Basic Information The Physical Therapy and Research Journal (Revista de Fisioterapia e Pesquisa) (ISSN 1809-2950), continuation of the University of São Paulo Physiotherapy Journal (Revista de Fisioterapia da Universidade de São Paulo) (ISSN 1413-7879), is a scientific journal created in 1994, whose mission is to disseminate scientific production and knowledge in the field of physiotherapy and rehabilitation and related disciplines. In aspects related to basic, clinical, and applied research. Frequency: quarterly INDEXING SOURCES SCIELO- Scientific Electronic Library Online BVS – Biblioteca Virtual em Saúde (Virtual Health Library) CINAH – Cumulative Index to Nursing and Allied Health Literature LILACS – Latin American and Caribbean Health Sciences LATINDEX – Sistema Regional (Regional System) Sport DISCUS Intelectual property All journal content, except where identified, is licensed under a Creative Commons License of the type attributed BY Sponsors The publication receives funding from: AGUIA – USP Agency for Academic Information Management FMUSP – USP School of Medicine CREFITO - Regional Council of Physiotherapy and Occupational Therapy
Universidade de São Paulo. Faculdade de Medicina
Effectiveness of muscle strengthening in early postoperative total knee arthroplasty: systematic review with meta-analysis
Total Knee Arthroplasty (TKA) is a surgical intervention, in which the affected joint is replaced by a prosthesis. Physical therapy is essential in rehabilitation after TKA, which can decrease the length of hospital stay, reduce symptoms and improve knee function. This study aimed to analyze the effects of muscle strengthening on the functioning of individuals with TKA in the early postoperative period. Studies were retrieved from the Pubmed, PEDro, LILACS, EMBASE, CINAHL and Cochrane Library databases, using following terms and keywords: Arthroplasties, Knee Replacement, Physiotherapy, Exercise, Rehabilitation and Postoperative. All included studies were assessed for methodological quality, using the PEDro Scale. Only randomized controlled trials involving unicompartmental knee replacement in the early postoperative period were included in this review. All meta-analyses were conducted using the Review Manager - RevMane software described as standardized mean difference (SMD) with 95% confidence intervals (CI). Nine studies were chosen to review the full text. The main findings demonstrated that muscle strengthening, after comparison with other variables, was effective only for the variable muscle strength (two studies, n=155; MD=−1.39, 95% CI [−2.58, −0.19]; p=0,02; I²=96%) improving overall functioning. For the other analyses, however, no significant differences were observed. This study outcomes suggest muscle strengthening—when initiated in the early postoperative period—is better than the comparison conditions in knee functioning.
Copyright (c) 2025 Alany Gabrielli Leite https://creativecommons.org/licenses/by-sa/4.0
Physical Therapy students’ perception of the Objective Structured Clinical Examination: a mixed methods approach
The objective structured clinical examination (OSCE) has become a popular approach for assessing clinical competence in health programs. Although OSCE is widely acknowledged for its validity and reproducibility in assessing clinical skills, Physical Therapy students’ perceptions of this approach remain underexplored. This study aims to analyze the views of Physical Therapy students on the educational efficacy of OSCE, evaluating its strengths and weaknesses. This descriptive study with mixed method approach surveyed students about OSCE, combining quantitative and qualitative analysis. OSCE in Respiratory Physical Therapy was conducted as part of the course assessment. Physical Therapy students were invited to complete a survey addressing their perceptions of exam relevance, logistics, and impact. The instrument comprised 17 closed-ended and five open-ended questions. Quantitative data were analyzed using descriptive statistics, while qualitative data were subjected to content analysis, performed independently by two investigators. In total, 63 students (87% women, 22.5±1.76 years) completed the survey. Overall, 73% of participants found the exam to be both relevant and effective, while 74.6% acknowledged its contribution to their learning. Additionally, 68.3% believed that the experience aided in their preparation for clinical practice. Positive and negative themes have emerged from the content analysis. For instance, positive aspects include immediate feedback at the end of the exam and simulated clinical experiences, while negative aspects encompass anxiety, time constraints, and a stressful environment. This study demonstrated that Physical Therapy students perceive OSCE as a valuable learning method. They appreciated the training it provided in human relationships for clinical practice, while simultaneously identifying stress as a notable negative aspect.
