Navegando por Palavras-chave "knee"

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    2018 International Olympic Committee Consensus Statement on Prevention, Diagnosis, and Management of Pediatric Anterior Cruciate Ligament Injuries
    (Sage Publications Inc, 2018) Ardern, Clare L.; Ekas, Guri; Grindem, Hege; Moksnes, Havard; Anderson, Allen F.; Chotel, Franck; Cohen, Moises [UNIFESP]; Forssblad, Magnus; Ganley, Theodore J.; Feller, Julian A.; Karlsson, Jon; Kocher, Mininder S.; LaPrade, Robert F.; McNamee, Mike; Mandelbaum, Bert; Micheli, Lyle; Mohtadi, Nicholas G. H.; Reider, Bruce; Roe, Justin P.; Seil, Romain; Siebold, Rainer; Silvers-Granelli, Holly J.; Soligard, Torbjorn; Witvrouw, Erik; Engebretsen, Lars
    In October 2017, the International Olympic Committee hosted an international expert group of physical therapists and orthopaedic surgeons who specialize in treating and researching pediatric anterior cruciate ligament (ACL) injuries. The purpose of this meeting was to provide a comprehensive, evidence-informed summary to support the clinician and help children with ACL injury and their parents/guardians make the best possible decisions. Representatives from the following societies attended: American Orthopaedic Society for Sports Medicine
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    Associação do valgo dinâmico do joelho no teste de descida de degrau com a amplitude de rotação medial do quadril
    (Sociedade Brasileira de Medicina do Exercício e do Esporte, 2012-06-01) Maia, Maurício Silveira [UNIFESP]; Carandina, Marcelo Henrique Factor [UNIFESP]; Santos, Marcelo Bannwart [UNIFESP]; Cohen, Moises [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    INTRODUCTION: The knee is a widely studied joint due to its high incidence of injuries. Most studies correlate these lesions with the valgus during flexion of the knee (dynamic), which is attributed mainly to the poor performance of the gluteus medius muscle. OBJECTIVE: This study had the aim to evaluate the association between the hip medial rotation and the valgus angle (in two dimensions) during the stair descent test obtained through photogrammetry (SAPO software). METHODS: 104 female volunteer athletes were evaluated in the measurement of the hip internal rotation (Craig's test) and the angle value of knee valgus during the descending of a step; the analyses were submitted to inter-rater reliability assessment observed with the Bland and Altman plot. The data were analyzed through multiple linear regression in order to adjust the results to the age of the evaluees. RESULTS: The angle generated in the medial rotation of the hip presented average of 45.3 degrees, with the increase of the knee valgus, while the valgus during the descent movement presented average of 8.6 degrees. Significant inverse relation in the association of the medial rotation and knee valgus was found. CONCLUSION: The presented data show a possible association between the reduction of the medial rotation of the hip with the increase of the knee valgus; however, the data are not conclusive since the evaluation was bidimensional. The obtained results suggest the need of more conclusive studies.
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    Baixa dose de methotrexate comparado a placebo em osteoartrite de joelho
    (Sociedade Brasileira de Reumatologia, 2007-10-01) Holanda, Haroldo Tenório De [UNIFESP]; Pollak, Daniel Feldman [UNIFESP]; Pucinelli, Mário Luis Cardoso [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: to evaluate the efficacy of low-dose methotrexate in the treatment of knee osteoarthritis. METHODS: 58 patients were separated into two groups in a prospective, double-blinded, placebo-controlled, randomized 4 months study. Group 1 received a 7,5 mg weekly dose of methotrexate whilst group 2 received placebo. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lequèsne Algofunctional Index and the Visual Analogue Scale (VAS) for pain were utilized as measurement of primary evaluation. The quantity of paracetamol used for analgesia served as a secondary evaluation. RESULTS: the patient s average age was of 60.4 years in the group 2 and 61.8 years in group 1 (p = 0.43). In both groups, women predominated, comprising 93.1% in group 1 and 72.4% in group 2 (p = 0.08). There were no statistically significant difference between both groups regarding WOMAC (p = 0.94), Lequèsne (p = 0.87) and VAS (p = 0.89. Likewise, in the paracetamol consumption there was not statistically significant difference between both groups. However, there was tendency to increased consumption in the placebo group. CONCLUSION: methotrexate provided neither symptomatic relief nor did it reduce the functional limitation when compared to placebo in knee osteoarthritis. Methotrexate showed a tendency to decrease the consumption of paracetamol in knee osteoarthritis.
