Bruna Wageck

Cross-cultural Adaptation and Measurement Properties of the Brazilian Portuguese Version of the Victorian Institute of Sport Assessment-Patella (VISA-P) Scale

STUDY DESIGN Clinical measurement. OBJECTIVES To translate, adapt, and test the measurement properties of the Brazilian Portuguese version of the Victorian Institute of Sport Assessment-Patella (VISA-P) questionnaire. BACKGROUND It is important to objectively measure symptoms and functional limitations related to patellar tendinopathy using outcome measures that have been validated in the language of the target population. Cross-cultural adaptations are also useful to enhance the understanding of the measurement properties of an assessment tool, regardless of the target language. METHODS The VISA-P questionnaire was translated into Brazilian Portuguese, culturally adapted, and titled VISA-P Brazil. It was then administered on 2 occasions with a 24- to 48-hour interval between them, and a third time after a month of physical therapy treatment. The following measurement properties were analyzed: internal consistency, test-retest reliability, agreement, construct validity, floor and ceiling effects, and responsiveness. RESULTS The VISA-P Brazil had high internal consistency (Cronbach α = .76; if item deleted, Cronbach α = .69-.78), excellent reliability and agreement (intraclass correlation coefficient = 0.91; 95% confidence interval: 0.85, 0.95; standard error of measurement, 5.2 points; minimal detectable change at the 90% confidence level, 12.2 points), and good construct validity (Pearson r = 0.60 compared to Lysholm). No ceiling and floor effects were detected for the VISA-P Brazil, and the responsiveness, based on 32 patients receiving physical therapy intervention for 1 month, demonstrated a large effect size of 0.97 (95% confidence interval: 0.68, 1.25). CONCLUSION The VISA-P Brazil is a reproducible and responsive tool and can be used in clinical practice and research to assess the severity of pain and disability of patients with patellar tendinopathy.

Kinesio Taping does not decrease swelling in acute, lateral ankle sprain of athletes: a randomised trial

QUESTION Does Kinesio Taping reduce swelling in athletes who have suffered an acute, lateral ankle sprain? DESIGN Randomised controlled trial with concealed allocation, intention-to-treat analysis and blinded assessment. PARTICIPANTS Thirty-six athletes who participated regularly in one of seven different sports modalities and suffered an acute ankle sprain. INTERVENTION The experimental group received Kinesio Taping application for 3 days, which was designed to treat swelling. The control group received an inert Kinesio Taping application. OUTCOME MEASURES For the comparison between groups, the swelling was measured via volumetry, perimetry, relative volumetry and two analyses of the difference in volume and perimetry between ankles of each participant. Data were collected immediately after the 3 days of intervention and at follow-up, which was 15 days post intervention. RESULTS At 3 days after intervention, there were no differences between groups for swelling in volumetry (MD -2 ml, 95% CI -28 to 32); perimetry (MD 0.2 cm, 95% CI -0.6 to 1.0); relative volumetry (MD 0.0 cm, 95% CI -0.1 to 0.1); and the other analyses. At day 15 follow-up, there were no significant between-group differences in outcomes. CONCLUSION The application of Kinesio Taping, with the aim of stimulating the lymphatic system, is ineffective in decreasing acute swelling after an ankle sprain in athletes. TRIAL REGISTRATION Brazilian Registry of Clinical Trials, RBR-32sctf.

Kinesio Taping does not improve the symptoms or function of older people with knee osteoarthritis: a randomised trial