Copyright (c) 2025 Thiago Oliveira Santos, Priscila Gomes de Jesus Oliveira, Rafaela Oliveira Silva, Lília Maria Mendes Bernardi, Raquel Annon https://creativecommons.org/licenses/by-sa/4.0
Respiratory system parameters and clinical markers in children with cystic fibrosis
This study aimed to investigate the relationship between respiratory system parameters and clinical markers in individuals with cystic fibrosis (CF), as well as to compare individuals with altered oscillometric parameters to those with values within normal range. This cross-sectional analytical study involved children and adolescents with CF. Data collected included anthropometric measurements, disease severity, bacterial colonization, genetic mutations, and parameters from impulse oscillometry (IOS) and spirometry. A total of 115 evaluations were conducted. Correlation was found between respiratory system parameters and the association of total airway resistance (R5) and 5 Hz reactance (X5) with genetic mutations, BMI percentiles, and disease severity. Significant differences were observed between the TypicalX5 and AlteredX5 groups (FEV1% and FEF25-75%, p<0.001) and the TypicalR5 and AlteredR5 groups (FEV1% and FEF25-75%, p<0.001). Height, FEV1 (L), and FEF25-75% (L) explained 69.2% of variations in X5 (kPa), while height and FEV1 (L) together explained 68.2% of variations in R5. Conclusion: This study verified the relationship between spirometric and oscillometric parameters, and found that R5 and X5 are linked to genetic mutation, BMI percentile, and disease severity Routine spirometry, as well as weight and height assessment, are essential in the management of lung disease
Copyright (c) 2025 Tayná Castilho, Renata Maba Gonçalves Wamosy, Patricia Morgana Rentz Keil, Bruna Weber Santos, Tatiana Godoy Bobbio, Camila Isabel Santos Schivinsk https://creativecommons.org/licenses/by-sa/4.0
Cross-culturally adaptation of the knowledge of disease management-cf-adolescent questionnaire into Brazilian Portuguese
This study cross-culturally adapted the Knowledge of Disease Management-CF-Adolescent (KDMCF- Adolescent) questionnaire into Brazilian Portuguese and tested its measurement properties. Cross-cultural adaptation followed five standardized steps: translation, consensus on the translated version, back translation, consensus on the back translation version, and application of the final version to 35 adolescent patients aged 11 to 20 years with social distancing measures, the questionnaire was delivered online using the Google Forms platform. Data underwent Rasch analysis using the WINSTEPS software. Since no issues regarding understanding were reported, we made no changes in any of the translated items. KDM-CF-Adolescent divided the sample into two levels of knowledge and the items into three levels of difficulty, leading to person and item reliability indices of 0.67 and 0.81, respectively, and internal consistency of 0.69. All items fit the Rasch model expectations since all infit/outfit and associated z values were within the expected range. Principal component analysis confirmed the existence of two dimensions; however, they did not function as independent scales. Analysis showed no duplication of any content and no floor and/or ceiling effects. The Brazilian Portuguese version of the KDM-CF-Adolescent questionnaire showed satisfactory measurement properties in measuring the knowledge of adolescents with CF about the disease. cystic fibrosis (CF). Due to the COVID-19 pandemic and
Copyright (c) 2025 Hilda Angélica Iturriaga Jimenez, Luci Fuscaldi Teixeira-Salmela, Lívia de Castro Magalhães, Marcelo Velloso https://creativecommons.org/licenses/by-sa/4.0
Mobilization of intensive care unit patients during renal replacement therapy: a survey with physical therapists
Although physical therapy techniques are widely applied at the intensive care unit (ICU), patients under renal replacement therapy (RRT) are often excluded from mobility studies. We aimed to investigate which are the mobilization interventions performed by physical therapists in ICU patients during RRT and what is the perception regarding its safety. This was a survey study with physical therapists who work at ICUs that have continuous renal replacement therapy (CRRT) and/or intermittent hemodialysis (IHD) in the city of São Paulo, Brazil. A structured questionnaire was sent electronically. Responses were analyzed separately for CRRT and IHD and compared with proportion test. A total of 71 forms were received, and 51 were included. Physical therapists were employed at public (56.8%) and private hospitals, of secondary (54.9%) and tertiary levels. Nine physical therapists reported specific protocols for mobilization practice during RRT at the ICU. Mobilization interventions were performed more frequently during CRRT than IHD (91% vs. 65%, p=0.005). Passive and active limb mobilization were the most frequently performed interventions. 21% of respondents reported complications for IHD and 26% for CRRT, mainly related to the hemodialysis system. Many participants (66.7% for IHD and 44.1% for CRRT) reported to have never searched for literature recommendations. Among those who searched, the findings varied greatly. We concluded that there is lack of standardization for mobilization interventions during RRT. Mobilization is more frequently performed during CRRT and the most applied techniques are passive and active limb mobilization. Complications reported during the mobilization practice were mainly related to the hemodialysis system and not frequent
Copyright (c) 2025 Luciene di Santi Martins, Thamires Aparecida Carvalho de Matos, Leda Tomiko Yamada da Silveira https://creativecommons.org/licenses/by-sa/4.0
Diaphragmatic ultrasonography as a predictor for mechanical ventilation weaning in adults: an integrative review
Diaphragmatic ultrasonography (US) has been used to evaluate several respiratory diseases. Due to portability, this examination can easily be performed at bedside, in wards, emergency rooms and especially in the intensive care unit To identify and analyze how diaphragmatic ultrasonography can support safe mechanical ventilation weaning based on scientific evidence. This is an integrative literature review. Bibliographic survey was conducted from September to November 2022 in the following electronic databases: SciELO, LILACS and PubMed. A total of eight articles were included and evaluated using the Newcastle- Ottawa and PEDro scales, showing intermediate to high methodological quality. In total, the studies included 482 adult volunteers, of both sexes, aged 58.09±8.03, who had undergone invasive mechanical ventilation for at least 24 hours and were under ventilation to continue invasive ventilation weaning. In the selected studies, we found three evaluative variables: diaphragmatic excursion (DE) (75%); diaphragmatic thickness (DT) (62.5%); and diaphragmatic thickening fraction (DTF) (100%). Incorporating DT, DE and DTF into protocols for mechanical ventilation weaning in critically ill patients seems to support decision-making on the ideal time for weaning, reducing extubation failure.
Copyright (c) 2025 Enathanael Ribeiro Soares, Joel Freires de Alencar Arrais, Flávio Vinicius Fagundes Xavier, Adalberto Veronese da Costa, Glêbia Alexa Cardoso, Wildberg Alencar Lima https://creativecommons.org/licenses/by-sa/4.0
Knowledge of physical therapists about developmental coordination disorder in Fortaleza, Brazil
The study sought to analyze whether undergraduate students and physical therapy professionals have the necessary knowledge to intervene with children with developmental coordination disorder (DCD) and whether they can identify their terms, concepts and motor and psychosocial characteristics. The sample was divided into two groups: professionals (n=45) and physical therapy students (n=16), who responded to a questionnaire based on previous studies on the topic, presented via an online form. Data collection occurred over 12 weeks, and the data were descriptively analyzed, presenting absolute and relative response frequencies. All 61 participants indicated a lack of knowledge about DCD. Although the term was considered more familiar among students (56.2%) compared to professionals (48.8%), all participants, overall, demonstrated limited knowledge about aspects related to the definition, prevalence, and identification of DCD. Participants highlighted the need for additional training on the subject. It was evident that due to the lack of knowledge about DCD, strategies to disseminate information about the topic are essential. This is crucial for incorporating DCD into common diagnostic possibilities for the pediatric population, particularly in regional contexts.
