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Introducción: En 2013, desarrollamos una escala, para evaluar resúmenes de congresos de la Sociedad de Cirujanos de Chile (SOCICH). Objetivo: Determinar consistencia interna y confiabilidad interobservador de una escala para evaluar resúmenes de congresos. Material y Método: Estudio de confiabilidad. Doce cirujanos fueron capacitados de forma virtual durante 8 horas, para aplicar la escala. Una vez finalizado el entrenamiento, se les envió un cuestionario para evaluar contenidos de la capacitación, y varios resúmenescasos para ser evaluados con la escala antes señalada. Se aplicó estadística descriptiva, luego se estimó el grado de acuerdo entre observadores para cada ítem de la escala. Posteriormente, se evaluó el coeficiente de correlación (CCI), utilizando un modelo de dos factores mixtos en el que los efectos de los evaluadores son aleatorios y los ítems fijos; utilizando una definición de acuerdo absoluto. Además, se evaluó la consistencia interna de los ítems utilizando alfa de Cronbach, considerando intérvalos de confianza del 95% (IC 95%). Resultados: Luego de analizar las mediciones de los 9 ítems por los 12 observadores, se verificó que el CCI fue de 0,871; con un IC 95% de 0,700; 0,965. El valor de la consistencia interna fue de 0,7 considerando los 9 ítems, no se recomienda eliminar ningún ítem. Conclusión: La escala tiene buena confiabilidad interobservador y los ítems son consistentes entre sí; por lo que puede ser considerada como un instrumento confiable para la valoración de resúmenes de congresos.

Background: In 2013, we developed a scale to evaluate the abstracts of the congresses of the Society of Surgeons of Chile (SOCICH). Objective: To determine internal consistency and interobserver reliability of a scale to evaluate conference abstracts. Material and Methods: Reliability study. Twelve surgeons were trained virtually for 8 hours, to apply the scale. Once the training was finished, they were sent a questionnaire to evaluate the contents of the training, and several summaries-cases to be evaluated with the aforementioned scale. Descriptive statistics were applied, then the degree of agreement between observers was estimated for each item of the scale. Subsequently, intraclass correlation coefficient (ICC) was evaluated, using a mixed two-factor model where the effects of the evaluators are random and the items are fixed, using a definition of absolute agreement. In addition, the internal consistency of the items was evaluated using Cronbach's alpha, considering 95% confidence intervals (95% CI). Results: After analyzing the measurements of the 9 items by the 12 observers, it was verified that the ICC was 0.871; with a 95% CI of 0.700; 0.965. The internal consistency value was 0.7 considering the 9 items, it is not recommended to delete any item. Conclusions: The scale has good internal consistency and interobserver reliability. Therefore, it can be considered as reliable instrument to be used in the evaluation of abstracts for congresses.

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Thermoregulatory changes may influence the rats' prolonged physical performance and are commonly evaluated during treadmill running. Therefore, we determined the reliability of performance and thermoregulatory parameters in rats subjected to incremental-speed exercises (i.e., we assessed whether the testing protocol provides measurements that are consistent and free from error). Twenty rats were subjected to two sessions of incremental exercises at 24 °C, separated by 48 h, until they were fatigued. The rats' performance and thermoregulatory responses were determined, and values concerning the reliability of these parameters [e.g., intraclass correlation coefficient (ICC) and minimal detectable change (MDC)] were calculated. Our data revealed that the core temperature (TCORE) at fatigue and heat loss threshold were the most reproducible parameters, showing good reliability (ICC between 0.75 and 0.90). Moreover, all performance parameters assessed, the change in TCORE, the rate of TCORE increase, and the TCORE increase-to-distance traveled ratio presented moderate reliability. We then investigated whether changes in performance and thermoregulation induced by a warm environment were greater than the MDC95% values determined in the first experiment. Eight rats were subjected to incremental exercises at two environmental conditions: 24 °C and 31 °C. Individual analyses showed that most rats presented thermoregulatory differences between exercises at 31 °C and 24 °C greater than the calculated MDC95% values; this was not the case for their performance. In conclusion, we provide data on the reliability of rats' performance and thermoregulatory parameters during incremental-speed running. Also, the exercise in a warm environment produced detectable thermoregulatory changes relative to the exercise under temperate conditions.