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    A Comparison of Hip Strength Between Sedentary Females With and Without Patellofemoral Pain Syndrome
    (J O S P T,, 2010-10-01) Magalhaes, Eduardo [UNIFESP]; Fukuda, Thiago Yukio [UNIFESP]; Sacramento, Sylvio Noronha; Forgas, Andrea; Cohen, Moises [UNIFESP]; Abdalla, Rene Jorge [UNIFESP]; Eduardo Magalhaes Inst; Universidade Federal de São Paulo (UNIFESP); Irmandade Santa Casa Misericordia; NAPAM Nucleus Support Res Movement Anal; Clin Fractures; Hosp Coracao
    STUDY DESIGN: Cross-sectional study.OBJECTIVE: To compare the hip strength of sedentary females with either unilateral or bilateral patellofemoral pain syndrome (PFPS) to a control group of sedentary females of similar demographics without PFPS.BACKGROUND: It has been suggested that hip muscle weakness may be an important factor in the etiology of young female athletes with PFPS. This syndrome is also common in sedentary females and it is unclear if similar findings of hip weakness would be present in this population.METHODS: Females between 15 and 40 years of age (control group, n = 50; unilateral PFPS, n = 21; bilateral PFPS, n = 29) participated in the study. Strength for all 6 hip muscle groups was measured bilaterally on all subjects using a hand-held dynamometer.RESULTS: the hip musculature of sedentary females with bilateral PFPS was statistically weaker (range, 12%-36%; P<.05) than that of the control group for all muscle groups. the hip abductors, lateral rotators, flexors, and extensors of the injured side of those with unilateral PFPS group were statistically weaker (range, 15%-20%; P<.05) than that of the control group, but only the hip abductors were significantly weaker when compared to their uninjured side (20%; P<.05).CONCLUSION: This study demonstrates that hip weakness is a common finding in sedentary females with PFPS. J Orthop Sports Phys Ther 2010;40(10):641-647 doi:10.2519/jospt.2010.3120
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    Cross-cultural Adaptation and Measurement Properties of the Brazilian Portuguese Version of the Victorian Institute of Sport Assessment-Patella (VISA-P) Scale
    (J O S P T,, 2013-03-01) Wageck, Bruna Borges; Noronha, Marcos Amaral de; Lopes, Alexandre Dias [UNIFESP]; Cunha, Ronaldo Alves da [UNIFESP]; Takahashi, Ricardo Hisayoshi; Costa, Leonardo Oliveira Pena; Univ Estado Santa Catarina; La Trobe Rural Hlth Sch; Univ Cidade São Paulo; Universidade Federal de São Paulo (UNIFESP); Saude Plena
    STUDY DESIGN: Clinical measurement.OBJECTIVES: To translate, adapt, and test the measurement properties of the Brazilian Portuguese version of the Victorian Institute of Sport Assessment-Patella (VISA-P) questionnaire.BACKGROUND: It is important to objectively measure symptoms and functional limitations related to patellar tendinopathy using outcome measures that have been validated in the language of the target population. Cross-cultural adaptations are also useful to enhance the understanding of the measurement properties of an assessment tool, regardless of the target language.METHODS: the VISA-P questionnaire was translated into Brazilian Portuguese, culturally adapted, and titled VISA-P Brazil. It was then administered on 2 occasions with a 24- to 48-hour interval between them, and a third time after a month of physical therapy treatment. the following measurement properties were analyzed: internal consistency, test-retest reliability, agreement, construct validity, floor and ceiling effects, and responsiveness.ESULTS: the VISA-P Brazil had high internal consistency (Cronbach alpha =.76; if item deleted, Cronbach alpha = .69-18), excellent reliability and agreement (intraclass correlation coefficient = 0.91; 95% confidence interval: 0.85, 0.95; standard error of measurement, 5.2 points; minimal detectable change at the 90% confidence level, 12.2 points), and good construct validity (Pearson r = 0.60 compared to Lysholm). No ceiling and floor effects were detected for the VISA-P Brazil, and the responsiveness, based on 32 patients receiving physical therapy intervention for 1 month, demonstrated a large effect size of 0.97 (95% confidence interval: 0.68, 1.25).CONCLUSION: the VISA-P Brazil is a reproducible and responsive tool and can be used in clinical practice and research to assess the severity of pain and disability of patients with patellar tendinopathy.