Copyright (c) 2025 José Davi Nunes Martins, Marcela de Castro Ferracioli Gama https://creativecommons.org/licenses/by-sa/4.0
This cross-sectional study compared work ability between individuals affected and not affected by mild COVID-19. The participants underwent serological testing for SARS-CoV-2 and answered the Work Ability Index (WAI) questionnaire. The seropositive group had a lower final WAI score compared to the seronegative group (40 [36–44] vs 43 [38–45]; p=0.008). The presence of three or more current injuries/diseases (PR=3.23; 95%CI:1.59-6.54; p<0.0001) and female sex (PR=3.28; 95%CI:1.27–8.46; p=0.014) were determining factors for lower work ability in the seropositive group. Work ability was poorer in individuals who had mild COVID-19, although the disease was not a determining factor for this decrease.
Copyright (c) 2025 Sylvia Correia de Almeida, Tiótrefis Gomes Fernandes, Guilherme Peixoto Tinoco Arêas, Jaila Dias Borges Lalwani, Pritesh Lalwani, Thaís Sant’Anna https://creativecommons.org/licenses/by-sa/4.0
Use of vaginal dilators and effects on vaginal volume and quality of life: a randomized clinical trial
Although it is advised to use vaginal dilators following radiotherapy to prevent vaginal stenosis, compliance is frequently low. This study aimed to assess adherence to the use of vaginal dilators after brachytherapy and its effects in women who received phone call or texting apps guidance. A total of 30 women who previously underwent brachytherapy for cervical cancer were randomized into two groups using the R program: monitoring via phone calls and monitoring via text messages. They underwent gynecological examination with measurement of vaginal volume and answered the Functional Assessment of Cancer Therapy-Cervix Cancer (FACT-CX) questionnaire at the initial consultation and at the sixth month. No association was found between adherence and the types of follow-up (p=0.79). In the first month, 43.3% adhered to dilators, 36.6% did so in the third month, and 23% in the sixth month. The highest adherence group had higher difference in vaginal volume scores (16.81±10.45 cm3) compared to the nonadherence group (10.45±9.55 cm3) with a strong effect size (d=1.68). The difference between the initial and final vaginal volume was not associated with the FACT-CX scores (rho=−0.369; p=0.08. Although no differences were observed in adherence to dilators and type of follow-up, high adherence demonstrated a direct effect on increasing vaginal volume, showing the need to promote educational forms that encourage adherence.
Copyright (c) 2025 Natalia Carion Haddad, Marco Aurelio Pinho de Oliveira, Leila Cristina Soares https://creativecommons.org/licenses/by-sa/4.0
Effects of dual-task training on gait and balance in post-stroke individuals: a systematic review with meta-analysis
This article aims to investigate the effects of dual-task training in the gait and balance of post-stroke individuals via a systematic review with meta-analysis of clinical trials with adequate methodological quality. Searches in the electronic databases PubMed, Lilacs, SciELO, PEDro, up to September 2024, by two independent researchers. We included randomized clinical trials, with dual-task training in post-stroke individuals, with an average PEDro scale score of six or higher. The outcome measures of interest were any related to gait and/or balance, which could be assessed using tests or questionnaires. Study methodological quality was assessed using the PEDro scale. Eight studies were included. Overall, dual-task training showed to be effective in improving gait speed by 0.11 m/s (95%CI 0.02–0.21; I2=11%; p=0.02), cadence by 7.30 steps/minute (95%CI 2.46–12.14; I2=0%; p=0.003), and balance (SMD 0.45; 95%CI 0.08–0.81; I2=36%; p=0.02). No significant results were found for stride length (SD 1.72; 95%CI −9.15–12.59; I2=22%; p=0.76) and mobility (95%CI −5.64–1.88; I2=0%; p=0.33). This systematic review showed, via meta-analysis, that dual-task training can significantly improve gait speed, cadence, and balance in post-stroke individuals. However, we recommend new clinical trials, with higher methodological quality, especially studying the effects on mobility and balance
Copyright (c) 2025 Ally Summer Santiago Procópio, Deivid Barbosa Portilho, Patrick Roberto Avelino, Kênia Kiefer Parreiras de Menezes https://creativecommons.org/licenses/by-sa/4.0
Neck circumference as a complementary measure for identifying excess body weight in children aged from 2 to 9 years
Neck circumference (NC) indicates nutritional status and indirectly measures upper body subcutaneous fat, an independent predictor of cardiometabolic diseases. This study aims to analyze the accuracy of NC as a measure to assess excess body weight in children aged from two to nine years according to sex. Sampling included 435 children from the Predictors of Maternal and Infant Excess Body Weight Study, a birth cohort study carried out in Brazil in participants’ homes. Data were collected from January 2012 to October 2021. Participants were subjected to anthropometric assessments. Their demographic and socioeconomic data were obtained. A positive correlation (p<0.05) occurred between NC and weight, height, and body mass index in boys and girls in follow-ups. Except for the one-two-year age group (AUC=0.73; 95%CI 0.65–0.81 for boys and girls), the accuracy of NC in indicating excess body weight in boys and girls equaled 0.80 or higher (AUC: 0.80–0.95; 95%CI: 0.71–1.00). Our findings showed that NC can screen Brazilian children aged two-nine years for excess body weight. However, further studies involving larger sample sizes and other populations are necessary to complement the data in this study.
