ABSTRACT Background Ear Acupuncture (EA) is a form of acupuncture in which needles are applied to the external ear and has been used in multiple painful conditions. Low back pain (LBP) is highly prevalent in active individuals and causes high economic burden to health systems worldwide. LBP affects the person’s ability to keep balance, especially in challenging conditions. Objective The aim of the study was to examine the effects of a single session of EA on pain intensity and body sway during postural tasks. Method Eighty adults with LBP and pain intensity equal to or greater than 4 (0-10 scale) were randomly allocated (1:1) to EA group (EAG) or placebo group (PG). Initially, the level of pain intensity was assessed. Next, participants stood still on a force plate either with feet in parallel or in semi-tandem and with eyes open or closed. Then, the EAG was treated with EA for 20 min and the PG was treated with detuned ultrasound. After the treatment, pain intensity was assessed again and the postural test was repeated. Pain intensity was the primary outcome and center of pressure sway area and speed were the secondary outcomes measured. Results Results revealed that pain intensity decreased in both groups after treatment, but decreased more in the EAG. For postural control, no effect of treatment and no interaction between treatment and postural condition on body sway were found. Conclusion Those findings indicate that EA is better than placebo to reduce pain, but neither treatment has any effect on postural control.

ABSTRACT BACKGROUND: Non-specific low back pain is a major health problem worldwide. Interventions based on exercises have been the most commonly used treatments for patients with this condition. Over the past few years, the Pilates method has been one of the most popular exercise programmes used in clinical practice. OBJECTIVES: To determine the effects of the Pilates method for patients with non-specific acute, subacute or chronic low back pain. METHODS: Search methods: We conducted the searches in CENTRAL, MEDLINE, EMBASE, CINAHL, PEDro and SPORTDiscus from the date of their inception to March 2014. We updated the search in June 2015 but these results have not yet been incorporated. We also searched the reference lists of eligible papers as well as six trial registry websites. We placed no limitations on language or date of publication. Selection criteria: We only included randomized controlled trials that examined the effectiveness of Pilates intervention in adults with acute, subacute or chronic non-specific low back pain. The primary outcomes considered were pain, disability, global impression of recovery and quality of life. Data collection and analysis: Two independent raters performed the assessment of risk of bias in the included studies using the 'Risk of bias' assessment tool recommended by The Cochrane Collaboration. We also assessed clinical relevance by scoring five questions related to this domain as 'yes', 'no' or 'unclear'. We evaluated the overall quality of evidence using the GRADE approach and for effect sizes we used three levels: small (mean difference (MD) < 10% of the scale), medium (MD 10% to 20% of the scale) or large (MD > 20% of the scale). We converted outcome measures to a common 0 to 100 scale when different scales were used MAIN RESULTS: The search retrieved 126 trials; 10 fulfilled the inclusion criteria and we included them in the review (a total sample of 510 participants). Seven studies were considered to have low risk of bias, and three were considered as high risk of bias. A total of six trials compared Pilates to minimal intervention. There is low quality evidence that Pilates reduces pain compared with minimal intervention, with a medium effect size at short-term follow-up (less than three months after randomization) (MD -14.05, 95% confidence interval (CI) -18.91 to -9.19). For intermediate-term follow-up (at least three months but less than 12 months after randomization), two trials provided moderate quality evidence that Pilates reduces pain compared to minimal intervention, with a medium effect size (MD -10.54, 95% CI -18.46 to -2.62). Based on five trials, there is low quality evidence that Pilates improves disability compared with minimal intervention, with a small effect size at short-term follow-up (MD -7.95, 95% CI -13.23 to -2.67), and moderate quality evidence for an intermediate-term effect with a medium effect size (MD -11.17, 95% CI -18.41 to -3.92). Based on one trial and low quality evidence, a significant short-term effect with a small effect size was reported for function (MD 1.10, 95% CI 0.23 to 1.97) and global impression of recovery (MD 1.50, 95% CI 0.70 to 2.30), but not at intermediate-term follow-up for either outcome. Four trials compared Pilates to other exercises. For the outcome pain, we presented the results as a narrative synthesis due to the high level of heterogeneity. At short-term follow-up, based on low quality evidence, two trials demonstrated a significant effect in favour of Pilates and one trial did not find a significant difference. At intermediate-term follow-up, based on low quality evidence, one trial reported a significant effect in favour of Pilates, and one trial reported a non-significant difference for this comparison. For disability, there is moderate quality evidence that there is no significant difference between Pilates and other exercise either in the short term (MD -3.29, 95% CI -6.82 to 0.24) or in the intermediate term (MD -0.91, 95% CI -5.02 to 3.20) based on two studies for each comparison. Based on low quality evidence and one trial, there was no significant difference in function between Pilates and other exercises at short-term follow-up (MD 0.10, 95% CI -2.44 to 2.64), but there was a significant effect in favour of other exercises for intermediate-term function, with a small effect size (MD -3.60, 95% CI -7.00 to -0.20). Global impression of recovery was not assessed in this comparison and none of the trials included quality of life outcomes. Two trials assessed adverse events in this review, one did not find any adverse events, and another reported minor events. AUTHORS CONCLUSIONS: We did not find any high quality evidence for any of the treatment comparisons, outcomes or follow-up periods investigated. However, there is low to moderate quality evidence that Pilates is more effective than minimal intervention for pain and disability. When Pilates was compared with other exercises we found a small effect for function at intermediate-term follow-up. Thus, while there is some evidence for the effectiveness of Pilates for low back pain, there is no conclusive evidence that it is superior to other forms of exercises. The decision to use Pilates for low back pain may be based on the patient's or care provider's preferences, and costs.

