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Background: Deficits in knee flexor strength and rate of torque development (RTD) might be present in women with patellofemoral pain (PFP). In addition, maximal strength and RTD of the knee flexors and extensors might be related with subjective and objective function in women with PFP. However, both conjectures are still poorly understood.Research Question: Do women with PFP have deficits in the maximal strength and RTD of the knee flexors and extensors during isometric, concentric, and eccentric contractions? Is there a relationship between maximal strength and RTD of the knee flexors and extensors with subjective and objective function in women with PFP?Methods: Fifty-six women with, and 46 women without, PFP participated. Maximal strength and RTD (to 30% and 60% maximal torque) during isometric, concentric, and eccentric contractions of the knee flexors and extensors were assessed using an isokinetic dynamometer. Objective assessment included single leg hop test (SLHT) and forward step-down test (FSDT). Subjective assessment involved the anterior knee pain scale.Results: Women with PFP had small to large deficits in maximal strength and RTD of the knee flexors and extensors during isometric, concentric and eccentric contractions (Effect sizes: -0.43 to -1.10; p ≤ 0.016). Small to moderate correlations of maximal concentric and eccentric knee flexor strength and RTD with SLHT and FSDT (r = 0.28 to 0.41; p ≤ 0.037) were identified. Subjective or objective function were not correlated with maximal isometric knee flexor strength and RTD, or any knee extensor measures (p > 0.05).Significance: Maximal strength and RTD deficits of the knee flexors and extensors were identified in this female PFP cohort, but they were unrelated to subjective function. The relationship of concentric and eccentric knee flexor strength and RTD deficits with poor objective function should be considered in future exercise trials for women with PFP. [ABSTRACT FROM AUTHOR]

Background: Evidence indicates the presence of both kinesiophobia and knee extension strength deficits in women with patellofemoral pain (PFP). Both impairments may contribute to apparent compensatory gait patterns including reduced cadence and peak knee flexion during stair negotiation.Research Question: Is kinesiophobia or knee extension strength associated with movement pattern in women with patellofemoral pain?Methods: Forty women with PFP were assessed with three-dimensional kinematic analyses during stair descent; isokinetic dynamometry of the knee extensors (isometric, concentric and eccentric); and the Tampa scale for kinesiophobia. Pearson coefficients were calculated to determine relationship among variables.Results: Kinesiophobia correlated significantly with cadence (r = -0.62, p < 0.001), and peak knee flexion (r = -0.76, p < 0.001). No significant correlations were found between any knee extensor strength variables and kinematics (cadence or peak knee flexion); or kinesiophobia (p > 0.05).Significance: Findings of this study could suggest addressing strength impairments alone may not adequately address kinesiophobia and movement pattern impairments in women with PFP. However, high-quality randomised controlled trials are needed to test this assumption. Further value may be added if currently evidence-based knee strengthening exercise is combined with education and/or graded exposure to address kinesiophobia, and consideration to gait retraining to address altered movement patterns at the knee. [ABSTRACT FROM AUTHOR]

Background: Patellofemoral pain (PFP) has been linked to increased patellofemoral joint stress as a result of excessive hip internal rotation. Lower hip strength and/or excessive rearfoot eversion have been used to explain such altered movement pattern; however, it is unknown which one is the best predictor of excessive hip internal rotation.Research Question: To investigate if peak rearfoot eversion and/or peak concentric hip abductor strength can predict peak hip internal rotation during stair ascent in women with PFP.Methods: This cross-sectional study included thirty-seven women with PFP which underwent three-dimensional kinematic analysis during stair ascent and hip abductor strength analysis in an isokinetic dynamometer. A forced entry linear regression model analysis was carried out to determine which independent variables present the best capability to predict the hip internal rotation.Results: Peak concentric hip abductor strength significantly predicted peak hip internal rotation during stair ascent (R2 = 0.27, p = 0.001). Peak rearfoot eversion did not predict peak hip internal rotation during stair ascent (R2 < 0.01, p = 0.62). A Post-hoc analysis was conducted to explore if a subgroup with excessive rearfoot eversion would predict hip internal rotation. Based on a previous reported cut-off point, 48.6% of the participants were classified as excessive rearfoot eversion. For the subgroup with excessive rearfoot eversion, peak concentric hip abductor strength and peak rearfoot eversion significantly predicted peak hip internal rotation during stair ascent (R2 = 0.26, p = 0.02; R2 = 0.42, p = 0.003, respectively). For non-excessive rearfoot eversion subgroup, peak concentric hip abductor strength significantly predicted peak hip internal rotation during stair ascent (R2 = 0.53; p < 0.001); and peak rearfoot eversion did not (R2 = 0.01; p = 0.65).Significance: Findings indicate that hip muscle strength seems to be related with hip internal rotation in all women with PFP. Rearfoot eversion seems to be related with hip internal rotation only in a subgroup with excessive rearfoot eversion. [ABSTRACT FROM AUTHOR]

