SUMMARY OBJECTIVE: This study aims to compare heart rate variability (HRV) between patients with chronic neck pain and patients with chronic low back pain and to correlate the chronic pain variables with heart rate variability indices. METHODS: This is a cross-sectional study. We divided the sample into two groups: neck pain (n=30) and low back pain (n=30). We used the Numeric Pain Rating Scale, Neck Disability Index, Roland-Morris Disability Questionnaire, Pain-Related Catastrophizing Thoughts Scale, Tampa Scale of Kinesiophobia, and Pain Self-Efficacy Questionnaire. For heart rate variability analysis, we used the following indices: mean RR, standard deviation of all RR intervals, mean heart rate, root mean square differences of successive RR intervals, triangular index, triangular interpolation of the interval histogram, low-frequency band in arbitrary units and in absolute values, high-frequency band in arbitrary units and in absolute values, standard deviation of the instantaneous beat-to-beat variability (standard deviation 1), long-term standard deviation of continuous RR intervals (standard deviation 2), and Stress Index. We used Student’s t-test for comparisons and Spearman’s coefficient for correlations. RESULTS: We observe insignificant values in the differences between the groups. Disability and self-efficacy were correlated with heart rate variability only in patients with chronic neck pain, whereas catastrophizing and kinesiophobia showed greater correlations with heart rate variability in patients with chronic low back pain. CONCLUSIONS: Autonomic dysfunction of individuals with chronic neck pain, when compared to patients with chronic low back pain, does present insignificant differences.

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.

SUMMARY OBJECTIVE: This study aimed to validate the internal structure of the Brazilian version of the Baecke Habitual Physical Activity Questionnaire. METHODS: A cross-sectional study was conducted with individuals over 18 years old of both sexes, with Brazilian Portuguese as their native language. The structure of the Baecke Habitual Physical Activity Questionnaire was tested by confirmatory factor analysis. The model fit was evaluated by the following indices: root mean square error of approximation, comparative fit index, Tucker-Lewis index, standardized root mean square residual, and χ²/degrees of freedom. We used the Akaike information criterion and Bayesian information criterion to compare different structures of the Baecke Habitual Physical Activity Questionnaire. RESULTS: A total of 241 individuals participated in this study. The original structure of the Baecke Habitual Physical Activity Questionnaire with 16 items and 3 domains was compared to a structure with 14 items and 3 domains. The internal structure of the Baecke Habitual Physical Activity Questionnaire with 14 items showed better fit indices and lower Akaike information criterion and Bayesian information criterion values. CONCLUSION: The best internal structure of the Brazilian version of the Baecke Habitual Physical Activity Questionnaire in adults presents 3 domains and 14 items.

SUMMARY OBJECTIVE: This study aimed to translate, adapt, and analyze the reliability of the Workplace Sitting Breaks Questionnaire (SITBRQ) for use in Brazil. METHODS: This is a cross-sectional study. The translation and cross-cultural adaptation were conducted considering the following six phases: translation, synthesis of translations, back translation, analysis by a committee of experts, test of the pre-final version, and final version. We included workers aged 18 years or above, both genders, and able to understand, read, and write in Brazilian Portuguese. The final version was applied to workers in two moments (i.e., test and retest), with an interval of 7 days, for reliability calculation. RESULTS: In the translation and cross-cultural adaptation phase, the pre-final version was applied to a sample of 35 workers. For item a of the SITBRQ, there was 100% understanding by respondents, while item b was understood by 94.28%. The reliability phase was conducted with 115 workers. For both items, almost perfect was identified with kappa >0.81. CONCLUSIONS: The SITBRQ version into Brazilian Portuguese has adequate adaptation and excellent values of reliability.

