ABSTRACT BACKGROUND: The High Activity Arthroplasty Score (HAAS) is a self-administered questionnaire, developed in British English, that reliably and validly measures the levels of sports activities in patients following hip and knee arthroplasty surgery. OBJECTIVE: To cross-culturally adapt the HAAS to Brazilian Portuguese language. DESIGN AND SETTING: A cross-sectional study was conducted at a public university hospital in Brazil. METHODS: The Brazilian version of the HAAS was created through a six-step process: translation, synthesis, committee review, pretesting, back-translation, and submission to developers. The translation step was conducted by two independent bilingual translators, both native speakers of Brazilian Portuguese. The back-translation was performed by an independent translator, a native speaker of British English. To ensure the questionnaire's comprehensibility, 46 volunteers (51% men; average age 34-63) participated in the pre-testing step. RESULTS: The cross-cultural adaptation process necessitated modifications to certain terms and expressions to achieve cultural equivalence with the original HAAS. CONCLUSION: The HAAS has been translated from English into Brazilian Portuguese and culturally adapted for Brazil. The validation process for HAAS-Brazil is currently underway.

ABSTRACT BACKGROUND: The Hip Sports Activity Scale (HSAS) is a hip-specific instrument for assessing the present levels of physical activity among patients with femoroacetabular impingement (FAI) syndrome. When evaluating treatment outcomes in patients with FAI syndrome, it is necessary to use joint-specific instruments and ones that can evaluate the levels of physical activity in these patients, such as the HSAS-Brazil. OBJECTIVE: To validate the HSAS-Brazil among a group of physically active patients after arthroscopic treatment of FAI syndrome. DESIGN AND SETTING: Cross-sectional research of quantitative and qualitative types using data obtained from July 2018 to October 2019. METHODS: A total of 58 patients of both genders diagnosed with FAI syndrome and who had undergone hip arthroscopy participated in this research. To establish reliability and validity, patients first answered the Brazilian versions of the 12-Item Short-Form Health Survey (SF-12), Nonarthritic Hip Score (NAHS), and HSAS; after a 48-hour interval, they answered the HSAS-Brazil again. RESULTS: For test-retest reliability, the interclass correlation was 0.908 (P < 0.001). The HSAS-Brazil correlated to the NAHS-Brazil (r = 0.63, P < 0.001), as well as the SF-12 (Physical Health) (r = 0.42, P = 0.001). CONCLUSION: The HSAS-Brazil was validated and proved to be a reliable and valid scale to assess sports activity levels in physically active patients with FAI syndrome after arthroscopic treatment.

ABSTRACT Muscle strength is an essential part of the functional assessment of health professionals to select and analyze the effects of clinical interventions. This study aimed to determine the influence of gender and age on isometric strength of hip and knee muscle groups. A total of 127 subjects (50.4% men), aged from 20 to 49 years (stratified into three groups: 20-29 years; 30-39 years; and 40-49 years) participated in this study. A hand-held dynamometer was used to measure isometric normalized torque of the hip abductors, hip external rotators, knee extensors, and knee flexors muscles. Regressions and a two-way analysis of variance were used to identify the influence of age and gender on torque of each muscle group. Age and gender were included in the regression model for all groups. Generally, men aged 20-29 and 30-39 were stronger than age-paired women. For participants aged 40-49, torque was similar for men and women for all muscle groups. There was no difference among age groups for women. Generally, young men were stronger than older men. The association between age and gender in hip and knee strength was proved and liable of subgroup stratification after measurements with a hand-held isometric dynamometer.

