RESUMO A comunidade científica manifesta atualmente um elevado nível de interesse no jejum intermitente - períodos de abstinência voluntária da ingestão de energia, variando de várias horas a dias. O jejum intermitente é clinicamente relevante e pode representar uma estratégia não-farmacológica eficaz para melhorar o desempenho físico e a composição corporal. Tem sido estudado principalmente em atletas durante o período religioso do Ramadão e em pessoas predispostas a diminuir a adiposidade corporal sem perda paralela de massa isenta de gordura. O objetivo desta revisão é fornecer uma visão geral do impacto do jejum intermitente durante o Ramadão vs. jejum intermitente não-Ramadão ao nível do rendimento físico e da composição corporal. A literatura evidencia algumas inconsistências ao nível da interação entre o jejum intermitente e o rendimento físico. Contudo, verifica-se que o jejum intermitente não-Ramadão é eficaz para melhorar a potência aeróbia máxima. Não obstante, esta intervenção reduz o desempenho durante sprints repetidos ao longo dos primeiros dias de intervenção. Por outro lado, o jejum intermitente durante o Ramadão diminui a potência aeróbia máxima e isto é mais expressivo durante a segunda metade deste período religioso. Ao contrário, ambas as intervenções são manifestamente inócuas ao nível da força muscular e da capacidade anaeróbia. No que se refere à composição corporal, existe maior consensualidade. De acordo com os dados disponíveis, ambas as intervenções estimulam adaptações benéficas a este nível. Ainda assim, as perdas de massa gorda são mais pronunciadas com o jejum intermitente não-Ramadão.

ABSTRACT The scientific community currently expresses a high level of interest in intermittent fasting - periods of voluntary abstinence from energy intake, ranging from several hours to days. Intermittent fasting is clinically relevant and may represent an effective non- pharmacological strategy to improve physical performance and body composition. It has been studied mainly in athletes during the religious period of Ramadan and in people predisposed to decrease body fat without loss of fat-free mass parallel. The purpose of this review is to provide an overview of the impact of intermittent fasting during Ramadan vs. non-Ramadan intermittent fasting in terms of physical performance and body composition. The literature shows some inconsistencies in terms of the interaction between intermittent fasting and physical performance. However, non-Ramadan intermittent fasting is found to be effective in improving maximal aerobic power. Nevertheless, this intervention reduces performance during the repeated sprints over the first few days of intervention. On the other hand, intermittent fasting during Ramadan being the maximum aerobic power and this is more expressive during the second half of this religious period. However, both interventions are manifestly innocuous in terms of muscle strength and anaerobic capacity. With regard to body composition, there is greater consensus. According to available data, both interventions encourage beneficial adaptations at this level. Still, fat loss is more pronounced with intermittent non-Ramadan fasting.

Abstract Objective To assess the effects of three 8-week exercise programs on the frequency, intensity, and impact of headaches in patients with headache attributed to temporomandibular disorder (TMD). Methodology Thirty-six patients diagnosed with headache attributed to TMD participated in the study and were divided into three groups of 12 patients: a therapeutic exercise program (G1, mean age: 26.3±5.6 years), a therapeutic and aerobic exercise program (G2, mean age: 26.0±4.6 years), and an aerobic exercise program (G3, 25.8±2.94 years). Headache frequency and intensity were evaluated using a headache diary, and the adverse headache impact was evaluated using the Headache Impact Test (HIT-6). The intensity was reported using the numerical pain rating scale. These parameters were evaluated twice at baseline (A01/A02), at the end of the 8-week intervention period (A1), and 8–12 weeks after the end of the intervention (A2). Results At A1, none of the G2 patients reported having headaches, in G1, only two patients reported headaches, and in G3, ten patients reported headache. The headache intensity scores (0.3 [95% CI: -0.401, 1.068]), (0.0 [95% CI: -0.734, 0.734]) and HIT-6 (50.7 [95% CI: 38.008, 63.459]), (49.5 [95% CI: 36.808, 62.259]), significantly decreased in G1 and G2 at A1. At A2 headache intensity scores (0.5 [95% CI: -0.256, 1.256]), (0.0 [95% CI: -0.756, 0.756]) and HIT-6 (55.1 [95% CI: 42.998, 67.268]), (51.7 [95% CI: 39.532, 63.802]) in G1 and G2 haven’t change significantly. The effects obtained immediately after the completion of the intervention programs were maintained until the final follow-up in all groups. Conclusion The programs conducted by G1 (therapeutic exercises) and G2 (therapeutic and aerobic exercise) had significant results at A1 and A2.