SUMMARY OBJECTIVE: The objective of this study was to investigate the reliability and construct validity of the Self-Estimated Functional Inability because of Pain questionnaire for workers in a sample of Brazilian workers with musculoskeletal pain. METHODS: This is a questionnaire validation study. Workers with musculoskeletal pain were included. Besides the Self-Estimated Functional Inability because of Pain questionnaire for workers, we used the following instruments to perform construct validity: the Work Ability Index and the Numerical Pain Rating Scale. A subsample answered the Self-Estimated Functional Inability because of Pain questionnaire for workers in two moments to calculate reliability by means of the intraclass correlation coefficient and internal consistency by means of the Cronbach’s alpha. RESULTS: A total of 190 Brazilian workers were included. Regarding the construct validity, we observed a correlation with magnitude above 0.50 between the Self-Estimated Functional Inability because of Pain questionnaire for workers and the Numerical Pain Rating Scale, given that these two instruments have similarity in the construct, and correlations above 0.30 between the Self-Estimated Functional Inability because of Pain questionnaire for workers and the domains 2, 3, and 4 of the Work Ability Index. Regarding reliability, we observed adequate reliability (intraclass correlation coefficient=0.864) and internal consistency (Cronbach’s alpha=0.807). CONCLUSION: The Self-Estimated Functional Inability because of Pain questionnaire for workers is a reliable and valid instrument to be used in Brazilian workers with musculoskeletal pain.

SUMMARY OBJECTIVE: The main aim of this study was to evaluate the structural validity of the Brazilian version of the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ). METHODS: Individuals with chronic low back pain were included. The data collection of the study occurred by means of online platform. Confirmatory factor analysis was performed. The theoretical version proposed for the JOABPEQ with five domains was tested. The following indices were considered to verify the fit of the model: comparative fit index (CFI), Tucker-Lewis index (TLI), root mean square error of approximation (RMSEA), and chi-square/degrees of freedom (DF). RESULTS: The final sample consisted of 175 volunteers, mostly women (68%), adults (mean age of 28.98 years), lean (mean body mass index of 25 kg/m2), with incomplete higher education, single, with mean of pain chronicity of 61.50 months and mean of pain intensity of 6.78 points on the Numeric Pain Scale. Regarding the structure of the JOABPEQ, the original version with five domains was adequate: chi-square/DF=1.52, CFI=0.954, TLI=0.948, and RMSEA=0.055. The factorial load ranges from 0.41 to 0.90. CONCLUSIONS: This study confirms the structure of JOABPEQ with 5 domains (low back pain, lumbar function, walking ability, social life function, and mental health) and 25 items in individuals with chronic low back pain.

SUMMARY OBJECTIVE: The aim of this study was to verify the correlation between tactile acuity, intensity of pain at rest, and movement and functional capacity in individuals with chronic neck pain. METHODS: This was a cross-sectional study composed of two groups: individuals with chronic neck pain and individuals without neck pain. Evaluations were performed using the Numerical Rating Pain Scale at rest and movement, Neck Disability Index, and two-point discrimination test. RESULTS: The final sample consisted of 100 volunteers, 50 in each group. The groups did not show significant differences (p>0.05) in personal characteristics. It was observed that volunteers with cervical pain presented alterations in tactile care, with a significant and clinical increase in the perceived distance (Median 6.66; 95%CI 6.29-7.02; Cohen’s d 7.22; 95%CI 6.15-8.30), and yet, positive, moderate, and significant correlation between two-point discrimination test, intensity of pain at rest and movement, and neck disability index (r=0.778-0.789, p<0.05). CONCLUSION: Tactile acuity is associated with pain intensity at rest and movement and functional capacity in individuals with chronic neck pain.

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.

RESUMO Este estudo teve como objetivo verificar a validade de face e conteúdo do questionário Self-Estimated Functional Inability because of Pain (SEFIP) para trabalhadores, aqui chamado de questionário SEFIP-work. Este é um estudo de validade do questionário. Nosso grupo já traduziu e adaptou a versão original do SEFIP, que foi desenvolvido para investigar a dor musculoesquelética e disfunção a ser aplicada a dançarinos (SEFIP-dance). No entanto, devido ao amplo escopo da SEFIP-dance, fizemos mudanças e adaptações na versão traduzida e adaptada ao português brasileiro para permitir o seu uso com trabalhadores. Assim, a validade de face e conteúdo foram realizadas para o desenvolvimento do SEFIP-work baseadas em pareceres de especialistas em doenças ocupacionais e reabilitação. Após a validade de face e de conteúdo, esta versão da SEFIP-work foi aplicada a 30 indivíduos que trabalham com dor músculoesquelética. Os participantes eram falantes nativos de português brasileiro com idade igual ou superior a 18 anos. Assim, foram introduzidas três alterações no questionário. Todos os participantes entenderam os itens e alternativas da SEFIP-work. O escore total médio da SEFIP-work foi de 6,59 (DP=3,66), com o item “parte inferior das costas” sendo o mais marcado (n=28; 93,33%), pontuação média de 1,18 (SD=0,73). Em conclusão, a versão brasileira adaptada da SEFIP-work apresenta um nível aceitável de compreensão por parte dos trabalhadores na investigação da dor ou desconforto músculoesqueléticos.