Background: Kinesio Taping® has been widely used in clinical practice. However, it is unknown whether this type of tape is more effective than placebo taping in patients with chronic lower back pain. Objective: To compare the effectiveness of Kinesio Taping® in patients with chronic non-specific low back pain against a placebo tape and a control group. Method: This is a 3-arm, randomized controlled trial with a blinded assessor. Sixty patients with chronic non-specific low back pain were randomized into one of the three groups: Kinesio Taping® group (n=20), Micropore® (placebo) group (n=20) and control group (n=20). Patients allocated to both the Kinesio Taping® group and the placebo group used the different types of tape for a period of 48 hours. The control group did not receive any intervention. The outcomes measured were pain intensity (measured by an 11-point numerical rating scale) and disability (measured by the 24-item Roland Morris Disability Questionnaire). A blinded assessor measured the outcomes at baseline, 48 hours and 7 days after randomization. Results: After 48 hours, there was a statistically significant difference between the Kinesio Taping® group versus the control group (mean between-group difference = -3.1 points, 95% CI=-5.2 to -1.1, p=0.003), but no difference when compared to the placebo group (mean between-group difference= 1.9 points, 95% CI=-0.2 to 3.9, p=0.08). For the other outcomes no differences were observed. Conclusions: The Kinesio Taping® is not better than placebo (Micropore®) in patients with chronic low back pain.

BACKGROUND: Evidence-Based Practice (EBP) has been widely used by health professionals. However, no study in Brazil has investigated the data regarding the knowledge and difficulties related to EBP from a representative sample of physical therapists.OBJECTIVE: To identify behavior, knowledge, skills, resources, opinions and perceived barriers of Brazilian physical therapists from the state of São Paulo regarding EBP.METHOD: A customized questionnaire about behavior, knowledge, skills, resources, opinions and perceived barriers regarding EBP was sent by email to a sample of 490 physical therapists registered by the Registration Board of São Paulo, Brazil. Physical therapists who did not respond to the questionnaire were contacted by telephone and/or letter. The data were analyzed descriptively.RESULTS: The final response rate was 64.4% (316/490). Because 60 physical therapists were no longer practicing, 256 answers were analyzed. The physical therapists reported that they routinely read scientific papers (89.5%) as a resource for professional development, followed by continuing education courses (88.3%) and books (86.3%). Approximately 35% of the respondents reported a clear understanding of the implementation of research findings in their practice; approximately 37% reported no difficulties in critically appraising scientific papers; and 67.2% strongly agreed that EBP is important for their practice. The most commonly reported barriers were related to difficulties in obtaining full-text papers (80.1%), using EBP may represent higher cost (80.1%) and the language of publication of the papers (70.3%).CONCLUSION: Physical therapists from São Paulo state believe that they have knowledge and skills to use EBP. Although they have favorable opinions regarding its implementation, they still encounter difficulties in implementing EBP successfully.