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    Efetividade do treinamento sensório-motor em pacientes com osteoartrite de joelho: um ensaio clínico controlado randomizado
    (Universidade Federal de São Paulo (UNIFESP), 2013-05-29) Gomiero, Aline Basolli [UNIFESP]; Trevisani, Virginia Fernandes Moca Trevisani [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: To evaluate the effectiveness of sensorimotor training (SMT) and resistance training (RT) on pain and function of a group of individuals with knee osteoarthritis. Methods: Single blind randomized controlled trial. The study included 96 subjects aged between 50 and 75 years with clinical and radiological diagnosis of osteoarthritis of the knee according to the criteria of the American College of Rheumatology. After randomization, participants were divided into three groups: Group 1 - SMT (n = 32), Group 2 - RT (n = 32) and Group 3 - CG (n = 32) for a training program lasting 16 weeks and frequency of twice a week. Interventions for the RT group consisted of guidelines, heating on a bicycle ergometer, exercises for the quadriceps and hamstring muscles and stretching of the lower limbs. The SMT group also received the guidelines, heating and stretching exercises performed by the group RT, associated with interventions consisting of agility drills, balance disorder, coordination and balance of the lower limbs. The CG held just warming up and stretching, also attending the sector twice a week, but without the interventions. Evaluations were performed before (T0) and after the intervention period (T16) and included evaluation of pain by visual analog scale (VAS), the timed up go test (TUG), surface electromyography of the quadriceps muscle (EMG), test of strength of the quadriceps muscle with a dynamometer, Tinetti and Berg functional tests, and the quality of life questionnaires SF-36 and WOMAC knee function, Lequesne and ADLS. The data were analyzed using analysis of variance (ANOVA) with repeated measures analysis by intention to treat (ITT) with a significance level of 5%. Results: 92 patients completed the protocol. There was no difference between groups regarding age, gender distribution, weight and height (p> 0.005). In the RT group, we found statistically significant differences among the evaluated variables for the strength of the quadriceps muscle (p = 0.006), self-assessed physical function questionnaire WOMAC (p = 0.004), and sub-scales of the SF-36 physical functioning (p <0.001), vitality (p = 0.001) and emotional role (p <0.001); and a trend towards improvement, but without statistical significance, on outcomes pain (VAS), TUG test, Tinetti test, the questionnaires Lequesne and ADLS and on the subscales physical role and mental health of SF-36. Regarding the group that underwent sensorimotor training (SMT), our results indicate a significant improvement between the times assessed in the outcomes quadriceps muscle strength (p <0.001) and subscale of SF-36 emotional role (p = 0.004). There was no statistical significance in other variables, however, the group that performed SMT also showed trend towards improvement in pain (VAS), the TUG test, Tinetti test, and the Lequesne questionnaires ADLS and sub-scales physical role and mental health of SF-36. Conclusion: Despite not finding significant differences between groups, both intervention groups showed improvement or a trend towards improvement in most variables measured. Both forms of exercise caused a reduction of perceived pain and functional improvement in the population studied; reducing the negative impact on quality of life of these individuals.