ABSTRACT Our study aimed to perform the face and content validity of Self-Estimated Functional Inability because of Pain (SEFIP) for workers, here called the SEFIP-work questionnaire. This is a questionnaire validity study. Our group previously translated and adapted the original version of the SEFIP, which was developed to investigate musculoskeletal pain and dysfunction to be applied to dancers (SEFIP-dance). However, due to the broad scope of the SEFIP-dance, we made changes and adaptations in the Brazilian Portuguese version of the SEFIP-dance to allow its use in workers. Therefore, face and content validity were performed for the development of the SEFIP-work based on opinions of committee of occupational disease and rehabilitation experts. After face and content validity, this SEFIP-work version was applied to 30 working individuals with musculoskeletal pain. The participants were native Brazilian Portuguese speakers aged 18 years and older. Thus, three changes were made to the questionnaire. All participants understood the SEFIP-work items and alternatives. The average total SEFIP-work score was 6.59 (SD=3.66), with the item “parte inferior das costas” (lower back) being the most marked (n=28; 93.33%), with an average score of 1.18 (SD=0.73). In conclusion, the Brazilian Portuguese version of SEFIP-work presents an acceptable level of understanding by workers in the investigation of musculoskeletal pain or discomfort.

RESUMEN Este estudio objetivó verificar la validez aparente y de contenido del cuestionario Self-Estimated Functional Inability because of Pain (SEFIP) destinado a trabajadores, aquí llamado cuestionario SEFIP-work. Este es un estudio sobre la validez del cuestionario. Nuestro grupo ya ha traducido y adaptado la versión original de SEFIP, que fue desarrollada para investigar el dolor musculoesquelético y su disfunción destinada a la aplicación a bailarines (SEFIP-dance). Debido al amplio alcance de SEFIP-dance, se realizó cambios y adaptaciones en la versión traducida y adaptada al portugués brasileño para permitir su aplicación a los trabajadores. Así se realizó la validez aparente y de contenido para desarrollar el SEFIP-work con base en dictámenes de expertos en enfermedades profesionales y en rehabilitación. Después de la validez aparente y de contenido, la versión de SEFIP-work se aplicó a 30 personas que trabajan con dolor musculoesquelético. Los participantes son hablantes nativos de portugués brasileño con edad igual o superior a 18 años. Se agregaron tres cambios al cuestionario. Todos los participantes entendieron los ítems y las alternativas de SEFIP-work. El promedio de la puntuación total de SEFIP-work fue de 6,59 (DE=3,66), con el ítem “parte inferior de la espalda” como el más marcado (n=28; 93,33%) y puntuación promedio de 1,18 (DE=0,73). Se concluye que la versión brasileña adaptada de SEFIP-work presenta un nivel aceptable de comprensión por parte de los trabajadores en la investigación del dolor o malestar musculoesquelético.

ABSTRACT BACKGROUND: Self-Estimated Functional Inability because of Pain (SEFIP) is a questionnaire specifically designed to measure musculoskeletal pain or discomfort. OBJECTIVE: To perform translation and cross-cultural adaptation of the SEFIP for dancers (SEFIP-dance), for use in Brazilian Portuguese. In addition, as a secondary objective, we adapted the translated version of SEFIP-dance for use among athletes or exercise practitioners (SEFIP-sport). DESIGN AND SETTING: Questionnaire translation and cross-cultural adaptation study conducted at a public university. METHODS: The Brazilian version of the SEFIP-dance questionnaire was developed following the processes of translation (involving two translators with Brazilian Portuguese as their mother tongue and fluency in English), backtranslation (involving two translators with English as their mother tongue and fluency in Brazilian Portuguese), committee review and pre-testing. SEFIP-sport was developed following the processes of content and face validation. RESULTS: SEFIP-dance was applied to 30 dancers, of mean age 22.38 years (standard deviation [SD] = 3.41), among whom 14 were men (46.66%). The participants understood 100% of the SEFIP-dance items and alternatives. SEFIP-sport was applied to 30 athletes or physical exercise practitioners, of mean age 25.09 years (SD = 8.93), among whom 25 were men (86.33%). The participants understood 100% of the SEFIP-sport items and alternatives. CONCLUSION: The Brazilian Portuguese versions of SEFIP-dance, translated and cross-culturally adapted for dancers, and SEFIP-sport, adapted for athletes or physical exercise practitioners, were shown to have adequate levels of understanding.

