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An editorial is presented on expecting manuscripts for using estimation methods instead of null hypothesis statistical tests. Topics include statistical inference being the process of making inferences about populations using data from samples; and availability of alternative methods of statistical inference and promotion of the methods in statistical, medical, and physiotherapy journals.

Sleep quality and weight are inversely correlated in young adults (i.e., as weight increases, sleep quality decreases), but results are still inconsistent among older adults. To examine the association between body mass index (BMI) and the waist-to-hip ratio (WHR) with sleep quality in older adults. 513 participants >60 years old were recruited. Data on BMI, WHR, age, gender, alcohol consumption, depression, comorbidities, and sleep (Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI)) were collected. Univariate and multivariate linear regression methods were used to evaluate the association between BMI, WHR and PSQI. 503 participants were included. There was a significant association between BMI (β = 0.10 95%CI: 0.04 to 0.15) and PSQI in the linear analysis, but not confirmed in the multivariate regression. No significant associations were observed between WHR and PSQI. Neither BMI nor WHR were related to sleep quality in the older population. [ABSTRACT FROM AUTHOR]

Poor sleep is a risk factor for falling among older adults. This study aimed to investigate whether poor sleep quality and excessive daytime sleepiness in older people was associated with fear of falling. Participants aged 60 years or older were interviewed, with those who did not have preserved cognitive skills being excluded. Data on age, gender, body mass index, alcohol consumption, mental status, depression, excessive daytime sleepiness, sleep quality, comorbidities and fear of falling were collected. Univariate and multivariate linear regression were conducted. The logistic regression assessed the association between daytime sleepiness and fear of falling. The odds of an older adult being afraid of falling was 3 times higher among those with excessive daytime sleepiness, in comparison to those with no excessive daytime sleepiness. The higher the daytime sleepiness, the greater the fear of falling. Health professionals should be aware of older patients' sleepiness because it can increase fear of falling and influence their treatment. [ABSTRACT FROM AUTHOR]

• Older adults have smaller pelvic and trunk rotation range of motion than adults during gait. • This difference exists for both comfortable and fast walking speeds. • There were no differences in pelvic and trunk movement in the sagittal and frontal planes. Cognitive, sensory, and biomechanical factors may affect gait of older adults. Among biomechanical factors, reduced pelvis and trunk range of motion (ROM) were associated with slower gait speed, shorter step length, and increased susceptibility to fall in older adults. To systematically review the studies that compared trunk and pelvic movement during gait among adults and older adults. Electronic search was conducted on MEDLINE, EMBASE, and Cinahl from inception until May 2020. Studies that compared trunk and/or pelvis kinematics during gait between adults and older adults were included. The following data were extracted from studies: gait speed, walking surface, and pelvis trunk ROM during gait in the three planes of motion. Meta-analyses were calculated for slow, comfortable, and fast gait speeds using random effects models. GRADE determined the strength of evidence. Twelve studies were included in this review. There was moderate-quality evidence that older adults have reduced pelvic rotation ROM at comfortable speed (SMD = −0.90 [−1.35, −0.45]) and high-quality evidence that older adults also have reduced pelvic rotation ROM at fast walking speed (SMD = −1.55 [−3.43, −0.33]). In addition, there was low-quality evidence that older adults have reduced trunk rotation at fast walking speed (SMD = −0.63 [−1.23, −0.03]). There were no differences for pelvic and trunk movement in the sagittal and frontal planes. There is low to high quality of evidence that older adults walk with less pelvic rotation ROM in comfortable and fast walking speeds, and less trunk rotation ROM during fast walking speed. [ABSTRACT FROM AUTHOR]