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    Estudo radiográfico da reconstrução do ligamento cruzado anterior pela via transtibial
    (Soc Brasileira Med Esporte, 2014-07-01) Fernandes, Rafael de Souza Campos; Franciozi, Carlos Eduardo da Silveira [UNIFESP]; Campos Fernandes, Ricardo de Souza; Subtil de Oliveira, Marlon Alves; Nascimento, Laura; McNeill Ingham, Sheila Jean [UNIFESP]; Daher, Samir Salim; Waisberg, Jaques; Abdalla, Rene Jorge [UNIFESP]; Hosp Coracao HCor; Inst Assistencia Med Servidor Publ Estadual IAMSP; Universidade Federal de São Paulo (UNIFESP)
    Introduction: the rupture of the anterior cruciate ligament (ACL) is often due to sports activities and its reconstruction methods have undergone constant changes due to improvements in the surgical techniques. Objective: To evaluate the radiological placement of the tibial and femoral tunnels using the transtibial technique assisted by the femoral pre-drilling. Method: Radiological analysis (AP and lateral), at 4 weeks postoperatively in 98 patients, totaling 100 cases of ACL reconstruction. Three examiners evaluated the placement of the tibial and femoral tunnels. Methods for assessing the positioning of the tunnels were: Scanlan, Staubli and Rauschning and Bernard. Results: the a angle (AP) was 64.13 degrees (+/- 4.29 degrees) and the beta angle (lateral) was 57.28 degrees (+/- 4.41 degrees). the mean tibial positioning was 41.99% (+/- 5.14%). the ACL graft was inserted into the lateral condyle of the femur and the average percentage of radiographic positioning in the green quadrant was 62%, the yellow quadrant, 37% and 1% in the red quadrant. Conclusions: the transtibial technique for ACL reconstruction, assisted by the femoral pre-drilling provides the anatomical position of the graft in the majority of the cases, as radiological evidence.
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    Fatores associados à qualidade de vida em idosos com osteoartrite de joelho
    (Universidade de São Paulo, 2008-12-01) Alexandre, Tiago Da Silva; Cordeiro, Renata Cereda [UNIFESP]; Ramos, Luiz Roberto [UNIFESP]; Universidade de Taubaté Depto. de Fisioterapia; Universidade Federal de São Paulo (UNIFESP)
    This study inquired whether quality of life (QoL) among elderly patients with knee osteoarthritis (OA) may be influenced by sociodemographic and/or clinic and functional factors. A sample of 40 elderly outpatients from a gerontological rehabilitation service in São Paulo answered the Brazilian version of the 36-Item Short Form Survey (SF-36). Functionality, joint stiffness and pain were assessed by the Womac - Western Ontario and MacMaster Universities Osteoarthritis Index. Further data on sociodemographic and clinical features, including pain-relieving strategies, were obtained by a complementary questionnaire. By means of linear regression analysis, an independent relationship was found between the Womac functionality domain and six SF-36 domains (p<0.05). In the studied sample, poor QoL was found to be correlated to difficulty in functional activities, using a gait assistive device, to present bilateral knee impairment, to resort to several means to relieve pain, as well being illiterate and living with another elderly (r=0.3; p<0.05). The most impaired functional activities were those that involve knee flexion and extension, and weight support on the affected limb. Both sociodemographic and clinical, functional factors generated by OA negatively influenced QoL of elderly patients with knee OA.
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    Is the Use of Spreaders an Accurate Method for Ligament Balancing?
    (Churchill Livingstone Inc Medical Publishers, 2017) Ferreira, Marcio C.; Franciozi, Carlos Eduardo S. [UNIFESP]; Kubota, Marcelo S. [UNIFESP]; Priore, Ricardo D.; Ingham, Sheila J. M.; Abdalla, Rene J.
    Background: To analyze 2 methods of manual spreader gap assessment accuracy, visual vs blinded, compared with a controlled tensioner in total knee arthroplasty. Methods: Twenty-two fresh frozen cadaver knees were used to perform total knee arthroplasty by 22 surgeons. Extension and flexion gaps were measured with empirical manual force application with spreaders in 2 different manners: (1) surgeons were blinded to gap geometry formation-blind method group (BM) and (2) surgeons viewed them-viewing method group (VM). A tensioner was used to measure the corresponding ligament tension applied during spreader measurements and to measure the extension and flexion gaps with standard force of 100 and 80 N (tensioner method [TM]) in each femorotibial compartment. Results: All measurements with spreaders (VM and BM) presented extension and flexion gaps oversized and asymmetric (P < .0001), when compared with the same gaps measured with the tensioner. Approximately 63% (P = < 0.001) and 77.3% (P = .161) of the VM group and 68.2% (P = .018) and 77.3% (P = .161) of the BM group demonstrated asymmetry for extension and flexion gaps up to 3 mm to the TM. Gaps measured in the VM group presented results with slightly less oversizing and asymmetries than the measurements in the BM group compared with TM, although significantly different (P < .0001). Conclusion: The assessment of extension and flexion gaps with empirical manual applied force spreaders produced oversized and asymmetric gaps compared with the use of tensioner. No visual influence was observed during the spreader applied empirical manual force compared with the blinded assessment. (C) 2017 Elsevier Inc. All rights reserved.
