Introduction: Participation is defined by the International Classification of Functioning, Disability and Health (ICF) as the individual's involvement in everyday situations, being determined by intrinsic factors and the environment. Objectives: To carry out the cross-cultural adaptation of the Measure of Participation and the Environment - Children and Youth (PEM-CY) to Brazilian Portuguese; and to analyze their psychometric properties in a sample of children and youth with and without disabilities, aged 5-17 years. Methods: This is a methodological study developed in two stages. The first one comprised the process of cross-cultural adaptation, which was divided and executed in five stages, following the methodology widely used and recommended by Beaton and Collaborators. The stages were divided into: (I) Initial adaptation to Brazilian Portuguese; (II) Synthesis of the versions; (III) Back-translation; (IV) Committee of experts; (V) Parent understanding and back-translation for final approval. The second stage was characterized by the application of the questionnaire to 101 parents and/or caregivers of children and youth with and without disabilities from 3 Brazilian states, in order to attest their psychometric properties, as well as to identify supposed differences in participation and characteristics of the environment at home, at school and in the community between the two groups. Results: Linguistic and grammatical modifications were made to facilitate fluency, interpretation and comprehension in reading the instrument, as well as to make the expressions more equivalent to the language in the first stage of the study, giving rise to the definitive version of PEM-CY Brasil, which was approved by the authors of the original version and is commercially available on CanChild's official website. In the second stage, of the 101 children and youth recruited, 62 had a disability and 39 presented a typical development; 45.5% were female and 54.5% were male, with a mean age of 9.36 years (+/- 3.47). The internal consistency of the instrument varied from good to excellent when considering all the participation items and the environment, respectively, at home (α = 0.873 and α = 0.760), at school (α = 0.877 and α = 0.948) and in the community (α = 0.889 and α = 0.855). There were significant differences between groups in terms of the number of activities performed in the three scenarios, indicating that children with disabilities participated in fewer activities at home (p = 0.000), at school (p = 0.001) and in the community (p = 0.000 ). Children with disabilities were less involved than their non-disabled peers in school setting activities (p = 0.034). In relation to the environment, the disabled group perceived higher barriers at home (p = 0.001) and fewer aids in the home (p = 0.000), school (p = 0.002) and community (p = 0.011) settings than the non-disabled group. Conclusion: After the transcultural adaptation process, the Brazilian version of PEM-CY can be considered a valid and reliable instrument to measure participation in activities at home, at school and in the community, as well as the characteristics of the environment. At the same time, the instrument made it possible to identify differences between children and youth with and without disabilities in relation to participation and the environment.

Background: Chest movement quantification and noninvasive monitoring have been useful in evaluation of newborn (NB) lung function. Different methods have already been tested, however, there is little progress regarding the agreement of these new tools in neonatal practice. Aim: To evaluate the agreement between the tidal volume (TV) estimated by the three-dimensional analysis of the thoracoabdominal movement in the Matlab^® software and the TV predicted by the body weight of term newborns (NBs). Methods: This is a cross-sectional, quantitative and analytical study with NBs filmed for 2 minutes in a dorsal position and maximal exposure of the thoracoabdominal region. TV (in ml) was estimated from the three-dimensional analysis of thoracoabdominal movement in the Matlab^® software and compared to the predicted TV per kilogram of weight for each NB (5 ml/kg), on a Bland-Altman plot. Results: Thirteen NBs (gestational age: 39.1 ± 0.8 weeks), with a mean weight and length of 3175.4 ± 493.8g and 49 ± 2.8cm, respectively, were included in the study. TV estimated by the kinematic analysis was 16.3 ± 4.2 ml and 15.9 ± 2.5 ml according to the calculation for the predicted value for weight. The difference between the means of the studied values was 0.4 ml (bias), with p = 0.624 and confidence interval of -5.2 to 6.0 ml. Conclusions: The methods for TV measuring are interchangeable in this sample of NBs, suggesting that the threedimensional analysis of thoracoabdominal motion in Matlab^® software can estimate the TV of terms NBs, in a simple, fast and noninvasive way. Thus, the evaluation by Matlab^® is promising and should be tested with methods that are gold standard for TV evaluation.