RESUMEN La fuerza muscular es un componente básico de la evaluación funcional de los profesionales de la salud para seleccionar y analizar los efectos de las intervenciones clínicas. El objetivo de este estudio fue determinar la influencia del sexo y de la edad en las mediciones de fuerza isométrica de los grupos musculares de la cadera y la rodilla. En el estudio participaron 127 sujetos (50,4% hombres), de entre 20 y 49 años de edad (estratificados en grupos: 20 a 29 años; 30 a 39 años; y 40 a 49 años). El torque isométrico normalizado de los abductores y rotadores externos de la cadera y de los extensores y flexores de la rodilla se midió con un dinamómetro manual. Se utilizaron regresiones y el análisis de varianza (Anova) para identificar la influencia de la edad y el sexo en el torque. Tanto la edad como el sexo se incluyeron en el modelo para todos los grupos musculares. En general, los hombres de entre 20 y 29 años y los de 30 a 39 mostraron tener más fuerza que las mujeres del mismo grupo de edad. Para los participantes de 40 a 49 años, el torque fue similar entre hombres y mujeres para todos los grupos musculares. No hubo diferencias entre los grupos de edad en el grupo de mujeres. En general, los hombres más jóvenes demostraron ser más fuertes que los hombres de mediana edad. La relación entre la edad y el sexo en la fuerza muscular de la cadera y la rodilla se probó y demostró ser susceptible a la estratificación después de las mediciones realizadas con el dinamómetro manual.

RESUMO A força muscular é um componente essencial da avaliação funcional de profissionais da saúde para selecionar e analisar efeitos de intervenções clínicas. O objetivo do estudo foi determinar a influência do sexo e da idade sobre medidas de força isométrica de grupos musculares do quadril e do joelho. Participaram da pesquisa 127 sujeitos (50,4% homens), com idade de 20 a 49 anos (estratificados em grupos: 20 a 29 anos; 30 a 39 anos; e 40 a 49 anos). O torque isométrico normalizado de abdutores e rotadores externos de quadril e extensores e flexores de joelho foi medido com dinamômetro manual. Regressões e uma análise de variância (Anova) foram usados para identificar a influência da idade e do sexo sobre o torque. Tanto idade quanto sexo foram incluídos no modelo para todos os grupos musculares. Em geral, homens de 20 a 29 anos e de 30 a 39 anos demonstraram mais força do que mulheres da mesma faixa etária. Para participantes de 40 a 49 anos, o torque foi similar entre homens e mulheres para todos os grupos musculares. Não houve diferença entre as faixas etárias no grupo de mulheres. Em geral, homens mais jovens se mostraram mais fortes do que homens mais velhos. A relação entre idade e sexo na força muscular do quadril e do joelho foi provada e se mostrou passível de estratificação após as medições feitas com o dinamômetro manual.

Abstract BACKGROUND: The Hip Sports Activity Scale (HSAS) is a reliable and valid tool for determining the levels of sports activities among patients with femoroacetabular impingement (FAI). OBJECTIVE: To translate and cross-culturally adapt the HSAS to the Brazilian Portuguese language. DESIGN AND SETTING: This was a cross-sectional study conducted at the State University of Rio de Janeiro. METHODS: The Brazilian version of the HSAS was developed following a process that comprised six steps: translation, synthesis, back-translation, review by committee, pretesting and submission of documentation to the developers. The translation phase involved three independent bilingual translators whose mother language was Brazilian Portuguese. The back-translation phase involved three independent translators whose mother language was English. In order to verify comprehension of the questionnaire, 30 undergraduate students in physical education (65% men), with mean age 23.2 years (standard deviation = 6.8), participated in the pre-testing phase. RESULTS: During the translation step, some terms and expressions were changed to obtain cultural equivalence to the original HSAS. In the pre-testing phase, each item of the scale showed a comprehension level of 100%. CONCLUSION: The HSAS was translated from English to the Brazilian Portuguese language and adapted to Brazilian culture. The HSAS validation is ongoing.

