Percorrer por autor "Moniz, Sara"
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- Caracterização da intervenção da Fisioterapia em indivíduos com dor crónica lombar e seus resultados a nível da dor e capacidade funcionalPublication . Moniz, Sara; Cruz, EduardoObjectivo: Este trabalho teve como objectivo contribuir para o processo de adaptação cultural da Quebec Back Pain Disability Scale (QBPDS), através do estudo da sua Validade de Constructo e Poder de Resposta, e caracterizar a intervenção realizada pela fisioterapia (FT) e os resultados obtidos em utentes com dor crónica lombar (DCL). Introdução: A redução da incapacidade funcional associada à DCL é um dos principais objectivos e resultados da intervenção da FT nestes utentes. Com o intuito de proceder à sua avaliação, pode recorrer-se a um conjunto de diferentes instrumentos de medida, sendo a QBPDS uma das escalas mais utilizadas para medir a incapacidade. Embora esta tenha sido anteriormente adaptada para a população portuguesa, não foram determinadas as suas propriedades psicométricas. Por outro lado, apesar da literatura referir que os serviços de FT são bastante procurados por indivíduos com DCL, em Portugal, a informação existente sobre a prática da FT nesta condição clínica e sobre os resultados obtidos é ainda escassa. Metodologia: Recorreu-se a um estudo de coorte prospectivo com uma amostra de conveniência, constituída por 119 indivíduos com DCL, que iniciaram fisioterapia em 16 centros/ hospitais/ clínicas de Fisioterapia/ utentes no domicílio, e cumpriam os critérios de inclusão e exclusão estabelecidos. Os utentes foram avaliados no momento pré-intervenção e num segundo momento até 6 semanas depois. As propriedades psicométricas da Quebec Back Pain Disability Scale –Versão Portuguesa (QBPDS-VP) avaliadas foram a Validade de Constructo e o Poder de Resposta. Posteriormente procedeu-se à caracterizar a prática da FT quanto às modalidades utilizadas, número de sessões de tratamento e duração do episódio de cuidados. Adicionalmente descreveu-se os resultados obtidos após a intervenção da FT, ao nível da dor e incapacidade. Resultados: Os resultados revelaram um resultado positivo para a Validade de Constructo da QBPDS-VP e um elevado Poder de Resposta (área abaixo da curva ROC = 0,736; IC95%=0,639-0,833). Apresenta ainda uma diferença mínima clinicamente importante (DMCI) de 7 pontos (sensibilidade =72,4% e especificidade = 69,8%). Aquando da intervenção da FT em casos de DCL, existe uma grande diversidade de modalidades realizadas combinadas em diferentes pacotes de intervenção, e verificou-se um número médio de sessões realizadas de 14,22 visitas por utente, numa duração de episódio de cuidados maioritariamente superior a 6 semanas. Os resultados da intervenção revelaram uma redução significativa da incapacidade funcional e da intensidade da dor (z= -7,440 e z=-6,625; respectivamente, p=0,000). Conclusão: Os resultados do presente estudo revelam que a QBPDS-VP possui uma boa Validade de Constructo e Poder de Resposta. Revela ainda que a intervenção da FT em casos de DCL, apesar de apresentar grande diversidade nas modalidades utilizadas por vezes até divergentes das recomendações dadas pelas normas de orientação clínica, e uma duração do episódio de cuidados aparentemente superior aos dados fornecidos pela literatura; proporciona uma redução significativa dos níveis de dor e incapacidade em utentes com DCL.