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OBJECTIVE: To evaluate learning results of critical care physiotherapists participating in a muscle ultrasound (MUS) educational program. DESIGN: Cross-sectional study. SETTING: A custom-made 20-hour MUS course was performed over a 2-week time period, including knobs familiarization, patient positioning, anatomic landmarks, image acquisition, and limb muscle measurements. PARTICIPANTS: Nineteen critical care physiotherapists with little to no prior experience in ultrasound (N=19). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Theoretical knowledge, hands-on skills acquisition, and satisfaction were assessed. Inter- and intrarater reliability on landmarks, thickness, and pennation angle of quadriceps between participants was evaluated using intraclass correlation coefficients (ICCs). Reliability among instructors measured prior to the course was also reported as a reference. RESULTS: The percentage score (mean±SD) of knowledge questionnaires was 69±11 (pre-course), 89±10 (post-course), and 92±9 (hands-on skills). Course satisfaction scores ranged from 90%-100%. Pooled interrater reliability of participants (median ICC [interquartile range]) was good (0.70 [0.59-0.79]) for thickness, moderate (0.47 [0.46-0.92]) for landmarks, and absent (0.00 [0.00-0.05]) for pennation angle and the intrarater reliability was good (0.76 [0.51-0.91]) for thickness and weak (0.35 [0.29-0.52]) for pennation angle. Interrater ICC values for instructors were excellent (0.90) for thickness, good (0.67) for landmarks, and moderate (0.41) for pennation angle and intrarater ICC values were excellent (0.94) for thickness and good (0.75) for pennation angle. CONCLUSIONS: Although our sample was quite small and homogeneous, increased theoretical knowledge, high hands-on performance acquisition, and good satisfaction of physiotherapists were observed. Reliability was moderate to excellent for thickness and landmarks and absent to weak for pennation angle. Landmarking and pennation angle remain challenges for physiotherapist training in the application of MUS. Further studies are needed to identify variables that could modify reliability during MUS training.

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The quality of life in the workplace can be achieved by creating a place more humanized and strategies that provide wellness to workers. The aim of this study was to investigate the effectiveness of telehealth education program to promote quality of life of office workers.This is a cluster randomized controlled trial (RCT). The participants were office workers computer users (n = 326). All received 9 audiovisual content (grouped into topics: musculoskeletal health, healthy diet, and mental health) that addresses the real needs identified by them in the focus groups. The intervention group (n = 178) was instructed to seek the tutor support about topics addressed by the audiovisual content. The primary outcome measure was quality of life by WHOQOL-BREF. The secondary outcome measure was level of physical activity of the participants. Data analysis was performed by General Linear Mixed Model. After six months of telehealth education program a general improvement in health and environmental domain, was observed in the intervention group. During that period, a within-group analysis showed that there was a significant improvement in the intervention group, with respect to quality of life in general health (p < 0.05) and in the environmental domain (p < 0.01).In the baseline to the eighth month, there were statistically significant changes within-group for the general health (p < 0.05) and for the physical domain (p < 0.01) in both groups (p < 0.01). Telehealth education program promoted an improvement in the participants' quality of life. There was no benefit in favor of the telehealth education program, with tutor support in relation to the conventional program. TRIAL REGISTRATION: The trial was prospectively registered at ClinicalTrial.gov (NCT02980237). The date of registration was August 23, 2016.

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This study aimed to measure the reliability of a test for measuring the strength and strength imbalance of the hip abductors and adductors, using isokinetic equipment adapted for isometric testing. Thirteen healthy, physically active male individuals took part in the research. Two unilateral isometric tests were undertaken using a load cell attached to an adapted abductor bench machine: a hip abduction test and hip adduction test. Tests consisted of two maximum voluntary isometric contractions made for six seconds with a break of one minute between each. The following dynamic variables were measured: maximum force, mean force, rate of force development for each limb (right and left), and the existence of asymmetries between the limbs. For statistical analysis, the t-test, intraclass correlation coefficient (ICC), and standard error of measurement (SEM) were applied. Results: The methodology utilized for the evaluation of the hip abductors and adductors did not show reliability in most of the parameters researched, with the ICC neither sufficient or low, and the retest performance higher than the test (p < 0.05). The applied test was not reliable for assessing strength and strength imbalances of hip abductors and adductors in most of the parameters investigated. These results indicate that the hip joints, more precisely, the abductor and adductor muscles, are complex structures to be assessed. They need to be previously familiarized with the proposed exercise, as their performance does not occur habitually. It is recommended to develop new tests in order to measure hip abduction and adduction strength adding a prior familiarization procedure