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    Isokinetic evaluation of the knee in patients with rheumatoid arthritis
    (Elsevier B.V., 2002-12-01) Meireles, S. M.; Oliveira, L. M.; Andrade, M. S.; Silva, A. C.; Natour, J.; Universidade Federal de São Paulo (UNIFESP)
    Objectives. Rheumatoid arthritis is a chronic inflammatory disease with a clinical picture of arthritis, muscle hypotrophy, loss of range of motion, loss of strength and disability. the objective of this study was to evaluate knees of patients with rheumatoid arthritis using an isokinetic dynamometer. Methods. Fifty patients with a diagnosis of rheumatoid arthritis and 50 control subjects were evaluated using an isokinetic dynamometer (Cybex 6.000) regarding the following parameters: peak torque, peak torque angle, power, total work, peak torque acceleration time, set total work, torque acceleration energy ('explosion') and endurance. Comparisons between rheumatoid arthritis and the control group, left side versus right side, flexors and extensors and the proportion between flexors and extensors were made. the subjects were also evaluated through the Health Assessment Questionnaire, visual and analogical scale of pain, EPM-ROM and goniometry of the knee. Results. the results showed that patients with rheumatoid arthritis have less strength than the control group (P < 0.05); the extensors are stronger than the flexors (P < 0.05); no significant differences between the right and the left knee for rheumatoid arthritis and the control group were observed and the proportion between flexors and extensors is the same in both groups. We concluded that regarding the isokinetic parameters, the knees of subjects with rheumatoid arthritis are different from normal knees with decreased strength parameters, maintaining the proportion between flexors and extensors with a global loss of strength in the segment, excluding the high speeds in some of the parameters. Joint Bone Spine 2002; 69 : 566-73. (C) 2002 Editions scientifiques et medicales Elsevier SAS.
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    Isometric Strength Ratios of the Hip Musculature in Females With Patellofemoral Pain: A Comparison to Pain-Free Controls
    (Lippincott Williams & Wilkins, 2013-08-01) Magalhaes, Eduardo [UNIFESP]; Silva, Ana Paula M. C. C.; Sacramento, Sylvio N.; Martin, RobRoy L.; Fukuda, Thiago Y.; Universidade Federal de São Paulo (UNIFESP); Brotherhood Holy House Misericordia; Clin Fractures Proorthoped; Duquesne Univ; Univ Pittsburgh; CUSC
    MagalhAes, E, Silva, APMCC, Sacramento, SN, Martin, RL, and Fukuda, TY. Isometric strength ratios of the hip musculature in females with patellofemoral pain: a comparison to pain-free controls. J Strength Cond Res 27(8): 2165-2170, 2013The purpose of the study was to compare hip agonist-antagonist isometric strength ratios between females with patellofemoral pain (PFP) syndrome and pain-free control group. One hundred and twenty females between 15 and 40 years of age (control group: n = 60; PFP group: n = 60) participated in the study. Hip adductor, abductor, medial rotator, lateral rotator, flexor, and extensor isometric strength were measured using a hand-held dynamometer. Comparisons in the hip adductor/abductor and medial/lateral rotator and flexor/extensor strength ratios were made between groups using independent t-tests. Group comparisons also were made between the anteromedial hip complex (adductor, medial rotator, and flexor musculature) and posterolateral hip complex (abductor, lateral rotator, and extensor musculature). On average, the hip adductor/abductor isometric strength ratio in the PFP group was 23% higher when compared with the control group (p = 0.01). the anteromedial/posterolateral complex ratio also was significantly higher in the PFP group (average 8%; p = 0.04). No significant group differences were found for the medial/lateral rotator ratio and flexor/extensor strength ratios. the results of this study demonstrate that females with PFP have altered hip strength ratios when compared with asymptomatic controls. These strength imbalances may explain the tendency of females with PFP to demonstrate kinematic tendencies that increase loading on the patellofemoral joint (i.e., dynamic knee valgus).
