A Change for the BetterIn the last few years, the Brazilian Journal of Physical Therapy (BJPT) has shown all of its dynamism by making the necessary changes to promote its sustained growth and fulfill its editorial mission.These changes include a substantial increase in the visibility of the Journal's publications as a result of indexing in bibliographic databases such as
BACKGROUND Diaphragmatic evaluation is crucial in clinical practice, and no studies have reported the intra- and interobserver reproducibilities of the radiographic method to evaluate diaphragmatic mobility. OBJECTIVE To analyze the reliability of radiographic measurement as a method for assessing the mobility of the left and right hemidiaphragms. METHOD Forty-two patients, who were waiting for cholecystectomy surgery, were evaluated relative to the following parameters: physical examination, pulmonary function and radiographic evaluation. The measure of mobility of each hemidiaphragm was randomly determined by two physical therapists at two different times. The intra- and interobserver reproducibilities of the measurements were determined by the intraclass correlation coefficient (ICC[2,1]) and the 95% confidence interval (CI). The Bland-Altman plot was also used. The level of significance was 5%. RESULTS In the analysis of intra-observer reproducibility in radiographic evaluations of the left and right hemidiaphragms, ICC[2,1] indicated a "very high correlation" for both observer A (ICC[2,1] = 0.99, p <0.001 and ICC[2,1] = 0.97, p <0.001, respectively) and observer B (ICC[2,1] = 0.99, p <0.001 and ICC[2,1] = 0.99 p <0.001, respectively). In the analysis of interobserver reproducibility, the ICC[2,1] indicated a "very high correlation" for the 1st and 2nd radiographic evaluations of the right hemidiaphragm (ICC[2,1] = 0.98 and ICC[2,1] = 0,99, respectively, p <0.001) and left hemidiaphragm (ICC[2,1] = 0.98 and ICC[2,1] = 0.99, respectively, p <0.001). CONCLUSION The intra and interobserver tests of the radiographic measure of mobility of the left and right hemidiaphragms showed high reliability.
BACKGROUND:There is a lack of questionnaires in Brazilian Portuguese to evaluate patient-reported lower limb function.OBJECTIVE:To translate, cross-culturally adapt to the Brazilian population, and evaluate the psychometric properties of the Lower Extremity Functional Scale (LEFS).METHOD:The LEFS was translated by two independent assessors and back-translated to English. Then, the LEFS-Brazil was tested on 20 patients who answered the questionnaire in the cross-cultural adaptation phase. For the evaluation of the psychometric properties, 100 patients answered the questionnaire. The reliability was tested by two independent assessors. The Medical Outcomes Study 36-item from Health Survey (SF-36) was used as the criterion method for construct validity. The sensitivity to change was tested for four consecutive weeks.RESULTS:The internal consistency was α = 0.96. The intra-observer reliability was CCI (intraclass correlation coefficient) = 0.96 and CCI interobserver = 0.98; the Bland and Altman mean difference (d) intra-observer = -1.52 and d interobserver = 0.46. The correlation between the LEFS and SF-36 in the first week was the following: physical function r=0.82, physical role r=0.57, emotional role r=0.43 and mental health r=0.33. The LEFS was responsive when comparing the mean of the first week to the second, third and fourth weeks and comparing the second to the fourth week. The cut-off point was 11, and the area under the receiving operator curve was 0.96 95% CI [0.88;0.99], with sensitivity = 0.96, 1-specificity = 0 and standard error = 0.02.CONCLUSION:The LEFS-Brazil is reliable, valid and responsive.
Background: Previous studies have shown a relationship between shoulder posterior capsule tightness and shoulder pain in overhead athletes. However, this relationship has not been studied in tennis players. Objectives: Assessment of the shoulder range of motion (ROM), strength and posterior capsule tightness of skilled amateur tennis players who had complaints of dominant shoulder pain in comparison with tennis players without pain. Method: Forty-nine skilled amateur tennis players were distributed in 2 groups: Control Group (n=22) and Painful Group (n=27). The first group was composed of asymptomatic subjects, and the second was composed of subjects with shoulder pain on the dominant side. These groups were evaluated to determine the dominant and non-dominant shoulder ROM (internal and external rotation), isometric shoulder strength (internal and external rotation) and posterior shoulder tightness by blind evaluators. Results: The ANOVA results indicated significant differences between the groups in the dominant shoulder ROM, posterior capsule tightness, external rotation strength and strength ratio (p<0.05). The intragroup analysis (dominant versus non-dominant) in the Painful Group displayed a significant difference for ROM, posterior capsule tightness and external rotation strength (p<0.05). Conclusions: The tennis players with pain in the dominant shoulder presented greater posterior capsule tightness, internal rotation deficit (ROM), external rotation gain (ROM) and deficits in external rotation strength than the tennis players without pain.
BACKGROUND Thoracic cirtometry is a simple and accessible technique to evaluate chest mobility during forced breathing. However, it does not allow for the assessment of compensatory movements commonly used by people with chronic diseases, such Duchenne muscular dystrophy (DMD). DMD is a condition characterized by progressive and irreversible degeneration of the musculoskeletal system. OBJECTIVES To expand the method of thoracic cirtometry to allow for the assessment of compensatory movements; to analyze the reliability of the tool; and to describe thoracic mobility of children with DMD during deep breathing. METHOD Sixty boys, 30 with DMD (10.1±0.5 years) and 30 healthy controls (9.5±0.6 years) participated in the study. The expanded thoracic cirtometry was organized in two phases: 1. the body could move freely, allowing the assessment of compensatory movements (free thoracic cirtometry) and 2. the body without compensatory movements, allowing for the direct study of the movements of the chest (guided thoracic cirtometry). This method includes videotaping and systematic observation of body movements using descriptive and numeric data. We investigated reliability of these measures in both groups. RESULTS Measures of axial and the xiphoid thoracic cirtometry (both free and guided) showed excellent reliability. All measures were significantly different between groups. In DMD boys, free thoracic cirtometry presented a greater value of chest expansion when compared with the guided measures, which probably occurred due to compensatory movements. The most commons were movements of the head, shoulder and torso. CONCLUSIONS The expanded thoracic cirtometry method showed excellent reliability and achieved the objectives of determining measures of chest mobility and compensatory movements during deep breath. We suggested its use in the respiratory evaluation of children with DMD.
