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AIM: To investigate the effect of physical therapy interventions on spatiotemporal gait parameters in children with cerebral palsy. METHODS: Six databases were searched: PubMed, Embase, Web of Science, Science Direct, Lilacs, and Scopus. Two independent reviewers worked on primary study selection based on titles, abstracts, and full text reading. We included randomized controlled trials investigating the role of therapeutic interventions on gait kinematics in children with cerebral palsy. The independent reviewers extracted information about study population, intervention type, main outcomes, and methodological quality according to PEDro Scale. The body of evidence was synthesized through GRADE. RESULTS: Twenty-six studies were found addressing the following treatment categories: functional electrical stimulation, transcranial stimulation, gait training, muscular strengthening, vibratory platform training, and serial casting. A moderate level of evidence was identified for vibratory platform training, gait training, transcranial stimulation (positive effect), and isolated muscle strengthening (negative effect) in relation to gait velocity. Electrical stimulation showed a moderate level of evidence regarding stride length. The evidence for other outcomes was of low or very low quality. CONCLUSION: Vibratory platform, gait training, electrical stimulation, and transcranial stimulation were effective to improve spatiotemporal gait parameters, especially velocity in children with cerebral palsy.Implication for rehabilitationImprovement and maintenance of gait of children with cerebral palsy is a great challenge to rehabilitation professionalsVibratory platform, gait training, electrical stimulation, and transcranial stimulation improve gait parameters.Isolated strength training was not effective to improve gait parameters in Cerebral Palsy.Long-term effect of most techniques on gait parameters until unclear.

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PURPOSE: Considering the relevance of muscle strength for sustaining good musculoskeletal health among workers who perform physically demanding work, the aim of this study was to evaluate the effectiveness of a therapeutic exercise program on muscle strength and low back symptoms among hospital nursing assistants. METHODS: One hundred and twenty-nine nursing assistants filled out a questionnaire on personal, occupational information and health status, which allowed the identification of workers able to exercise. Ninety participants were randomly allocated to an intervention and a reference group. The therapeutic exercise program (TEP) lasted 12 weeks and included warm-up, strengthening and stretching exercises. Muscle strength of trunk flexors and trunk extensors, hamstring flexibility, and low back symptoms were evaluated before and after the intervention period by two blinded assessors. The comparison between groups was carried out using Mann-Whitney and χ2 tests at a significance level of 0.05. RESULTS: The average participation in the exercise program was 17.5 sessions. Results showed increased trunk flexors muscle strength (p = 0.002; effect size: 0.77), improved pressure pain threshold for dorsal longissimus (p = 0.001; effect size > 0.8), and reduced low back symptoms (p = 0.002; OR = 6.25). No differences between groups were identified for back extensor muscle strength or flexibility. CONCLUSION: The exercise program applied is a feasible intervention which resulted clinically relevant results for nursing assistants' musculoskeletal health expressed through trunk flexors muscle strength improvement and low back symptoms control among nursing assistants. This RCT brings contribution to the Occupational Health field as the exercise program applied resulted in clinically relevant results for nursing assistants' musculoskeletal health. This study brings contribution especially for low-income and middle-income countries where low back pain and disability can be considered more severe as adequate resources to address the problem are scarce. Thus, we must highlight the importance of low-cost preventive strategies, like exercise programs carried out in hospital settings to avoid the progress of disability among active nursing personnel.

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Objective : This cross-sectional study aimed at analyzing: 1. the main musculoskeletal symptoms (MSS) presented by hospital nursing workers and; 2. personal, occupational, and health factors related to MSS among them. Method : Two questionnaires were filled in by 245 nurse technicians (NTs) and licensed practical nurses (LPNs) (response rate 95%) associated with direct patient care sectors from a hospital. These questionnaires were: the standardized version of the Nordic Musculoskeletal Questionnaire (NMQ) and one including questions on 15 demographic independent variables potentially related to outcomes from the NMQ. Univariate analyses and binary logistic regression analyses were performed to identify which variables would explain the occurrence of MSS in different body regions. Results: The low back (57%), shoulder (52%), and neck (48%) were identified as the most affected regions. The logistic regression analysis showed that low back symptoms in the last 12 months were significantly associated with LPN activities (OR=2.36; CI=1.24-4.5) and previous sick leave due to MSS (OR=5.97; CI=1.2-29.1). Smoking was significantly associated with symptoms in the low back (OR=2.77; CI=1.13-6.8) and thoracic spine (OR=2.37; CI=1.04-5.40). Physical exercise showed a protective effect on the cervical spine (OR=0.42; CI=0.23-0.77). Previous sick leave was significantly associated with pain in the knees (OR=4.24; CI=1.33-13.5) and in the upper limbs (OR=5.36; CI=1.07-26.7). Conclusions: The nursing workers who were evaluated presented a high prevalence of MSS. Previous history of sick leave was strongly associated with the presence of symptoms in various body regions. These results indicate the need for preventive programs in the hospital environment in order to control more severe MSS in nursing professionals. .