Silmara Salete de Barros Silva Mastroeni
Copyright (c) 2025 Daniela dos Santos, Silmara Salete de Barros Silva Mastroeni, Cecilia Burigo Corrê, Marco Fabio Mastroeni https://creativecommons.org/licenses/by-sa/4.0
Analysis of pulmonary function and comparison of time to early mobilization in patients undergoing laparoscopic bariatric surgery: a quasi-experimental study
Early mobilization applied after bariatric surgery aims to reduce postoperative complications. Notably, there is no consensus on the appropriate time to start it. This study aimed to analyze the recovery of lung function and length of stay in patients undergoing bariatric surgery at different mobilization times. Quasi-experimental, interventional study with 167 patients divided into three groups: the first 55 patients began early mobilization 6 hours after surgery (G6); other 55 patients started after 4 hours (G4) and the last 57 patients started after 2 hours (G2). Spirometry was performed preoperatively and before mobilization, the measurements obtained were forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF), maximum voluntary ventilation (MVV) and forced expiratory flow by 25–75% (FEF25–75%). There was a prevalence of females (82.04%), hospitalization time was shorter in G2 (p<0.050) and vital signs remained at physiological values. There was a significant reduction in FEV1, FVC, MVV, FEF25- 75% and PEF values in the immediately after surgery, followed by a gradual increase (p≤0.05) as the days progressed. This study identified that the physiotherapeutic protocol initiated 2, 4 or 6 hours after surgery was effective regarding hemodynamic stability, reduction of hospitalization time and recovery of lung function over time in patients undergoing bariatric surgery. However, no difference was observed r
Copyright (c) 2025 Fernanda Cardoso Silva, Italo Gabriel Ferreira Germano, Andréia Maria da Silva Vilela Terra, Admar Concon Filho, Carolina Kosour, Fabiana Della Via https://creativecommons.org/licenses/by-sa/4.0
Development and validation of the body posture self-perception questionnaire
The assessment of self-perceived body posture still lacks valid instruments that measure the “perception” construct. This study aims to develop and validate the content of a questionnaire that assesses self-perceived static body posture alignment in school-aged children and adolescents. In total, six experts in postural assessment and education — three dedicated to clinical practice and three, to the scientific area — evaluated the Self-Bodpos proposed instrument by a validation questionnaire with general and specific questions about each item and the options for closed answers and contained spaces for suggestions. The content validity index (CVI) served to calculate the experts’ responses. In total, two rounds of evaluations with the experts were necessary. In the first round, CVI ranged from 90 to 40%, requiring further adjustments in the drawings and response options. In the second round, the CVI reached values above 90%, ending the content validation stage. The Self-Bodpos proposed questionnaire offers a valid tool to assess children’s and adolescents’ self-perceived static body posture, which can serve scientific research, clinical practice, and the educational environment
Copyright (c) 2025 Marcelle Guimarães Silva, Ingrid Santos, Betiane Moreira Pilling, Cláudia Tarragô Candotti https://creativecommons.org/licenses/by-sa/4.0
Musculoskeletal symptoms in higher education teachers: implications of the COVID-19 pandemic
During the COVID-19 pandemic, non-essential services, such as universities, started working from home, making professors adapt to spending more hours in front of screens and sitting down. As a result, the new routine has triggered pain, poor posture and stress points, as well as affecting mental health. Therefore, this study aimed to estimate the prevalence of musculoskeletal symptoms in 60 professors at a Higher Education Institution, whose work routine has changed due to the COVID-19 pandemic. This was an original cross-sectional study carried out between February and May 2022, which used the Sociodemographic Questionnaire and the Nordic Musculoskeletal Questionnaire, as well as the Sit and Reach and Third Finger on the Ground tests to assess flexibility and hamstring muscles, in addition to the postural assessment software (SAPO). The most notable results revealed the prominent occurrence of pain or discomfort in the cervical and lumbar regions, in agreement with the most common postural deviations, such as the neck, shoulders, pelvis and legs. This correlation can be attributed to the high incidence of sedentary lifestyles due to the pandemic, which has resulted in longer hours sitting. Social isolation and working from home have led to musculoskeletal disorders even among physically active professors. Physical activity should therefore be increasingly encouraged for a better quality of life and continued well-being, as well as breaks from work and time for leisure
Copyright (c) 2025 Luiza Morais Araújo Souza, Larissa Mirelle de Oliveira Pereira, Wagner Elias de Melo Moreira, Jasiara Carla de Oliveira Coelho, Samyra Giarola Cecílio Cecílio https://creativecommons.org/licenses/by-sa/4.0
Translation and cross-cultural adaptation of the Self-Efficacy for Exercise scale for post-stroke individuals
After a stroke, several factors can influence the practice of physical activity, one of which may be selfefficacy. Self-efficacy is defined as confidence in performing a specific behavior. The Self-Efficacy for Exercise scale was developed to assess self-efficacy for performing physical exercise. This scale is available in English, Chinese, and Malay. For its use in the Brazilian population, its translation and cross-cultural adaptation are necessary. This study aimed to translate into and cross-culturally adapt the English version of the Self-Efficacy for Exercise scale for Brazilian Portuguese. This is a methodological study that followed the recommendations of the STROBE and COSMIN practical guides. The translation and cross-cultural adaptation of the scale was carried out in six stages: (1) translation, (2) synthesis, (3) back translation, (4) expert committee review, (5) pre-test, and (6) approval by the authors of the scale. This study outcomes show that the translation and cross-cultural adaptation of this scale had satisfactory results from a conceptual, semantic, and cultural point of view, thus enabling its use in the Brazilian population. The Self-Efficacy for Exercise - Brasil is an adequate scale to assess confidence in performing physical exercise and can be a new instrument to be incorporated in the assessment of post-stroke individuals in the Brazilian population
