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BACKGROUND: The accurate diagnosis of pelvic floor muscle impairments is essential. The plethora of terms and the lack of evidence to support widely used pelvic floor muscle function (PFMF) measurements hinder diagnostic labels. OBJECTIVE: To structure an examination of PFMF using visual observation and digital palpation and terms consistent with the ICF terminology, and to test its intra and interrater reliability/agreement. METHODS: A panel of 9 physical therapists applied Delphi method to structure the PFMF exam under ICF terminology and to verify its measurements reproducibility. For reliability and agreement, a convenience sample of women aged 51.2 ± 14.7 years had the sensitivity to pressure, pain, muscle tone, involuntary movement reaction, control of voluntary movement (contraction/relaxation), coordination, strength, and endurance examined by two raters, in the same day for interrater (n = 40), and one week apart, for intrarater reliability (n = 25). Percent agreement, linear weighted kappa, intraclass correlation coefficient, and Bland-Altman's limits of agreement were calculated (alpha = 0.05). RESULTS: Four round Delphi discussion structured the PFMF exam, named EFSMAP (Exame das Funções Sensoriais e Motoras do Assoalho Pélvico/Examination of Pelvic Floor Sensory and Motor Functions), set a list of concepts and instructions targeted at reproducibility and established PFMF diagnostic labels. Reliability, except for pain and tone, were moderate to excellent (Kw= 0.67-1.0 and ICC=0.48-0.82). Agreement was substantial for most PFMF features (0.64-1.00), except pain. CONCLUSIONS: The EFSMAP was successfully developed as a valid and reliable exam to be used in research and clinical practice; it provides labels for the diagnosis of pelvic floor muscle impairments. It might be easily adopted worldwide as it uses ICF terminology.

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Resumo Introdução Acidentes de trânsito são importante problema de saúde pública, contudo pouco se conhece sobre as sequelas deles decorrentes. Objetivo Analisar as deficiências e incapacidades em vítimas de acidentes de trânsito. Método Estudo transversal com base em dados primários de uma amostra de vítimas de acidentes de trânsito não fatais atendidas em serviços selecionados de urgência e emergência de Mato Grosso em setembro de 2014. O instrumento de coleta foi baseado no Checklist da Classificação Internacional de Funcionalidade, Incapacidade e Saúde. Resultados Foram avaliadas 228 vítimas de acidentes de trânsito, predominando jovens, sexo masculino, motociclistas. Deficiências de função do corpo mais comprometidas foram as sensoriais e dor (49,3%) e neuromuscoloesqueléticas (45,8%), enquanto as de estrutura do corpo relacionavam-se ao movimento (85,5%); ambas apresentando gravidade moderada. Referente à limitação de atividade e restrição à participação, predominaram problemas relacionados à mobilidade (42,0%), prevalecendo gravidade moderada (30,5%). Dentre os fatores ambientais, destacaram-se como principais barreiras os serviços, sistemas e políticas (66,3%) e, como facilitadores, o apoio e relacionamento com familiares e amigos (40,9%). Conclusão Aproximadamente metade das vítimas de acidentes de trânsito apresentou deficiências e incapacidades. O estudo preenche uma lacuna importante para a compreensão deste problema de saúde pública.

Abstract Introduction Traffic accidents are an important public health problem; however, little is known about their consequences. Objective To analyze disabilities in traffic accident victims. Methods Cross-sectional study, based on primary data from a sample of victims of non-fatal traffic accidents, attended at selected emergency services in Mato Grosso in September 2014. The collection instrument was based on the International Classification Checklist Functionality, Disability, and Health. Results 228 victims of traffic accidents were evaluated, predominantly young men, motorcyclists. Body function deficiencies most affected were sensory and pain (49.3%) and neuromusculoskeletal (45.8%), while those of body structure were related to movement (85.5%); both presenting moderate severity. Regarding activity limitation and participation restriction, problems related to mobility predominated (42.0%), with moderate severity (30.5%). Among the environmental factors, services, systems, and policies stood out as barriers (66.3%) and the support and relationship with family and friends as facilitators (40.9%). Conclusion Approximately half of the victims of traffic accidents had disabilities. The study fills an important gap for understanding this public health problem.

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BACKGROUND: Gross motor development curves for children with Cerebral Palsy (CP), grouped by Gross Motor Function Classification System (GMFCS) levels, help health care professionals and parents to understand children's motor function prognosis. Although these curves are widely used in Brazil to guide clinical decision-making, they were developed with Canadian children with CP. Little is known about how these patterns evolve in children and adolescents with CP in low-income countries like Brazil. The PARTICIPA BRAZIL aims to: (i) to identify and draw a profile of functioning and disability of Brazilian children and adolescents with CP by classifying them, for descriptive purposes, with all five valid and reliable functional classifications systems (gross motor function, manual ability, communication function, visual and eating and drinking abilities); (ii) to create longitudinal trajectories capturing the mobility capacity of Brazilian children and adolescents with CP for each level of the GMFCS; (iii) to document longitudinal trajectories in the performance of activities and participation of Brazilian children and adolescents with CP across two functional classification systems: GMFCS and MACS (Manual Abilities Classification System); (iv) to document longitudinal trajectories of neuromusculoskeletal and movement-related functions and exercise tolerance functions of Brazilian children and adolescents with CP for each level of the GMFCS; and (v) to explore interrelationships among all ICF framework components and the five functional classification systems in Brazilian children and adolescents with CP. METHODS: We propose a multi-center, longitudinal, prospective cohort study with 750 Brazilian children and adolescents with CP from across the country. Participants will be classified according to five functional classification systems. Contextual factors, activity and participation, and body functions will be evaluated longitudinally and prospectively for four years. Nonlinear mixed-effects models for each of the five GMFCS and MACS levels will be created using test scores over time to create prognosis curves. To explore the interrelationships among ICF components, a multiple linear regression will be performed. DISCUSSION: The findings from this study will describe the level and nature of activities and levels of participation of children and youth with CP in Brazil. This will support evidence-based public policies to improve care to this population from childhood to adulthood, based on their prognosis.

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