SUMMARY OBJECTIVE: This study aimed to compare pain intensity, stiffness, functionality, central sensitization, and self-efficacy, between individuals with bilateral knee osteoarthritis and unilateral knee osteoarthritis. METHODS: We included sedentary participants with knee osteoarthritis. The diagnosis was defined by a specialist, in which there was a complaint of pain and/or altered function in the lower limbs (duration ≥3 months); morning stiffness; pain intensity ≥3; Kellgren-Lawrence 2–3° associated with X-ray; persistence of symptoms >3 months. We used the following tools: Western Ontario and McMaster Universities Arthritis Index, Numerical Pain Scale, Central Sensitization Inventory, and Pain Self-Efficacy Questionnaire. Intergroup comparisons were performed using the t-test. RESULTS: The sample consisted of 118 adult individuals, divided into two groups: bilateral knee osteoarthritis (n=59) and unilateral knee osteoarthritis (n=59). We observed a significant difference (p<0.05) and a large effect size (d≥0.8), in the comparisons between: stature, body mass index, physical function, central sensitization, and self-efficacy. CONCLUSION: Individuals with bilateral knee osteoarthritis have higher levels of central sensitization, impaired functionality, and a lower level of self-efficacy.

Resumo O presente artigo propõe que os parâmetros conceituais do enfoque em “Cadeias Mercantis” possibilitam férteis recursos de formulação, exploração e desvendamento de problemas na geografia humana. Em seu teor confere um destaque para a articulação entre geografia econômica e a geografia agroalimentar, embora a referida proposta também alcance articulações entre outras subáreas. Com estes fins, se realizou um estudo de natureza exploratória, procedendo um levantamento bibliográfico, documental e de dados e se vale de uma concisa análise de caso do sistema produtivo-comercial da sojicultura brasileira. Formula-se a concepção de “Teia Geoeconômica” para salientar fatores socioinstitucionais na dimensão geopolítica da economia. Chega-se à compreensão de que estes marcos conceituais são propícios para problematizar questões a respeito de dinâmicas de inserção e posicionamento de subestruturas nas economias nacionais, destas economias na economia mundial e das relações de poder nestes espaços.

Abstract This article proposes that the conceptual parameters of the focus on "Commodity Chains" offer fertile resources for the formulation, exploration, and unraveling of problems in human geography. To this end, an exploratory study was carried out, beginning with a bibliographical, documentary, and data survey followed by a concise case analysis of the productive-commercial system of Brazilian soybean production. The "Geoeconomic Web" concept was formulated to highlight socio-institutional factors in the geopolitical dimension of the economy. It is understood that these conceptual frameworks are suitable to problematize issues about the dynamics of insertion and positioning of substructures in national economies, of these economies in the world economy, and power relations in these spaces.

Resumen Este artículo propone que los parámetros conceptuales del enfoque de “Cadenas de Mercancías” posibilitan recursos fértiles para la formulación, exploración y desentraño de problemas de la geografía humana. En su contenido, enfatiza la articulación entre geografía económica y geografía agroalimentaria, aunque la propuesta antes mencionada también alcanza articulaciones entre otras subáreas. Para estos efectos, se realizó un estudio exploratorio, procediendo con un relevamiento bibliográfico, documental y de datos y se realizó un conciso análisis de caso del sistema productivo-comercial de la soyicultura brasileña. El concepto de “Telaraña Geoeconómica” se formula para resaltar los factores socioinstitucionales en la dimensión geopolítica de la economía. Se comprende que estos marcos conceptuales son adecuados para problematizar cuestiones sobre la dinámica de inserción y posicionamiento de las subestructuras en las economías nacionales, de estas economías en la economía mundial y de las relaciones de poder en estos espacios.

BACKGROUND: The original structure of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) has been contested in several languages. OBJECTIVE: To assess the structural validity of the Brazilian version of WOMAC among patients with knee osteoarthritis. DESIGN AND SETTING: Structural validity study conducted at physiotherapy clinics and primary healthcare units. METHODS: The study included males and females aged 40 to 80 years who were all native Brazilian Portuguese speakers, with knee pain in the previous six months and a diagnosis of knee osteoarthritis. We used exploratory factor analysis (EFA) followed by confirmatory factor analysis (CFA) with implementation of a polychoric matrix and the robust diagonally weighted least squares (RDWLS) extraction method. The adequacy of the model was assessed using the following fit indices: root mean square error of approximation (RMSEA), comparative fit index (CFI), Tucker-Lewis index (TLI), standardized root mean square residual (SRMR) and chi-square/degree of freedom (DF). RESULTS: 203 patients with knee osteoarthritis were included. The model proposed in this study with two factors, i.e. “pain” (items 1, 2, 3 and 4) and “physical function” (items 10, 11, 16, 17, 18, 19, 21 and 22), showed adequate fit indices in CFA: chi-square/DF = 1.30; CFI = 0.976; TLI = 0.970; RMSEA = 0.039; and SRMR = 0.070. The factorial loads ranged from 0.68 to 0.76 for the “pain” domain and 0.44 to 0.62 for the “physical function” domain. CONCLUSION: The Brazilian version of WOMAC with two domains, i.e. “pain” (four items) and “physical function” (eight items), presents the best structure.

A proposta deste estudo foi analisar e verificar a existência de alterações neurofisiológicas nos indivíduos com síndrome de Down, como a hiporreflexia, estática e dinâmica, que, se presente, pode ocasionar prejuízo no controle sensório-motor dos músculos, e consequentemente a hipotonia, contribuindo para alterações no desenvolvimento motor. O sinal eletromiográfico (EMG), início e término do sinal eletromiográfico, foi coletado de 24 voluntários com diagnóstico de síndrome de Down e 25 voluntários como grupo controle, durante 2 situações distintas: período de latência dinâmico e teste de reflexo monossináptico (estático) patelar e aquileu. Em relação aos aspectos neurofisiológicos, observou-se que, para todas as variáveis analisadas, houve diferença estatisticamente significante (p<0,05) entre os grupos. A existência de alterações neurofisiológicas (retardo do período de latência) comprovadas neste estudo, oriundas de um prejuízo no controle sensório-motor, as quais podem ser responsáveis pela hipotonia muscular, mostrou-se como um dos vários possíveis fatores determinantes pelas alterações no desenvolvimento motor dessas crianças, tornando-se importante devido às alterações neuromusculares que podem interferir nas atividades funcionais.

The purpose of this study was to analyze and verify the existence of neurophysiological changes in individuals with Down syndrome, such as hyporeflexia, static and dynamic, which, if present, may cause impairment in sensory-motor control of muscles, and consequently hypotonia, contributing to changes in motor development. The electromyographic signal (EMG), start and termination electromyographic signal, was collected from 24 volunteers with a diagnosis of Down syndrome and 25 volunteers as controls for 2 different situations: the dynamic latency period and monosynaptic reflex (static) patellar and Achilles. For neurophysiological aspects, it was observed that for all variables analyzed, statistical difference (p<0.05) between groups. The existence of neurophysiological changes (delay of the latency period) demonstrated in this study originated from an impairment in sensory-motor control, which may account for the decreased muscle tone, presents as one of several possible factors for the changes in motor development of children, which shows important due to neuromuscular disorders that can interfere in functional activities.