96), very good measurement error (2.5%), and construct validity for peak VO 2 measurement compared to the CPET (r = 0.85; p < 0.001) to assess exercise capacity in subjects with moderate to severe asthma, with appropriate ceiling (10%) and floor (0%) effects., Conclusion: The IST presented excellent reliability and very good measurement error and validity to assess exercise capacity in subjects with moderate to severe asthma, without ceiling or floor effects., Competing Interests: Decleration of competing interest All authors declare no conflicts of interest., (Copyright © 2022 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction and Objective: The Bronchiectasis Health Questionnaire (BHQ) is a simple, repeatable, and self-reporting health status questionnaire for bronchiectasis. This study aims to cross-culturally adapt the BHQ into Brazilian Portuguese and evaluate its measurement properties., Methods: The participants answered the Saint George...s Respiratory Questionnaire (SGRQ) and the modified Medical Research Council (mMRC) scale for dyspnea. The Brazilian-Portuguese version of the Bronchiectasis Health Questionnaire (BHQ-Brazil) was used at baseline (test) and after 14 days (retest). The psychometric analyses included internal consistency, test-retest reliability, and construct validity: factorial validity, convergent validity, and discriminative validity, agreement, and ceiling and floor effects., Results: The BHQ-Brazil demonstrated adequate internal consistency (Cronbach...s alpha...=...0.92) and substantial reliability (intraclass correlation coefficient...=...0.86; 95%CI: 0.79...0.90). The exploratory factorial analysis was considered suitable. All items presented a factorial load >0.40. The convergent validity of the BHQ-Brazil with mMRC was moderate (r...=......0.53, p...<...0.001), while concurrent validity with the SGRQ was strong (symptoms: r...=......0.72, activities: r...=......0.60, impact: r...=......0.60, total score: r...=......0.75, all p...<...0.001). The standard error of measurement was 4.81 points. The discriminative validity demonstrated that individuals with more pulmonary exacerbations, colonization by Pseudomonas aeruginosa, worst dyspnea, and a higher number of affected lung lobes presented the lowest quality of life. No floor or ceiling effects were observed., Conclusion: The BHQ-Brazil presents adequate measurement properties to evaluate the impact of bronchiectasis on health-related quality of life, and can be used in clinical and research settings., (Copyright © 2020 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.)