Background The Iconographical Falls Efficacy Scale (Icon-FES) is an innovative tool to assess concern of falling that uses pictures as visual cues to provide more complete environmental contexts. Advantages of Icon-FES over previous scales include the addition of more demanding balance-related activities, ability to assess concern about falling in highly functioning older people, and its normal distribution. Objective To perform a cross-cultural adaptation and to assess the measurement properties of the 30-item and 10-item Icon-FES in a community-dwelling Brazilian older population. Methods The cross-cultural adaptation followed the recommendations of international guidelines. We evaluated the measurement properties (i.e. internal consistency, test–retest reproducibility, standard error of the measurement, minimal detectable change, construct validity, ceiling/floor effect, data distribution and discriminative validity), in 100 community-dwelling people aged ≥60 years. Results The 30-item and 10-item Icon-FES-Brazil showed good internal consistency ( alpha and omega >0.70) and excellent intra-rater reproducibility (ICC 2,1 = 0.96 and 0.93, respectively). According to the standard error of the measurement and minimal detectable change, the magnitude of change needed to exceed the measurement error and variability were 7.2 and 3.4 points for the 30-item and 10-item Icon-FES, respectively. We observed an excellent correlation between both versions of the Icon-FES and Falls Efficacy Scale – International (rho = 0.83, p < 0.001 [30-item version]; 0.76, p < 0.001 [10-item version]). Icon-FES versions showed normal distribution, no floor/ceiling effects and were able to discriminate between groups relating to fall risk factors. Conclusion Icon-FES-Brazil is a semantically and linguistically appropriate tool with acceptable measurement properties to evaluate concern about falling among the community-dwelling older population. [ABSTRACT FROM AUTHOR]

A correction to the article "Statistical Inference Through Estimation: Recommendations From the International Society of Physiotherapy Journal Editors," by M. R. Elkins et al, that was published in a 2022 issue is presented.

The article presents the recommendations from the "International Society of Physiotherapy Journal" on the use of statistical inference through estimation.

Background: Existing guidelines and systematic reviews provide inconsistent recommendations on epidural corticosteroid injections for sciatica. Key limitations of existing reviews are the inclusion of trials with active controls of unknown efficacy and failure to provide an estimate of the size of the treatment effect. Purpose: To determine the efficacy of epidural corticosteroid injections for sciatica compared with placebo. Data Sources: International Pharmaceutical Abstracts, PsycINFO, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL. Study Selection: Randomized, placebo-controlled trials assessing the efficacy of epidural corticosteroid injections in participants with sciatica. Data Extraction: Two independent reviewers extracted data and assessed risk of bias. Leg pain, back pain, and disability were converted to common scales from 0 (no pain or disability) to 100 (worst possible pain or disability). Thresholds for clinically important change in the range of 10 to 30 have been proposed for these outcomes. Effects were calculated for short-term (>2 weeks but ≤3 months) and long-term (≥12 months) follow-up. Data Synthesis: Data were pooled with a random-effects model, and the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach was used in summary conclusions. Twenty-five published reports (23 trials) were included. The pooled results showed a significant, although small, effect of epidural corticosteroid injections compared with placebo for leg pain in the short term (mean difference, -6.2 [95% CI, -9.4 to -3.0]) and also for disability in the short term (mean difference, -3.1 [CI, -5.0 to -1.2]). The long-term pooled effects were smaller and not statistically significant. The overall quality of evidence according to the GRADE classification was rated as high. Limitation: The review included only English-language trials and could not incorporate dichotomous outcome measures into the analysis. Conclusion: The available evidence suggests that epidural corticosteroid injections offer only short-term relief of leg pain and disability for patients with sciatica. The small size of the treatment effects, however, raises questions about the clinical utility of this procedure in the target population. Primary Funding Source: None. [ABSTRACT FROM AUTHOR]