QUESTION Does Kinesio Taping reduce pain and swelling, and increase muscle strength, function and knee-related health status in older people with knee osteoarthritis? DESIGN Randomised, controlled trial with concealed allocation, intention-to-treat analysis and blinded assessment. PARTICIPANTS Seventy-six older people with knee osteoarthritis. INTERVENTION The experimental group received three simultaneous Kinesio Taping techniques to treat pain, strength and swelling. The control group received sham taping. All participants kept the taping on for 4 days. OUTCOME MEASURES The outcomes were: concentric muscle strength of knee extensors and flexors, measured by isokinetic dynamometry with an angular velocity of 60 deg/second normalised for body mass [(Nm/kg) x 100 (%)]; pressure pain threshold via digital pressure algometry (kgf/cm(2)); lower-limb swelling via volumetry (l) and perimetry (cm); physical function via the Lysholm Knee Scoring Scale (0 = worst to 100=best); and knee-related health status via the Western Ontario and McMaster (WOMAC) osteoarthritis index (0=best to 96=worst). Outcomes were measured at Day 4 (end of the taping period) and Day 19 (follow-up) after the start of the treatment. RESULTS At Day 4, there were no significant between-group differences for knee extensor muscle strength (MD -1%, 95% CI -7 to 5), knee flexor muscle strength (MD 2%, 95% CI -3 to 7), the pressure pain threshold at any measured point, volumetry (MD 0.05 L, 95% CI -0.01 to 0.11), perimetry at any measured point, Lysholm score (MD -4 points, 95% CI -9 to 2), or WOMAC score (MD -2 points, 95% CI -8 to 4). The lack of significant between-group difference was also seen at the follow-up assessment on Day 19. CONCLUSION The Kinesio Taping techniques investigated in this study provided no beneficial effects for older people with knee osteoarthritis on any of the assessed outcomes. TRIAL REGISTRATION Brazilian Registry of Clinical Trials, RBR-36r3t5. [Wageck B, Nunes GS, Bohlen NB, Santos GM, de Noronha M (2016) Kinesio Taping does not improve the symptoms or function of older people with knee osteoarthritis: a randomised trial.Journal of Physiotherapy62: 153-158].

Massage therapy decreases pain and perceived fatigue after long-distance Ironman triathlon: a randomised trial

QUESTION Can massage therapy reduce pain and perceived fatigue in the quadriceps of athletes after a long-distance triathlon race (Ironman)? DESIGN Randomised, controlled trial with concealed allocation, intention-to-treat analysis and blinded outcome assessors. PARTICIPANTS Seventy-four triathlon athletes who completed an entire Ironman triathlon race and whose main complaint was pain in the anterior portion of the thigh. INTERVENTION The experimental group received massage to the quadriceps, which was aimed at recovery after competition, and the control group rested in sitting. OUTCOME MEASURES The outcomes were pain and perceived fatigue, which were reported using a visual analogue scale, and pressure pain threshold at three points over the quadriceps muscle, which was assessed using digital pressure algometry. RESULTS The experimental group had significantly lower scores than the control group on the visual analogue scale for pain (MD -7 mm, 95% CI -13 to -1) and for perceived fatigue (MD -15 mm, 95% CI -21 to -9). There were no significant between-group differences for the pressure pain threshold at any of the assessment points. CONCLUSION Massage therapy was more effective than no intervention on the post-race recovery from pain and perceived fatigue in long-distance triathlon athletes. TRIAL REGISTRATION Brazilian Registry of Clinical Trials, RBR-4n2sxr.

Movement adjustments in preparation for single-leg jumps in individuals with functional ankle instability.

There is some evidence showing that people with functional ankle instability (FAI) can present changes in postural control during the landing phase of a jump. These studies also show preliminary results indicating possible changes during phases prior to landing. Therefore, the objective of this study was to investigate whether movement adjustments prior to a jump are different between people with and without FAI. Sixty participants with (n=30) and without (n=30) FAI participated in this study. The main outcome measures were the variability of range of motion in ankle inversion/eversion and dorsiflexion/plantarflexion; and variability of center of pressure for the directions anterior-posterior and medio-lateral during the pre-jump period for drop jump, vertical jump and during single-leg stance. The group with instability showed more variability of center of pressure in anterior-posterior direction (p=0.04) and variability of range of motion in ankle dorsiflexion/plantar flexion (p=0.04) compared to control in the single-leg stance test. For the within-group comparisons, the group with instability showed more variability of center of pressure in anterior-posterior direction in the drop jump higher than single-leg stance and vertical jump. The same pattern was seen for the control group. Thus, this study suggests that people with FAI have greater ankle range of motion variability and center of pressure variability in the anterior-posterior axis when compared to healthy individuals during single-leg stance. For those same two variables, preparation for a drop jump causes more postural instability when compared to the preparation for a vertical jump and to single-leg stance.