Studies on packaging accessibility are still incipient in Brazil. Many of these packagings can represent a challenge to users, whether due to non-informative labels, tricky tabs or seals, or even those that need strength to open. This paper brings a simple test to determine the necessary torque force to open PET bottles, and to predict the amount of users that could not open it. The findings suggest that a considerable amount of users could not open it or would have some difficulties to exert the necessary force. [ABSTRACT FROM AUTHOR]

Introduction: Attributes of the neighborhood-built environment are associated with self-reported physical activity, but only a few studies have concentrated on device-measured physical activity in Latin America. This study examines the associations of perceived neighborhood-built environment attributes, device-measured sedentary time, and light-intensity and moderate-to-vigorous physical activity in adults from 8 Latin American countries.Methods: Data from Estudio Latinoamericano de Nutrición y Salud adult study, an observational multicountry study (N=2,478), were analyzed in 2020. Data were collected between 2014 and 2015. Perceived neighborhood-built environment attributes were measured using the Neighbourhood Environment Walkability Survey. Sedentary time, light-intensity physical activity, and moderate-to-vigorous physical activity data were collected using accelerometers.Results: No associations between perceived neighborhood-built environment attributes and sedentary time were found. Positive perceptions of walking/cycling facilities (β=6.50, 95% CI=2.12, 10.39) were associated with more light-intensity physical activity. Perceptions of better aesthetics (Argentina) and better walking/cycling facilities (Brazil and Ecuador) were positively associated with light-intensity physical activity. Land use mix-diversity (β=0.14, 95% CI=0.03, 0.25), walking/cycling facilities (β=0.16, 95% CI=0.05, 0.27), aesthetics (β=0.16, 95% CI=0.02, 0.30), and safety from traffic (β=0.18, 95% CI=0.05, 0.24) were positively associated with moderate-to-vigorous physical activity. Land use mix-diversity, street connectivity, and safety from traffic were positively associated with moderate-to-vigorous physical activity in Venezuela.Conclusions: These findings have implications for policy recommendations, which can guide policies to promote physical activity in the region. Land use mix-diversity, walking/cycling facilities, aesthetics, and safety from traffic can maintain or increase the levels of light-intensity and moderate-to-vigorous physical activity among Latin American adults. [ABSTRACT FROM AUTHOR]

Introduction: Musculoskeletal injuries (MSKi) are a common challenge for those in military careers. Compared to their male peers, reports indicate that female military members and recruits are at greater risk of suffering MSKi during training and deployment. The objectives of this study were to identify the types and causes of MSKi among female military personnel and to explore the various risk factors associated with MSKi.Materials and Methods: A scoping review was conducted over a 4-month time frame of English language, peer-reviewed studies published from 1946 to 2019. Search strategies for major biomedical databases (e.g., MEDLINE; Embase Classic + Embase; and the following EBM Reviews-Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Health Technology Assessment, and the NHS Economic Evaluation Database) were developed by a senior medical information specialist and included 2,891 titles/abstracts. Study selection and data collection were designed according to the Population, Concept, and Context framework. Studies were included if the study population provided stratified data for females in a military context.Results: From a total of 2,287 citations captured from the literature searches, 168 peer-reviewed publications (144 unique studies) were eligible for inclusion. Studies were identified from across 10 countries and published between 1977 and 2019. Study designs were primarily prospective and retrospective cohorts. Most studies assessed both prevalence/incidence and risk factors for MSKi (62.50%), with few studies assessing cause (13.69%). For MSKi of female recruits compared to active female members, the prevalence was higher (19.7%-58.3% vs. 5.5%-56.6%), but the incidence (0.02%-57.7% vs. 13.5%-71.9%) was lower. The incidence of stress fractures was found to be much higher in female recruits than in active members (1.6%-23.9% vs. 2.7%). For anthropometric risk factors, increased body fat was a predictor of MSKi, but not stress fractures. For physiological risk factors for both female military groups, being less physically fit, later menarche, and having no/irregular menses were predictors of MSKi and stress fractures. For biomechanical risk factors, among female recruits, longer tibial length and femoral neck diameter increased the risk of stress fractures, and low foot arch increased risk of an ankle sprain. For female active military members, differences in shoulder rotation and bone strength were associated with risk of MSKi. For biological sex, being female compared to male was associated with an increased risk of MSKi, stress fractures, and general injuries. The consequences of experiencing MSKi for active military included limited duties, time off, and discharge. For recruits, these included missed training days, limited duty days, and release.Conclusions: This scoping review provides insight into the current state of the evidence regarding the types and causes of MSKi, as well as the factors that influence MSKi among females in the military. Future research endeavors should focus on randomized controlled trials examining training paradigms to see if women are more susceptible. The data presented in the scoping review could potentially be used to develop training strategies to mitigate some of the identified barriers that negatively impact women from pursuing careers in the military. [ABSTRACT FROM AUTHOR]