Copyright (c) 2025 Maria Tereza Mota Alvarenga, Patrick Avelino, Ruani Tenório, Ana Luiza de Castro, Izadora Santos, Kênia de Menezes, Aline Alvim Scianni https://creativecommons.org/licenses/by-sa/4.0
Functional limitations of adults with traumatic brachial plexus injury in the first medical appointment: a cross-sectional study
The effective treatment of traumatic brachial plexus injury (BPI) requires studies evaluating its functional outcomes. Nevertheless, these studies are scarce, especially in the Northeastern Brazil. Thus, this cross-sectional study aimed to identify the main physical and functional limitations and the quality of life of patients over 18 years of age diagnosed with traumatic BPI, during their first specialized consultation. Sociodemographic and clinical information were recorded, and the outcomes evaluated were: muscle strength, range of motion (ROM) and pain; functionality and quality of life assessed by the Disabilities of the Arm Shoulder and Hand (DASH) and World Health Organization Quality of Life (WHOQOL-BREF) questionnaires, respectively. There was a predominance of men (92%) aged 34±10.5 years with total plexus injury (56%) and motorcycle accident etiology (68%). Most of the sample lived far from the capital (52%), had neuropathic pain (87%) and ROM restrictions. The DASH score ranged from 30.8 to 93.3 points and the physical domain was the most affected in the WHOQOL-BREF. This study points out the young, working age profile of patients with traumatic BPI and the predominance of physical and functional deficits, even before the first specialized consultation
Copyright (c) 2025 Alessandra Carolina de Santana Chagas, Bruna Ferraz Gominho, Elayne de Oliveira Silva, Fernando Henrique Morais de Souza, Juliana Fernandes, Daniella Araújo de Oliveira https://creativecommons.org/licenses/by-sa/4.0
Comparison of two protocols of home-based exercise on the physical fitness of older women with breast cancer under hormonal treatment: a clinical trial
This study aims to compare the effects of two home-based physical exercise protocols on the physical fitness of older women with breast cancer using hormone therapy. This is a comparison study between the effects of two clinical trials developed with patients and different execution periods, subjected to different home-based exercise protocols. In total, 68 older women, aged between 60 and 74 years old, diagnosed with breast Group A (n=38) performed a protocol consisting of 29 exercises and group B (n=30) used a protocol with 12 exercises, both lasting 12 weeks and providing guidance via an introductory lecture, self-instructional material, and weekly telephone contacts. Physical fitness assessment was carried out using the Senior Fitness Test at the beginning and after the 12th week. Statistical analyzes were performed using STATA version 12, with a p<0.05 significance level. The evaluated protocols showed gains related to the components of physical fitness, range of motion and strength, with Group A showing greater gains than Group B. The choice between protocols must be made according to the adopted therapeutic objectives cancer, stage I or II, were included, allocated into 2 groups
Copyright (c) 2025 Ana Clara Carvalho Gonçalves Guerra, Guilherme Henrique de Lima Matias, Breno Augusto Bormann de Souza Filho, Érika Fernandes Tritany, Victor Rafael Fernandes da Silva, Cleber Nascimento do Carmo, João Guilherme Bezerra Alves, Jurema Telles Alves de Oliveira Lima, José Roberto da Silva Júnior https://creativecommons.org/licenses/by-sa/4.0
Students, professors and preceptors’ perspectives of physical therapy undergraduate and graduate courses in emergency remote teaching during social distancing: a cross-sectional study - electronic survey
During the period of emergency remote teaching (ERT), it became crucial to understand the perceptions of those involved in the national pedagogical scenario. This study aimed to describe the perspectives of students, professors, and physical therapy preceptors on ERT during social distancing due to COVID-19. The survey was distributed through social media and registered 995 visitors, resulting in 709 valid responses. The sample included 59 professors and preceptors as well as 650 undergraduate and graduate students. Most participants were female (80.2%), students were aged from 20 to 34 years and professors and preceptor from 20 to 49 years; the latter were predominantly linked to private higher education institutions (92%), mostly in the Brazilian Southeast (82.9%). Confidence in digital platforms use varied between groups: 81.4% of professors and preceptors reported high levels of confidence, while only 58.3% of students reported the same. The results highlighted the financial impact (86.6%), the difficulties in accessing classes (76.6%) and the preference for the continued use of digital platforms (79.5%). Engagement and interaction during classes were affected (83.2%), as well as academic and professional performance (79.4%), especially among professors and preceptors (79.5%). The correlation between confidence in digital platforms use and academic/ professional performance was significant for teachers and preceptors (r=0.323) and not significant for students and the overall sample. Confidence in technology use proved to be vital to the success of ERT. Despite the negative effects observed in the variables analyzed, the preference for remote learning was high.