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    Reference values for concentric knee isokinetic strength and power in nonathletic men and women from 20 to 80 years old
    (J O S P T, Alliance Group Communications, 1999-02-01) Neder, J. Alberto; Nery, Luiz E.; Shinzato, Gilson T.; Andrade, Marília S.; Peres, Clovis; Silva, Antonio C.; Universidade Federal de São Paulo (UNIFESP)
    Study Design: A prospective, controlled, randomized study.Objective: To establish reference Values for prediction of concentric isokinetic knee strength and power in a sample of nonathletic men and women.Background: Adequate interpretation of knee isokinetic strength and power relies on a representative frame of reference. However, none of the most widely cited prediction studies used a randomly selected sample of nonathletic subjects, therefore limiting the clinical application of these studies.Methods and Measures: We evaluated the concentric right and left knee extensor and flexor peak torque, total work, set total work, average power, and torque acceleration energy (Cybex 6000 System) in 96 healthy subjects (45 men and 51 women, aged 20 to 80), randomly selected from more than 8000 individuals.Results: By stepwise regression analysis, we found that gender, age, weight, height, and regular physical activity explained up to 84% of the Variability of the dependent Variables: a set of linear prediction equations for strength (at 60 degrees/s) and power (at 300 degrees/s) is provided.Conclusions: Results from this study might provide a clinically useful frame of reference for interpretation of concentric isokinetic knee strength and power in nonathletic men and women.
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    Synovial C-Shaped Tibial Footprint of the Anterior Cruciate Ligament
    (Sage Publications Inc, 2016) Janovsky, César [UNIFESP]; Kaleka, Camila Cohen [UNIFESP]; Alves, Maria Teresa Seixas [UNIFESP]; Ferretti, Mario [UNIFESP]; Cohen, Moises [UNIFESP]
    Background: Although numerous anatomic studies about the anterior cruciate ligament (ACL) structure and attachments have been performed, these studies have not reached consensus on the ACL footprint. Purpose: To investigate the existing controversy regarding the morphology of the tibial ACL insertion (footprint) and confirm histologically that the tibial ACL footprint is not completely filled with ligament tissue. Study Design: Descriptive laboratory study. Methods: The tibial ACL footprint was dissected from 20 different fresh-frozen cadaveric knees (all males
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    Translation, Cross-cultural Adaptation, and Clinimetric Testing of Instruments Used to Assess Patients With Patellofemoral Pain Syndrome in the Brazilian Population
    (J O S P T,, 2013-05-01) Cunha, Ronaldo Alves da [UNIFESP]; Costa, Leonardo Oliveira Pena; Hespanhol Junior, Luiz Carlos [UNIFESP]; Pires, Raquel Simoni; Kujala, Urho M.; Lopes, Alexandre Dias [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); São Paulo Running Injury Grp; Univ Cidade São Paulo; George Inst Global Hlth; Univ Jyvaskyla
    STUDY DESIGN: Clinical measurement study.OBJECTIVES: To cross-culturally adapt the Anterior Knee Pain Scale (AKPS), the Functional Index Questionnaire (FIQ), and the Pain Severity Scale (PSS) for patellofemoral pain syndrome (PFPS) into Brazilian Portuguese. This study also aimed to test the measurement properties of the AKPS, the FIQ, and the PSS, and the existing Brazilian Portuguese versions of the numeric pain rating scale (NPRS) and the Global Perceived Effect scale in a group with PFPS.BACKGROUND: PFPS is a common condition. Therefore, translated, culturally adapted, and clinimetrically tested instruments for measuring PFPS are needed.METHODS: the AKPS, FIQ, and PSS instruments were cross-culturally adapted into Brazilian Portuguese. the measurement properties of the AKPS, FIQ, PSS, NPRS, and Global Perceived Effect scale (internal consistency, ceiling and floor effects, and construct validity) were tested in 83 patients with PFPS. the reproducibility and responsiveness were tested in 52 patients with PFPS in a test-retest design, with follow-up testing at 48 to 72 hours and at 4 weeks after baseline.RESULTS: the AKPS, the FIQ, and the PSS yielded adequate internal consistency (Cronbach alpha ranging from .75 to .87) and excellent reliability (intraclass correlation coefficients [model 2,1] ranging from 0.90 to 0.97). the AKPS and the PSS yielded very good agreement (standard error of measurement, 2.9% and 3.5%, respectively). the highest correlations were observed among the AKPS, the FIQ, and the PSS (Pearson r>0.60, P<.05). No floor or ceiling effects were observed for any of the instruments. Effect sizes used for measuring internal responsiveness ranged from moderate to high for all measures. the NPRS and the AKPS were the measures with the highest external responsiveness.CONCLUSION: the Brazilian Portuguese versions of the AKPS, FIQ, PSS, NPRS, and Global Perceived Effect scale have acceptable measurement properties.