Highlights the findings and application of Cochrane reviews and other evidence pertinent to the practice of physical therapy. The Cochrane Library is a respected source of reliable evidence related to health care. Cochrane systematic reviews explore the evidence for and against the effectiveness and appropriateness of interventions—medication, surgery, education, nutrition, and exercise—and the evidence for and against the use of diagnostic tests for specific conditions. Cochrane reviews are designed to facilitate the decisions of clinicians, patients, and others in health care by providing a careful review and interpretation of research studies published in the scientific literature. Each article in this Physical Therapy (PTJ) series will summarize a Cochrane review or other scientific evidence resource on a single topic and will present clinical scenarios based on real patients to illustrate how the results of the review can be used to directly inform clinical decisions. This article focuses on the effectiveness of supervised exercise therapy for intermittent claudication. Can supervised exercise therapy help a person with intermittent claudication? [ABSTRACT FROM AUTHOR]

As the population ages, the prevalence of chronic musculoskeletal conditions, such as low back pain (LBP), increases. Sarcopenia, defined an age related loss of skeletal muscle mass, is a prevalent condition in the older population contributes significantly to functional decline, disability, frailty, and falls. The coexistence of both conditions may negatively impact the functional decline of the older adults, which may require a specific therapeutic approach to deal with both conditions. However, the first step is to investigate the prevalence of probable sarcopenia among older adults with chronic LBP and whether older adults with both conditions are more clinically disabled than older adults with chronic LBP without probable sarcopenia. The aims of this study were to determine the prevalence of probable sarcopenia among older adults with chronic LBP seeking physical therapy care in a primary care setting and to investigate whether older adults with chronic LBP and probable sarcopenia present with higher pain and disability than those with chronic LBP and no probable sarcopenia. This is a cross-sectional study design. We recruited older adults (age ≥60) living in Belo Horizonte, Brazil, reporting LBP for more than 3 months, seeking physical therapy care in a basic health unit (i.e. primary care setting) from the Brazilian National Healthcare System. Data collected included age, sex, pain intensity (0-10 scale), disability (i.e., Roland Morris disability questionnaire) and probable sarcopenia (i.e. algorithm from the European Working Group on Sarcopenia in Older People – EWGSOP2). To compare pain and disability levels in older adults with chronic LBP with and without probable sarcopenia, we calculate the mean difference (MD) and its confidence interval (CI). A total of 156 participants (73%women), mean age of 69.5 ± 6.2 years, mean pain intensity of 7.1 ± 2.3 points, and mean disability of 12.7 ± 5.5 points. The prevalence of probable sarcopenia was 31.40%. Patients with chronic LBP and probable sarcopenia reported higher mean pain intensity (MD=1.63; 95%CI: 0.89, 2.37) and disability (MD=5.38; 95%CI: 3.69, 7.07) than those with no probable sarcopenia. Nearly a third of older adults with chronic LBP seeking physical therapy care were classified as having probable sarcopenia. These patients reported higher pain and disability than patients with chronic LBP with no probable sarcopenia. In clinical practice, an approach to screening cases in older adults with chronic LBP and probable sarcopenia may help to identify more severe and disabling cases of low back pain. Future studies should investigate the prognostic value of sarcopenia in older adults with LBP. It may be possible that future therapeutic approaches should be developed and tested to treat older adults with both conditions. [ABSTRACT FROM AUTHOR]