O presente estudo teve como objetivo avaliar a confiabilidade de um teste para avaliação da força e desequilíbrios de força de abdutores e adutores de quadril utilizando um equipamento isoinercial adaptado para isometria. Participaram do estudo 13 sujeitos saudáveis, do sexo masculino, fisicamente ativos. Foram realizados dois testes isométricos unilaterais utilizando uma célula de carga fixada em um banco abdutor adaptado: teste de Abdução de Quadril e Teste de Adução de Quadril. Os testes consistiram em duas contrações isométricas voluntárias máximas de seis segundos de duração com intervalo de um minuto entre elas. As seguintes variáveis dinâmicas foram avaliadas: Força Máxima, Força Média, Taxa de Produção de Força, para cada membro (direito e esquerdo), e a existência de assimetrias entre membros. Para análise estatística foram realizados teste t, coeficiente de correlação intraclasse (CCI) e erro padrão de medida. Resultados: A metodologia empregada para avaliação de adutores e abdutores de quadril não se mostrou confiável na maioria dos parâmetros investigados, com valores de CCI não significativos ou baixos, e o desempenho no reteste foi superior ao teste (p<0,05). O teste empregado não se mostrou confiável para avaliação da força e desequilíbrios de força de abdutores e adutores do quadril na maioria dos parâmetros investigados . Esses resultados demonstram que a articulação do quadril, mais precisamente os músculos abdutores e adutores, são estruturas complexas de se avaliarem, necessitando de uma familiarização prévia com o exercício proposto, por não serem movimentos realizados habitualmente. Recomenda-se novos testes para avaliação da força de adução e abdução de quadril adicionando um procedimento de familiarização prévio.

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The countermovement jump (CMJ) is often used as performance measure and monitoring tool. Traditionally, jump height (JH) is most often studied and reported, but other variables (e.g. force, velocity, power) can also be obtained during CMJ testing on a force plate. The aim of this study was to determine the intra-rater reliability of mechanical variables obtained during CMJs. For this, 41 physically active men (24 ± 4 years) performed four CMJs on a force plate with an interval of 48 to 168 hours (test-retest design). Six variables were analyzed: 1) jump height (JH), 2) peak force (PF), 3) peak power (PP), 4) velocity at takeoff (VTO), 5) rate of force (RFD) and 6) power (RPD) development. Five variables showed to be reliable (i.e. CV < 10%), except RFD (CV of 12.9%). Although JH exhibited an acceptable level of reliability (r = 0.94 and CV = 5.8%), better scores were observed for PF, VTO, and PP (CV ranging from 2.5 to 5.1%). The PF showed the best reliability scores (r = 0.99 and CV = 2.5%) and RPD, a relatively unexamined variable compared to the others, showed an acceptable level of reliability (r = 0.96 and CV = 7.8%). Therefore, JH, PF, PP, VTO, and RPD demonstrated acceptable scores of reliability. PF seems to be the most appropriate variable to use when small changes in performance are expected. Future studies should investigate the importance of RPD for performance evaluation.

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Portable haemoglobinometers have been used in order to estimate the prevalence of anaemia in diverse settings. However, few studies have been conducted to evaluate their performance in children of different age groups in distinct epidemiological contexts. To evaluate the reproducibility and reliability of a portable haemoglobinometer for the diagnosis of anaemia in children <5 years Hb was measured in the venous blood of 351 children <5 years by an automated system (standard method) and in three capillary blood samples, using a portable haemoglobinometer (HemoCue®; test method). The reproducibility of the device and of the test method was evaluated using the intraclass correlation coefficient (ICC) (Hb in its continuous form), κ and prevalence-adjusted bias-adjusted κ (PABAK) (categorised variable: anaemia: yes/no). For test method validation, Bland-Altman analyses were performed and sensitivity, specificity, accuracy rate, positive predictive value (PPV) and negative predictive values (NPV) were calculated. The haemoglobinometer presented good device reproducibility (ICC = 0·79) and reasonable method reproducibility (puncture, collection and reading) (ICC = 0·71). Superficial and fair agreement (κ) and good agreement (PABAK) were observed among the diagnoses obtained through the test method. The prevalence of anaemia was 19·1 and 19·7 % using the standard and the test method, respectively, with no statistically significant differences. The test method presented higher specificity (87·7 %) and NPV (88·3 %) than sensitivity (50·7 %) and PPV (49·3 %), and intermediary accuracy rate (57·8 %). HemoCue® showed good device reproducibility and reasonable method reproducibility, as well as good performance in estimating the prevalence of anaemia. Nevertheless, it showed a fair reliability and low individual diagnostic accuracy.