Copyright (c) 2025 Gislene Gomes da Silva, Alessandra Narciso Garcia, Diego Galace de Freitas https://creativecommons.org/licenses/by-sa/4.0
Use of aquatic environment for assessing functional tests: feasibility, benefits, and challenges compared to land-based tests
This study aimed to investigate the feasibility, benefits, and challenges of using aquatic environment to assess physical function tests compared with landbased assessments. A total of 40 individuals underwent the 6-minute walk test (TC6), 2-minute step test (TSD2’), and timed get-up-and-go (TUG) test, both on land and in a 1.2-meter water depth pool. Perceived exertion was measured using the Modified Borg scale. Paired Student’s t-tests and Cohen d were used to compare assessments in water and on land. Significance was set at 5%. Compared to land, participants walked less in water during the TC6 (d=3.69, p<0.001) and took longer to complete the TUG test (d=2.76, p=0.001). No differences were observed in perceived exertion between land and water during the TC6 (p=0.055) and TUG test (p=0.32). Regarding TME2’, there was no difference in performance between the environments (p=0.45). Conversely, participants experienced lower perceived exertion during the TSD2’ in water (d=1.15, p=0.001). In conclusion, an aquatic environment is a feasible option for conducting functional tests. Although water may have increased the difficulty of certain assessments, the perceived exertion in water was either lower than or comparable to that of land
Copyright (c) 2025 Gustavo Christofoletti, Anna Julia Santana Ribeiro, Maria Fernanda de Souza Macedo, Gabriela Maria da Silva Béé, Sidney Afonso Sobrinho-Junior, Jefferson Rosa Cardoso https://creativecommons.org/licenses/by-sa/4.0
Gaps in the physical therapy approach to functioning and disability after stroke: a scoping review
Investigating the use of the biopsychosocial model in healthcare can point to shortcomings in the approach to health domains that make care less comprehensive. There are gaps of information on how this model is employed by physical therapists in the care of stroke survivors. These data could contribute to health decision-making and targeting of resources across various intervention settings. This scoping review analyzed clinical trials conducted by physical therapists that had functioning/ disability in post-stroke adults as an outcome, with the aim of investigating the biopsychosocial model approach. Articles in which the intervention was applied by other professionals and/or published only in languages not mastered by the authors were excluded. Screening by two blinded reviewers returned 25 articles across eight databases (Medline, PEDro, Embase, Scopus, LILACS, CINAHL, Web of Science, and the Cochrane CENTRAL database). The content of the functioning/disability assessment measures was linked to the domains of the International Classification of Functioning, Disability, and Health (ICF). With the ICF categories, a more detailed content analysis was conducted, enabling a precise comparison across intervention settings. We found that the functioning/disability approach mostly focuses on covering the activity elements of the biopsychosocial model, mainly mobility and self-care, regardless of the intervention setting. The results of this study may be useful for guiding the practice of physical therapists, providing data for health managers to officially adopt the model as a decision-making guide and clarifying to patients some of the objectives of physical therapy after stroke.
International Classification of Functioning
Copyright (c) 2025 Shamyr Sulyvan de Castro; Sofia Queiros Vieira https://creativecommons.org/licenses/by-sa/4.0
Urinary incontinence and quality of life in women with severe obesity : an observational study
The primary objective of this study was to determine the prevalence of urinary incontinence (UI) in women with severe obesity. Other objectives included assessing the quality of life among women with obesity with UI and comparing levels of pelvic floor muscle strength and lumbar disability between women with and without UI. A cross-sectional observational study was conducted involving 56 women with class III obesity. The International Consultation of Incontinence Questionnaire-Short Form was used to detect the presence of UI, and the King’s Health Questionnaire was used to assess the quality of life of those considered incontinent. Pelvic floor muscle strength was evaluated using the PERFECT scale, while lumbar disability was verified using the Oswestry Disability Index. The results indicated that UI was prevalent in the studied population, with a rate of 57.1% (n=32). The sample showed low quality of life scores in the domains of “General Health Perception (51.5 ± 22.8) and “Impact of Incontinence” (51.0 ± 36.8). There were no statistically significant differences in pelvic floor muscle strength levels and lumbar disability between the groups with or without UI. However, there was a statistically significant difference in the incidence of vaginal childbirth in the subgroup with UI (62.5%) compared to the subgroup without UI (25%) (p=0.005). Overall, UI was prevalent in most of the studied population, and the sample showed poor quality of life. Furthermore, vaginal childbirth was found to influence the occurrence of UI.
Copyright (c) 2025 Lizyana Vieira, Renato Almeida https://creativecommons.org/licenses/by-sa/4.0
Adiposity, stress, and habitual physical activity predict executive function and memory performance in children and adolescents with obesity
Obesity during childhood and adolescence may delay cognitive development. This study aims to evaluate predictors that influence executive functions and memory in children and adolescents with obesity. A cross-sectional study was carried out with children and adolescents with obesity (aged 7–18 years) (n=32). Executive functions; episodic memory; semantic memory; body composition; inflammation biomarkers; cardiorespiratory fitness, stress, socioeconomic status, and regular physical exercise were assessed. A linear stepwise regression was performed with the variables with significant correlation. Adiposity (%fat) and BMI z-scores were associated with worse episodic memory. Verbal fluency was associated with visceral fat. At the tower of Hanoi test, planning and cognitive flexibility were associated with visceral fat, whereas the number of movements was associated with the practice of sports and physical exercise. Regular exercise favored the cognitive planning of children and adolescents with obesity. The number of errors was directly associated with the children stress scale score. In conclusion, body composition, memory, and the executive functions of cognitive flexibility and inhibitory control showed an association between each other. Executive functions and memory in children and adolescents might be associated with stress and regular physical exercise practice regardless of intensity.