ABSTRACT Some studies have shown that secondary infections during the COVID-19 pandemic may have contributed to the high mortality. Our objective was to identify the frequency, types and etiology of bacterial infections in patients with COVID-19 admitted to an intensive care unit (ICU) and to evaluate the results of ICU stay, duration of mechanical ventilation (MV) and in-hospital mortality. It was a single-center study with a retrospective cohort of patients admitted consecutively to the ICU for more than 48 h between March and May 2020. Comparisons of groups with and without ICU- acquired infection were performed. A total of 191 patients with laboratory-confirmed COVID-19 were included and 57 patients had 97 secondary infectious events. The most frequent agents were Acinetobacter baumannii (28.9%), Pseudomonas aeruginosa (22.7%) and Klebsiella pneumoniae (14.4%); multi-drug resistance was present in 96% of A. baumannii and in 57% of K. pneumoniae. The most prevalent infection was ventilator-associated pneumonia in 57.9% of patients with bacterial infections, or 17.3% of all COVID-19 patients admitted to the ICU, followed by tracheobronchitis (26.3%). Patients with secondary infections had a longer ICU stay (40.0 vs. 17 days; p < 0.001), as well as a longer duration of MV (24.0 vs 9.0 days; p= 0.003). There were 68 (35.6%) deaths overall, of which 27 (39.7%) patients had bacterial infections. Among the 123 survivors, 30 (24.4%) had a secondary infections (OR 2.041; 95% CI 1.080 - 3.859). A high incidence of secondary infections, mainly caused by gram-negative bacteria has been observed. Secondary infections were associated with longer ICU stay, MV use and higher mortality.

ABSTRACT BACKGROUND: The Hip Sports Activity Scale (HSAS) is a hip-specific instrument for assessing the present levels of physical activity among patients with femoroacetabular impingement (FAI) syndrome. When evaluating treatment outcomes in patients with FAI syndrome, it is necessary to use joint-specific instruments and ones that can evaluate the levels of physical activity in these patients, such as the HSAS-Brazil. OBJECTIVE: To validate the HSAS-Brazil among a group of physically active patients after arthroscopic treatment of FAI syndrome. DESIGN AND SETTING: Cross-sectional research of quantitative and qualitative types using data obtained from July 2018 to October 2019. METHODS: A total of 58 patients of both genders diagnosed with FAI syndrome and who had undergone hip arthroscopy participated in this research. To establish reliability and validity, patients first answered the Brazilian versions of the 12-Item Short-Form Health Survey (SF-12), Nonarthritic Hip Score (NAHS), and HSAS; after a 48-hour interval, they answered the HSAS-Brazil again. RESULTS: For test-retest reliability, the interclass correlation was 0.908 (P < 0.001). The HSAS-Brazil correlated to the NAHS-Brazil (r = 0.63, P < 0.001), as well as the SF-12 (Physical Health) (r = 0.42, P = 0.001). CONCLUSION: The HSAS-Brazil was validated and proved to be a reliable and valid scale to assess sports activity levels in physically active patients with FAI syndrome after arthroscopic treatment.

Resumo Objetivo Identificar o perfil de adesão à profilaxia medicamentosa de tromboembolismo em pacientes submetidos a cirurgias ortopédicas de artroplastia de joelho ou de quadril em hospital público. Métodos Estudo de coorte prospectivo, realizado no período de agosto de 2017 a setembro de 2018, com pacientes adultos que foram acompanhados desde a internação até o pós-operatório. Para medir a adesão, aplicou-se a Escala de Adesão Terapêutica de Morisky de oito itens. A quantificação do grau de adesão foi determinada segundo o resultado da soma de todas as respostas corretas: alta adesão (8 pontos), média adesão (6 a < 8 pontos), e baixa adesão (< 6 pontos). No presente estudo, foram divididos em altamente aderentes aqueles que tiveram alta adesão e parcialmente aderentes os pacientes que tiveram média ou baixa adesão. Resultados A análise da adesão mostrou que 73,0% dos pacientes foram altamente aderentes, enquanto 27,0% foram parcialmente aderentes à tromboprofilaxia. O anticoagulante prescrito na alta hospitalar foi o rivaroxabana, inibidor direto do fator Xa. Obtiveram maior adesão os pacientes que não necessitaram de reforço na orientação sobre a profilaxia durante o acompanhamento e, por conseguinte, relataram boa e ótima aceitação à profilaxia, embora estivessem polimedicados durante a alta hospitalar. Conclusão A análise dos dados obtidos permitiu concluir que os fatores que mais influenciaram na adesão foram os níveis de compreensão e aceitação dos pacientes quanto à profilaxia, a quantidade de medicamentos usada por dia pelo paciente, o custo do anticoagulante e o seu potencial em desenvolver reações adversas.