RESUMO Objetivo: avaliar o limiar de dor a palpação dos músculos mastigatórios em mulheres com Disfunção Temporomandibular de acordo com o questionário do Research Diagnostic Criteria of Temporomandibular Disorders (RDC/TMD). Métodos: realizou-se um estudo transversal utilizando a avaliação do limiar de dor a palpação dos músculos mastigatórios extraorais (temporal, masseter, região mandibular posterior, região submandibular) e intraorais (área do pterigoideo lateral e tendão do temporal), em mulheres, segundo o exame clínico do RDC/TMD. Resultados: foram avaliadas 60 mulheres, foi encontrada diferença estatisticamente significante para o limiar de dor a palpação entre os músculos avaliados segundo o RDC/TMD. Com destaque para a área do pterigoideo lateral, bilateralmente, seguido pelos músculos masseter e temporal. Conclusão: esse estudo sugere que a área do músculo pterigoideo lateral, bilateralmente, apresenta menor limiar de dor a palpação entre os músculos mastigatórios, seguido pelos músculos masseter e temporal segundo RDC/TMD.

ABSTRACT Purpose: to evaluate the pain threshold upon palpation of the masticatory muscles in women with temporomandibular disorder (TMD) according to the Research Diagnostic Criteria of Temporomandibular Disorders (RDC/TMD). Methods: a cross-sectional study was conducted involving the evaluation of pain threshold upon palpation of the extraoral muscles (temporal, masseter, posterior mandibular region, submandibular region) and intraoral muscles (lateral pterygoid area and temporal tendon) in women using the RDC/TMD clinical examination. Results: 60 women were evaluated. Statistically significant differences were found among the muscles evaluated regarding the pain threshold. The lateral pterygoid area, bilaterally, had the lowest pain threshold, followed by the masseter and temporal muscles. Conclusion: this study suggests that the lateral pterygoid muscle, bilaterally, has the lowest pain threshold upon palpation among the masticatory muscles, followed by masseter and temporal muscles, in women with TMD, according to the RDC/TMD evaluation.

OBJETIVO: comparar dois ângulos cervicais com as classificações oclusais em crianças de 6 a 10 anos com e sem Disfunção Temporomandibular (DTM),identificar se há prevalência de DTM quanto ao gênero, e se há influencia da oclusão sobre os ângulos estudados. MÉTODO: realizou-se um estudo observacional transversal com 91 crianças de ambos os gêneros de uma Instituição de Ensino privado, dispostas em Grupo A (sem DTM) e Grupo B (com DTM). Todas as crianças foram avaliadas seguindo uma ficha cadastral constituída de dados referentes a sexo, idade, peso, altura e exame clínico intra-oral para classificação oclusal de Angle. O diagnóstico e a severidade da DTM, foram verificados pelo questionário proposto por Fonseca. Para avaliação dos ângulos cervicais (A1 e A2) foi utilizada a fotogrametria e o Software Alcimagem®. RESULTADOS: entre as crianças avaliadas, 52 (57,14%) apresentaram maloclusão, sendo 29 com DTM e 23 sem DTM, 39 (42,85%) apresentaram normoclusão, sendo 18 sem DTM e 21 com DTM. Quando comparados os ângulos (A1 e A2) a classe oclusal, foi encontrada diferença significante entre as crianças normoclusivas e maloclusivas com o ângulo A1 (p=0,04). CONCLUSÃO: esse estudo demonstrou que o ângulo A1 (C7, ATM e Ápice do Mento) foi estatisticamente significante quando associado com a condição oclusal. Não foi encontrado associação, na população estudada, entre ângulo cervical e DTM. Além disso, também foi possível observar que, a prevalência de crianças do gênero feminino com DTM é significantemente maior que a do gênero masculino. Esse estudo demonstrou que a maloclusão pode alterar somente o ângulo A1 e que a DTM não interfere nos ângulos cervicais estudados.