Background: We tested whether stressful workplace characteristics confound or moderate the association between occupational physical activity and depressive symptoms.Method: We used data of 36,442 employed adults (16,992 women), with a mean age of 39.3 ± 12.6y, from the 2013 Brazilian National Health Survey. Depressive symptoms were assessed through the Patient Health Questionnaire-9 (cut-point: ≥10). Occupational physical activity was self-reported and classified using the cut-point of 150 min/week and the highest quintile. Ten stressful workplace characteristics (e.g. exposure to stress, noise, violence) were also self-reported dichotomously. Logistic regression models were used considering the adjustment for potential confounders.Results: Most of the stressful workplace characteristics were associated with elevated depressive symptoms (8/10 characteristics) and higher occupational physical activity (9/10 characteristics). Although there were no interactions in combined associations, we found that the association between occupational physical activity and depressive symptoms consistently reduced after adjusting for the cluster of positive screening for at least two stressful workplace characteristics in men [highest quintile: ORunadjusted: 1.63 (95%CI 1.22-2.17) vs ORadjusted: 1.36 (1.08-1.91); ≥150 min/week: ORunadjusted: 1.43 (1.09-1.88) vs ORadjusted: 1.25 (0.95-1.64)], and women [highest quintile: ORunadjusted: 2.15 1.73-2.66) vs ORadjusted: 1.83 (1.47-2.29); ≥150 min/week: ORunadjusted: 2.11 (1.68-2.65) vs ORadjusted: 1.80 (1.42-2.27)].Limitations: The cross-sectional design limits the causal inference.Conclusions: Stressful workplace characteristics did not moderate, but acted as confounders in the association between occupational physical activity and elevated depressive symptoms and should be considered in future studies. [ABSTRACT FROM AUTHOR]

Aims: We analyzed the joint association of high ultra-processed food ingestion and sedentary behavior (SB) with anxiety-induced sleep disturbance among Brazilian adolescents.Methods: Data from the Brazilian Scholar Health Survey, a nationally representative survey of 9th grade adolescents [mean: 14.28 years (range: 11-18 years)] conducted in 2015 (n = 100,648) were used. Self-reported anxiety-induced sleep disturbance, SB (TV viewing and total sitting time), and frequency of ingestion of different ultra-processed foods were collected. Age, ethnicity, type of city (capital or interior), region of the country, and habitual physical activity (global scholar survey questionnaire) were covariates. Logistic regression analyses were conducted to assess the associations.Results: High ultra-processed food ingestion plus low SB [boys:OR:1.44(99%CI:1.16-1.79), girls:OR:1.41(99%CI:1.22-1.63)] were risk factors for anxiety-induced sleep disturbance. The highest risk of anxiety-induced sleep disturbance was observed among those who joint high ultra-processed food ingestion with high SB [boys:OR:1.85(99%CI:1.46-2.35), girls:OR:1.62(99%CI:1.39-1.89)]. In addition, the interaction of high ultra-processed food ingestion with TV-viewing substantially increased the odds of anxiety-induced sleep disturbance [boys:OR:2.03(99%CI:1.61-2.56), girls:OR:2.04(99%CI:1.76-2.36)].Conclusions: Both the high consumption of ultra-processed foods and SB (especially TV-viewing) appear to be independently associated with anxiety-induced sleep disturbance in both sexes. However, the co-occurrence of both negative lifestyle behaviors is associated with a substantial increase in the risk of anxiety-induced sleep disturbance. Future longitudinal research is required to confirm/refute our findings and explore potential mechanisms. [ABSTRACT FROM AUTHOR]

Objective: Depression is commonly associated to physical multimorbidity and there is an urgent need to identify modifiable risk factors. Physical activity (PA) is good for health, but the association between PA and multimorbidity with depressive symptoms is unclear. Thus, we investigated whether meeting weekly recommended PA guidelines influences the association between multimorbidity and depressive symptoms.Methods: Data were used from a national survey conducted in Brazil in 2013 with 60,202 adults (≥ 18 years). Information regarding depressive symptoms (PHQ-9), PA, and chronic disease was collected via interview-administered questionnaires. Data on covariates (age, educational status, employment status, tobacco smoking, alcohol consumption, and TV-viewing) were also assessed. Adjusted logistic regression models were used.Results: Overall, men and women with one or more chronic conditions who were inactive (engaging in <150 min PA per week) had higher odds of elevated depressive symptoms than active individuals with no chronic condition. However, only in men, physical inactivity interacts with heart disease (OR: 2.59; 95%CI: 1.10 to 6.09), cancer (OR: 21.54; 95%CI: 2.67 to 173.94) and chronic obstructive pulmonary disease (COPD) (OR: 8.26; 95%CI: 2.20 to 31.01) regarding elevated depressive symptoms.Conclusion: Our data suggest that engaging in weekly recommended PA targets may attenuate association of heart disease, cancer and COPD with depressive symptoms among men. [ABSTRACT FROM AUTHOR]