Abstract Objective The present paper aims to identify the profile of compliance to thromboembolism drug prophylaxis in patients undergoing knee or hip arthroplasty at a public hospital. Methods This is a prospective cohort study, carried out from August 2017 to September 2018, with adult patients who were followed-up from admission until the postoperative period. The Morisky Medication Adherence Scale, consisting of eight items, was applied. Compliance was quantified according to the sum of all correct answers as high (8 points), medium (6 to < 8 points), and low compliance (< 6 points). For the present study, subjects with high compliance were referred as highly compliant, whereas those with medium to low compliance were referred as partially compliant. Results The compliance analysis showed that 73.0% of the patients were highly compliant and 27.0% were partially compliant to thromboprophylaxis. The anticoagulant prescribed at hospital discharge was rivaroxaban, a direct factor Xa inhibitor. Compliance was greater in patients who did not require reinforcement in prophylaxis guidance during follow-up; these subjects reported good and excellent acceptance of prophylaxis, although they were on multiple medications at discharge. Conclusion The data analysis allowed us to conclude that the factors that most influenced compliance were the levels of understanding and acceptance of prophylaxis by the patients, the amount of medication used per day by the subject, the cost of the anticoagulant agent, and its potential to cause adverse reactions.

Resumo Fundamentos A incidência de injúria miocárdica (IM) em pacientes com COVID-19 no Brasil é pouco conhecida e o impacto prognóstico da IM, mal elucidado. Objetivos Descrever a incidência de IM em pacientes com COVID-19 em unidade de terapia intensiva (UTI) e identificar variáveis associadas à sua ocorrência. O objetivo secundário foi avaliar a troponina I ultrassensível (US) como preditor de mortalidade intra-hospitalar. Métodos Estudo observacional, retrospectivo, entre março e abril de 2020, com casos confirmados de COVID-19 internados em UTI. Variáveis numéricas foram comparadas com teste t de Student ou U de Mann-Whitney, sendo o teste X2 empregado para as categóricas. Realizou-se análise multivariada com as variáveis associadas à IM e p<0,2 objetivando determinar preditores de IM. Curva ROC foi empregada para determinar o valor da troponina capaz de predizer maior mortalidade intra-hospitalar. Funções de sobrevida foram estimadas pelo método de Kaplan-Meier a partir do ponto de corte apontado pela curva ROC. Resultados Este estudo avaliou 61 pacientes (63,9% do sexo masculino, média de idade de 66,1±15,5 anos). A IM esteve presente em 36% dos casos. Hipertensão arterial sistêmica (HAS) [RC 1,198; IC95%: 2,246-37,665] e índice de massa corporal (IMC) [RC 1,143; IC95%: 1,013-1,289] foram preditores independentes de risco. Troponina I US >48,3 ng/ml, valor determinado pela curva ROC, prediz maior mortalidade intra-hospitalar [AUC 0,786; p<0,05]. A sobrevida no grupo com troponina I US >48,3 ng/ml foi inferior à do grupo com valores ≤48,3 ng/dl [20,3 x 43,5 dias, respectivamente; p<0,05]. Conclusão Observou-se alta incidência de IM na COVID-19 grave com impacto em maior mortalidade intra-hospitalar. HAS e IMC foram preditores independentes de risco de sua ocorrência. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)

