Clarissa Cardoso dos Santos-Couto-Paz

Cross-cultural adaptation to Brazilian Portuguese of the Michigan Neuropathy Screening Instrument: MNSI-Brazil

Since 1994, the University of Michigan Diabetes Research and Training Center proposed an instrument to measure neuropathies not yet adapted to use in Brazil. Then, this study aimed to adapt cross-culturally the Michigan Neuropathy Screening Instrument (MNSI) into Brazilian Portuguese, verifying its reliability. Thirty diabetic patients were initially evaluated with the adapted version after completed the essential steps to accomplish the cross-cultural adaptation. Twenty-two of them completed the procedures to repeat the measured scores after day 1 (trial 0). The repeated measurements were tested at days 2 or 3 (trial 1) by another rater (inter-rater reliability) and retested at day 20 (trial 2) by one of the attended raters (inter-test reliability). There were not great semantics, linguistics or cultural differences between two versions and excellent reliability was confirmed by intra-class correlation coefficient above 0.840. It was concluded that MNSI in the Brazilian version is reliable and it is ready to use.

Differences in orthotic design for thumb osteoarthritis and its impact on functional outcomes: A scoping review.

Background: Orthoses are a well-known intervention for the treatment of thumb osteoarthritis; however, there is a multitude of orthotic designs and not enough evidence to support the efficacy of specific models. Objective: To examine the influence of different orthoses on pain, hand strength, and hand function of patients with thumb osteoarthritis. Study design: Literature review. Methods: A scoping literature review of 14 publications reporting orthotic interventions for patients with thumb osteoarthritis was conducted. Functional outcomes and measures were extracted and analyzed. Results: In total, 12 studies reported improvements in pain and hand strength after the use of thumb orthoses. Comparisons between different orthotic designs were inconclusive. Conclusion: The use of orthoses can decrease pain and improve hand function of patients with thumb osteoarthritis; however, the effectiveness of different orthoses still needs support through adequate evidence. Clinical relevance Multiple orthoses for thumb osteoarthritis are available. Although current studies support their use to improve pain and hand function, there is no evidence to support the efficacy of specific orthotic designs. Improved functional outcomes can be achieved through the use of short orthoses, providing thumb stabilization without immobilizing adjacent joints.

Cervical-scapular muscles strength and severity of temporomandibular disorder in women with mechanical neck pain

Introduction: Changes in cervical muscle function have been observed in patients with neck pain (NP) and TMD. However, the relationship between TMD severity and neck muscle strength in the presence/absence of NP is unknown. Objective: To determine the prevalence of TMD in women with and without mechanical NP and assess the cervical-scapular muscle strength and its association with TMD severity. Methods: Fifteen volunteers without neck pain (CG) and 14 women with mechanical neck pain (NPG) took part and were selected by the Neck Disability Index. The diagnosis and severity of TMD were determined by the Research Diagnostic Criteria for TMD and Temporomandibular Index (TI), respectively. The strength of the upper trapezius muscle, and cervical flexor and extensor muscles was measured by digital hand dynamometer. Results: 64.5% of women with NP and 33.3% without NP were diagnosed with TMD (p = 0.095). The NPG showed lower strength of the cervical flexor (p = 0.044) and extensor (p=0.006) muscles, and higher TI (p = 0.038) than in the CG. It was also verified moderate negative correlation between TI and the strength of dominant (p = 0.046, r = -0.547) and non-dominant (p = 0.007, r = -0.695) upper trapezius, and cervical flexors (p = 0.023, r = -0.606) in the NPG. Conclusion: There was no difference in the prevalence of TMD in women with and without NP. However, women with NP have lower cervical muscle strength - compared to those without NP - which was associated with greater severity of TMD. Thus, in women with NP associated with TMD, it is advisable to assess and address the severity of this dysfunction and identify the cervical-scapular muscles compromise.

Towards parameters and protocols to recommend FES-Cycling in cases of paraplegia: a preliminary report

Functional Electrical Stimulation assisted cycling (FES-Cycling) is increasingly becoming an alternative option recommended to people with spinal cord injury struggling with paraplegia and interested in practicing sports. In order to propose preconditions to guide FES-Cycling recommendation, we aimed to investigate some features and their potential relationships with responsiveness to Neuromuscular Electrical Stimulation (NMES). Fourteen volunteers attended a public recruitment forum to be assessed about their responsiveness through the 16-sessions of NMES. Volunteers were separated in two groups (responsive and non-responsive to NMES) which were investigated in the light of some personal, clinical, structural and functional features. Fifty seven percent of the initial sample responded to electrical stimulation with a visual contraction. This responsive group was predominantly composed by subjects presenting traumatic spinal cord injuries above T12 vertebral level. Only two subjects became responsive at the 3rd and 16th sessions. Among the observed features, the etiology and level of injuries seems to be more associated to responsiveness. Our observations seem to indicate that subjects with traumatic spinal cord injury above T12 level were the best potential candidates for FES-cycling.