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PURPOSE: The objective of the present study was to correlate neck and upper-limb disabilities with neck flexion in university students who are smartphone users. While handling smartphones, a posture with sustained neck flexion known as "Text Neck" is usually adopted, and some authors related to musculoskeletal symptoms on the neck and the upper limb. However, recent studies state that such an association is questionable. METHODS: This is an observational study when evaluating 192 university students through questionnaires such as the Neck Disability Index (NDI), Disabilities of Arm, Shoulder, and Hand (DASH), besides the maximal neck flexion, grip and lateral pinch strength of the participants. RESULTS: The sociodemographic questionnaire demonstrated that most participants had used the device for 5 to 10 years, for five or more hours per day. The DASH questionnaire scores presented an average of 7.2 points, while the data regarding grip and lateral pinch strength showed averages of 29.5 kgf and 8.8 kgf, respectively. The NDI questionnaire scores presented an average of 10.5. The average range of motion of the maximum neck flexion was 27°. CONCLUSION: There was no association between neck flexion with the DASH and NDI or the grip and lateral pinch strength after the correlation and binary logistic regression analyses. The results show that the scores of DASH, NDI, hand grip and lateral pinch strength, have no association with the maximum neck flexion.

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Physical factors and tissue characteristics determine the transmission of light through tissues. One of the significant clinical limitations of photobiomodulation is the quantification of fluence delivered at application sites and optical penetration depth in vivo. There is also the difficulty of determining the distances of the application points to cover a uniformly irradiated area. Thus, the aim was to evaluate in vivo the influence of melanin on light transmission of the 660 nm and 830 nm laser wavelengths on skin and tendon. Thirty young individuals of both sexes were recruited, divided into two groups based on melanin index, and submitted to photobiomodulation protocols in the posterior region of the elbow (skin-skin) and the calcaneus tendon (skin-tendon-skin). The irradiation area was evaluated using a homemade linear array of five sensors. We found significant transmission power values for different melanin indexes and wavelengths (p<0.0001). Also, different equipment can generate significant differences in the transmitted power at an 830-nm wavelength. Average scattering values are 14 mm and 21 mm for 660 nm, in higher and lower melanin index, respectively. For 830 nm, values of 20 mm and 26 mm are indicated. Laser light transmission in vivo tissues is related to wavelength, beam diameter, tissue thickness, and composition, as well as melanin index. The 830-nm laser presents higher light transmission on the skin than 660 nm. The distances between the application points can be different, with higher values for 830 nm than 660 nm.

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ABSTRACT BACKGROUND AND OBJECTIVES: Approaches to coping with pain, such as patient education, are directly related to the professionals' skill level. The identification of possible learning gaps in the different stages of training can contribute to the development of new teaching strategies and methods. This study aimed to evaluate and compare the level of knowledge about the neurophysiology of pain and the self-perception of abilities to care for individuals with pain in undergraduate and graduate students in physiotherapy in Brazil. METHODS: This is a cross-sectional analytical observational study, in which the Neurophysiological Pain Questionnaire (QND) was applied to assess the level of knowledge about the neurophysiology of pain. A self-administered questionnaire was also used to collect sociodemographic data from the sample and to assess self-perception of abilities to care for individuals with pain. The characteristics of the study population were defined by descriptive statistics. For the analysis of QND score distribution and self-perception of abilities to care for individuals with pain, the Shapiro-Wilk test was used. In the bivariate analysis to compare the distribution of the QND score and self-perception of abilities to care for individuals with pain between the stages of undergraduates and schooling after graduation, the Kruskal-Wallis test was used, with a significance level of 5% and 95% confidence interval. The statement Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was used as a guide for reporting the results of the study. RESULTS: A total of 306 volunteers participated in the study, 208 undergraduate students (22.3 ± 3.2 years) and 98 physiotherapists (31.7± 8.7 years). The average QND score for undergraduate students was 6.17 and 8.56 for physiotherapists, considering a total of 12 points. There was a significantly higher difference in the scores obtained on the QND by undergraduates in the intermediate phase and in the last year (p<0.05), as well as in the self-perception of abilities to care for individuals with pain and perform a biopsychosocial approach to the patient, between the different phases of the course. However, among physiotherapists, no significant difference was observed in the total QND score, and in the self-perception of abilities to care for individuals with pain. CONCLUSION: The findings of this study suggest that the level of knowledge about the neurophysiology of pain and self-perception of skills to care for individuals with pain differs between academics and physiotherapy professionals. However, the low QND score of physiotherapy undergraduates, as well as the absence of significant differences in the QND between the different levels of physiotherapist training, suggest that curricular implementation and specific training on pain may be indispensable to increase the level of knowledge and skills of physiotherapists in the treatment of individuals with pain.