Background: The puerperium comprises a unique and variable period in the life of all women who become mothers, starting after delivery until the organism returns to pre-gravid conditions. In addition, psychological and social changes are also present at this time. However, there is still a gap in the literature regarding the use of a specific and comprehensive instrument that addresses the full complexity of health and health-related states for postpartum women. Both the content and structure of the International Classification of Functioning, Disability and Health (CIF) allow us to broaden the understanding and optimize the planning of physiotherapeutic interventions designed to maintain the functionality of these patients. Objective: to identify categories of the International Classification of Functioning, Disability and Health (CIF) to evaluate the functionality of puerperae from the perception of Brazilian physiotherapists and to carry out content validation. Methods: a study developed from the Delphi methodology in three electronic rounds, including Brazilian physiotherapists with expertise in women's health. The process involved the capture of biopsychosocial aspects in the physiotherapeutic treatment of puerperae, identification of categories of the CIF and validation of content. Two independent researchers analyzed the categories, with concordance assessed by the Kappa coefficient. The Content Validity Index was calculated by category and in total, with cut-off point set at 0.80. Descriptive statistics served to characterize the sample. Results: The panel consisted of 45 participants, with a median age of 33 years, predominantly women (93.7%), doctoral (42.2%) and over 10 years of experience (40%). We identified 1,261 significant contents, associated to 258 categories of the CIF and Personal Factors. Initially, 74 categories obtained a sufficiently high consensus for judgment in the second round of Delphi, which were reduced to 66 specific categories validated by 89% of experts at the end of the third round, 11 of body functions, 14 for body structures, 14 activity and participation, 18 environmental factors and 9 personal factors. Conclusion: a total of 66 categories were identified based on the perception of physiotherapists regarding the functionality of puerperal women. These findings are unprecedented worldwide and may strengthen the implementation of the biopsychosocial health care model of this population.

Background: Breast cancer (CM) is one of the main health problems among women, which can have an impact on morbidity and mortality. Currently breast cancer has great chances of cure, due to the early diagnosis and the less aggressive and more effective treatments, which still provoke deleterious effects. These include impairments in sleep quality and functionality, which contribute negatively to the health of women surviving CM. There was a lack of similar studies related to the subject. Objective: To identify sleep quality, functioning and its clinical associations in women survivors of breast cancer and out of clinical treatment. Methodology: This is a cross-sectional study of 32 women who survived CM at least one year after the clinical treatment between January and September 2018. Data collection instruments consisted of general and clinical information of the disease and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) questionnaires; Pittsburgh Sleep Quality Index (PSQI); Functional Assessment of Cancer Therapy-Fatigue (FACT-F); Disabilities of the arm and Shoulder (DASH); International Physical Activity Questionnaire (IPAQ, short version), plus the six-minute walk test (6MWT). Statistical analysis was performed using SPSS 20.0. The Shapiro-Wilk test was applied for the normality of the data and the Cronbach's alpha test (α), Spearman's and Pearson's correlation, the Student's t test and the Mann Whitney U test were used. The clinical effect was analyzed by Cohen's d and to verify the association of the data the bivariate linear regression test was used. We adopted p <0.05 for all tests. Results: Among the main outcomes, it is worth noting that there is a prevalence of women who survived breast cancer with sleep problems (71.9%) and functional limitations (90.6%) even after the end of the clinical treatment and throughout the survival free from disease. Poor sleep is correlated with subjective sleep quality (rs = 0.769), sleep disturbances (rs = 0.624), sleep latency (rs = 0.625), sleep duration (rs = 0.581), and sleep disturbances during the day (rs = 0.654), and functional limitation with cognition (rs = 0.758), mobility (rs = 0.709), domestic activity / labor (rs = 0.718) and participation (r = 0.701). We observed a significant difference in sleep quality with worse scores for the FACT-F, DASH and WHODAS 2.0 scales, as well as the functional limitation with the worst scores for the DASH, FACT-F and PSQI scales (p <0.05). It was also observed that poor sleep was a predictor of worse scores for FACT-F, DASH and WHODAS 2.0 (p <0.05). Conclusions: The findings demonstrate that poor sleep is a predictor of worse scores for fatigue, quality of life, functional performance of the upper limbs and functionality, and that higher levels of deficiency affect lower scores for functional performance of the upper limbs, fatigue, quality of life and quality of sleep, demonstrating the negative impacts of sleep precarisation and the functionality of these women, denoting the relevance and urgency of inclusion of aspects related to sleep and functionality and their clinical associations in the clinical evaluations and therapeutic behaviors directed at women surviving cancer of breast.