Revisões sistemáticas têm como objetivo sumarizar toda a evidência disponível, através de métodos rigorosos, para responder a uma pergunta de pesquisa específica com o mínimo de viés possível. Revisões sistemáticas são amplamente utilizadas na fisioterapia, porém nem todas as revisões possuem boa qualidade. Esse tutorial tem como objetivo guiar os autores do Brazilian Journal of Physical Therapy sobre como revisões sistemáticas deveriam ser conduzidas e descritas para que sejam aceitas para publicação. Espera-se que esse tutorial irá auxiliar autores de revisões sistemáticas, assim como editores e revisores de periódicos em como conduzir, descrever, fazer análise crítica e interpretar esse tipo de delineamento de pesquisa.

Systematic reviews aim to summarize all evidence using very rigorous methods in order to address a specific research question with less bias as possible. Systematic reviews are widely used in the field of physical therapy, however not all reviews have good quality. This tutorial aims to guide authors of the Brazilian Journal of Physical Therapy on how systematic reviews should be conducted and reported in order to be accepted for publication. It is expected that this tutorial will help authors of systematic reviews as well as journal editors and reviewers on how to conduct, report, critically appraise and interpret this type of study design.

Background : While the research design of articles published in medical journals and in some physical therapy journals has already been evaluated, this has not been investigated in Brazilian physical therapy journals. Objective : To describe the research design used in all articles published in Brazilian scientific journals that are freely available, have high Qualis rankings, and are relevant to physical therapy over a 7-year period. Method : We extracted the bibliometric data, research design, research type (human or animal), and clinical area for all articles published. The articles were grouped into their level of evidence, and descriptive analyses were performed. We calculated the frequency, proportions of articles, and 95% confidence interval of these proportions with each research design in each journal. We cross-tabulated the clinical areas with research designs (expressed as number and percentages). Results : A total of 1,458 articles from four Brazilian journals were found: Revista Brasileira de Fisioterapia, Revista Fisioterapia em Movimento, Revista Fisioterapia e Pesquisa, and Revista Acta Fisiátrica. The majority of articles were classified as level II of evidence (60%), followed by level III (29%) and level I (10%). The most prevalent research designs were cross-sectional studies (38%), single-case or case-series studies, and narrative reviews. Most articles reported human research and were in the musculoskeletal, neurologic, and cardiothoracic areas. Conclusions : Most of the research published in Brazilian physical therapy journals used levels II and III of evidence. Increasing the publication rate of systematic reviews and randomized controlled trials would provide more high-quality evidence to guide evidence-based physical therapy practice.