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    Ultrasonographic study of the femoro-patellar joint and its attachments in infants from birth to 24 months of age. Part II: children with Down syndrome
    (Lippincott Williams & Wilkins, 2007-07-01) Mizobuchi, Roberto Ryuiti; Galbiatti, Jose Antonio; Neto, Francisco Quirici; Milani, Carlo; Fujiki, Edison Noboru; Oliveira, Heverton Cesar de; Navarro, Ricardo Dizioli; Bensahel, Henri; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do ABC (UFABC); Robert Debre Children Hosp
    An ultrasonographic study was carried out in 25 infants (50 knees) with Down syndrome, whose age ranged from zero to 24 months, average being 13.2 months; 13 were males and 12 were females. The ultrasonographic investigation was performed with the knee being in full extension for the transversal view and in 30 degrees flexion for the sagittal view. The Insall-Salvati index and femoral cartilaginous sulcus angle were measured. Insall-Salvati index values ranged from 1.06 to 1.15 (average 1.10), with standard deviation of 0.16. No significant differences were observed with regard to Insall-Salvati index values in normal children. The femoral cartilaginous sulcus angle in infants with Down syndrome ranged from 152.7 to 155.8 degrees (average 154.3) with standard deviation of 7.959. In Down syndrome we noticed significant difference as compared to the normal values. The authors suggest that ultrasonography is useful in Down syndrome for an early diagnosis of instability of the patella.
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    Ultrasonographic study of the femoropatellar joint and its attachments in normal infants from birth to 24 months of age: Part I
    (Lippincott Williams & Wilkins, 2007-07-01) Mizobuchi, Roberto Ryuiti; Galbiatti, Jose Antonio; Neto, Francisco Quirici; Milani, Carlo; Fujiki, Edison Noboru; Oliveira, Heverton Cesar de; Bensahel, Henri; Navarro, Ricardo Dizioli [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do ABC (UFABC); Robert Debre Children Hosp
    Eighty knees of 40 musculoskeletally normal infants whose age ranged from 0 to 24 months (average 9.65 months) were ultrasonographically analyzed. The lengths of the patella, patellar ligament - and the Insall-Salvati index, knee being flexed at 30 degrees, were assessed. The angles of the femoral cartilaginous sulcus knee flexed at 0, 30, 60, and 90 degrees were also defined. Patellar length varied from 1.84 to 2.02 cm (mean, 93.3cm; standard deviation, 0.35); patellar ligament length varied from 1.67 to 1.86 (mean, 1.76 cm; standard deviation, 0.25); the Insall-Salvati index varied from 1.04 to 1.13, (mean, 1.09; standard deviation, 0.14); and femoral cartilaginous sulcus angle ranged from 148.7 to 149.3 degrees (average, 148.9 degrees and standard deviation, 6.20). Statistical tests showed no significant difference in the proposed measures according to sex and side (right/left). Moreover, we did not observe significant difference in the femoral cartilaginous sulcus angle with respect to the various degrees of knee flexion. Thus, we conclude that ultrasonography is useful for determining the normal values of the Insall-Salvati index and femoral cartilaginous sulcus angle in infants from 0 to 24 months. Then, we suggest standardization of this imaging procedure for the early diagnosis of deformities, which might impair the knee in infants within this range of age.