Introduction: The International Classification of Functioning, Disability and Health (ICF) is presented as a classification strategy that may be useful for the identification of multidimensional aspects related to the physical health of the elderly. Due to the extension of the ICF, the Core Sets are presented as strategies that facilitate its application. A Core Set of the ICF was proposed to classify the physical health of the elderly, but it is necessary to know its validity in relation to measures recognized for this purpose, as well as its reproducibility. Objective: To evaluate the convergent validity of the core set for the physical health of the elderly in relation to validated measures for the evaluation of this domain, as well as its reproducibility. Methods: This is a validity study, composed of a population of elderly residents in the city of Santa Cruz, Rio Grande do Norte, Brazil. A total of 101 elderly individuals over 60 years old, of both sexes, without cognitive alterations were included. We evaluated palmar grip strength, physical performance in the Short Physical Performance Battery (SPPB) and physical activity level by International Physical Activity Questionnaire (IPAQ) long version. The Core Set of the ICF was also applied, which is composed of 30 categories (14 body functions, 4 body structures, 9 activity and participation, and 3 environmental factors), from which the each component. To evaluate the reproducibility, the Intraclass Correlation Coefficient (ICC) was used between two measurements performed in a range of 5-8 days. The association between the core set results and the other research instruments was evaluated using the Kruskal-Wallis, Mann-Whitney and Spearman correlation tests. In all the steps were considered 5% alpha and 95% CI. Results: It was observed that elderly individuals with higher levels of physical activity in IPAQ had lower impairment index in the components body functions (p = 0.012) and in the performance (p = 0.002) and capacity (p = 0.005) constructs of the component activity and participation. For SPPB, it was observed that better results are related to lower impairment index in the body functions (p <0.001), body structures (p = 0.006), activity and participation (p <0.001), and lower use of aid devices and medications (p <0.001). A higher palmar grip strength was related to a lower impairment index in the body functions (p = 0.001), body structures (p = 0.004) and activity and participation (p <0.001), and the categories that treated of medication use (p = 0.002) and of aid devices (p = 0.004). The ICC analysis indicated good reproducibility for most components evaluated, with a minimum of 0.59 for the category of access to health services and a maximum of 0.95 for the category of medication use. Conclusion: The results show that the core set is valid in relation to the manual grip strength, lower limbs performance and physical activity level, and reproducible, indicating that the data obtained through this tool can be used with confidence by clinicians and researchers.