OBJETIVOS: Revisar estudos controlados aleatorizados sobre a eficácia do método Pilates no tratamento da dor lombar crônica não específica. MÉTODO: Buscas foram realizadas nas bases de dados MEDLINE, EMBASE, PEDro, SciELO, LILACS, CINAHL e CENTRAL em março de 2013. Foram selecionados apenas estudos controlados aleatorizados em adultos com dor lombar crônica não específica, cujo tratamento foi baseado no método Pilates comparado com nenhuma intervenção ou intervenção mínima, outros tipos de intervenção ou exercícios, sem restrição ao idioma de publicação. Os dados referentes à dor e incapacidade foram extraídos de textos, tabelase figuraspara combinação por metanálise. RESULTADOS: Dos 1545 artigos encontrados, oito foram considerados elegíveis e sete foram incluídos na metanálise. Dois estudos compararam o método Pilates com outros exercícios, e quatro estudos compararam com nenhuma intervenção ou intervenção mínima para dor a curto prazo; quatro estudos compararam o método Pilates com intervenção mínima para incapacidade a curto prazo. Na metanálise, houve diferença significante para dor e incapacidade na comparação com nenhuma intervenção ou intervenção mínima (diferença entre médias=1,6 pontos; IC 95% 1,4 a 1,8; diferença entre médias=5,2 pontos; IC 95% 4,3 a 6,1; respectivamente). O método Pilates não foi superior para o desfecho dor com relação a outros exercícios a curto prazo. CONCLUSÃO: Sugere-se que o método Pilates é mais eficaz que intervenção mínima para melhora da dor e incapacidade a curto prazo. O método Pilates não é mais eficaz que outros tipos de exercícios para melhora da dor a curto prazo.

OBJECTIVE: To systematically review the available evidence on the efficacy of the Pilates method in patients with chronic nonspecific low back pain. METHOD: Searches were performed in MEDLINE, EMBASE, PEDro, SciELO, LILACS, CINAHL and CENTRAL in March 2013. Randomized controlled trials that tested the effectiveness of the Pilates method (against a nontreatment group, minimal intervention or other types of interventions) in adults with chronic low back pain were included regardless the language of publication. The outcome data were extracted from the eligible studies and were combined using a meta-analysis approach. RESULTS: The searches identified a total of 1,545 articles. From these, eight trials were considered eligible, and seven trials were combined in the meta-analysis. The comparison groups were as follows: Pilates versus other types of exercises (n=2 trials), and Pilates versus no treatment group or minimal intervention (n=4 trials) for short term pain; Pilates versus minimal intervention for short-term disability (n=4).We determined that Pilates was not better than other types of exercises for reducing pain intensity. However, Pilates was better than a minimal intervention for reducing short-term pain and disability (pain: pooled mean difference=1.6 points; 95% CI 1.4 to 1.8; disability: pooled mean difference=5.2 points; 95% CI 4.3 to 6.1). CONCLUSIONS: Pilates was better than a minimal intervention for reducing pain and disability in patients with chronic low back pain. Pilates was not better than other types of exercise for short-term pain reduction.

CONTEXTUALIZAÇÃO: A maior parte dos instrumentos utilizados para avaliação dos fatores de risco de desenvolvimento dos distúrbios musculoesqueléticos relacionados ao trabalho foram originalmente desenvolvidos em língua inglesa, dificultando seu uso em países cuja língua primária não é o inglês, como é o caso do Brasil. OBJECTIVO: Testar as propriedades clinimétricas do instrumento Quick Exposure Check (QEC) para o português-brasileiro. MÉTODO: A versão original do QEC foi traduzida e adaptada transculturalmente para o português-brasileiro e testada em 107 trabalhadores de dois setores de produção de uma indústria têxtil. A consistência interna e a validade de construto foram testadas utilizando apenas valores basais dos participantes, enquanto a reprodutibilidade foi avaliada em um delineamento de teste e reteste, com intervalo de sete dias. RESULTADOS: A versão adaptada apresentou níveis adequados de consistência interna (α Cronbach=0,76), confiabilidade intraobservador moderada (ICC entre 0,41 e 0,60) e confiabilidade interobservador variando de moderada a substancial (ICC entre 0,62 e 0,86). O erro-padrão da medida (EPM) variou de 8,3 a 11,2 pontos. Níveis moderados de validade de construto foram observados (r de Pearson=0,38). CONCLUSÃO: A versão do QEC para o português-brasileiro possui propriedades clinimétricas adequadas para mensuração de diferentes níveis de exposição aos fatores de risco ergonômicos, podendo ser utilizada por pesquisadores e profissionais da saúde e segurança ocupacional.