Abstract Background The incidence of myocardial injury (MI) in patients with COVID-19 in Brazil and the prognostic impact of MI have not been elucidated. Objectives To describe the incidence of MI in patients with COVID-19 in the intensive care unit (ICU) and to identify variables associated with its occurrence. The secondary objective was to assess high-sensitivity troponin I as a predictor of in-hospital mortality. Methods Retrospective, observational study conducted between March and April 2020 with cases of confirmed COVID-19 admitted to the ICU. Numerical variables were compared by using Student t test or Mann-Whitney U test. The chi-square test was used for categorical variables. Multivariate analysis was performed with variables associated with MI and p<0.2 to determine predictors of MI. The ROC curve was used to determine the troponin value capable of predicting higher in-hospital mortality. Survival functions were estimated by use of the Kaplan-Meier method from the cut-off point indicated in the ROC curve. Results This study assessed 61 patients (63.9% of the male sex, mean age of 66.1±15.5 years). Myocardial injury was present in 36% of the patients. Systemic arterial hypertension (HAS) [OR 1.198; 95%CI: 2.246-37.665] and body mass index (BMI) [OR 1.143; 95%CI: 1.013-1.289] were independent risk predictors. High-sensitivity troponin I >48.3 ng/mL, which was determined in the ROC curve, predicts higher in-hospital mortality [AUC 0.786; p<0.05]. Survival in the group with high-sensitivity troponin I >48.3 ng/mL was lower than that in the group with values ≤48.3 ng/dL [20.3 x 43.5 days, respectively; p<0.05]. Conclusion There was a high incidence of MI in severe COVID-19 with impact on higher in-hospital mortality. The independent risk predictors of MI were SAH and BMI. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)

RESUMO JUSTIFICATIVA E OBJETIVOS: Este estudo teve como objetivo identificar a associação entre a força muscular do quadril e os escores de questionários subjetivos de avaliação funcional e psicológica em pacientes com dor crônica no quadril. MÉTODOS: Cinquenta e cinco pacientes com lesões dolorosas no quadril (30 homens) realizaram testes isométricos do pico de força de abdutores, extensores e rotadores internos e externos do quadril com um dinamômetro portátil. O grau de funcionalidade foi medido pelo Hip Outcome Score (HOS) e Lower Extremity Functional Score (LEFS), a dor foi avaliada pela escala analógica visual (EAV) e a cinesiofobia foi calculada pelo questionário de Tampa. O coeficiente de correlação de Pearson foi utilizado (alfa=5%) para testar as associações entre a força muscular e os escores dos questionários. RESULTADOS: Houve correlações significativas entre a força de todos os quatro músculos do quadril e o HOS (r>0,29). Apenas os rotadores externos do quadril apresentaram correlação significativa com a intensidade da dor (r=-0,30). Nenhuma correlação significativa foi encontrada para LEFS (r<0,24) e questionário de Tampa (r¬0,15). CONCLUSÃO: A redução no pico de força dos extensores, abdutores e rotadores externos do quadril foi associada à redução no nível de funcionalidade do quadril, mas não se correlacionou com o nível de funcionalidade geral dos membros inferiores ou com o grau de cinesiofobia. Além disso, uma redução da força dos rotadores externos do quadril foi relacionada a aumento na intensidade da dor.

ABSTRACT BACKGROUND AND OBJECTIVES: This study aimed to identify the association between hip muscle strength and the scores from subjective functional and psychological evaluation questionnaires in patients with chronic hip pain. METHODS: Fifty-fivepatients with painful hip injuries (30 males) performed isometric peak strength tests of the abductors, extensors, and internal and external rotators of the hips with a hand-held dynamometer. The degree of functionality was measured by the Hip Outcome Score (HOS) and Lower Extremity Functional Score (LEFS), pain was estimated by the Visual Analog Scale (VAS) and kinesiophobia was calculated using the Tampa questionnaire. The Pearson correlation coefficient was used (alfa=5%) to test the associations between the muscle strength and the scores from the questionnaires. RESULTS: There were significant correlations between the strength of all four hip muscles and the HOS (r>0.29). Only the hip external rotators showed a significant correlation with pain (r=-0.30). No significant correlations were found for LEFS (r<0.24) and Tampa questionnaires (r¬0.15). CONCLUSION: The reduction in peak strength of the hip extensors, abductors and external rotators was associated with a reduction in the level of hip functionality but did not correlate with neither the level of overall functionality of the lower limbs nor the degree of kinesiophobia. Also, a reduction of hip external rotators strength was related to an increase in the intensity of pain.

