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.

Background: Rehabilitation is an important process in the recovery of upper limb motor function after stroke. In addition, studies have shown that therapist verbal instruction during treatment is an effective strategy in this process. One way for the therapist to facilitate the command to be passed to the learner is by using verbal cues for guidance. They are called focus of attention: internal focus -IF (own body) and external focus -EF(consequence of movement in the environment). Objective: To verify the effects of focus types on post-stroke upper extremity motor performance. Methods: This study recruited twelve subjects and randomly into two groups by simple draw. The groups were asked to perform two motor tasks with the affected limb (16 repetitions), using verbal commands directed by a trained therapist. In the first phase, G1 received commands with IF, while G2 was instructed with commands with EF. After one week, the command type was changed between groups. To obtain the variables (movement time, average velocity and number of speed peaks), a device developed by the authors (Temporal Data Acquisition Instrument - TDAI) and free kinematic software - CVMob version 4.0 was used. Results: Both EF and IF promote significant differences in movement time and speed, however, only IF provided significant results in both tasks. Discussion: The benefits of one focus of attention on the other are not fully confirmed. However, not receiving any kind of attention guidance induces the patient to adopt their own strategies, compromising motor performance. It is pertinent that during the rehabilitation the therapist is aware of the importance of choosing the verbal commands that will be oriented Conclusion: Both focus provided similar motor enhancements and the results provides some support for the hypothesis that the benefits of the EF are accentuated when preceded by the IF.

Objective: Understanding the content of quality of life questionnaires assists to choose the most appropriate instrument for evaluating women with urinary incontinence. The International Classification of Functioning, Disability and Health (ICF) can be used as a standardized method of comparing these instruments, providing an unified language for the obtained information. Thus, this study aimed to link the International Consultation on Incontinence Questionnaire (ICIQ-SF); King's Health Questionnaire (KHQ); Incontinence Quality of Life Questionnaire (IQoL) and Bristol Female Urinary Tract Symptoms Questionnaire (BFLUTS) questionnaires with the ICF. Methods: Linking the questionnaires content and the ICF was performed using the method described by Cieza and colleagues. Results: The questionnaires included 48 ICF categories, 49% were from activities and participation component (d) and 36.8% from body functions (b). Conclusion: The scales are linked with the ICF at different levels. ICIQ-SF was the most limited instrument. BFLUTS and IQoL presented greater agreement with the ICF, but the concepts in their items are mostly linked to body function, denoting a biomedical vision. The KHQ demonstrated greater affinity with the ICF, and most concepts were related to the activities and participation categories, approaching more effectively the biopsychosocial model on which the Classification is based.

The Chronic Spinal Problem (CSP) is an important public health problem. In Brazil, data from the National Health Survey (NHS) estimated 27.0 million people (18.5%) who reported CSP, affecting more women than men. This study aims to identify, among women of reproductive age, the factors associated with CSP. It is a cross-sectional study carried out with data from the NHS, where the dependent variable was the prevalence of CSP, and associated factors included socio-demographic items, life habits, reproductive history, nutritional status, diagnosis of depression and health perception. A total of 22,621 women aged 18-49 years were evaluated, 14.8% of whom reported having CSP. The risk factors to CSP, were: increase in age; living with spouse/partner; multiparity; be a smoker; overweight or obese, have Waist Circumference (WC) above 80cm and Circumference/Height (C/H) index above 0.5; negative self-perception of health; and depression. The protection factor to CSP found was the schooling. The observed associations conclude that age, living with spouse/partner, smoking, multiparity, overweight and obesity, increased risk for cardiovascular diseases, diagnosis of depression and self-perceived negative health are associated with the development of CSP in women of reproductive age.

Introduction: The aging process triggers intense physiological changes that can lead to impairment of physical and cognitive capacities in the elderly and that tend to decrease mobility and restrict daily activities. Memory is one of the first functions to regress in aging, with difficulties in activities involving evocation and visuospatial recognition in dual task (DT) conditions. The interaction between aging and pathological processes can profoundly impact cognitive and physical function, as seen in mild cognitive impairment (MCI), dementia and idiopathic Parkinson's disease (PD), which affect the elderly. Objectives: To describe and analyze the interference of the cognitive task on static postural control through a dual cognitive-motor task evaluation protocol; describe and verify the association between performance of dual task, mobility and clinical-functional aspects in healthy elderly, elderly with MCI and elderly with PD, comparing them; to verify the perception and preferences related to the dual task in healthy elderly, elderly with CCL and elderly with PD, comparing them. Methods: The study presents a cross-sectional and analytical design, with a non-probabilistic sample and for convenience. The participants were submitted to clinical-functional evaluation through 13 measurement instruments and evaluation of static postural control through computerized posturography with evaluation protocol composed of 16 conditions, 14 conditions of dual motor-cognitive task. Results: A total of 35 elderly patients were included in three groups: healthy elderly (n=15), mild cognitive impairment (n=9) and Parkinson's disease group (n=11). For the mobility tests, there was a temporal increase during the execution of dual motor and cognitive tasks for the three groups compared to the simple tests. Motor DT in lane 8 resulted in longer execution times for all three groups. In all the posturography evaluation conditions the elderly with MCI showed less correctness in relation to the other groups, especially for citation of months with use of pop music. Conclusions: The 8-lane mobility test with or without double task is useful as an evaluation method for elderly patients with or without neurological dysfunction with a strong correlation of the test at 8 with sit-ups and Time Up and Go tests. of evaluation protocol with the use of dual motor-cognitive task allowed the verification of the interference of the cognitive task on the postural control, especially the tasks of verbal fluency. The protocol was easy to apply and understood by the elderly, simple and feasible. Most individuals considered DT to be easy to perform and that the addition of music did not hinder orthostatism.