Copyright (c) 2025 Daniel Almeida Freitas, Bruno Alvarenga Soares, Arthur Rocha Gomes, Túlio Pereira Alvarenga e Castro, Bethânia Alves de Avelar Freitas, Herbert Renato Coelho Gomes, Ana Cristina Rodrigues Lacerda, Fernanda Cordoba Lanza, Fernanda de Oliveira Ferreira, Vanessa Amaral Mendonça, Hércules Ribeiro Leite https://creativecommons.org/licenses/by-sa/4.0
Implementation of a physiotherapy protocol in the treatment of obstructive sleep apnea at Hospital Alemão Oswaldo Cruz – São Paulo, Brazil
Obstructive sleep apnea (OSA) is a high prevalence sleep-disordered breathing associated with cardiovascular and metabolic complications. Adherence to continuous positive airway pressure (CPAP) therapy is crucial to treatment success and efficiency. Patients are frequently diagnosed during hospitalization, and they do not have access to the right support or orientation about the risks associated with this disorder and the importance of treatment. In this scenario, it is relevant to standardize a protocol of excellence in the OSA treatment. The primary aim of this report is to describe the OSA treatment protocol implemented in a tertiary care hospital. As a secondary aim, to describe the characteristics of the patients included. This is a descriptive and retrospective study, via the analysis of electronic medical records of the patients, who were included in the OSA treatment protocol designed by the sleep physical therapy group, in the Inpatient Units of a hospital in São Paulo during a five years-period. During the Obstructive sleep apnea (OSA) is a high prevalence sleep-disordered breathing associated with cardiovascular and metabolic complications. Adherence to continuous positive airway pressure (CPAP) therapy is crucial to treatment success and efficiency. Patients are frequently diagnosed during hospitalization, and they do not have access to the right support or orientation about the risks associated with this disorder and the importance of treatment. In this scenario, it is relevant to standardize a protocol of excellence in the OSA treatment. The primary aim of this report is to describe the OSA treatment protocol implemented in a tertiary care hospital. As a secondary aim, to describe the characteristics of the patients included. This is a descriptive and retrospective study, via the analysis of electronic medical records of the patients, who were included in the OSA treatment protocol designed by the sleep physical therapy group, in the Inpatient Units of a hospital in São Paulo during a five years-period. During the study period, 126 patient were analyzed, and 108 were included and had their profiles described. According to the reviewed medical records, the average age of patients was 73 years with 70% males. The most prevalent comorbidity was hypertension (80%) followed by diabetes (50%). In total, 74% were adherents to therapy with CPAP during hospitalization. It is feasible to implement a protocol for treatment of hospitalized patients with the diagnosis of OSA. Keywords | Obstructive Sleep Apnea; Continuous Positive Airway Pressure; Physical Therapy Department; Hospital; Inpatients.
Copyright (c) 2025 Aline Nogueira Aielo, Darlene Yuri Yoshimori, Eliane Cristina Zacarias, Fernanda Evaristo Niyama, Elica Batista Alves, Silvia Fukuzaki https://creativecommons.org/licenses/by-sa/4.0
Individual factors are associated with musculoskeletal pain and discomfort in workers from a beverage company
Work-related musculoskeletal disorders may be associated with several risk factors. This study objective was to analyze the association of occupational risk factors and individual factors with musculoskeletal pain/discomfort in workers who performed dynamic loading activities as well as static postural functions in a beverage company that offers ergonomics and workplace exercises program to all employees. Associations of age, time on the job, nonadherence to labor gymnastics, Work Ability Index (WAI), perception of fatigue by the Need For Recovery scale (NFR), physical and mental health, general health status by the Short Form-36 (SF-36) questionnaire, and pain by the Nordic pain map were analyzed using Fisher’s exact test and logistic regression in a cross-sectional observational study with odds ratios (OR), 95%CI, p < 0.05. Of the 100 workers evaluated, 57% reported pain, with the lumbar region being the most prevalent (47%). An association was found with back pain, being 10.45 times related to workability, 7.4 times for age, 10.25 times for physical aspects; 6.13 times for functioning; 5.17 for general health status; 4.96 for social functioning, and 3.01 for emotional well-being for the SF-36 domains. The need for rest was 3.40 times associated with the presence of pain, time in the job was 4.12 times associated, while absenteeism was 7.35 and nonadherence to workplace exercises was 2.95 times associated. This sample findings suggest that individual factors such as physical health care and psychosocial support, in addition to workplace exercises and breaks, could be relevant as a preventive approach to alleviate pain.
Copyright (c) 2025 Vinícius Restani de Castro, Marisa de Cássia Registro Fonseca, Lisandra Vanessa Martins https://creativecommons.org/licenses/by-sa/4.0
Functioning and associated factors in older adult users of primary health care
Population aging is a major challenge for public health, society, and policymakers worldwide. This challenge becomes increasingly complex in developing countries. Our research evaluated the functioning and factors associated with clinical and sociodemographic aspects of older adult users of Primary Health Care in Fortaleza city. A cross-sectional analytical study was conducted using the World Health Organization Disability Assessment Schedule (WHODAS 2.0) to measure functioning. Mann-Whitney and Kruskall-Wallis tests were employed for bivariate analyses, along with negative binomial regression for multivariate analysis. Age was associated with the loss of functioning across all WHODAS 2.0 domains (p<0.01). Respondents who presented clinical decompensation related to any comorbidity performed worse in the self-care (p<0.05), school and work activities (p<0.05), life activities (p<0.05), participation (p<0.05), and total domains (p<0.01). Our findings reinforce the key role of Primary Health Care as a strategic space to preserve functioning in the older adult population.