Introdução A auto-avaliação da funcionalidade e grau de dor pelo paciente, obtida através de preenchimento de questionários específicos tem ganho relevo enquanto ferramenta complementar à avaliação objetiva do médico Objetivos Este estudo visa traduzir e realizar a adaptação cultural do questionário American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) para a língua Portuguesa e testar a sua validade e fiabilidade. A existência do ASES traduzido e validado para a língua Portuguesa permitirá a sua utilização como uma ferramenta para avaliar a dor e as limitações funcionais em pacientes portugueses com disfunção do ombro. Metodologia O estudo foi realizado em duas etapas. A primeira etapa consistiu na tradução do ASES para a língua Portuguesa e na sua adaptação cultural. A versão original do ASES passou pelo processo específico de tradução e adaptação cultural, que compreende as etapas de tradução inicial, retrotradução, comité, pré-teste e aprovação do autor original. O segundo passo, envolveu a determinação da fiabilidade e validade da ASES para a população Portuguesa. Resultados A fiabilidade intra-individual mostrou excelentes resultados com os resultados do ICC de 0,93 (P <0,001) e 0,92 (P <0,001) para ASES direita e esquerda, respetivamente. Quanto à consistência interna o valor foi bom, com um alfa de Cronbach = 0,80. No que concerne à validade de construto os resultados do ASES-PT demonstraram uma forte correlação com os resultados da versão em Português do DASH (r = -0,92; P <0,001 ). Conclusão A versão em Português do ASES é semanticamente equivalente à versão original, e demonstrou ser fiável e válida.

Introduction Self-evaluation of the functionality and degree of pain of the patient, obtained through specific questionnaires, has gained importance as a complementary tool to the objective clinical assessment. Objectives The aim of the study is to translate and perform the cross-cultural adaptation of the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) into Portuguese and to test the validity, reliability and responsiveness for Portuguese patients. The existence of the ASES translated and validated for the Portuguese language will enable its use as a tool to assess pain and functional limitations in Portuguese patients with shoulder dysfunction Methods The first step was to translate the ASES into Portuguese and to perform cultural adaptation. The original version of the ASES underwent the specific process of translation and cultural adaptation, comprising steps of initial translation, back translation, committee, pre-testing and approval of the original author. The second step involved determining the reliability and validity of the ASES to the Portuguese population. Results Test-retest reliability showed excellent results with ICC values of 0.93 (P<0.001) and 0.92 (P<0.001) for ASES right and left, respectively. Regarding internal consistency the value was good, with a Cronbach alpha=0.80 and in what concerns the construct validity the scores of the ASES-PT showed strong correlation with the scores of the Portuguese version of the DASH (r = -0.92; P<0.001). Conclusion The Portuguese version of the ASES is semantically equivalent to the original version, and has demonstrated to be reliable and valid.

Background: There is sparse literature that provides evidence of cervical and shoulder postural alignment of 15 to 17-year-old adolescents and that analyzes sex differences. Objectives: To characterize the postural alignment of the head and shoulder in the sagittal plane of 15 to 17-year-old Portuguese adolescents in natural erect standing and explore the relationships between three postural angles and presence of neck and shoulder pain. Method: This cross-sectional study was conducted in two secondary schools in Portugal. 275 adolescent students (153 females and 122 males) aged 15 to 17 were evaluated. Sagittal head, cervical, and shoulder angles were measured with photogrammetry and PAS software. The American Shoulder and Elbow Surgeons Shoulder Assessment (ASES) was used to assess shoulder pain, whereas neck pain was self-reported with a single question. Results: Mean values of sagittal head, cervical, and shoulder angles were 17.2±5.7, 47.4±5.2, and 51.4±8.5º, respectively. 68% of the participants revealed protraction of the head, whereas 58% of them had protraction of the shoulder. The boys showed a significantly higher mean cervical angle, and adolescents with neck pain revealed lower mean cervical angle than adolescents without neck pain. 53% of the girls self-reported regular neck pain, contrasting with 19% of the boys. Conclusions: This data shows that forward head and protracted shoulder are common postural disorders in adolescents, especially in girls. Neck pain is prevalent in adolescents, especially girls, and it is associated with forward head posture.