Introduction: in spite of the popularity of soccer at the youth level, data on the incidence of injuries in Brazil is limited. Muscle injuries are the most frequent in soccer, accounting for about 30% of all injuries. Although scientific knowledge on muscle injuries has increased in the last decade, the prevalence of these injuries has not decreased. Few studies on this field were dedicated to young soccer players, which highlights the need for further research. Objectives: to describe the incidence of injuries sustained by male elite youth soccer players over the 2017 season; to investigate the interaction between age, previous injury, match and training exposure and strength imbalances in the occurrence of muscle injuries in this population. Methods: demographic and anthropometric data, history of injuries, match and training exposure, and strength variables were recorded and analyzed. Injury incidence was calculated as the number of injuries occurred, divided by the number of hours of exposure on match play and training sessions, times 1,000. Players who sustained a non-contact muscle injury composed the injured group (IG) and players who suffered no non-contact injuries composed the uninjured group (UG). The relative risk was calculated and independent t-tests, the chi-square test and a multivariate logistic regression model were also conducted in the statistical analysis, considering P<.05. Results: one hundred and eighty seven injuries were documented in 122 players (65.2%). The overall incidence of injuries was 1.86 per 1,000 hours of exposure, with a rate six times higher in matches compared to training (P < .0001). Forty-five muscular injuries occurred in 34 players: 16 (36%) hamstring; 12 (27%) quadriceps; 14 (31%) adductor; and 3 (6%) calf injuries. The IG had a greater exposure to training [Mean Difference (MD) = 25.70 hours, 95% Confidence Interval (CI) = 1.12, 50.27, P = .041] and a greater overall exposure (match plus training) (MD = 32.97 hours, 95% CI = 6.22, 59.73, P = .016) than the UG. Regarding the time of arrival at the club, the IG presented a significantly smaller time of arrival in comparison to the UG (MD = - 6.57 months, 95% CI = 11.99, -1.18, P = .017). The muscle strength tests revealed that the IG had greater eccentric quadriceps strength (MD = 3.29 N / kg.100, 95% CI = 1.41, 5.17, P = .001), compared to the UG. The IG also had a lower hamstring:quadriceps strength (H:Q) ratio than the UG (MD = -5.24, CI95% = -8.84, -1.65; P = .005). Previous lower limb injury significantly increased the chance of sustaining a muscle injury (OR: 3.027, 95% CI = 1.133, 8.086). Conclusion: the risk of injury was higher during match play than during training and older players (U-20 years old) were the most likely to sustain injuries. Muscle injuries were the most prevalent and athletes with a previous history of lower limb injury, lower values of H:Q ratio and smaller time of arrival at the club, presented a higher risk of suffering muscle injuries. The interaction of both modifiable and non-modifiable risk factors seems to better explain the occurrence of injuries and this type of analysis should be continuously performed in the attempt to prevent injuries in adolescents.

Background: Incremental shuttle walk test (ISWT) and  endurance shuttle walk test (ESWT) are very commonly used as an alternative to evaluate functional capacity in clinical practice for individuals with COPD. However, the physiological responses provided during and after these tests are still poorly understood. Aim: to proceed a systematic review to evaluate the physiological responses during and after ISWT and ESWT in subjects with COPD. Methods: The search databases used were Medline, CINAHL, Cochrane Central Register of Controlled Trials, Web of Science and Scopus. 4,071 abstracts were identified, 16 articles were included. The quality of the studies was evaluated by EPHPP. Results: 15 studies presented poor methodological quality according to EPHPP. 893 subjects with mild to severe COPD were evaluated. The studies that evaluated pre and post, heart rate and saturation of oxygen in two ISWTs, found significant differences in relation to baseline values, but not between them. The same behavior happened with blood pressure, dyspnoea and respiratory rate. The VO2peak compared between ISWT and ESWT presented similar values, with no statistical difference. In only one study, fatigue, dyspnea and minute ventilation also showed no significant variations. Only one article evaluated distance in the ESWT (384 ± 193 m) and ISWT (338 ± 102 m). The highest distance was observed in the study that the participants presented mild to moderate stage of COPD. Conclusion: most studies prioritized the ISWT. The knowledge of the physiological responses during the tests is limited, because not all the studies evaluate the variables pre, during and after tests to produce better comparison.

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.