RESUMO JUSTIFICATIVA E OBJETIVOS: Abordagens para o enfrentamento da dor, como educação do paciente, estão diretamente relacionadas ao nível de habilidades dos profissionais. A identificação de possíveis lacunas do aprendizado nas diferentes fases de formação pode contribuir para o desenvolvimento de novas estratégias e métodos de ensino. O objetivo deste estudo foi avaliar e comparar o nível de conhecimento sobre neurofisiologia da dor e a autopercepção de habilidades para atender indivíduos com dor em alunos de graduação e graduados em fisioterapia no Brasil. MÉTODOS: Trata-se de um estudo observacional analítico do tipo transversal, em que foi aplicado o Questionário Neurofisiológico de Dor (QND) para avaliar o nível de conhecimento sobre neurofisiologia da dor. Também foi utilizado um questionário autoaplicado para coletar os dados sociodemográficos da amostra e avaliar a autopercepção de habilidades para atender indivíduos com dor. As características da população do estudo foram definidas pela estatística descritiva. Para a análise da distribuição do escore QND e da autopercepção de habilidades para atender indivíduos com dor foi utilizado o teste Shapiro-Wilk. Na análise bivariada para a comparação de distribuição do escore QND e da autopercepção de habilidades para atender indivíduos com dor entre as fases dos graduandos e a escolaridade após a formação foi utilizado o teste de Kruskal-Wallis, nível de significância de 5% e intervalo de confiança de 95%. A declaração Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) foi utilizada como guia para relatar os resultados do estudo. RESULTADOS: Um total de 306 voluntários participaram do estudo, sendo 208 alunos de graduação (22,3 ± 3,2 anos) e 98 fisioterapeutas (31,7± 8,7 anos). A pontuação média do QND para os alunos de graduação foi 6,17 e de 8,56 para os fisioterapeutas, considerando um total de 12 pontos. Observou-se uma diferença significativamente superior na pontuação obtida no QND pelos graduandos da fase intermediária e do último ano (p<0,05), bem como na autopercepção de habilidades para atender indivíduos com dor e realizar uma abordagem biopsicossocial do paciente entre as diferentes fases do curso. Contudo, entre os fisioterapeutas, não foi observada diferença significativa na pontuação total do QND e na autopercepção de habilidades para atender indivíduos com dor. CONCLUSÃO: Por meio dos achados deste estudo, foi possível observar que o nível de conhecimento sobre neurofisiologia da dor e autopercepção de habilidades para atender indivíduos com dor difere entre acadêmicos e profissionais de fisioterapia. Entretanto, a pontuação baixa do QND dos graduandos de fisioterapia, bem como a ausência de diferenças significativas do QND entre os diferentes níveis de formação dos fisioterapeutas, sugere que a implementação curricular e capacitações específicas sobre dor são indispensáveis para ampliar o nível de conhecimento e habilidades dos fisioterapeutas no tratamento de indivíduos com dor.

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Tissue injuries that affect the skin and/or adjacent tissues and are usually over a bony prominence are called pressure injuries. The prevalence of these dysfunctions remains high, and despite technological advances, there is no consensus on the most appropriate treatment. The objective of this review was to evaluate the efficacy of photobiomodulation (PBM), ultrasound, and high-frequency electrophysical agents in the healing of pressure injuries in adults and the elderly. The search was conducted in the PubMed, Embase, Cochrane Library, Web of Science, and PEDro databases; in clinical trial records, a list of references of the selected articles, as well as through manual search (Google), of the last 5 years in humans in English and Portuguese. Nine thousand and sixty-seven studies were identified, 13 pre-selected, and 6 were included in this systematic review. PBM showed similar efficacy to other technologies indicated in other studies in healing pressure injuries. PBM with red wavelength (660 nm) in stages 2 and 3 pressure injuries effectively promoted healing compared to standard care. It was observed that the use of PBM accelerates tissue repair in pressure injuries; therapeutic ultrasound showed similar efficacy to other electrophysical agents but was effective in reducing the area of pressure injuries when comparing pre- and post-intervention. No clinical studies using the high-frequency electrophysical agent have been described in the last 5 years.