PURPOSE: to compare two cervical angles with occlusal classifications in children between 6 and 10 years old with and without Temporomandibular Disorders (TMD), to identify if there is a prevalence of TMD according to gender, and if there is influence of occlusion on the studied angles. METHOD: it was conducted a cross sectional observational study with 91 children of both gender in Group A (without TMD) and Group B (TMD). All children were evaluated following a registration form consisted of sex, age, weight, height data and intra-oral clinical examination for occlusal classification of Angle. The diagnosis and severity of TMD were scanned by the questionnaire proposed by Fonseca. For the cervical angles evaluation (A1 and A2) it was used the photogrammetry and the Alcimagem® software. RESULTS: among the evaluated children, 52 (57.14%) presented malocclusion, 29 with TMD and 23 without TMD. 39 (42,85%) presented normal occlusion, 18 without TMD and 21 with TMD. When the angles were compared, it was found a difference between normal occlusion and malocclusion children with the angle A1 (p=0.04). CONCLUSION: this study demonstrated that the angle A1 (C7, TMJ and Mentum Vertex) was statistically significant when associated to the occlusal condition. No association was found in the evaluated population, between TMD and cervical angle. Besides, it was also observed that the prevalence of female children with TMD is significantly larger than the male. This study demonstrated that malocclusion can change only the angle A1 and the TMD does not interfere with the studied cervical angles.

Estudo realizado em 117 pacientes infectados pelo HIV, internados em um hospital de referência, no período de um ano, compreendido entre 1/10/95 a 30/9/96. Todos os pacientes tinham idade igual ou superior a 15 anos e se submeteram à coleta de escarro para pesquisa de BAAR, por indicação clínica. Todas as 117 amostras coletadas foram submetidas à baciloscopia, 116 à cultura (ocorreu contaminação em uma amostra) e teste de sensibilidade em todas as 39 cepas isoladas. As cepas foram avaliadas pelos testes de PNB e TCH e em seguida encaminhadas a um centro de referência laboratorial para tipificação da espécie. A baciloscopia foi positiva em 34,2% (40/117) das amostras. Entre as 39 cepas isoladas, três não pertenciam ao complexo M. tuberculosis (M. avium intracelulare em duas e não identificada em uma). A taxa de resistência atribuída ao M. tuberculosis isoladamente foi de 13,90% (5/36). Não foi encontrada resistência atribuída a uma única droga e a combinação responsável pela maior taxa de resistência foi a de rifampicina com isoniazida. A resistência primária e secundária foi, respectivamente, de 20% (4/20) e de 9,1% (1/10). Entre os aspectos sociodemográficos e clínicos, a resistência às drogas esteve significativamente associada apenas a maior número de internações prévias (p < 0,03). Esses dados sugerem uma possível transmissão intra-hospitalar de cepas multirresistentes entre pacientes infectados pelo HIV.

This study was performed in 117 patients infected by HIV, admitted to a reference hospital, in a period of one year (from 10/1/95 to 9/30/1996). All patients were 15 years old or more and had their sputum collected for AFB research, by clinical indication. All the 117 collected samples were submitted to bacilloscopic examination and 116 to culture (due to contamination in one sample) and also drug susceptibility test in all the 39 isolated strains. The strains were evaluated by PNB and TCH tests, and sent to a reference laboratory to typify the specimens. The bacilloscopic examination was positive in 34.2% (40/117) of the samples. From the 39 isolated strains, three did not belong to the M. tuberculosis complex (M. avium intracellulare in two, and one not identified strain). The resistance rate attributed separately to the M. tuberculosis was 13.90% (5/36). Resistance was not found that could be attributed to a single drug and the combination responsible for the highest resistance rate was that of rifampicin and isoniazid. The primary and secondary resistance was 20% (4/20) and 9.1% (1/10), respectively. Among social-demographic and clinical aspects, drug resistance was just significantly associated to a larger number of previous hospitalization (p < 0.03). These data suggest an intrahospital possible transmission of MDR (multi drug resistant) strains, among patients infected by HIV.