Eduardo Brazete Cruz

Instituto Politécnico de Setúbal · Departamento de Fisioterapia

This study aims to perform the cross-cultural adaptation to European Portuguese of the Composite Physical Function Scale and to assess its validity and reliability in a sample of community-dwelling older adults. The scale was translated into European Portuguese, back translated, and piloted in a sample of 16 representative individuals. Its validity...

In chronic shoulder pain, adaptations in the nervous system such as in motoneuron excitability, could contribute to impairments in scapular muscles, perpetuation and recurrence of pain and reduced improvements during rehabilitation. The present cross-sectional study aims to compare trapezius neural excitability between symptomatic and asymptomatic...

Background Low back pain (LBP) is a long-term health condition with distinct clinical courses. Its characterization together with the identification of prognostic factors for a persistent LBP course may trigger the development of personalized interventions. This study aimed to investigate the courses of chronic LBP (CLBP), its cumulative impact, an...

Background: Scapular muscles changes, as increased upper trapezius activity and decreased middle and lower trapezius and serratus anterior muscle activity, have been demonstrated in shoulder pain specific or non-specific conditions. Shoulder external rotation exercises have been recommended to improve scapular activity in shoulder pain. Objective...

Hip and knee osteoarthritis (HKOA) is a chronic disease characterized by joint pain that leads to reduced physical function and health-related quality of life (HRQoL). At present, no cure is available. Clinical trials indicate that people with HKOA benefit from physical activity in several health-related outcomes. However, few studies have evaluate...

Abstract Background Pain due to knee and / or hip osteoarthritis (HKOA) is the most common symptom for seeking healthcare. Pain interferes on daily activities, social and occupational participation in people with HKOA. The goal of this study is to estimate the prevalence of unmanageable pain levels (UPL) among people with HKOA), characterize this p...

Background: Low back pain is the leading cause of disability worldwide. Currently, the usual practice of intervention of patients with low back pain in primary health care overuses low-value interventions and that are insufficient for an effective treatment of low back pain. The best available scientific evidence recommends the implementation of a...

Introduction: Although the course of a low back pain (LBP) episode is favourable, recurrences are frequent. Exercise interventions are suggested as the most effective strategies to reduce the risk of recurrence, but patients do not exercise regularly. Evidence highlights the need to develop behaviour change-informed interventions to facilitate pati...

Objectives: The aim of this study is to describe the design process of the MyBack programme, which is a tailored intervention to prevent recurrences among individuals who recovered from an episode of low back pain. Methods: The Behaviour Change Wheel and Theoretical Domains Framework (TDF) informed the development of the MyBack programme. It was ca...

Objectives: MyBack is a tailored exercise and behavioural change programme to prevent recurrences of low back pain. The aim of this study is to describe the systematic process of developing an intervention for health professionals to optimize the implementation of the MyBack in primary healthcare settings. Methods: A stepwise approach, using the Be...

Objective: MyBack is a tailored exercise and behaviour change programme to prevent low back pain recurrences. The aim of this study was to explore barriers and facilitators to the implementation of the MyBack programme and to the adoption of regular exercise practice, from the physiotherapists’ and patients’ perspectives, respectively. Methods: For...

Objectives To estimate the prevalence of medical care-seeking among adults with low back pain (LBP) and to characterise and compare use of diagnostic procedures and medical management between primary and secondary care. Design Cross-sectional study. Setting Data from the EpiReumaPt, a nationwide population-based study conducted in Portugal includ...

Objective To identify long-term trajectories of physical function and health-related quality of life (HRQoL) among people with hip and/or knee osteoarthritis (HKOA) and the sociodemographic, lifestyle, and clinical factors associated with different trajectories. Methods Participants with HKOA from the EpiDoC study, a 10-year follow-up (2011–2021)...

Background: Pain due to knee or hip osteoarthritis (HKOA) is the most common symptom for seeking health care given its interference on daily activities, social and occupational participation. The goal of this study is to estimate the prevalence of unmanageable pain levels (UPL) among people with hip and/or knee osteoarthritis (HKOA), characterize t...