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ABSTRACT BACKGROUND AND OBJECTIVES: Photobiomodulation (PBM) is an important therapeutic tool for inflammatory process modulation. In this study, the anti-inflammatory and analgesic effect of two different energies and two different wavelengths (660 nm and 830 nm) were investigate and compared through the model of carrageenan-induced paw edema in mice. METHODS: Male Swiss mice, 36 animals (n=6 animals/group) were divided into six groups: Group 1 (saline-control), Group 2 (carrageenan), Group 3 (carrageenan + laser 660 nm, 5.88 J), Group 4 (carrageenan + laser 660 nm, 2.94 J), Group 5 (carrageenan + laser 830 nm, 5.88 J), and Group 6 (carrageenan + laser 830 nm, 2.94 J). PBM was applied 1h after the carrageenan injection which induced paw edema and hyperalgesia, which were measured by means of a plethysmometer and by flicker test using a water bath at 38ºC (±0.5ºC), respectively. Left paws of mice injected with carrageenan exhibited local edema that persisted for up to 6h after its administration. All animals were evaluated before, 1, 2, 3, 4, and 6 h after the injection of carrageenan. RESULTS: PBM, specially the 830 nm wavelength with 2.94 J of energy, reduced the paw edema induced by carrageenan. In addition, the 660 nm wavelengths (5.88 J / 2.94 J) and 830 nm (2.94 J) inhibited thermal hyperalgesia induced by carrageenan after 4 h of paw injection. CONCLUSION: There was evidence that the PBM 830 nm (2.94 J) produced a more pronounced anti-inflammatory effect, while the 660 nm (5.88 J / 2.94 J) energy laser was more effective to inhibit the hyperalgesia response induced by the carrageenan injection.

RESUMO JUSTIFICATIVA E OBJETIVOS: A fotobiomodulação (FBM) é uma importante ferramenta terapêutica para modulação dos processos inflamatórios. Neste estudo, investigou-se o efeito anti-inflamatório e analgésico de duas energias e dois comprimentos de onda diferentes (660 nm e 830 nm) através do modelo de edema de pata induzido por carragenina em camundongos. MÉTODOS: Trinta e seis camundongos Swiss machos (n=6 animais/grupo) foram divididos em seis grupos: Grupo 1 (controle salino), Grupo 2 (carragenina), Grupo 3 (carragenina + laser 660 nm, 5,88 J), Grupo 4 (carragenina + laser 660 nm, 2,94 J), Grupo 5 (carragenina + laser 830 nm, 5,88 J) e Grupo 6 (carragenina + laser 830 nm, 2,94 J). A FBM foi aplicada 1h após a injeção de carragenina que induziu o edema de pata e a hiperalgesia térmica, os quais foram medidos por meio de um pletismômetro e pelo flicker test em banho-maria a 38ºC (±0,5ºC), respectivamente. As patas esquerdas injetadas com carragenina apresentaram edema local que persistiu por até 6h após sua administração. Todos os animais foram avaliados antes, 1, 2, 3, 4, e 6 horas após a injeção de carragenina. RESULTADOS: A FBM, principalmente o comprimento de onda 830 nm com 2,94 J de energia, reduziu o edema de pata induzido pela carragenina. Além disso, o comprimento de onda 660 nm (5,88 J / 2,94 J) e o 830 nm (2,94 J) inibiram a hiperalgesia térmica induzida pela carragenina após 4h da injeção na pata. CONCLUSÃO: Evidenciou-se que a FBM 830 nm (2,94 J) produziu efeito anti-inflamatório mais pronunciado, enquanto o laser de 660 nm (5,88 J / 2,94 J) de energia foi mais eficaz para reduzir a resposta de hiperalgesia induzida pela injeção de carragenina.