BACKGROUND: Most of the available instruments aimed to assess risk exposure associated with work-related musculoskeletal disorders were originally developed in English, which makes their use difficult in countries such as Brazil. OBJECTIVE: To test the clinimetric properties of the Quick Exposure Check (QEC) instrument previously adapted into Brazilian-Portuguese. METHOD: The original version of the QEC was translated and cross-culturally adapted into Brazilian-Portuguese and tested with 107 workers in two sectors of a textile factory. The internal consistency and construct validity were tested using only baseline values from the participants while reproducibility (reliability and agreement) was evaluated in a test-retest design with a seven-day interval. RESULTS: The adapted version presented appropriate levels of internal consistency (Cronbach's α=0.76); moderate intra-observer reliability (ICCs ranging from 0.41 to 0.60); moderate to substantial inter-observer reliability (ICCs ranging between 0.62 and 0.86). The standard error of the measurement (SEM) ranged from 8.3 to 11.2 points. Moderate levels of construct validity (Pearson's r=0.38) were observed. CONCLUSIONS: The Brazilian version of the QEC has appropriate clinimetric properties for measuring different levels of exposure to ergonomics risk factors and can now be used by Brazilian researchers and Occupational Health professionals.

CONTEXTUALIZAÇÃO: A Unidade de Biofeedback Pressórico (UBP) é uma ferramenta de avaliação usada na prática clínica e pesquisa científica para analisar indiretamente a atividade muscular do transverso abdominal (TrA). A validade concorrente da UBP em uma amostra clinicamente relevante ainda não está esclarecida. OBJETIVO: Avaliar a validade concorrente e acurácia diagnóstica da UBP em mensurar a atividade muscular do TrA em pacientes com dor lombar crônica inespecífica. MÉTODO: Este estudo foi realizado usando um delineamento de validação. Cinquenta pacientes com dor lombar crônica inespecífica foram recrutados. Para testar a validade concorrente, ambas as medidas pressóricas (teste índice) e eletromiográficas superficiais (teste padrão de referência) foram comparadas e coletadas por um fisioterapeuta a partir de uma manobra de contração voluntária do músculo TrA. RESULTADOS: Os participantes tinham em média 22 anos, 63,7 kg, 1,70 m de altura, e a duração média de dor lombar era de 1,9 ano. Observou-se um coeficiente Phi fraco e não significativo (r=0,2; p<0,20). Com relação aos testes de acurácia diagnóstica, os resultados sugerem uma baixa sensibilidade (60%) e especificidade (60%) da UBP. O valor preditivo positivo foi elevado (0,8), e o valor preditivo negativo foi baixo (0,2). Conclusões: A validade concorrente da UBP em mensurar a atividade muscular do TrA em pacientes com dor lombar crônica inespecífica é pobre, considerando a baixa correlação e acurácia diagnóstica com a EMG de superfície.

BACKGROUND: The Pressure biofeedback unit (PBU) is an assessment tool used in clinical practice and research aimed to indirectly analyze the transversus abdominis (TrA) muscle activity. The concurrent validity of the PBU in a clinically relevant sample is still unclear. OBJECTIVE: The purpose of this study was to evaluate the concurrent validity and diagnostic accuracy of the PBU in measuring TrA muscle activity in patients with chronic nonspecific low back pain. METHOD: This study was performed using a validation, cross-sectional design. Fifty patients with chronic nonspecific low back pain were recruited for this study. To test the concurrent validity both PBU measures (index test) and superficial electromyographic measures (reference-standard test) were compared and collected by a physical therapist in a series of voluntary contraction maneuvers of TrA muscle. RESULTS: Participants were on average 22 years old, weighed 63.7 kilos, 1.70 meters height and mean low back pain duration was 1.9 years. It was observed a weak and non-significant Phi coefficient (r=0.2, p<0.20). With regards to diagnostic accuracy tests, our results suggest a low sensitivity (60%) and specificity (60%) of the PBU. The positive predictive value was high (0.8) and negative predictive value was low (0.2). Conclusions: Concurrent validity of the PBU in measuring TrA muscle activity in patients with chronic nonspecific low back pain is poor given the low correlation and diagnostic accuracy with superficial EMG.