Background Pain due to knee or hip osteoarthritis (HKOA) is the most common symptom for seeking health care given its interference on daily activities, social and occupational participation. The goal of this study is to estimate the prevalence of unmanageable pain levels (UPL) among people with hip and/or knee osteoarthritis (HKOA), characterize th...

Several tools have been used to assess muscular stiffness. Myotonometry stands out as an accessible, handheld, and easy to use tool. The purpose of this review was to summarize the psychometric properties and methodological considerations of myotonometry and its applicability in assessing scapular muscles. Myotonometry seems to be a reliable method...

Recent studies show that musculoskeletal conditions contribute significantly to years lived with disability considering the entire global population. Pain and functional disability are the main problems that people with these conditions suffer. Neural mobilization has been shown to be an effective intervention in the treatment of musculoskeletal pa...

Background Low Back Pain (LBP) is a long-term health condition with distinct clinical courses. The characterization of these courses together with the identification of prognostic factors of a persistent disabling LBP course has the potential to enable a better identification of patients in high-risk and ultimately allow the development of personal...

Introduction: Low back pain (LBP) is the most prevalent musculoskeletal condition worldwide and it is responsible for high healthcare costs and resources consumption. It represents a challenge for primary care services that struggle to implement evidence-based practice. Models of care (MoCs) are arising as effective solutions to overcome this prob...

Background: Pain due to knee or hip osteoarthritis (HKOA) is the most common symptom for seeking health care given its interference on daily activities, social and occupational participation. The goal of this study is to estimate the prevalence of inadequate pain relief (IPR) among people with hip and/or knee osteoarthritis (HKOA), characterize thi...

Background: Hip/knee osteoarthritis (HKOA) is a leading cause of disability and imposes a major socioeconomic burden. The aim of this study is to estimate the prevalence of HKOA in Portugal, characterised the clinical severity of HKOA in the population, and identified sociodemographic, lifestyle, and clinical factors associated with higher clinical...

Background/Purpose: Low back pain (LBP) constitutes an important cause of disability and morbidity in general population. Appropriate care for LBP includes non-pharmacological interventions based on a biopsychosocial framework of patient education and advice. World Health Organization recommends that excessively medical solutions should be avoided....

Background: The expected increase of Low Back Pain (LBP) related prevalence and disability represents an urgent challenge for Portuguese health systems. Most episodes of LBP have little or no consequences however, the great disability reported by a substantial minority of patients, those with persistent disabling LBP, explains the disturbing social...

Background/Purpose: Low back pain (LBP) constitutes an important cause of disability and morbidity in general population. Appropriate care for LBP includes non-pharmacological interventions based on a biopsychosocial framework of patient education and advice. World Health Organization recommends that excessively medical solutions should be avoided....

Background: Cerebral palsy (CP) is the most common cause of motor disability in children and can cause severe gait deviations. The sagittal gait patterns classification for children with bilateral CP is an important guideline for the planning of the rehabilitation process. Ankle foot orthoses should improve the biomechanical parameters of patholog...

Background: Non-Specific Chronic Low Back Pain is considered the leading cause of years lived with disability worldwide, as well as the biggest cause of activity limitation and abstinence from work all over the world, causing great economic disruption to individuals, their families, communities, industry, and governments. Although exercise has been...

Background: Worldwide, the current management of knee osteoarthritis appears heterogeneous, high-cost and often not based on current best evidence. The absence of epidemiological data regarding the utilisation of healthcare services may conceal the need for improvements in the management of osteoarthritis. The aim of this study is to explore the p...

Introduction Knee osteoarthritis (OA) is a prevalent condition with associated high disability and healthcare costs. Evidence of major gaps in the implementation of evidence-based interventions in people with knee OA led several healthcare systems to implement models of care (MoCs) in order to improve knowledge translation and guaranty their econom...