Chronic low back pain (LBP) is a prevalent condition in older adults, being identified as a cause of disability in this population. Despite ir validity and reliability, the functional capacity tests are not often administered in patients with LBP but provide useful information related to mobility. A measurement property of the functional capacity tests that has not been investigated extensively in the LBP field is the resiveness, such as the capacity to detect changes during the intervention. To determine the responsiveness of three functional capacity tests, the Timed Up and Go test, the 4-meter Walk test, the 5 times Sit to Stand test, and to compare with the responsiveness of the Roland Morris Disability Questionnaire (RMDQ) in older adults with chronic LBP undergoing an 8-week intervention. This is a responsiveness study with measurement before and after an 8-week intervention. It was prospectively registered at the Brazilian Registry of Clinical Trials (RBR-9prhzng). Patients with nonspecific LBP (age ≥60) were recruited. The functional capacity tests and the RMDQ were administered at baseline and after 8 weeks. The intervention followed the recommendations from clinical practice guidelines for the management of nonspecific LBP: The responsiveness was determined by calculating the effect size (ES), correlation analysis, and the analysis of the Receiver Operating Characteristic (ROC) Curve to calculate the area under the curve (AUC). 118 older adults with chronic LBP were recruited. The RMDQ was the most responsiveness measure, followed by the Sit to Stand test. The ES for the RMDQ was large (ES= -0,74; 95%IC: -0,56; -0,92), whereas the 5 Times Sit to Stand test presented a small effect (EF= -0,45, 95%CI: - 0,26; -0,64). The Timed UP and Go test and the 4-meter Walk test small ESs (ES< 0,25). The 5 Times Sit to Stand test was the only one to show a fair correlation (0,25 < r <0,50) with RMDQ. The ROC analysis, only the RMDQ showed AUC values above the cut-off point of 0,70. The RMDQ was responsive to an 8-week lumbar stabilization program in older adults with chronic LBP. The 5 Times Sit to Stand test was the most responsive but presented limitations with regard to the capacity to discriminate patients who recovered from those who did not recover. A possible explanation for the lack of responsiveness foto the tests may be due to the nature of the intervention, which was not focused on increasing ability and balance, components that are necessarily assessed by functional capacity tests. Functional capacity tests are widely used to assess mobility and balance in older adults. Only the 5 Times Sit to Stand test was considered to able to detect changes in older adults who underwent an 8-week intervention program. The RMDQ was more responsive than any of the functional capacity tests. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the association of sedentary behavior and physical activity from childhood to adolescence with prevalence of low back pain in adolescents. In addition, we also explored whether sleep quality influences this association. Methods: This is a cross-sectional epidemiological study. Participants (aged 10–17 years) were recruited from public and private schools in Brazil. Sedentary behavior and previous and current engagement in physical activity were assessed through questionnaires. Low back pain and sleep quality were assessed by the Nordic questionnaire and Mini-Sleep Questionnaire, respectively. Sex, age, body mass index, abdominal obesity, socioeconomic status and sleep quality were used as potential confounders. Binary logistic regression models were used to generate values of odds ratio (OR) and 95% confidence intervals (95%CI). Results: A total of 1,001 (44,5% boys; n = 446) were included. Overall prevalence of low back pain was 18%, with higher rates among inactive and sedentary participants. Physical inactivity from childhood to adolescence in combination with high sedentary behavior doubled the likelihood of having low back pain (OR = 2.40 [95%CI: 1.38–4.18]), independent of potential confounders. Sleep quality attenuates, but not eliminates, this association (OR = 2.19 [95%CI: 1.25–3.84]). Conclusion: Being inactive from childhood to adolescence in combination with high sedentary behavior is associated with low back pain in adolescents. Sleep quality seems to attenuate, but not eliminate, this association. [ABSTRACT FROM AUTHOR]

• Hip extensors (HEX) torque was able to predict hip external rotators (HER) torque. • Both measures were strongly correlated in adults and older individuals. • There is no difference between directly measured and predicted values of HER torque. • The prediction equation was valid and accurate to estimate HER torque. The use of predictive equation of muscular torque can reduce physical effort and time spent during evaluation. To establish, validate, and test the accuracy of a prediction equation to estimate the hip external rotators (HER) torque in adults and older adults by means of hip extensors (HEX) torque measurement. Eighty-three healthy adults (development set) were assessed to test the association of HEX and HER torques and to establish the prediction equation. A separate 36 adults and 15 older adults (validation sets) were assessed to test the ability of the equation to estimate HER torque. Hip isometric strength was assessed by a handheld dynamometer. Simple linear regression analysis revealed that HEX torque was associated with HER torque (r = 0.80; p < 0.0001), resulting in the following prediction equation: HER torque = −0.02 + (0.58 * HEX torque). Paired t -test revealed no difference between directly measured and predicted values of HER torque in adults (mean difference = 0.02; 95% CI = −0.115, 0.072) and older adults (mean difference = 0.05; 95% CI = −0.02, 0.12). The HEX and HER torques were strongly correlated. The prediction equation was valid, accurate, and can be used to estimate HER muscle strength in healthy adults and older adults, requiring only the direct measurement of HEX torque. [ABSTRACT FROM AUTHOR]