CONTEXTUALIZAÇÃO: As revisões sistemáticas são consideradas a melhor forma de sintetizar toda a informação existente sobre um determinado tópico, porém não se conhece, até o momento, a qualidade da apresentação textual das revisões sistemáticas em fisioterapia publicadas no idioma português. Objetivo: Analisar a apresentação textual de revisões sistemáticas em fisioterapia publicadas no idioma português utilizando as recomendações PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). MÉTODO: Foram analisadas todas as revisões sistemáticas apresentadas na base de dados PEDro até o mês de agosto de 2011. Para a análise da descrição textual foi utilizada a lista de verificação PRISMA. Cada revisão foi avaliada por pares de revisores independentes e, em caso de discordância entre os pares, um terceiro avaliador fez a arbitragem final. RESULTADOS: Foram identificadas 37 revisões sistemáticas que foram publicadas entre os anos de 2003 e 2010. Menos de 30% dos itens da lista de verificação PRISMA foram descritos pelos autores, sendo que a maioria dos itens satisfeitos se refere às seções de introdução e discussão. Observou-se que não houve um aumento na adesão aos itens recomendados para a apresentação textual com o passar do tempo. CONCLUSÕES: A adesão aos critérios preconizados pela lista de verificação da PRISMA é baixa para revisões sistemáticas publicadas no idioma português, o que pode ser reflexo do desconhecimento da existência de tais recomendações. A implementação de recomendações aos autores pelos periódicos nacionais poderá auxiliar os autores na redação de seus artigos, melhorando a clareza com que reportam seus estudos.

BACKGROUND: Systematic reviews are considered the best design to synthesize all existing information of a given research topic. To date, there is no study that investigated the quality of reporting of systematic reviews relevant to physical therapy published in Portuguese. Objective: To analyse the quality of reporting of systematic reviews in the field of physical therapy published in Portuguese by using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) checklist. METHOD: All systematic reviews published in Portuguese that were indexed on PEDro database up to August 2011 were included. The quality of reporting of the eligible papers was analysed by using the PRISMA checklist. Each quality assessment was performed by two independent reviewers with arbitration of a third reviewer if necessary. RESULTS: A total of 37 systematic reviews were identified. These studies were published between 2003 and 2010. Less than 30% of the PRISMA checklist items were satisfied, being most of the items related to the introduction and discussion sections. No improvements over time were observed. CONCLUSIONS: Most of the studies did not satisfy the items from the PRISMA Checklist. It seems that most of authors did not know the existence of this checklist. The implementation of reporting statements such as the PRISMA statement by Portuguese-written journals is likely to help authors to write their systematic reviews in a more transparent and clear way.

OBJETIVOS: Avaliar as atitudes e crenças de fisioterapeutas brasileiros sobre a dor lombar crônica e identificar características sociodemográficas que as influenciam. MÉTODOS: Este estudo transversal incluiu 100 fisioterapeutas brasileiros que atendem pacientes com dor lombar crônica em sua rotina clínica. As atitudes e crenças foram avaliadas pela Pain Attitudes and Beliefs Scale for Physiotherapists (PABS.PT) e Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS). Foram construídos modelos de regressão linear multivariada para verificar as possíveis características sociodemográficas que poderiam estar associadas com as atitudes e crenças dos fisioterapeutas. RESULTADOS: Os escores médios dos fatores biomédico e comportamental da PABS.PT foram 27,06 (DP 7,19) e 24,34 (DP 6,31), respectivamente, e o escore médio da HC-PAIRS foi 45,45 (DP 10,45). O escore do PABS.PT Fator biomédico foi associado com gênero e anos de experiência profissional. Já o escore do PABS.PT Fator comportamental não foi associado com nenhuma variável. O escore do HC-PAIRS foi significativamente associado com o número de pacientes com dor lombar atendido por mês. Esses resultados indicam que fisioterapeutas experientes tendem a seguir uma abordagem biomédica no tratamento de pacientes com dor lombar crônica. Além disso, quanto menor a experiência profissional, mais forte é a crença na relação entre dor e incapacidade. CONCLUSÕES: Os fisioterapeutas brasileiros mostram-se incertos acerca dos fatores que envolvem o desenvolvimento e a manutenção da dor lombar crônica e também sobre a relação entre dor e incapacidade nesses pacientes. Isso põe em questão as atitudes e práticas em relação ao manejo dos pacientes com dor lombar crônica no Brasil.