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OBJECTIVE: This cross-sectional study aimed at analyzing: 1. the main musculoskeletal symptoms (MSS) presented by hospital nursing workers and; 2. personal, occupational, and health factors related to MSS among them. METHOD: Two questionnaires were filled in by 245 nurse technicians (NTs) and licensed practical nurses (LPNs) (response rate 95%) associated with direct patient care sectors from a hospital. These questionnaires were: the standardized version of the Nordic Musculoskeletal Questionnaire (NMQ) and one including questions on 15 demographic independent variables potentially related to outcomes from the NMQ. Univariate analyses and binary logistic regression analyses were performed to identify which variables would explain the occurrence of MSS in different body regions. RESULTS: The low back (57%), shoulder (52%), and neck (48%) were identified as the most affected regions. The logistic regression analysis showed that low back symptoms in the last 12 months were significantly associated with LPN activities (OR=2.36; CI=1.24-4.5) and previous sick leave due to MSS (OR=5.97; CI=1.2-29.1). Smoking was significantly associated with symptoms in the low back (OR=2.77; CI=1.13-6.8) and thoracic spine (OR=2.37; CI=1.04-5.40). Physical exercise showed a protective effect on the cervical spine (OR=0.42; CI=0.23-0.77). Previous sick leave was significantly associated with pain in the knees (OR=4.24; CI=1.33-13.5) and in the upper limbs (OR=5.36; CI=1.07-26.7). CONCLUSIONS: The nursing workers who were evaluated presented a high prevalence of MSS. Previous history of sick leave was strongly associated with the presence of symptoms in various body regions. These results indicate the need for preventive programs in the hospital environment in order to control more severe MSS in nursing professionals.

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BACKGROUND: Children are often exposed to ergonomic risk factors at school. Thus, the school is a potential environment for developing musculoskeletal disorders and implementing back care programs. OBJECTIVES: To evaluate the effect of an educational program on schoolchildren's knowledge regarding back pain prevention. METHODS: 392 students from 4th to 8th grade from a Brazilian state school took part in the study; 114 students (30%) were evaluated at follow-up. The back care program included pre- and post-intervention assessments and a follow-up assessment, as well as theoretical and practical lessons. The time interval between the pre- and post-intervention assessments was 9 weeks, and between the post-intervention and follow-up assessments, it was 2 years. Statistical analysis included non-parametric ANOVA tests. Significance level was set at 5% (p<0.05). RESULTS: There was a significant increase (p<0.001) between pre- (3.6±2.9) and postintervention (7.5±2.2) scores and a significant decrease in the follow-up score (5.1±2.5). However, the follow-up score was still significantly higher (p<0.001) than the pre-intervention score. The rate of correct answers in the post-intervention assessment increased for all questions, and some of them were still high at follow-up. Significant differences were identified for the comparison between grades, with the 8th grade being significantly different from the other grades. CONCLUSION: The back care program showed an increase in the level of knowledge of Brazilian schoolchildren. Two years after the intervention, students still retained ergonomic concepts. Although the program has limitations, theoretical knowledge acquisition is the first step towards adopting healthy postural habits to prevent back pain.

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BACKGROUND: Children are often exposed to ergonomic risk factors at school. Thus, the school is a potential environment for developing musculoskeletal disorders and implementing back care programs. OBJECTIVES: To evaluate the effect of an educational program on schoolchildren's knowledge regarding back pain prevention. METHODS: 392 students from 4th to 8th grade from a Brazilian state school took part in the study; 114 students (30%) were evaluated at follow-up. The back care program included pre- and post-intervention assessments and a follow-up assessment, as well as theoretical and practical lessons. The time interval between the pre- and post-intervention assessments was 9 weeks, and between the post-intervention and follow-up assessments, it was 2 years. Statistical analysis included non-parametric ANOVA tests. Significance level was set at 5% (p<0.05). RESULTS: There was a significant increase (p<0.001) between pre- (3.6±2.9) and postintervention (7.5±2.2) scores and a significant decrease in the follow-up score (5.1±2.5). However, the follow-up score was still significantly higher (p<0.001) than the pre-intervention score. The rate of correct answers in the post-intervention assessment increased for all questions, and some of them were still high at follow-up. Significant differences were identified for the comparison between grades, with the 8th grade being significantly different from the other grades. CONCLUSION: The back care program showed an increase in the level of knowledge of Brazilian schoolchildren. Two years after the intervention, students still retained ergonomic concepts. Although the program has limitations, theoretical knowledge acquisition is the first step towards adopting healthy postural habits to prevent back pain.