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INTRODUCTION: About 10 million people have low back pain (LBP) disability in Brazil. Several therapies are used to treat this condition, such as kinesiotherapy, manual therapy (MT), and photobiomodulation (PBM). Although the use of these methods in LBP has been investigated, studies evaluating the efficacy of the association between these techniques are still needed. OBJECTIVE: To evaluate the activation of the lumbar region muscles by PBM or MT associated with kinesiotherapy for the treatment of LBP. METHODS: Twenty individuals with chronic LBP were randomlydivided into two groups. The first group (MT) received vertebral mobilization associated with a kinesiotherapy exercise program. The second group (830nm-PBM) received PBM associated with the exercise program, twice a week for 8 weeks. Evaluation of pain perceived was performed by the visual analogic scale (VAS), lumbar disability by the Oswestry questionnaire, muscle strength by strain gauge, and activation through surface electromyography (EMG). Data were collected before and after the treatment. EMG data was analyzed by MatLab®. The ANOVA two-way test was used (degree of significance p≤0.05), and the size of the effect by the Hedge test. RESULTS: Considering pain, the two groups presented a significant result (p<0.05). In muscle activation, only the multifidus was different during the side bridge (p<0.05) when compared intragroup. None of the variables were different when evaluating intergroup. CONCLUSION: Both MT and PBM associated with kinesiotherapy for 8 weeks are effective in reducing pain, and improving motor control and stability of the lumbar spine in patients with chronic LBP.

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INTRODUCTION: The skin flap is a surgical technique widely used in clinical practice and generally presents postoperative complications. Therefore, elucidating interventions that assist in tissue conservation is essential. Photobiomodulation (PBM) and therapeutic ultrasound (TUS) are non-invasive alternatives for assisting tissue repair, however, there is no consensus on the parameters used. OBJECTIVE: To describe the effectiveness of the different parameters of PBM and TUS in the viability of the dorsal random pattern skin flap in mice. METHODS: Fifty-five Swiss mice were used, distributed in eleven groups. The animals were submitted to surgical technique including revascularization of the area limited through a plastic barrier (polyester/polyethylene) with the same dimension as the flap. PBM or TUS was applied for five consecutive days. Photographic and thermographic recordings were performed with Cyber-Shot DSC-P72 and FlirC2 cameras and analyzed using the ImageJ® and FLIR Tools software, respectively. In the statistical analysis, the data were submitted to the GraphPad Prism® 8.0 software. Analysis of variance (ANOVA Two-way) and Tukey's post-test was performed, considering 5% significance level. RESULTS: Groups 5 (PBM830 nm; 10 J/cm²) and 6 (TUS 3 MHz; 0.4 W/cm²) showed percentages of viable tissue significantly higher on the third and fifth day of the experiment, when compared to the other groups. The temperature decreased significantly in group 1 when compared to the others in the postoperative period. CONCLUSION: The continuous TUS at 3 MHz and PBM 830 nm were more effective in improving the viability of the dorsal random pattern skin flap in mice.

INTRODUÇÃO: O retalho cutâneo é uma técnica cirúrgica amplamente empregada na prática clínica e comumente apresenta complicações pós-operatórias. Portanto, elucidar intervenções que auxiliem na conservação do tecido são fundamentais. A fotobiomodulação (FBM) e o ultrassom terapêutico (UST) são alternativas não invasivas que auxiliam no reparo tecidual, contudo, ainda não há consenso sobre os parâmetros a serem utilizados. OBJETIVO: Descrever a efetividade dos diferentes parâmetros da FBM e do UST na viabilidade do retalho cutâneo randômico dorsal em camundongos. MÉTODOS: Utilizou-se 55 camundongos Swiss, distribuídos em onze grupos. Os animais foram submetidos à técnica cirúrgica com a revascularização da área limitada através de uma barreira plástica (poliéster/polietileno) da mesma dimensão do retalho. Aplicou-se a FBM ou UST durante cinco dias consecutivos. O registro fotográfico e termográfico foi realizado com as câmeras Cyber-Shot DSC-P72 e FlirC2, sendo posteriormente analisados nos softwares ImageJ® e FLIR Tools, respectivamente. Na análise estatística, os dados foram submetidos ao software GraphPad Prism® 8.0 e ao teste Shapiro-Wilk para a análise da normalidade. Realizou-se a análise de variância (ANOVA Two-way) e pós-teste de Tukey, com nível de significância de 5%. RESULTADOS: Os grupos 5 (FBM 830 nm; 10 J/cm²) e 6 (UST 3 MHz; 0,4W/cm²) apresentaram porcentagens de tecido viável significativamente maiores no terceiro e quinto dia do experimento. A temperatura reduziu significativamente no grupo-1 quando comparado aos demais no pós-operatório. CONCLUSÃO: O UST contínuo a 3 MHz e FBM 830 nm, foram mais eficazes melhorando a viabilidade a do retalho cutâneo randômico dorsal em camundongos.