Background: Worldwide, the current management of knee osteoarthritis appears heterogeneous, high-cost and often not based on current best evidence. The absence of epidemiological data regarding the utilisation of healthcare services may conceal the need for improvements in the management of osteoarthritis. The aim of this study is to explore the pr...

Background: Low back pain is a worldwide major problem and represents the leading cause of the loss of disability-adjusted life years in Portugal. Many patients still have pain and/or disability few months later. Current practice overuses low-value care and underuses high-value care. The effectiveness of stratified care on prognostic risk of develo...

Purpose To examine the association between different minimum important change (MIC) values for pain and disability and a successful response in global perception of improvement in patients with chronic nonspecific low back pain (CNLBP). Methods A prospective cohort study was conducted. At baseline, all participants completed a sociodemographic and...

This study followed assembly line workers during 7 months, comprising a 4-wk season holidays. The main purposes were to determine the potential effect of working time on the presence and intensity of upper limb musculoskeletal symptoms, as to verify the effect of 4 wk of job interruption in the upper limb musculoskeletal symptoms presence and inten...

Background Assembly lines work is frequently associated to work-related upper limb musculoskeletal disorders. The related disability and absenteeism make it important to implement efficient health surveillance systems. The main objective of this study was to identify self-reported variables that can determine work-related upper limb musculoskeletal...

Objective: The Assessments of SpondyloArthritis in- ternational Society Health Index (ASAS HI), estimates the impact of Spondyloarthritis (SpA) on global functioning and health. This article assesses the con- struct validity, reliability and responsiveness of the Por- tuguese version of the ASAS HI. Patients And Methods: Patients fulfilling ASAS cl...

Purpose: The primary aim of this study was to explore relevant outcome domains for patients with chronic low back pain (CLBP) undergoing physiotherapy. A secondary aim was to examine potential discrepancies between meaningful changes in pain and disability and the global perception of improvement. Methods: An explanatory mixed methods design was em...

Background Non-specific low back pain (NSLBP) is the most prevalent musculoskeletal condition in western countries and is associated with persistent disability and high consumption of health care resources. NSLBP patients first seek primary health care services but the outcomes are often uncertain. This study aimed to examine the clinical course of...

Background: There is an increasing recognition of the importance of using a conceptual framework covering the full range of relevant health domains and outcome measures addressed by physical therapy modalities in patients with chronic low back pain (CLBP). However, little is known about what outcome domains have been measured and through what meas...

Background The effectiveness of physiotherapy in patients with chronic low back pain is usually measured through changes in pain and disability domains. However, recent research has suggested that these two domains are not sufficient to capture all the physiotherapy benefits when patients’ perspective is considered. Objective The aim of this study...

Objective: The Assessments of SpondyloArthritis international Society Health Index (ASAS HI), estimates the impact of Spondyloarthritis (SpA) on global functioning and health. This article assesses the construct validity, reliability and responsiveness of the Portuguese version of the ASAS HI. Patients and methods: Patients fulfilling ASAS class...

After obtaining ethical approval, two focus groups (one for each professional group) were carried out. The focus groups were based on a semi-structured interview schedule, audio-recorded and transcribed verbatim. Firstly, two researchers independently coded the transcripts. Secondly, these researchers discussed the codes and examined their scope an...

Construct and discriminant validity of the European Portuguese version of the Start Back Screening Tool (SBT-PT). Cruz, E. B. 1, Fernandes, R.1, Caeiro, C. 1, Rodrigues, AM.2, Branco, J. C.2, Gomes, L. A.1, Paiva, S.1 , Canhão, H.2 1 Departamento de Fisioterapia, Escola Superior de Saúde – Instituto Politécnico de Setúbal, Setúbal, Portugal; 2 Epi...

Predictive validity of the START BACK Screening Tool (SBT) to identify patients at risk of developing persisting disabling low back pain. Cruz, E. B. 1, Fernandes, R.1, Caeiro, C. 1, Branco, J. C.2, Rodrigues, AM.2, Gomes, L. A.1, Paiva, S.1 , Canhão, H.2 1 Departamento de Fisioterapia, Escola Superior de Saúde – Instituto Politécnico de Setúbal, S...