CONTEXTUALIZAÇÃO: As crianças estão expostas a um conjunto de fatores de risco ergonômicos na fase escolar. Tais fatores tornam a escola um ambiente propício ao desenvolvimento de alterações musculoesqueléticas, assim como para a implementação de programas de cuidados com a coluna vertebral. OBJETIVO: Avaliar os efeitos de um programa educacional de cuidados com a coluna sobre o nível de conhecimento de escolares brasileiros quanto à prevenção de dor na coluna vertebral. MÉTODOS: Trezentos e noventa e dois estudantes da 4ª à 8ª série de uma escola estadual participaram do estudo, sendo que 114 deles (30%) foram avaliados no follow up. O programa foi composto por avaliações pré, pós-intervenção e follow up, por aulas teóricas e práticas. O intervalo entre as avaliações pré e pós-intervenção foi de nove semanas e, entre a avaliação pré e o follow up, foi de dois anos. A análise estatística incluiu ANOVA não-paramétrica e o nível de significância foi de 5%. RESULTADOS: Houve diferença significativa no nível de conhecimento (pfollow up (5,1±2,5), sendo que a pontuação no follow up foi significativamente superior à do pré-teste. Foi encontrada diferença significativa entre as séries, sendo que a 8ª série atingiu pontuação maior que as demais (p CONCLUSÃO: O programa preventivo proporcionou aumento no nível de conhecimento dos estudantes, mesmo após dois anos de sua implementação. Embora o programa tenha limitações, a aquisição de conhecimento é o primeiro passo para a adoção de hábitos posturais saudáveis para a prevenção de dores na coluna vertebral.

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CONTEXTUALIZAÇÃO: As disfunções musculoesqueléticas representam um problema de saúde mundial. Dentre o conjunto de medidas para controle dessas alterações está a prática de exercício físico em ambiente ocupacional que pode ser realizada no próprio setor de trabalho ou em ambientes à parte, mas dentro da empresa. Entretanto, há controvérsias quanto à efetividade e à forma de aplicação desse tipo de intervenção. OBJETIVOS: Avaliar a efetividade e fornecer evidências a respeito da prática de exercício físico no ambiente ocupacional para o controle da dor musculoesquelética. MÉTODOS: As seguintes bases bibliográficas foram consultadas: PubMed, MEDLINE, Embase, Cochrane, PEDro e Web of Science. Dois revisores independentes selecionaram os estudos pertinentes, e as eventuais discordâncias foram solucionadas por consenso. Foram incluídos no estudo os ensaios clínicos randomizados controlados que realizaram intervenção no local de trabalho envolvendo exercício e avaliaram a dor musculoesquelética. A escala PEDro, que tem pontuação de 0-10, foi utilizada para avaliação da qualidade dos estudos incluídos nesta revisão. RESULTADOS E CONCLUSÕES: A busca eletrônica resultou em um total de 8680 referências publicadas em inglês. Ao final do processo de seleção, 18 estudos foram incluídos. Forte evidência foi encontrada para a efetividade do exercício físico no controle de dor cervical em trabalhadores que realizavam atividades em escritórios ou setores administrativos, descritos como sedentários enquanto evidência moderada foi encontrada para a região lombar daqueles que realizavam atividades envolvendo manuseio de pacientes ou materiais na indústria, desde que os treinamentos fossem aplicados por períodos superiores a dez semanas, incluíssem exercícios realizados com algum tipo de resistência e fossem supervisionados. Nenhum estudo avaliando trabalhadores sedentários relatou resultados positivos para o controle da dor musculoesquelética em ombros. ...

BACKGROUND: Musculoskeletal disorders have been recognized as a worldwide health problem. One of the measures for controlling these disorders is workplace exercise, either at the workstation or in a separate environment within the company. However, there is controversy regarding the effectiveness and means of applying these interventions. OBJECTIVES: To assess and provide evidence of the effectiveness of workplace exercise in controlling musculoskeletal pain. METHODS: The following databases were searched: PubMed, MEDLINE, Embase, Cochrane, PEDro and Web of Science. Two independent reviewers selected the elegible studies. Possible disagreements were solved by consensus. All randomized controlled clinical trials that evaluated exercise interventions in the workplace musculoskeletal pain relief were included. The PEDro scale (range=0-10 points) was used to rate the quality of the studies included in this review. Results and CONCLUSIONS: The electronic search yielded a total of 8680 references published in English. At the end of the selection process, 18 studies were included. Strong evidence was found to support the effectiveness of physical exercise in controlling neck pain among workers who performed sedentary tasks in offices or administrative environments, while moderate evidence was found for low back pain relief among healthcare and industrial workers who performed heavy physical tasks. These positive results were reported when the training periods were longer than 10 weeks, the exercises were performed against some type of resistance and the sessions were supervised. None of the studies evaluating sedentary workers reported positive results for controlling musculoskeletal shoulder pain. Further randomized controlled trials are needed to comparatively evaluate, among other aspects, the effects of light and heavy training for shoulder pain relief.