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OBJECTIVES: To evaluate the psychometric properties of the Transfer Assessment Instrument Questionnaire (TAI-Q), a self-assessment measure to evaluate transfer quality compared with clinician-reported measures. DESIGN: Participants self-assessed transfers from their wheelchair to a mat table using the TAI-Q. For session 1, participants self-assessed their transfer both before and after reviewing a video of themselves completing the transfer (session 1). Self-assessment was completed for another transfer after a 10-minute delay (session 2, intrarater reliability) and after a 1- to 2-day delay (session 3, test-retest reliability). Self-assessment was compared with a criterion standard of an experienced clinician scoring the same transfers with the Transfer Assessment Instrument (TAI) version 4.0 (concurrent validity). SETTING: 2017 National Veterans Wheelchair Games. PARTICIPANTS: Convenience sample of full-time wheelchair users (N=44). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: TAI-Q and TAI. RESULTS: After video review of their transfer, acceptable levels of reliability were demonstrated for total TAI-Q score for intrarater (intraclass correlation [ICC], 0.627) and test-retest reliability (ICC, 0.705). Moderate to acceptable concurrent validity was demonstrated with the TAI (ICC, 0.554-0.740). Participants tended to underestimate the quality of their transfer (reported more deficient items) compared with the TAI. However, this deficit decreased and reliability improved from pre-video review to post-video review and from session 1 to session 2. The minimum detectable change indicated that a change of 1.63 to 2.21 in the TAI-Q total score is needed to detect a significant difference in transfer skills. CONCLUSIONS: When paired with video review, the TAI-Q demonstrates moderate to acceptable levels of reliability and validity for the total score. Self-assessment was completed quickly (<5min) and could help to potentially screen for deficiencies in transfer quality and opportunities for intervention.

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BACKGROUND: The use of local muscle vibration is a promising technique to improve motor performance in people with movement impairments. Majority of studies have failed to properly describe the used system and its reliability, making it difficult to transfer this promising technique to clinical practice. OBJECTIVE: To describe technical details of a custom-made vibratory system (RCVibro System), as well as to determine its reliability and functionality. METHODS: The vibration frequency and the electric potential difference/vibration frequency curve of six devices were assessed (at the same day and at different days), allowing us to determine the system reliability. In addition, the RCVibro System functionality was analyzed by the center-of-pressure behavior assessment during the tibialis anterior bilateral stimulation in fifteen young people. RESULTS: The RCVibro System showed a very-high reliability between assessments within the same day (ICC(2,6) ranging from 0.95 to 0.99; p<0.01) and between different days (ICC(2,6) ranging from 0.81 to 0.98; p<0.01). We also observed a forward center-of-pressure displacement (p<0.01) and an increase in the center-of-pressure velocity (p<0.01). CONCLUSION: We conclude that RCVibro System is a highly reliable system. The results demonstrate the potential usage of RCVibro System in clinical and research settings. Further investigation is needed in people with motor and neurological disorders.

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OBJECTIVE: The nociceptive blink reflex (nBR) can be useful to investigate trigeminal nociceptive function. The aim of this study was to estimate the reliability of the nBR evoked by electrical stimulation of the three branches of the trigeminal nerve under the following conditions: over time (test-retest and intrarater reliability) and by two examiners (interrater reliability). MATERIALS AND METHODS: Twenty-one healthy participants were evaluated in two sessions (24 h apart). The nBR was elicited by a so-called "nociceptive-specific" electrode placed over the entry zone of the right supraorbital (V1R), infraorbital (V2R), mental (V3R), and left infraorbital (V2L) nerve. The outcomes were individual electrical sensory (I 0) and pain thresholds (I P); root mean square (RMS), area-under-the-curve (AUC), and onset latencies of R2 responses (determined twice after a recalibration session); and stimulus-evoked pain on a 0-10 numerical rating scale. Intraclass correlation coefficients (ICCs) and Kappa statistics were computed (α = 5%). RESULTS: ICCs were fair to excellent in 82% of the psychophysical measures (fair 21%, good 31%, excellent 30%) and in 86% of V1R, V2R, and V2L nBR parameters, whereas 52% of V3R showed poor reliability. ICCs for intrarater reliability were fair to good in 70% of measurements (fair 20%, good 50%) and in 75% of interrater measurements after the recalibration (fair 55%, good 20%). All kappa values showed at least fair agreement and the majority of the nBR measures (93%) presented moderate to excellent reliability. CONCLUSION: The nBR and its associated psychophysical measures can be considered a sufficiently reliable test. CLINICAL SIGNIFICANCE: The nBR can be recommended as an electrophysiological technique to assess trigeminal nociceptive function.