Introduction: The International Classification of Functioning, Disability and Health (ICF), published in 2001 by the World Health Organization (WHO), describes participation as the involvement of the individual in a real life situation. Being involved and participative in activities at home, at school and in the community is an important part of childhood and wellbeing indicator, as it improves health and quality of life, and is linked to social development outcomes and is an important rehabilitation goal. The Young Children's Participation and Environment Measure (YC-PEM) is a tool that assesses the frequency, involvement and impact of the environment on the participation of children between zero and five years of age, with and without disabilities, in home, daycare / pre-school environments. -school and community. Because it is a tool developed according to the ICF model, which has been extensively used in different contexts, the availability of translation and cross-cultural adaptation of this tool will be very useful to support future Brazilian validation. Objective: To translate and culturally adapt YC-PEM for use in Brazil. Method: The process was authorized by the authors of the original instrument. This is a methodological and multicenter study composed of 6 steps: (1) Translation from English - North American to Portuguese - Brazil; (2) Synthesis of translations; (3) Expert Committee Review; (4) Cognitive interview with parents / guardians; (5) back translation; (6) Consolidation of the final version. Results: Some terms, after the initial translation, had to be adapted to bring them closer to the cultural reality of the country. In step 2, all discrepancies found were carefully analyzed and the terms considered most common in Brazil were chosen. In steps 3 and 4, the item descriptions were replaced by better comprehension items and the examples were included in the questions, as well as a supplementary instruction material for self-application of the tool. In step 5 the final version was back-translated and sent to CanChild for evaluation and final approval (step 6). Conclusion: YC-PEM was translated into Brazilian Portuguese and cross-culturally adapted for this country and the final product, YC-PEM Brazil (Measurement of Participation and Environment - Small Children), was considered satisfactory. YC-PEM Brazil is expected to be able to help parents, guardians, and rehabilitation professionals identify the participation levels and environment characteristics of children aged zero to five, thus enabling the planning and implementation of rehabilitation interventions focused on these factors of great relevance to Brazilian children.

Objective: To investigate the deterioration of gait in different conditions associated with cognitive planning in healthy elderly. METHODS: This was a cross-sectional study involving 17 elderly women aged 60-75 years (66.00 ± 4.67). Individuals were clinically described by means of the following instruments: Dynamic Gait Index, Berg Balance Scale, Mine Mental State Examination and Leganes Cognitive Test. The experimental protocol consisted of performing the three cognitive tasks of the Stroop test - Word (Pal), Color (Co) and Word-Color (Pal-Co) - in four gait conditions: treadmill running, disturbances (MS), ground running with straight disturbances (MSPR), and ground running at eight (MS8). Each task was performed three times, with duration of 20 seconds and intervals of three minutes. The ICM was evaluated by muscle contraction index (ICCm), number of steps (NP), cadence (Ca) and velocity (VL). The ICCm was collected by means of surface electrodes and an 8-channel electromyograph, along with pressure sensors on the treadmill for ME, and sensors fixed in walking soles that synchronized gait cycles (support and oscillation). The normality of the data was analyzed and the one-way ANOVA and Pearson's correlation using SPSS 2.0 software were used. Results: The cognitive tasks of the Stroop test presented a deterioration in the final score of the test, presenting a significant effect of the reduction of number of Words and number of Colors (p <0.05) in all conditions when compared to ME (Pal 33 , 78 ± 6.31, Co 23.19 ± 5.78) on MS (Pal 26.76 ± 6.59, Co 16.84 ± 5.55), MS 8 (Pal 25.72 ± 6.53; 15,17 ± 5,76) and MSPR (Pal 22,94 ± 7,22, Co 16,11 ± 6,00), whereas for Color Word there was a significant effect on the reduction in the number of items (p <0, 05) only when compared to ME (13.58 ± 3.16) with MSPR (9.88 ± 3.50) and MS8 (9.84 ± 3.50). When comparing the cost of the Stroop task in the steps and cadence of the different gait conditions, a significant change in gait variability was observed from the usual to the slower (p <0.05), however only MS x MSPR and MSPR x MS8 did not show these differences (p> 0.05), whereas the cadence was not significant in ME x Normal, MS x MSPR, MS8 x MS and MSPR (p> 0.05) situations. The correlation analysis revealed a significant and positive relationship between steps and cadence with the Stroop task, only in the MS8 situation with number of colors (r = 0.549, p = 0.022, r = 0.561, p = 0.019). Conclusion: The findings suggest that the cognitive task during gait variability was altered, suffering a negative impact as the load was increased, and that patterns of gait variability produced different measures in the steps and cadence being larger viewed only between the activities.