Study Design: Observational cross-sectional.Objective: To investigate the association between leisure-time physical activity (LTPA) and low back pain (LBP) in adults from primary care settings, and to explore how sedentary behavior influences this association.Summary Of Background Data: LTPA is inversely associated with LBP. However, there is no study investigating this association in primary care settings from a middle-income country. Moreover, the influence of sedentary behavior in this association is unknown.Methods: Cross-sectional analysis of an ongoing longitudinal study with adults from Bauru, Brazil (n = 557). Data on physical activity, sedentary behavior (sitting time), LBP, body mass index (BMI), and chronic diseases were assessed by face-to-face interviews, physical evaluation, and medical records. Binary logistic regression was used to test the association of LTPA with the presence of LBP. Sociodemographic, behavioral, and health variables were used as covariables in the multivariable models.Results: The fully adjusted model showed that active participants were 33% less likely to have LBP when compared with those insufficiently active (odds ratios [OR]: 0.67 [95% CI: 0.46-0.98]). A significant association was found for active participants who spent less than 3 h/day sitting (OR: 0.45 [95% CI: 0.23-0.89]) but not for those who spent 3 h/day or more in sedentary activities (OR: 0.78 [95% CI: 0.48-1.27]). An inverse association of LTPA with LBP was observed in obese participants (OR = 0.49 [95% CI: 0.25-0.94]), but not in those with normal BMI and overweight.Conclusion: LTPA was inversely associated with the prevalence of LBP in adults from primary care. This association was influenced by sedentary behavior and BMI.Level of Evidence: 4. [ABSTRACT FROM AUTHOR]

• Measurement properties of most physical activity questionnaires have not been fully tested. • Construct validation and reliability of most physical activity questionnaires are not acceptable. • Methodological quality of most studies were considered poor. The number of questionnaires that measures physical activity levels has increased considerably. For Brazilian population it becomes a challenge, due to the need of a rigorous translation, adaptation and testing of measurement properties. Evaluate the methodological quality and criteria of physical activity questionnaires translated to Brazilian-Portuguese. Methodological quality and quality criteria was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments checklist. Sixty-nine studies were included, the most frequent questionnaires investigated were the International Physical Activity Questionnaire (n = 16) and the Baecke Physical Activity Questionnaire (n = 12). Translation (n = 13), reliability (n = 37) and construct validity (n = 44) were the measurement properties commonly investigated. For reliability, most studies were rated as 'adequate' for methodological quality. The Intraclass Correlation Coefficient of the questionnaires ranged from 0.20 to 1.0. For construct validity, 31 analyses showed 'inadequate' methodological quality, due to poor description of the comparator instrument. High level of evidence on reliability were found for Baecke Physical Activity Questionnaire, Self-administered Physical Activity Checklist and Physical Activity Questionnaire of the Surveillance System of Risk Factors and Protection for Chronic Diseases; on construct validity for Self-administered Physical Activity Checklist, Physical activity Questionnaire for Adolescents, Physical activity Questionnaire for Older Children and Sa ú de na B oa Questionnaire. Most questionnaires showed poor methodological quality and measurement properties. The Baecke Physical Activity Questionnaire and Self-administred Physical Activity Checklist showed better scorings for methodological quality and quality criteria. Further high methodological quality studies are still warranted. [ABSTRACT FROM AUTHOR]

The article shares insight on the benefit of research from low-income and middle-income countries (LMIC) for global health and the physiotherapy profession and stresses the need for support for LMIC research. It proposes solutions to address barriers or threats to conducting and publishing research in LMICs. It calls for international journals to consider equity, diversity and inclusion within the editorial board, prioritize recruitment of experienced reviewers and support authors from LMICs.