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INTRODUCTION: Reproducibility is an important aspect of any method intended to be a marker of disease progression. In this study we investigated approaches for improving motor unit number index (MUNIX) reproducibility. METHODS: We used the intraclass correlation coefficient (ICC) and the coefficient of variation (CV) to study reproducibility in healthy subjects. We tested reproducibility between test and retest of a single MUNIX from 3 different muscles (S-MUNIX) and also of the mean of a set of 3 measurements from these same muscles (M-MUNIX). RESULTS: M-MUNIX was more reproducible than S-MUNIX. The CV showed a greater improvement than the ICC in all 3 muscles. CONCLUSIONS: M-MUNIX may be a valuable approach for following motor unit loss, because it is more replicable than MUNIX. This may be especially relevant in amyotrophic lateral sclerosis patients, in whom MUNIX variability is higher than in healthy individuals. Muscle Nerve, 2016 Muscle Nerve 55: 635-638, 2017.

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PURPOSE: To determine the intra- and interrater agreement of mean flow velocity (MFV) and pulsatility index (PI) measurement in middle cerebral arteries, assessed by transcranial Doppler (TCD) with M-mode. METHODS: Masked experienced neurosonologists performed TCD with M-mode using handheld probe in healthy adult volunteers. The Bland-Altman method for concordance and intraclass correlation coefficient were used. RESULTS: Seventy-seven healthy volunteers and seven raters participated (3 on regular TCD shift and 4 off-shift). The intrarater absolute mean difference between measurements was 5.5 cm/s [95% confidence interval (CI), 4.7-6.3] for MVF and 0.073 (95% CI, 0.063-0.083) for PI. The difference between MFV measurements was significantly higher in off-shift raters (p = 0.015). The interrater absolute mean difference between measurements was 6.5 cm/s (95% CI, 5.5-7.5) for MVF and 0.065 (95% CI, 0.059-0.071) for PI. No influence was found for the middle cerebral artery side, volunteer's sex, or age, and there was no significant difference between raters. The intraclass correlation coefficient was 82.2% (95% CI 77.8-85.6) and 72.9% (95% CI 67.4-77.6) for MFV and PI, respectively. CONCLUSIONS: There exists good intra- and interrater agreement in MFV and PI measurements using M-mode TCD. These results support the use of this noninvasive tool and are important for clinical and investigational purposes.

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Assessing energy requirements is a fundamental activity in clinical dietetic practice. The aim of this study was to investigate which resting energy expenditure (REE) predictive equations are the best alternatives to indirect calorimetry before and after an interdisciplinary therapy in Brazilian obese women. In all, twelve equations based on weight, height, sex, age, fat-free mass and fat mass were tested. REE was measured by indirect calorimetry. The interdisciplinary therapy consisted of nutritional, physical exercise, psychological and physiotherapy support during the course of 1 year. The average differences between measured and predicted REE, as well as the accuracy at the ±10 % level, were evaluated. Statistical analysis included paired t tests, intraclass correlation coefficients and Bland-Altman plots. Validation was based on forty obese women (BMI 30-39·9 kg/m2). Our major findings demonstrated a wide variation in the accuracy of REE predictive equations before and after weight loss in non-morbid, obese women. The equations reported by Harris-Benedict and FAO/WHO/United Nations University (UNU) were the only ones that did not show significant differences compared with indirect calorimetry and presented a bias <5 %. The Harris-Benedict equation provided 40 and 47·5 % accurate predictions before and after therapy, respectively. The FAO equation provided 35 and 47·5 % accurate predictions. However, the Bland-Altman analysis did not show good agreement between these equations and indirect calorimetry. Therefore, the Harris-Benedict and FAO/WHO/UNU equations should be used with caution for obese women. The need to critically re-assess REE data and generate regional and more homogeneous REE databases for the target population is reinforced.

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BACKGROUND: Muscle weakness is the main cause of motor impairment among stroke survivors and is associated with reduced peak muscle torque. OBJECTIVE: To systematically investigate and organize the evidence of the reliability of muscle strength evaluation measures in post-stroke survivors with chronic hemiparesis. DATA SOURCES: Two assessors independently searched four electronic databases in January 2014 (Medline, Scielo, CINAHL, Embase). STUDY SELECTION: Inclusion criteria comprised studies on reliability on muscle strength assessment in adult post-stroke patients with chronic hemiparesis. DATA EXTRACTION: We extracted outcomes from included studies about reliability data, measured by intraclass correlation coefficient (ICC) and/or similar. The meta-analyses were conducted only with isokinetic data. RESULTS: Of 450 articles, eight articles were included for this review. After quality analysis, two studies were considered of high quality. Five different joints were analyzed within the included studies (knee, hip, ankle, shoulder, and elbow). Their reliability results varying from low to very high reliability (ICCs from 0.48 to 0.99). Results of meta-analysis for knee extension varying from high to very high reliability (pooled ICCs from 0.89 to 0.97), for knee flexion varying from high to very high reliability (pooled ICCs from 0.84 to 0.91) and for ankle plantar flexion showed high reliability (pooled ICC = 0.85). CONCLUSION: Objective muscle strength assessment can be reliably used in lower and upper extremities in post-stroke patients with chronic hemiparesis.