Abstract Background: The Hip Outcome Score (HOS) was developed to evaluate physically active patients with hip disease but without severe degenerative change. A translation and cultural adaptation into Brazilian Portuguese was previously conducted. The aim of this study was to validate the Brazilian version of the HOS (HOS-Brazil) among a group of physically active patients with a diagnosis of femoroacetabular impingement (FAI) or greater trochanteric pain syndrome (GTPS). Methods: The following questionnaires were applied: the HOS-Brazil; the validated Brazilian versions of the Nonarthritic Hip Score (NAHS) and the 12-Item Short-Form Health Survey (SF-12). The psychometric properties analyzed with regard to the validation process were reliability and validity. Internal consistency and intra-rater test- retest reliabilities were analyzed using Cronbach's alpha and the intraclass correlation coefficient (ICC) statistical tests based on test-retest agreement. Construct and content validities were examined using Pearson's correlation coefficient. Content validity was also analyzed based on evidence of floor, ceiling, or both types of effects from the questionnaires. Results: A total of 70 male and female patients were selected, aged between 19 and 70 years old. The internal consistency and intra-rater test-retest reliability values were high (Cronbach's a > 0.9; ICC > 0.9). The questionnaire showed acceptable convergent (r > 0.7) and divergent (r < 0.4) validities. No floor or ceiling effects were observed. Conclusion: The HOS-Brazil was validated. Additional studies are underway to evaluate its responsiveness.

ABSTRACT Objective: To compare the activation of the vastus lateralis (VL) and biceps femoris (BF) muscles during gait, as well VL/BF muscular co-contraction (MCC) between healthy (CG) and anterior cruciate ligament reconstructed (ACL-R) subjects. Methods: Nineteen subjects, ten controls and nine ACL-R patients had a VL and BF electromyogram (EMG) captured to calculate the MCC ratio. A Principal Component (PC) Analysis was applied to reduce the dimensionality effect of each of the MCC, VL and BF curves for both healthy and ACL reconstructed groups. The PC scores were used to calculate the standard distance (SD). SD values were employed in order to compare each dependent variable (MCC, VL and BF) between the two groups using unpaired t-test. Results: ACL-R group presented a lower VL activation at the beginning and at the end of the gait cycle, as compared to the control group. However, no difference was found for BF or VL/BF MCC. Conclusion: The gait analysis of ACL reconstructed patients demonstrated a persistent deficit in VL activation when compared to the control group, even one year after surgery. Level of Evidence III. Case Control Study

Objective : To compare gait spatiotemporal parameters of healthy and ACL reconstructed subjects in order to classify the status of gait normality. Methods : Fourteen healthy subjects and eight patients submitted to ACL reconstruction walked along a walkway while the lower limbs movement was captured by an infrared camera system. The frames where the initial contact and toe-off took place were determined and the following dependent variables, which were compared between groups through the Mann-Whitney test (a=0.05) were calculated: percentage of time in initial double stance, percentage of time in single stance, percentage of time in terminal double stance, stride length and gait velocity. Initially, all variables were compared between groups using a Mann-Whitney test. A logistic regression was applied, including all dependent variables, to create a model that could differentiate healthy and ACL reconstructed subjects. Results : ACL reconstructed group showed no differences in any spatiotemporal parameter of gait (p > 0.05) in relation to the control group, although the angular kinematic differences of the knee remained altered, as evidenced in a study with a similar sample. Conclusion : The regression classified all subjects as healthy, including the ACL reconstructed group, suggesting the spatiotemporal variables should not be used as the sole criterion of return to sports activities at the same level as prior to injury. Level of Evidence III, Case Control Study.