Purpose: Interleukin 10 (IL‐10) is a cytokine that plays a critical role with potent anti‐inflammatory properties when produced during exercise, limiting host immune response to pathogens and preventing tissue damage. The purpose of this systematic review was to assess the response of IL‐10 after acute exercise session in healthy adults. Methods: Databases of Ovid Medline (1978–2016), CINAHL (1998–2016), EMBASE (2003–2016), SportDiscus (1990–2016), and Web of Science library (1990–2016) were carefully screened. Clinical trials comparing exercise types in healthy individuals were included for pooled analysis. The trials of exercise were methodologically appraised by PEDro Scale. Results: Twelve randomized controlled and crossover trials containing 176 individuals were identified for inclusion. The Kruskal‐Wallis test showed no significant differences between type of exercise and the corresponding values in IL‐10 [X2(4) = 2.878; p = 0.449]. The duration of exercise was significantly correlated with increase in IL‐10 changes (Pearson's r = 1.00, 95%CI: 0.015–0.042, p < 0.0001) indicating that 48% of the variation in IL‐10 levels can be explained by the duration of the exercise performed. In addition, despite a linear increase, we did not find a significant correlation with the intensity of exercise and IL‐10 changes (Pearson's r = 0.218, 95%CI: −0.554–0.042, p < 0.035). Conclusion: Overall, the duration of the exercise is the single most important factor determining the magnitude of the exercise‐induced increase of plasma IL‐10. Interleukin 10 (IL‐10) is a cytokine that plays a critical role with potent anti‐inflammatory properties when produced during exercise, limiting host immune response to pathogens and preventing tissue damage. Overall, the duration of the exercise is the single most important factor determining the magnitude of the exercise‐induced increase of plasma IL‐10. [ABSTRACT FROM AUTHOR]

Objectives: To compare the responsiveness of disability measures with physical activity measures in patients with chronic low back pain (CLBP) undergoing a course of physical therapy treatment. Design: This is a prospective cohort study with two-month follow-up. Subjects: A total of 106 patients presenting with non-specific CLBP of more than three months duration were recruited. Main measures: Disability measures investigated were Quebec Back Pain Disability Scale and Roland Morris Disability Questionnaire. Physical activity measures analyzed include the Baecke Habitual Physical Activity Questionnaire and objective measures derived from an accelerometer (i.e. total time spent in moderate-to-vigorous and light physical activity, number of steps and counts per minute). Disability and physical activity measures were collected at the baseline and after eight weeks of treatment. For the responsiveness analyses, effect size (ES) and standardized response mean (SRM) were calculated. Correlations between the change in disability and physical activity measures were calculated. Results: Responsiveness for disability measures was considered to be large with ESs ranging from −1.03 to −1.45 and SRMs ranging from −0.99 to −1.34, whereas all physical activity measures showed values lower than 0.20. Changes in disability measures did not correlate with changes in physical activity measures (correlation coefficients ranged from −0.10 to 0.09). Conclusion: Disability measures were responsive after a course of physical therapy treatment in patients with CLBP. The lack of responsiveness in the physical activity measures might be due to the inability of these measures to detect change over time or the use of an intervention not designed to increase physical activity levels. [ABSTRACT FROM AUTHOR]