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The glutathione S-transferase (GST)-L1 multiplex serology assay has favorable properties for use in clinical trials and epidemiologic studies, including low cost, high throughput capacity, and low serum volume requirement. Therefore, we evaluated the GST-L1 assay as a measure of HPV16/18 vaccine immunogenicity. Our study population included 65 women selected from the Costa Rica Vaccine Trial who received the bivalent HPV16/18 virus-like particle (VLP) vaccine at the recommended 0/1/6-month schedule. We tested replicate serum samples from months 0/1/12 (i.e., after 0/1/3 doses) by GST-L1 and 3 other commonly used serology assays, VLP-ELISA, SEAP-NA, and cLIA. We calculated the percentage of women seropositive by GST-L1 by time point and HPV type (14 HPV types), and compared GST-L1 to other assays using Spearman rank correlation coefficients. After 1 vaccine dose, seropositivity by GST-L1 was 40% each for HPV16 and HPV18, increasing to 100% and 98%, respectively, after 3 doses. Seropositivity after 3 doses ranged from 32% to 69% for HPV types 31/33/45, for which partial vaccine efficacy is reported, though increases also occurred for types with no evidence for cross-protection (e.g., HPV77). GST-L1 correlated best after 3 doses with VLP-ELISA (HPV16 and HPV18 each ρ = 0.72) and SEAP-NA (HPV16 ρ = 0.65, HPV18 ρ = 0.71) (all P < 0.001); correlation was lower with cLIA. The GST-L1 is suitable for evaluating HPV16/18 vaccine immunogenicity after 3 vaccine doses, although in contrast to other assays it may classify some samples as HPV16/18 seronegative. The assay's utility is limited for lower antibody levels such as after receipt of 1 dose.

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OBJECTIVE: To evaluate the effects of pulsed electromagnetic field (PEMF) and exercises in reducing pain and improving function and muscle strength in patients with shoulder impingement syndrome (SIS). DESIGN: Double-blind, randomized controlled trial with a 3-month posttreatment follow-up. SETTING: Outpatient rehabilitation of a public hospital. PARTICIPANTS: Patients (N=56) between 40 and 60 years of age, with a diagnosis of SIS, were randomly assigned to receive active PEMF (n=26; mean age, 50.1y) or placebo PEMF (n=30; mean age, 50.8y). INTERVENTIONS: After 3 weeks of active or placebo PEMF, both groups performed the same program of exercises that focused on shoulder strengthening. MAIN OUTCOME MEASURES: A visual analog scale, the University of California/Los Angeles shoulder rating scale, the Constant-Murley shoulder score, and handheld dynamometry for muscle strength were used as outcome measures at baseline (pretreatment), at 3 weeks (after active or placebo PEMF), at 9 weeks (postexercise), and at 3 months posttreatment. RESULTS: Patients in the active PEMF group had a higher level of function and less pain at all follow-up time frames compared with baseline (P<.05). However, the placebo PEMF group had increased function and reduced pain only at the 9-week and 3-month follow-ups (P<.05)-that is, after performing the associated exercises. For the shoulder dynamometry, the active PEMF group had increased strength for lateral rotation at 9 weeks (P<.05), and increased strength for medial rotation at 9 weeks and 3 months (both P<.05) when compared with baseline. There was no significant difference for shoulder strength in the placebo PEMF group (P>.05), as well as no significant differences (P>.05) for all outcome measures. CONCLUSIONS: The combination of PEMF and shoulder exercises is effective in improving function and muscle strength and decreasing pain in patients with SIS. However, these results should be carefully interpreted because of the lack of differences between groups.