OBJECTIVES: To measure the attitudes and beliefs of Brazilian physical therapists about chronic low back pain and to identify the sociodemographic characteristics that are more likely to influence these attitudes and beliefs. METHODS: We conducted a cross-sectional study with 100 Brazilian physical therapists who routinely work with chronic low back pain patients. The attitudes and beliefs were measured by the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS.PT) and the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS). Multivariate linear regression models were built to identify sociodemographic characteristics that could be associated with physical therapists' attitudes and beliefs. RESULTS: Mean scores on the biomedical and biopsychosocial factors of PABS.PT were 27.06 (SD 7.19) and 24.34 (SD 6.31), respectively, and the mean score on HC-PAIRS was 45.45 (SD 10.45). The score on PABS.PTbiomedical was associated with gender and years of professional experience. No variable was associated with the score on PABS.PTbiopsychosocial. The score on HC-PAIRS was significantly associated with the number of back pain patients seen by the physical therapist each month. These results indicate that male and less experienced physical therapists tend to follow a biomedical approach to the treatment of chronic low back pain patients, and that the lower the professional experience the stronger the belief in the relationship between pain and disability. CONCLUSIONS: Brazilian physical therapists are uncertain of the factors involved in the development and maintenance of chronic low back pain and about the relationship between pain and disability in these patients.

OBJETIVOS: Avaliar os procedimentos de tradução/adaptação cultural e das propriedades de medida de questionários que avaliam dor e disfunções no ombro, os quais já foram traduzidos/adaptados para a língua portuguesa. MÉTODOS: Foram realizadas buscas sistematizadas nas bases de dados eletrônicas MEDLINE, EMBASE, CINAHL, SCIELO e LILACS para identificar os estudos relevantes. Foram extraídos os dados referentes à tradução e adaptação cultural, além dos dados das propriedades de medida de cada estudo. Todos os estudos foram analisados quanto à sua respectiva qualidade metodológica de acordo com as diretrizes para adaptação cultural e para as propriedades de medida. RESULTADOS: Um total de 876 estudos foi identificado nas buscas, e, desses, apenas 11 foram considerados elegíveis, sendo que eles adaptaram e/ou testaram sete instrumentos diferentes (DASH, WORC, SPADI, PSS, ASORS, ASES e UCLA). A maioria deles cumpriu adequadamente as recomendações das diretrizes de adaptação transcultural. Dois dos sete questionários não foram testados para nenhuma propriedade de medida (PSS e ASES), e apenas dois questionários (WORC e DASH) foram testados para praticamente todas as propriedades de medida, porém nem todas foram testadas adequadamente. Nenhum questionário testou por completo todas as propriedades de medida. CONCLUSÕES: Os processos de tradução e adaptação transcultural foram realizados de maneira adequada para a maioria dos instrumentos, porém a maioria não teve suas propriedades de medida testadas adequadamente. Recomenda-se que somente instrumentos testados para suas respectivas propriedades de medida sejam utilizados na prática clínica assim como em pesquisas.