OBJETIVO: traduzir para o português e adaptar culturalmente para o Brasil o questionário de avaliação clínica Hip Outcome Score (HOS).MÉTODOS: o questionário HOS foi traduzido para o português com metodologia constituída pelas etapas de tradução, retrotradução, pré-teste e tradução final.RESULTADOS: o pré-teste foi aplicado a 30 pacientes com dor no quadril sem artrose. No domínio relacionado a atividades de vida diária, não houve dificuldades de compreensão do questionário traduzido. Na apresentação da tradução final do questionário, todas as questões foram compreendidas por mais de 85% dos pacientes.CONCLUSÃO: o questionário HOP foi traduzido e adaptado culturalmente para a língua portuguesa e pode ser usado na avaliação clínica do quadril. Estudos adicionais estão em andamento com o objetivo de avaliar a reprodutibilidade e validade da tradução brasileira.

OBJECTIVE: to translate the Hip Outcome Score clinical evaluation questionnaire into Portuguese and culturally adapt it for Brazil.METHODS: the Hip Outcome Score questionnaire was translated into Portuguese following the methodology consisting of the steps of translation, back-translation, pretesting and final translation.RESULTS: the pretesting was applied to 30 patients with hip pain without arthrosis. In the domain relating to activities of daily living, there were no difficulties in comprehending the translated questionnaire. In presenting the final translation of the questionnaire, all the questions were understood by more than 85% of the individuals.CONCLUSION: the Hip Outcome Score questionnaire was translated and adapted to the Portuguese language and can be used in clinical evaluation on the hip. Additional studies are underway with the objective of evaluating the reproducibility and validity of the Brazilian translation.

Investigar o estado da arte acerca da coordenação motora durante a marcha em pacientes com lesão no ligamento cruzado anterior (LCA). Foram realizadas pesquisas, delimitadas entre 1980 e 2010, em diversas bases de artigos com palavras-chave relacionadas à coordenação motora, marcha e lesão no LCA. A partir da análise de títulos e aplicação dos critérios de inclusão/exclusão, 24 estudos foram selecionados inicialmente e, após a leitura do resumo, oito permaneceram na análise final. Os resultados indicam que pacientes com deficiência no LCA tendem a apresentar uma marcha menos variável, enquanto pacientes com reconstrução do LCA têm uma marcha mais variável, em relação a sujeitos hígidos. Os resultados sugerem a existência de diferenças na coordenação motora entre os segmentos entre sujeitos com e sem lesão no LCA, independentemente da reconstrução ligamentar. Pacientes com lesão no LCA apresentam aspectos relacionados ao comprometimento de adaptar seus padrões de marcha a diferentes condições externas, o que pode levar à degeneração precoce. No entanto, as técnicas usadas pelos estudos para o processamento dos dados biomecânicos foram limitadas no que diz respeito à obtenção de informações que possibilitem o desenvolvimento de estratégias de intervenção voltadas para a reabilitação da lesão. Isso se deve ao fato de as técnicas atuais de estudo da coordenação motora, apesar de possibilitar a identificação de alterações no padrão de marcha saudável, não serem capazes de identificar as principais articulações e fases do ciclo da marcha alteradas.

To investigate the state of art about motor coordination during gait in patients with anterior cruciate ligament (ACL) injury. Searches were carried out, limited from 1980 to 2010, in various databases with keywords related to motor coordination, gait and ACL injury. From the analysis of titles and applying the inclusion/exclusion criteria 24 studies were initially selected and, after reading the abstract, eight studies remained in the final analysis. ACL deficient patients tend to have a more rigid and less variable gait, while injured patients with ACL reconstruction have less rigid and more variable gait with respect to healthy individuals. The overall results suggest the existence of differences in motor coordination between the segments with intact and those with injured knee, regardless of ligament reconstruction. ACL injured patients present aspects related to the impairment of the capability to adapt the gait pattern to different environmental conditions, possibly leading to premature knee degeneration. However, the techniques used for biomechanical gait data processing are limited with respect to obtaining information that leads to the development of intervention strategies aimed at the rehabilitation of that injury, since it is not possible to identify the location within the gait cycle where the differences could be explained.