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INTRODUÇÃO: Um novo dispositivo para a avaliação e equilíbrio dinâmico de formação, o TOBtrainerMR, foi recentemente desenvolvido. OBJETIVO: Avaliar a confiabilidade entre sessões de avaliação de equilíbrio usando o TOBtrainerMR. O estudo também tem a finalidade de dar contagens de erro para que verdadeiras mudanças no desempenho possam ser identificadas. MÉTODOS: Trinta indivíduos sedentários saudáveis (nove homens, 21 mulheres com idade de 27,9 ± 2,9 anos) participaram deste estudo. O TOBtrainerMR foi usado para avaliar o equilíbrio no plano medial-lateral com os olhos abertos (MLOA) e com os olhos fechados (MLOF) e no plano anteroposterior com os olhos abertos (APOA) e com os olhos fechados (APOF). Os indivíduos foram instruídos para estar em posição ereta com braços ao longo do corpo e mãos lateralmente tentando manter a estabilidade da plataforma. Todos os dados foram registrados com o software TOBT. RESULTADOS: As amostras foram relacionadas, testes t avaliados, efeitos de aprendizagem e coeficientes de correlação intracIasse avaliados na sua confiabilidade. Erros padrão de medição e menores diferenças detectáveis foram calculadas para avaliar o erro de medição. Não foram encontradas diferenças significativas de medição entre a primeira e a segunda sessão. Os coeficientes de correlação intraclasse, os erros padrão de medição e as menores diferenças detectáveis para as quatro modalidades medidas variavam de 0,71 0,83, 0,32º a 0,80º e 0,90º a 2,22º, respectivamente. CONCLUSÕES: A confiabilidade entre sessões para avaliação de equilíbrio utilizando o TOBtrainerMR foi boa. Futuros investigadores têm agora dados de referência para avaliar se as diferenças de duas diferentes pontuações são reais ou se devem ao erro de medição e que mudanças são necessárias na pontuação do sujeito para se ter certeza de que ocorreu uma mudança real.

INTRODUCTION: A new device for assessing and training dynamic balance, the TOBtrainerMR, has been recently developed. OBJECTIVE: To asses the inter-session reliability of balance assessment using the TOBtrainerMR. The study has also the purpose of giving error scores so that true changes in performance can be identified. METHODS: Thirty healthy sedentary subjects (nine males, 21 females, age = 27.9 ± 2.9 years) participated in this study. The TOBtrainerMR was used to assess balance in the medial-lateral plane with eyes open (MLEO) and with eyes closed (MLEC), and in the anterior-posterior plane with eyes open (APEO) and with eyes closed (APEC). Subjects were instructed to be in a double-limb standing position with the hands at their sides trying to maintain platform stability. All the data were registered with the TOBT software. RESULTS: The samples were correlated, t-Tests assessed, learning effects and Intraclass Correlation Coefficients assessed in their reliability. Standard Errors of Measurement and Smallest Detectable Differences were calculated to assess measurement error. No significant differences between the first and the second session measurements were found. The Intraclass Correlation Coefficients, the Standard Errors of Measurement and the Smallest Detectable Differences for the four modalities measured ranged from 0.71 to 0.83, 0.32º to 0.80º and 0.90º to 2.22º, respectively. CONCLUSIONS: Inter-session reliability for balance assessment using the TOBtrainerMR was good. Future researchers have now reference data to evaluate whether differences in two different scores are real or due to measurement error and what changes are needed in a subject's score to be sure that a real change has occurred.

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Prenatal exposure to bisphenol A (BPA) may be associated with adverse health effects in the developing fetus; however, little is known about predictors of BPA exposure during pregnancy. We examined BPA exposure in 491 pregnant women from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) cohort and explored the role of living in the United States on significant dietary predictors of BPA exposure. Women provided urine samples up to two times during pregnancy (n=866 total samples). We computed the intraclass correlation coefficient (ICC) to evaluate variability in concentrations between collections and used generalized estimating equation (GEE) models to assess predictors of exposure. Geometric mean (GSD) BPA concentrations were 0.9 (2.8)µg/L and 1.0 (2.6)µg/L at the first and second prenatal visits, respectively. We observed greater within- than between-woman variability in urinary BPA concentrations (ICC=0.22). GEE models suggest that women who lived in the United States their entire life had 38% (CI: -0.1, 89.3) higher urinary BPA concentrations compared with other immigrant women. Additionally, women who consumed ≥3 sodas per day or hamburgers three times a week or more had 58% (CI: 18.0, 112.1) and 20% (CI: -0.2, 45.2) higher urinary BPA concentrations, respectively, compared with women who consumed no sodas or hamburgers. A higher percentage of women who lived their entire life in the United States reported increased consumption of sodas and hamburgers compared with other immigrant women. Independent of other factors, BPA urinary concentrations were slightly higher when the sample was collected later in the day. As in previous studies, high within-woman variability in urinary BPA concentrations confirms that several samples are needed to properly characterize exposure during pregnancy. Results also suggest that some factors could be modified to minimize exposures during pregnancy in our study participants (e.g., reducing soda and hamburger intake) and that factors associated with acculturation might increase BPA concentrations.