OBJECTIVES: To evaluate the quality of the adaptation procedures as well as the clinimetric testing of the shoulder disability questionnaires available in Portuguese that has occurred for each adaptation. METHODS: Systematic literature searches on MEDLINE, EMBASE, CINAHL, SCIELO and LILACS were performed to identify relevant studies. Data on the quality of the cross-cultural adaptation procedures and clinimetric testing were extracted. All studies were evaluated according to the current guidelines for cross-cultural adaptation and measurement properties. RESULTS: Seven different questionnaires adapted into Brazilian-Portuguese (DASH, WORC, SPADI, PSS, ASORS, ASES and UCLA) were indentified from eleven studies. Most of the studies performed the cross-cultural adaptation procedures following the recommendations from the guidelines. From a total of seven instruments, two were not tested for any measurement property (PSS and ASES) and two questionnaires (DASH and WORC) were evaluated for almost all of properties. None of the questionnaires were fully tested for their measurement properties. CONCLUSIONS: Although most of the shoulder disability questionnaires have been properly adapted into Brazilian-Portuguese, some of them were either inadequately tested or not tested at all. It is recommended that only tested instruments can be used in clinical practice, as well as in research.

CONTEXTUALIZAÇÃO: A corrida é uma das atividades físicas mais populares do mundo, sendo que o número de praticantes vem crescendo nos últimos 40 anos. Uma das consequências do aumento da popularidade da prática de corrida é o aumento das lesões musculoesqueléticas. OBJETIVOS: Descrever os hábitos, as características de treinamento e o histórico de lesões de corredores recreacionais, além de verificar possíveis associações entre os hábitos e as características de treinamento com lesões musculoesqueléticas prévias relacionadas à corrida. MÉTODOS: Duzentos corredores preencheram um formulário contendo questões sobre dados pessoais, histórico da prática de corrida, características do treinamento, tipo de tênis, tipo de pisada e histórico de lesões nos últimos 12 meses. Os dados foram analisados pela estatística descritiva e modelos de regressão logística. RESULTADOS: A maioria dos corredores eram homens, com idade média de 43 (DP=10,5) anos, índice de massa corporal de 24,2 (IQ=4,3) kg/m², volume de treino de 35 km semanais (IQ=28), e 55% dos corredores relataram apresentar alguma lesão musculoesquelética nos últimos 12 meses. As principais lesões encontradas foram as tendinopatias e as lesões musculares. A variável que apresentou associação com lesão musculoesquelética prévia relacionada à corrida foi a experiência de corrida entre cinco e 15 anos (Odds Ratio (OR)=0,2; IC95%=0,1 a 0,9). CONCLUSÕES: A prevalência de lesões musculoesqueléticas relacionadas à corrida nos últimos 12 meses foi de 55%, e a variável experiência de corrida foi associada com a ausência de lesões musculoesqueléticas prévias relacionadas à corrida.

BACKGROUND: Running is one of the most popular physical activities in the world and the number of runners has increased over the past 40 years. One of the consequences of the growing running popularity is the increase of musculoskeletal injuries. OBJECTIVES: To describe the routines, training characteristics and history of injury in recreational runners and to evaluate possible associations between the routines and training characteristics with previous musculoskeletal running-related injuries. METHODS: A total of 200 runners participated in this study. The participants completed an electronic form containing questions about personal characteristics, running experience, training characteristics, type of running shoes, foot type and previous injuries history over the last 12 months. The data were analyzed descriptively as well as by using logistic regression models. RESULTS: The majority of the runners was male, aged 43.0 (SD=10.5) years-old, have a body mass index of 24.2 (IQR=4.3) kg/m², and had training volume of 35.0 (IQR=28.0) kilometers per week. Fifty-five percent of runners had injuries over the last 12 months. The most prevalent injuries observed were tendinopathies and muscle injuries. The variable that showed an association with previous running-related injuries was running experience from 5 to 15 years (Odds Ratio (OR)=0.2; 95%CI=0.1 to 0.9). CONCLUSIONS: The prevalence of running-related injuries over the last 12 months was 55%. The variable running experience was associated with the absence of previous musculoskeletal running-related injuries.