Background Systematic reviews provide the best evidence about the effectiveness of healthcare interventions. Although systematic reviews are conducted with explicit and transparent methods, discrepancies might occur between the protocol and the publication. Objectives To estimate the proportion of systematic reviews of physical therapy interventions that are registered, the methodological quality of (un)registered systematic reviews and the prevalence of outcome reporting bias in registered systematic reviews. Methods A random sample of 150 systematic reviews published in 2015 indexed on the PEDro database. We included systematic reviews written in English, Italian, Portuguese and Spanish. A checklist for assessing the methodological quality of systematic reviews tool was used. Relative risk was calculated to explore the association between meta-analysis results and the changes in the outcomes. Results Twenty-nine (19%) systematic reviews were registered. Funding and publication in a journal with an impact factor higher than 5.0 were associated with registration. Registered systematic reviews demonstrated significantly higher methodological quality (median = 8) than unregistered systematic reviews (median = 5). Nine (31%) registered systematic reviews demonstrated discrepancies between protocol and publication with no evidence that such discrepancies were applied to favor the statistical significance of the intervention (RR = 1.16; 95% CI: 0.63–2.12). Conclusion A low proportion of systematic reviews in the physical therapy field are registered. The registered systematic reviews showed high methodological quality without evidence of outcome reporting bias. Further strategies should be implemented to encourage registration. [ABSTRACT FROM AUTHOR]

Study Design. Cross-cultural adaptation and analysis of measurement properties. Objective. To translate and cross-culturally adapt the Lumbar Spine Instability Questionnaire (LSIQ) into Brazilian-Portuguese and to test its measurement properties in Brazilian patients with low back pain. Summary of Background Data. The selection of subgroup of patients that respond better to specific interventions is the top research priority in the field of back pain. The LSIQ is a tool able to stratify patients with low back pain who responds better to motor control exercises. There is no Brazilian-Portuguese version of the LSIQ available. Methods. The original version of the LSIQ was translated and cross-culturally adapted. We collected data from 100 patients with low back pain. In addition to LSIQ, we also collected information about physical activity levels (measured by the International Physical Activity Questionnaire short version), disability (measured by the Roland Morris Disability Questionnaire), pain intensity (measured by the Pain Numerical Rating Scale), kinesiophobia (measured by the Tampa Scale of Kinesiophobia), and depression (measured by the Beck Depression Inventory). The measurement properties tested were internal consistency, reproducibility (reliability and agreement), construct validity, and ceiling and floor effects. Results. The Brazilian-Portuguese version of the LSIQ showed good measurement properties with a Cronbach alpha of 0.79, an intraclass correlation coefficient of 0.75, a standard error of measurement of 1.65 points, and a minimal detectable change of 3.54 points. We did not detect ceiling and floor effects. The construct validity analysis was observed a moderate correlation between the LSIQ and Pain Numerical Rating Scale r=0.46, Roland Morris Disability Questionnaire r=0.66, Tampa Scale of Kinesiophobia r=0.49, and Beck Depression Inventory r=0.44. Conclusion. The Brazilian-Portuguese version of LIQ has adequate measurement properties and can be used in clinical practice and research. [ABSTRACT FROM AUTHOR]

The increasing life expectancy, disabilities and dependence, represents the greatest adversity when associated with aging. Specialized interventions for elderly health care are needed to provide a healthy aging. It has been included 16 participants, older people, practitioners of physical activity, divided into two groups: G1 <60 years (n=9) and G2 ≥ 60 years (n=7), subject to an assessment of the physical performance of the lower limbs through the Short Physical Performance Battery - SPPB. The G1 group had higher scores for balance, longer time for speed test and less time to the strength of the lower limbs when compared to G2 group and there was prevalence of moderate performance for both of them. The SPPB test is a tool to assist health professionals to identify disabilities and elderly dependences and through physical activities they could intervene to an aging with quality of life. [ABSTRACT FROM AUTHOR]