Copyright (c) 2025 Chris Evert Moura Tabosa de Figueiredo, Shamyr Sulyvan de Castro, Marcelo José Monteiro Ferreira https://creativecommons.org/licenses/by-sa/4.0
Momentum project and the assessment of human movement: accessibility, low cost, and technological challenges
Copyright (c) 2025 Bianca Callegari, Givago da Silva Souza https://creativecommons.org/licenses/by-sa/4.0
The impact of an early, viable, and low-cost mobilization protocol in critically ill patients: comparison with conventional physical therapy
This study aims to analyze the outcomes of applying an early mobilization protocol, using low-cost interventions with the minimum necessary equipment in an intensive care unit. A clinical trial, controlled and randomized, conducted in collaboration with the Laboratory for Assessment and Research in Cardiorespiratory Performance of the Department of Physical Therapy at the Federal University of Minas Gerais and the Intensive Care Unit of Risoleta Tolentino Neves Hospital in Belo Horizonte, Brazil, over a period of 5 months. Patients were randomized into two groups (treatment n=67 and control n=67). The primary outcome was days of discharge from bed. Secondary outcomes included ICU length of stay, hospital length of stay, hospitalization costs, time on mechanical ventilation, ICU mortality, and hospital mortality. The group characteristics were similar in the initial assessment. It was found that 61 patients (97%) in the treatment group were discharged from bed compared to only two patients (3%) in the control group. The proposed mobilization protocol reduced hospitalization costs by 30.27%, an approximate difference of R$7,000.00 per patient. The mean ICU stay time for the treatment group was less than the control group. There were no statistically significant differences in ICU hours, hospital length of stay, or mechanical ventilation time. The results of this study demonstrated that the application of a low-cost and minimally equipped early mobilization protocol was safe and effective for patients, promoting early discharge from bed
Copyright (c) 2025 Rodrigo César Maia Moreira, Rodrigo Marques Tonella, Lucinara Martins Silva Tallarico, Taís Mendes de Camargo, Liliane Patrícia Souza Mendes, Mariana Hoffman Barbosa, Maria Clara Xavier Salles, Marcelo Velloso https://creativecommons.org/licenses/by-sa/4.0
Analysis of content, credibility, and reliability of information on chronic obstructive pulmonary disease treatment in YouTube™ videos: a cross-sectional observational study
Chronic Obstructive Pulmonary Disease (COPD) is characterized by airway abnormalities, resulting in persistent airflow obstruction. Treatment involves pharmacological and nonpharmacological interventions which are supported by several COPD consensus and guidelines. YouTube can often be used to share information about treatments for chronic diseases like COPD; however, the credibility of such information may not be adequate. This study evaluates the reliability and credibility of information concerning COPD treatment disseminated on YouTube, the most popular social media platform, and assess its alignment with the GOLD guideline. A cross-sectional observational study was conducted to select the first 200 English-language videos on COPD treatment posted on YouTube. Video evaluation used validated instruments, including the DISCERN tool (quality assessment), the Health on the Net Foundation Code of Conduct - HONcode (credibility assessment), and the GOLD guideline (reference). Poor agreement with the GOLD guideline (97.4%) was found. HONcode assessment showed that 75.7% of the videos achieved a high credibility rating. Regarding information quality, 75.7% of the videos received positive ratings based on the DISCERN tool. Despite exhibiting adequate credibility, the analyzed videos displayed fluctuating levels of quality, ranging from medium to low. Moreover, there was limited consensus between the videos and the GOLD guideline. Continuous analysis of such content can be used to ensure dissemination of reliable information on YouTube.
Ana Luíza da Silva Nunes Teixeira Rodrigues
Copyright (c) 2025 Ana Luíza da Silva Nunes Teixeira Rodrigues, Vanessa Kelly da Silva Lage, Redha Taiar, Joyce Noelly Vitor Santos, Laisa Braga Maia, Jousielle Márcia dos Santos, Vinícius Cunha Oliveira, Ana Cristina Rodrigues Lacerda, Vanessa Amaral Mendonça https://creativecommons.org/licenses/by-sa/4.0
WHODAS as a strategy to enable the application of the biopsychosocial model in clinical settings: a systematic review
This study aimed to identify how WHODAS 2.0 is being used in clinical trials. This is a systematic review that selected clinical trials in Portuguese, English, and Spanish that used WHODAS 2.0. The search was conducted in the following databases: MEDLINE, Embase, LILACS, and PEDro. Data were collected on country, year, population, objectives, version of WHODAS 2.0, and variables evaluated. This study found 206 references, after analysis and evaluation of the inclusion criteria, 32 articles were selected. Most studies were conducted in Asia (n=10), followed by America (n=9). Of the 32 studies, four used the 36-item version, 17 used the 12-item version, the others did not report or used results from specific domains. Regarding study population, most articles (n=24) included individuals with mental disorders as their target population. Among the health professionals who participated in the research, most were physicians and nurses. It was observed that despite being an instrument recommended by the WHO to assess functioning, only 32 studies used it. It was possible to observe that the instrument is disseminated worldwide and despite being a generic instrument, most studies used it to evaluate the population with mental disorders.
Copyright (c) 2025 Marina Carvalho Arruda Barreto, Cristine Mayara Cavalcante Camerino, Camila Ferreira Leite Leite, Shamyr Sulyvan de Castro Castro https://creativecommons.org/licenses/by-sa/4.0
Effect of pulmonary function on cardiorespiratory condition, mobility, and balance in people aged over 50 years: a cross-sectional study
This study aimed to evaluate the effect of static pulmonary function variables on cardiorespiratory condition, mobility, and balance in people aged over 50 years, as well as the effect of mobility and balance on three stress tests in the same sample. This is a cross-sectional study. Pulmonary function evaluation was performed by spirometry, the incremental shuttle walking test (ISWT), the six minute walk test (6MWT), the stairs test (ST), the timed up and go test (TUGT), and the Berg balance scale (BBS). SigmaStat® was used for statistical analysis, and the variables were correlated using Pearson’s correlation test (p<0.05). The sample consisted of 46 people [37 women (80.5%) and nine men (19.5%)] with a mean age of 61.02±8.29 years. Results of the correlation of pulmonary function with stress, mobility, and balance and stress tests were correlated with spirometric variables. In the sample, people with lower time in TUGT and better balance conditions who had better lung function. The better the mobility, the better the results in the stress tests. TUGT results showed moderate correlation with ISWT (0.41) and actual 6MWT (−0.43). On the other hand, BBS scores showed moderate correlation with ISWT(%) ((−-0.45), real 6MWT (0.43), and actual (−0.59) and predicted ST (-0.45). We conclude that pulmonary function affects cardiorespiratory condition, mobility, and balance in people aged over 50 years.
Copyright (c) 2025 Valdirene Tenório da Costa Alegria, Roberta Munhoz Manzano, Alexandre Ricardo Pepe Ambrozin https://creativecommons.org/licenses/by-sa/4.0