Introduction: Mental Practice (MP) allows the individual to perform tasks repeatedly without fatigue or any risk to safety. Studies show the efficacy of MP in stroke patients by improving motor skills and performance learning. Objective: The objective of this study was to investigate the effect of a PM program associated to physical task (PT), assessing the moment of insertion of the practice during therapy, and estimating motor and imaging functions. METHODS: This is a single-blind randomized controlled trial that evaluated the efficacy of mental practice conducted in patients diagnosed with chronic stroke. Patients were randomly assigned to the groups G1 (video + MP + PT), G2 (video + PT + MP) and G3 (video + PT). The modified Ashworth scale was the physical performance protocol of Fugl- Meyer, Functional Independence Measure (FIM), Theory of Mind Inventory (ToM), Surface Electromyography (EMGs), and the Action Research Arm test (ARAT) and Box and Block test (BBT). Results: Only 35 met the eligibility criteria, 21 accepted to participate in the study and were enrolled for the study, but only 10 completed the study. Thus, a variance test was performed between the groups, showing no statistical significance. Comparing the moments of the same group, there was a statistically significant result in G1 in Fugl Meyer's variables: hand and total upper limb, motor FIM, upper limb affected in ARAT and in BBT. Conclusion: The Mental Practice associated with physical training is an effective protocol. Our results still indicate a possible indication that mental practice has to be performed before physical training.

Background: Fibromyalgia (FM) is a syndrome characterized by chronic
widespread pain, fatigue, cognitive behavioral impairments, mood disorders
and sleep problems. Although the etiology of FM is unknown, it has been
recognized as a centralized pain state where the patient’s Central Nervous
System (CNS) is hyperactive, phenomenon known by Central Sensitization.
Transcranial Direct Current Stimulation (tDCS) is a non-invasive, safe and
cost-effective brain stimulation technique that modulates cortical excitability
and has been showing positive effects in FM patients. However, there is no
consensus on which method and exactly location of stimulation is most
effective and presents with more significant benefits in this patients
population. Objective: The aim of this study is to evaluate whether a 5
consecutive day treatment with tDCS stimulation results in better pain levels
when compared to sham, or placebo, and if there are any differential effect
between active tDCS and sham tDCS on pressure pain threshold, pressure
pain tolerance, mood disorders such as anxiety, depression and affectivity
and the disease functional impact in women with FM. Methods: This
randomized controlled trial had forty-five participants with FM, which were
randomized in one of three groups: active tDCS in the primary motor cortex
(M1; n=15) and dorsolateral prefrontal cortex (DLPFC; n=15) and sham
stimulation (SHAM; n=15). All the data were collected 7 days prior to the
begging of the intervention (baseline), on the 5 th day of treatment, with 7 and
21 days of follow-up. The pressure pain threshold and tolerance were also
revaluated at the 1 st day of treatment to analyze the immediate effect of tDCS.
A constant current of 2 mA intensity was administered during 5 consecutive
days for 20min. Results: The results showed there was no statistical
significant improvement in pain in any of the groups (p &gt; 0,05). However,
there was a reduction of 15,1% of the disease functional impact in M1 (p =
0,003) and 8,7% in DLPFC (p = 0,022) resulting in improved function of this
patient population. In addition, the results showed an improvement in anxiety
levels in DLPFC group (p &lt; 0,05) with effects maintenance of up to follow-up
periods. There was no statistical difference on the other variables.
Conclusion: The results of this study suggests that tDCS treatment of 5
consecutive days in cortical areas M1 and DLPFC of 2mA intensity for 20min
have significant results in function and anxiety in patients with FM with
sustained effects after treatment ended.