Background: Existing guidelines and systematic reviews provide inconsistent recommendations on epidural corticosteroid injections for sciatica. Key limitations of existing reviews are the inclusion of trials with active controls of unknown efficacy and failure to provide an estimate of the size of the treatment effect.Purpose: To determine the efficacy of epidural corticosteroid injections for sciatica compared with placebo.Data Sources: International Pharmaceutical Abstracts, PsycINFO, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL.Study Selection: Randomized, placebo-controlled trials assessing the efficacy of epidural corticosteroid injections in participants with sciatica.Data Extraction: Two independent reviewers extracted data and assessed risk of bias. Leg pain, back pain, and disability were converted to common scales from 0 (no pain or disability) to 100 (worst possible pain or disability). Thresholds for clinically important change in the range of 10 to 30 have been proposed for these outcomes. Effects were calculated for short-term (>2 weeks but ≤3 months) and long-term (≥12 months) follow-up.Data Synthesis: Data were pooled with a random-effects model, and the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach was used in summary conclusions. Twenty-five published reports (23 trials) were included. The pooled results showed a significant, although small, effect of epidural corticosteroid injections compared with placebo for leg pain in the short term (mean difference, -6.2 [95% CI, -9.4 to -3.0]) and also for disability in the short term (mean difference, -3.1 [CI, -5.0 to -1.2]). The long-term pooled effects were smaller and not statistically significant. The overall quality of evidence according to the GRADE classification was rated as high.Limitation: The review included only English-language trials and could not incorporate dichotomous outcome measures into the analysis.Conclusion: The available evidence suggests that epidural corticosteroid injections offer only short-term relief of leg pain and disability for patients with sciatica. The small size of the treatment effects, however, raises questions about the clinical utility of this procedure in the target population.Primary Funding Source: None. [ABSTRACT FROM AUTHOR]

Pelvic floor muscle training (PFMT) is considered to be the first-line treatment for female stress urinary incontinence (SUI). There are few studies that have tested the efficacy of unsupervised PFMT. The aim of this study was to compare the effectiveness of intensive supervised PFMT to unsupervised PFMT in the treatment of female SUI. Sixty-two women with SUI were randomized to either supervised or unsupervised PFMT after undergoing supervised training sessions. They were evaluated before and after the treatment with the Oxford grading system, pad test, quality of life questionnaire, subjective evaluation, and exercise compliance. After treatment, there were no differences between the two groups regarding PFM strength ( p = 0.20), International Consultation on Incontinence Questionnaire-Short Form score ( p = 0.76), pad test ( p = 0.78), weekly exercise compliance ( p = 0.079), and subjective evaluation of urinary loss ( p = 0.145). Both intensive supervised PFMT and unsupervised PFMT are effective to treat female SUI if training session is provided. [ABSTRACT FROM AUTHOR]

The midfoot joint complex (MFJC) is related to the mechanics and efficiency of the walking propulsive phase and low midfoot passive stiffness may require compensatory foot and ankle joint moments to avoid excessive pronation and inefficient propulsion. This study aimed to investigate the kinematics and kinetics of the MFJC and ankle during the propulsive phase of walking in subjects with larger and smaller midfoot passive stiffness. MFJC passive stiffness of 20 healthy adult participants, and the kinematics and kinetics of the MFJC (forefoot-rearfoot) and ankle (rearfoot-shank) during the stance phase of walking were measured. The participants were divided equally into two groups according to the MFJC passive stiffness. Ranges of motion (ROM) and mean joint moments were computed for the late stance. Independent t-tests (α = 0.05) revealed that subjects with lower midfoot passive stiffness showed an increased MFJC sagittal ROM (flattened longitudinal arch) (p = 0.002), increased ankle frontal ROM (more everted positions) (p = 0.002), increased MFJC frontal ROM (more inverted positions) (p = 0.019), as well as a tendency for larger ankle sagittal ROM (p = 0.056). They also showed increased MFJC (p = 0.021) and ankle (p = 0.018) moments in the sagittal plane, increased MFJC moment in the frontal plane (p = 0.047) and a tendency for a predominant ankle moment in the frontal (p = 0.058). Foot and ankle joint moments are possible strategies to reduce pronation and improve propulsion, but not sufficient to prevent the altered kinematics related to low midfoot stiffness. Therefore, midfoot passive stiffness is critical for foot and ankle kinematics and kinetics during walking propulsive phase and is a potential target of interventions. [ABSTRACT FROM AUTHOR]