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OBJECTIVE: To assess the influence of diabetic neuropathy (DN) on balance and functional strength in patients with diabetes mellitus type 2 (DM2). DESIGN: Cross-sectional study. SETTING: Diabetes outpatient unit. PARTICIPANTS: Adults (N=62; age range, 40-65y): 32 with DM2 (19 subjects without DN and 13 with DN) and 30 without DM2 (control group). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Upright balance, evaluated in 4 situations (fixed platform, unstable platform, with eyes open, with eyes closed), and functional strength, assessed with a five-times-sit-to-stand test, were analyzed using an electromagnetic system, with a sensor placed over C7 to allow maximum trunk displacements in the anterior-posterior and medial-lateral directions. The Berg Balance Scale and the Timed Up & Go test were also used. RESULTS: Subjects with DM2 had greater anterior-posterior displacement (P<.05) in the unstable platform with eyes closed condition compared with those without DM2, whereas no difference in medial-lateral displacement was observed between these groups. A difference in time was observed in the five-times-sit-to-stand test (P<.05), with subjects in the control group performing the tasks faster than either group of subjects with DM2. Additionally, subjects in the control group showed a higher score in the Berg Balance Scale and performed the Timed Up & Go test in less time compared with subjects in other groups. CONCLUSIONS: Subjects with DM2, with or without DN, showed deficits in postural control and functional strength compared with healthy individuals of the same age group.

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OBJECTIVE: This study assessed the agreement between self-reported and measured weight and stature in adolescents. METHODS: Ninety-seven students from public and private high schools of Cuiabá, in the state of Mato Grosso, Brazil (14 to 19 years old), were examined to assess the validity of self-reported weight and stature. The adolescents reported their weight and stature, which were subsequently measured by standard procedures. The body mass index was calculated from both self-reported and measured data. Weight status was classified according to body mass index Z-score and World Health Organization criteria. The differences between the self-reported and measured means were tested by the Student's paired t-test. Weighted Kappa's coefficient of agreement was used to assess the variations in weight status categorization using informed and measured data. Agreement between measurements was assessed by the Bland-Altman method and intraclass correlation coefficient. RESULTS: The means of self-reported and measured weights (p=0.30), statures (p=0.76) and body mass index (p=0.47) were not significantly different. There was high agreement between self-reported and measured measurements according to intraclass correlation coefficient (weight: r=0.99; stature: r=0.96; body mass index: r=0.97) and the mean agreements estimated by the Bland-Altman method were 99% for weight and 100% for stature. CONCLUSION: Given the excellent agreement with measured data, self-reported weight and stature are considered valid to be used in epidemiological studies on adolescents of Cuiabá, Mato Grosso, Brazil.

OBJETIVO: Avaliar a concordância entre as medidas de peso e estatura autorreferidas e aferidas em adolescentes. MÉTODOS: Noventa e sete estudantes de 14 a 19 anos de idade do ensino médio público e privado de Cuiabá, (Mato Grosso) foram examinados a fim de se avaliar a validade de medidas de peso e estatura autorreferidas. Os adolescentes referiram o peso e a estatura e, na sequência, as respectivas medidas foram aferidas com base em procedimentos padronizados. O índice de massa corporal foi determinado a partir das medidas estimadas e aferidas. O status de peso foi classificado com base no escore-Z do índice de massa corporal segundo proposta da Organização Mundial da Saúde. Utilizou-se o teste t de Student pareado para avaliar as diferenças entre as médias das medidas autorreferidas e aferidas. O coeficiente de concordância Kappa ponderado foi utilizado para se avaliarem as variações na categorização do status de peso estimado a partir de medidas informadas e aferidas. A concordância entre as medidas foi avaliada pelo método de Bland-Altman e pelo coeficiente de correlação intraclasse. RESULTADOS: Não se observaram diferenças entre as médias das medidas autorreferidas e aferidas de peso (p=0,30),: estatura (p=0,76) e índice de massa corporal (p=0,47). Houve elevada concordância entre as medidas autorreferidas e aferidas de acordo com o coeficiente de correlação intraclasse (peso: r=0,99; estatura: r=0,96; índice de massa corporal; r=0,97) e segundo o método de Bland-Altman (concordância média: peso=99%; estatura=100%). CONCLUSÃO: Dada a excelente concordância com as medidas aferidas, o peso e a estatura autorreferidos são considerados válidos para serem utilizados em estudos epidemiológicos com adolescentes de Cuiabá.

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