Short-term outcomes in Low Back Pain patients treated in primary health care in Portugal Cruz, E. B. 1, Gomes, L. A.1, Branco, J. C.2, Rodrigues, A.2, Fernandes, R.1, Caeiro, C. 1, Paiva, S.1 , Pinto, I.3, Moniz, R.3 , Canhão, H.2. 1 Escola Superior de Saúde – Instituto Politécnico de Setúbal, Portugal; 2 EpicDoC Unit, CEDOC – NOVA Medical School/...

Interdisciplinary stratified care for low back pain – A qualitative study of general practitioners` and physiotherapists` perceptions regarding its upcoming implementation in Portugal Caeiro, C.1, Paiva, S.1, Gomes, L.1, Fernandes, R.1, Canhão, H.2, Rodrigues, A.2, Sousa, R.2, Branco, J.2, Fryxell, A.3, Vicente, L.3, Cruz, E.1 1Physiotherapy Depar...

Background and objective The SPLIT project aims to introduce an interdisciplinary stratified model of care for patients with low back pain. This study aimed to explore the acceptability and identify potential barriers and facilitators regarding the upcoming implementation of this project, based on the general practitioners' and physiotherapists' pe...

Objective: The aim of this study was to compare the effectiveness of a combined intervention of manual therapy and exercise (MET) versus usual care (UC), on disability, pain intensity and global perceived recovery, in patients with non-specific chronic neck pain (CNP). Design: Randomized controlled trial. Setting: Outpatient care units. Subje...

Purpose: To cross-culturally adapt the Global Perceived Effect Scale (GPES) into Portuguese and investigate its psychometric properties in patients with chronic low back pain. Methods: Cross-cultural adaptation was carried out according to published guidelines. Along with measures for pain and disability, GPES was administered at baseline, 48-h lat...

Background: Low back pain (LBP) is the leading cause of disability in Portugal and worldwide. The majority of the patients use primary health care services but the treatment outcomes are unknown. Findings of prognostic studies indicate that a marked reduction in mean pain and disability is expected in the first 6-8 weeks, for acute or persistent LB...

Background The results of a recent study have suggested that the current clinical practice is not in line with clinical guideline recommendations and may not be delivering the best outcomes to Low Back Pain (LBP) Portuguese patients. Since the stratified primary care approach has demonstrated clinical and cost-effectiveness in the UK and other coun...

Background Chronic nonspecific neck pain (CNP) is a common health problem worldwide. Previous studies identified sociodemographic and clinical factors associated with successful outcomes in patients at discharge of physiotherapy treatment. However, the prognostic factors associated with an early response to physiotherapy treatment in patients with...

Background Low back pain (LBP) is the leading cause of disability in Portugal and worldwide. The majority of the patients use primary health care services but the treatment outcomes are unknown. Findings of prognostic studies indicate that a marked reduction in mean pain and disability is expected in the first 6-8 weeks, for acute or persistent LBP...

Background Chronic nonspecific neck pain (CNP) is a common health problem worldwide. The physiotherapy approach is the second line of treatment and a large variety of modalities are frequently used. However, the mean effect of interventions is small and it is unknown if the patients achieving clinically important change. Individual responder analys...

Background Research on non-pharmacological treatments for fibromyalgia patients has demonstrated that exercise and education have positive effects on pain and disability¹. However, the traditional approach of studying treatment effectiveness based exclusively on quantitative measures has been questioned. There is growing recognition of the importan...

Introduction: Chronic Low Back Pain (CLBP) is the most prevalent musculoskeletal condition in the Portuguese population. Given its multidimensional nature, the evidence suggests that the time criterion (over 12 weeks duration) does not adequately characterize CLBP patients, and it is important to evaluate the mechanisms underlying pain production....