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Abstract Background Traffic accidents are one of the main causes of death in Brazil and the increase in the mortality rate is concerning. Objective The study aims to perform a temporal analysis of mortality trends related to traffic accidents in Brazil and its states. Method This is an ecological study of time series of mortality from traffic accidents in Brazil and its Federative Units. Data was obtained from the Information System for Mortality (SIM), processed by Datasus and classified under the headings V01 to V89 (CID-10). Specific mortality rates were calculated and adjusted by age. The temporal tendency analysis was run on the Joinpoint Regression Program. Results The Brazilian male population showed no change in the average annual percentage for the mortality rate (-0.8%; CI 95% -1.7;0.1). Ten states showed increased mortality rates; nine presented a decline, and eight remained constant throughout the period. Conclusion The male population showed no change in the rates, but the mortality rate for the general Brazilian population decreased by 1% per year from 1997 to 2015. Both general and male populations had a decrease of 4.6% and 4.9% per year during the last years, respectively (2012-2015).

Resumo Introdução Acidentes de trânsito são uma das principais causas de morte no Brasil e no mundo. Objetivo O estudo teve por objetivo realizar uma análise temporal da tendência de mortalidade por acidentes de transportes terrestres no Brasil. Método Estudo ecológico de séries temporais da mortalidade por acidentes de transporte terrestre no Brasil no período de 1997 a 2015 para a população masculina. Os dados são provenientes do Sistema de Informação sobre Mortalidade (SIM), processados pelo Datasus e classificados nas rubricas V01 a V89 (CID-10). Foram calculadas as taxas específicas de mortalidade, ajustadas por idade, e realizada análise da tendência temporal através do software Joinpoint Regression Program. Resultados A população brasileira masculina não apresentou mudanças na taxa de mortalidade ao longo dos anos (-0.8%; CI 95% - 1.7;0.1). Dez estados tiveram aumento nas taxas de mortalidade, nove reduziram e oito mantiveram as taxas. Conclusão A população masculina não apresentou diferença nas taxas, entretanto, a população geral apresentou redução de 1% ao ano na taxa mortalidade. Além disso, ambas populações geral e masculina mostraram uma redução de 4,6% e 4,9% ao ano durante os últimos anos (2012- 2015).

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Report the effects of photobiomodulation (PBM) and therapeutic ultrasound (TUS) on the viability of TRAM in mice. MATERIALS AND METHODS: Fifty-five mice Swiss were subjected to treatment for 5 days. Group 1, treatment was performed with the agents switched off. Groups 2 to 5 were treated with different wavelengths 660 and 830 nanometers (nm) and groups 6 to 11 with TUS of 1 and 3 MHz frequency. Macrometric analyses were performed using a specific camera and analyzed by the ImageJ® software. Thermographic analyses were performed with the Flir C2 and analyzed using the FLIR Tools software. RESULTS: Group 9 obtained 95% of viable area on the 3rd day and 85% on the 5th day, showing the effectiveness of the TUS in the flap viability. Regarding skin temperature, there was a difference only in the immediate postoperative period in group 1, which had a lower temperature than the other groups. CONCLUSIONS: TUS demonstrated greater efficiency in maintaining the viability of TRAM. PBM 830 nm also demonstrated good results in the viability of TRAM.

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