- Cross-cultural Adaptation and Validation of the Quebec Back Pain Disability Scale to European Portuguese LanguagePublication . Cruz, Eduardo Brazete; Fernandes, Rita; Carnide, Filomena; Vieira, Ana; Moniz, Sara; Nunes, FilipaLow back pain (LBP) is an extremely commonly health condition. It is a musculoskeletal complaint affecting most people at some point in their lives and the consequent health care, community, and personal costs are considerable.The clinical course of acute LBP has been described as initially favorable; however, beyond 6 weeks,only very small reductions in mean pain and disability seem to occur. According to a recent meta-analysis 6 individuals with persistent LBP are expected to have moderate levels of pain and disability. In these individuals, pain can fl uctuate over time with recurrences or exacerbations and has a major impact on their functionality. In the majority of the situations (85%), chronic LBP (CLBP) could not be assigned to a recognizable, known,specifi c pathology 15 , 16 and it is most accurately labeled as nonspecific CLBP (NSCLBP). Individuals with NSCLBP are commonly referred to physiotherapy services, 17 where reducing pain and disability are the main treatment goals and outcomes.The Quebec Back Pain Disability Scale (QBPDS) is one of the most recommended questionnaires to assess functional disability associated with LBP. It was developed as a measure of “functional disability,” which was defined by the authors as “perceived difficulty associated with simple physical activities.” It is a self-administered, 20-item questionnaire where patients are asked to rate their degree of difficulty in performing a specifi c activity from 0 (“not diffi cult at all”) to 5 (“unable to do”) in each item. The QBPDS score ranges from 0 to 100, with high values indicating higher levels of disability. The QBPDS has been extensively tested and is generally acknowledged to have good validity, reliability, and responsiveness. It has been translated and culturally adapted into different languages, including Portuguese from Brazil. However, the cultural and linguistic differences between the European Portuguese and the Brazilian Portuguese languages inhibit the use of the Brazilian version among Portuguese people. Therefore, the aim of this study was to conduct the crosscultural adaptation of the Portuguese version of the QBPDS and investigate its reliability and validity in patients with CLBP. This article is part of a larger research project aiming to validate tools with clinical relevance.
- How to define the success of physiotherapy in chronic low back pain patients?Publication . Pires, Diogo; Cruz, Eduardo; Costa, Daniela; Ribeiro, Ana Margarida; Vieira, Ana Cristina; Moniz, Sara; Nunes, Carla
- Responsiveness and Interpretability of the Portuguese Version of the Quebec Back Pain Disability Scale in Patients With Chronic Low Back PainPublication . Vieira, Ana C.; Moniz, Sara; Fernandes, Rita; Carnide, Filomena; Cruz, Eduardo BrazeteImproving functional capacity is a common goal when providing physiotherapy treatment to patients with chronic low back pain (CLBP). In a clinical setting, clinicians and researchers are often interested in measuring change in a patient’s condition as a result of an intervention or to distinguish individual differences in response to treatment. To address change accurately in health-related outcomes, such as functional disability, clinicians need measurement tools that show responsiveness and are able to detect minimal changes in performance over time.This change must be large enough to be considered a “real” change and precise enough to detect small but important clinical changes over time considered to be important by patients and/or clinicians.The concepts of “minimal detectable change” (MDC) and “minimal clinically important difference” (MCID) have been introduced to help clinicians and researchers in assessing and interpreting patient changes. The MDC has been defi ned as the minimal amount of change that can be considered above the threshold of error expected in the measurement, whereas the MCID has been defined as the smallest change in an outcome measure that is perceived as benefi cial by the patient and that would lead to a change in the patient’s management, assuming an absence of excessive side effects and costs. The Quebec Back Pain Disability Scale (QBPDS) is a well established functional self-report questionnaire to assess changes in function in patients with CLBP participating in rehabilitation programs. Several studies have evaluated its reliability and validity and have had good results. However, studies addressing its responsiveness are scarce, especially in samples of patients with CLBP, and there is little agreement in their fi ndings. In those studies the MDC was in the range 11.04 23 to 24.6 (95% confi dence interval [CI]: 19.9–32.4) 14 and the MCID was in the range from 5 9 to 8.5 points. Moreover, and in what concerns its interpretability, there are only a few studies that have considered the MCID in relation to the MDC. Therefore, the purpose of this study was to examine the responsiveness of the QBPDS Portuguese version (PT) and to determine the MCID, MDC, and the floor/ceiling effects, in patients with CLBP.