Introduction Neck pain is a common musculoskeletal disorder worldwide. It can result in significant disability and impaired quality of life. More than 50% of patients with neck pain still report symptoms 1 year later despite receiving different forms of non-pharmacological and pharmacological treatment. Identifying patient characteristics that are...

Background: A good functionality is appointed by the elderly as one of the most important factors for a good quality of life, since it is associated with independency and autonomy. Studies show that elderly with food insecurity have greater limitations in daily living activities (DLA) when compared to food security elderly. Moreover, food insecure...

Purpose: The purpose of this case series was to describe the outcomes of a tailored pain neuroscience education (PNE) and individualised exercise programme for people with fibromyalgia (FM) who also have cognitive deficits. Materials and methods: Nine FM patients with memory and concentration problems underwent a six-week programme consisting of si...

Background and aims: Recent studies with non-specific chronic low back pain (CLBP) patients suggest that an early response to treatment might be a relevant prognostic indicator of a successful response to physiotherapy treatment. This study aimed to investigate the prognostic value of an early clinically important change, defined as a decrease in p...

Background and aims: Chronic neck pain (CNP) is a common health problem to which a large variety of physiotherapy modalities are frequently used. Individual responder analyses provide researchers with preliminary information about the chance of achieving clinically important treatment responses. This study aimed to pilot the effectiveness of a comb...

Background: Chronic low back pain (LBP) is a major health problem, related to persistent disability and high socioeconomic burden. Psychological factors, such as kinesiophobia are known to impact the course of LBP, altering movement patterns, reducing physical activity and contribute to maintain persistent pain and disability. This evidence has led...

Background and aims: Response to physiotherapy treatment in patients with non-specific Chronic Low Back Pain (CLBP) has been described as poor and heterogeneous. Few studies have investigated the pattern of response during the treatment period, and whether prognostic factors can be identified for different patterns of response. The aim of this stud...

The aim of this study was to determine the cutoffs that most accurately classify CLBP patients who perceived an overall improvement.

Assembly lines are related to health risks and work-related musculoskeletal disorders (WMSD), particularly of the neck and upper limbs (WULMSD). The assessment of perceived musculoskeletal symptoms is essential to WULMSD prevention, but studies in this field are lacking. A cross sectional survey on assembly line workers (n=270) was performed. The o...

Objective: There is a lack of outcome measures to assess the impact of axial spondyloarthritis (axSpA) on health, function and quality of life. The Assessment of SpondyloArthritis International Society (ASAS) group developed the ASAS Health Index (ASAS-HI) and the ASAS Environmental Factors Item Set (ASAS-EF) to measure functioning and health acro...

Background The Assessment of SpondyloArthritis international Society Health Index (ASAS HI), is a unidimensional questionnaire, that includes 17 items, measuring functioning and health in patients with spondyloarthritis (SpA) (1). At the beginning of this project, only an English version of the instrument existed. Objectives The aim of this study...

(GPs) and physiotherapists’ (PTs) low back pain (LBP) practice through the introduction and support of a subgrouping for targeted treatment system for the assessment and management of LBP patients in primary care. This system differs from ‘one-size fits all’ usual practice, as it suggests that GPs should systematically allocate LBP patients to one...

Background: The literature has suggested that Pain neurophysiology education (PNE) can have positive effects on pain, disability and maladaptive pain cognitions in fibromyalgia (FM) patients but no significant changes in these variables have been found in response to PNE in FM patients. Reasons for these findings may relate with the design of the P...

Background: Chronic low back pain (CLBP) is a common health problem to which a large number of types of treatments seem to produce similar mean improvement in patient’s symptoms. Individual responder analyses offer the possibility of providing patients and clinicians with supplementary information about the chance of achieving particular degrees of...

Introdução: As elevadas taxas de insucesso, segundo o benefício clínico da intervenção da Fisioterapia, sugerem haver características dos utentes que influenciam o sucesso/insucesso da intervenção. No entanto, os estudos dos fatores de prognóstico neste âmbito são escassos e inconsistentes. Objetivo: Este estudo pretende determinar se um modelo ba...