CONTEXTO E OBJETIVO O Nonarthritic Hip Score (NAHS) é um questionário de avaliação clínica que foi desenvolvido na língua inglesa para avaliar a função do quadril em pacientes jovens e fisicamente ativos. O objetivo desse estudo foi traduzir o questionário NAHS para a língua portuguesa do Brasil, adaptá-lo à cultura brasileira e validá-lo. TIPO DE ESTUDO E LOCAL Estudo de coorte, realizado entre 2008 e 2010, na Universidade do Estado do Rio de Janeiro (UERJ). MÉTODOS Questões sobre atividades físicas e tarefas domésticas foram modificadas para melhor adaptação à cultura brasileira. Reprodutibilidade, consistência interna e validade (correlação entre o Algofunctional Lequesne Index e o Western Ontario McMaster Universities Arthritis Index [WOMAC]) foram testadas. Os questionários NAHS-Brasil, Lequesne e WOMAC foram aplicados em 64 pacientes jovens e fisicamente ativos (média de idade, 40,9 anos; 31 mulheres). RESULTADOS O coeficiente de correlação intraclasse que avalia reprodutibilidade mostrou valores de 0,837 (P < 0,001). O gráfico de Bland-Altman revelou um erro médio da diferença das duas medidas de 0,42. A consistência interna foi avaliada pelo alfa de Cronbach com valores de 0,944. A validade entre os questionários NAHS-Brasil/Lequesne e NAHS-Brasil/WOMAC mostraram alta correlação, r = 0,7340 e r = 0,9073; respectivamente. O NAHS-Brasil mostrou boa validade sem efeitos de chão ou de teto. CONCLUSÃO O NAHS foi traduzido para a língua portuguesa do Brasil e adaptado para a cultura brasileira, mostrando ser uma ferramenta útil na prática clínica para avaliar a qualidade de vida de pacientes jovens e fisicamente ativos com dor no quadril.

CONTEXT AND OBJECTIVE The Nonarthritic Hip Score (NAHS) is a clinical evaluation questionnaire that was developed in the English language to evaluate hip function in young and physically active patients. The aims of this study were to translate this questionnaire into the Brazilian Portuguese language, to adapt it to Brazilian culture and to validate it. DESIGN AND SETTING Cohort study conducted between 2008 and 2010, at Universidade do Estado do Rio de Janeiro (UERJ). METHODS Questions about physical activities and household chores were modified to better fit Brazilian culture. Reproducibility, internal consistency and validity (correlations with the Algofunctional Lequesne Index and the Western Ontario and McMaster Universities Arthritis Index [WOMAC]) were tested. The NAHS-Brazil, Lequesne and WOMAC questionnaires were applied to 64 young and physically active patients (mean age, 40.9 years; 31 women). RESULTS The intraclass correlation coefficient (which measures reproducibility) was 0.837 (P < 0.001). Bland-Altman plots revealed a mean error in the difference between the two measurements of 0.42. The internal consistency was confirmed through a Cronbach alpha of 0.944. The validity between NAHS-Brazil and Lequesne and between NAHS-Brazil and WOMAC showed high correlations, r = 0.7340 and r = 0.9073, respectively. NAHS-Brazil showed good validity with no floor or ceiling effects. CONCLUSION The NAHS was translated into the Brazilian Portuguese language and was cross-culturally adapted to Brazilian culture. It was shown to be a useful tool in clinical practice for assessing the quality of life of young and physically active patients with hip pain.