Introduction: Self-rated Health (SRH) is one of the most used outcome measures in social epidemiology, public health research and clinical practice, and has been associated with morbidity and mortality in different populations. Physical performance measures are largely determined by physiological functions that typically decrease with age. Some evidence shows that SRH is associated with objective measures of physical performance; however, studies investigating association in low- and middle-income settings are rare, especially for middle-aged populations. Objective: To verify the relationship between SRH and physical performance measures, through tests that assess upper and lower limb strength in middle-aged and elderly women in a low-income setting of Brazil. Methods: This is a cross-sectional study of 571 middle-aged women (40-59 years old) and elderly women (60-80 years old) living in the municipalities of Parnamirim and Santa Cruz, Rio Grande do Norte. Participants who reported their health status as "excellent," "very good," or "good" were allocated to the "SRH good" group, and those who reported their health as "fair" or "poor" composed the group "SRH poor". The physical performance evaluation consisted of 4 tests: handgrip strength, one-legged balance with eyes open and closed, and chair stand test. The relationship between SRH and physical performance for middle-aged and older women was assessed by multiple linear regression adjusted for covariates (age, education, family income, BMI, physical activity, comorbidities, menopausal status, and reproductive history). Results: Middle-aged women who reported good SRH had better physical performance, such as stronger handgrip strength (β = 1,927, p <0.001), greater balance time with eyes closed (β = 1.339, p = 0.041) and were faster in the chair stand test (β = -0.770, p = 0.003) when compared to those who reported their health as "poor." For the group of elderly women there is no association between physical performance measures and SRH. Conclusion: This study showed that SRH is significantly associated with objective measures of physical performance in a sample of low-income middle-aged women and is therefore a useful tool for assessing the physical health of this population.

Objective: Diabetic polyneuropathy is highly prevalent among diabetic adults and elder promoting poorer physical functioning and quality of life (QOL). This study aimed to evaluate the effects of anodal tDCS of the M1 on QOL, physical fitness and pain in patients with diabetic polyneuropathy.

Subjects and methods: It was conducted a pilot, parallel, sham, randomized, double-blind trial with twenty patients with diabetic polyneuropathy. Five consecutive sessions of C3/Fp2 tDCS montage were done. Short Form 36 Health Survey (SF-36) was used to assess the primary outcome. Secondary outcomes measures were physical fitness level according to lower and upper body strength, flexibility and submaximal level of functional capacity. All outcomes were measured in 3 different times (baseline, 1 week and 2 week).

Results: Generalized estimating equations showed significant main effects of time x group on SF-36 score (x² = 48.79; p < 0.001) with significant difference between baseline to 1 week (p = 0.001) and 2 week (p = 0.001). SF-36 score showed significant difference between group only on 2 week (p = 0.05). Mental health, physical health, emotional, general health, physical function and functional capacity showed significant interaction time x group with increase in Active-tDCS group. Bodily pain differ between groups in 2 week (p = 0.001). TUG and 6MWT have shown significant improvement only in Active-tDCS group (p = 0.0075; p = 0.0001 respectively, according to ANOVA).

Conclusions: Five sessions of anodal M1 tDCS improve QOL and functionality in patients with diabetic polyneuropathy.

Purpose: To identify the principal health-related quality of life (HRQoL) questionnaires specific for Chronic Obstructive Pulmonary Disease in children, translated and validated for Brazilian children; and to examine how the reflected content in these tools are represented in the categories that compose the International Classification of Functioning, Disability and Health (ICF). Methods: This is a methodological study developed in two stages. The first stage comprehended a literature review for identification and selection of the questionnaires and the second consisted of linking the contents to ICF. For such purpose was followed the widely used Cieza and colleagues methodology, with the identification of meaningful concepts of questionnaires items and linking to correspondent categories on ICF, by two independent reviewers. Results: The following tools were identified and analyzed: Cystic Fibrosis Questionnaire (CFQ_parents6-13 and CFQ_6-11), Pediatric Asthma Quality of Life (PAQLQ), the self and proxy versions of DISABKIDS ® - Cystic Fibrosis Module, and of Pediatric Quality of Life Asthma Module (PedsQL-Asthma). Data were presented into absolute and relative frequencies. Kappa Coefficient was used to analyze inter-reviewers concordance. The study product was presented in two scientific papers. Conclusion: The analysis of the contents of quality of life questionnaires revealed that all of them are linked to the ICF at different levels. The majority of tools has a focus on body function, assigning a smaller or no frequency of these contents to the other components of human functioning, leading to a disadvantage in relation to a biopsychosocial assessment, as proposed by the ICF.