Diabetic sensorimotor polyneuropathy (DSPN) affects approximately 10% of the subjects newly diagnosed 1,2,3 as type 2 diabetes and this percentage can increase by duration, lack of glycemic and cardiovascular complications 3,4,5 . When appropriately treated by restoration of glycemic control 3 , the progression of the DSPN can be delayed and the diabetic ulcers and amputations reduced 3,6 . However, the neuropathy is still the major cause of diabetic foot presenting damaged nerve fibers and this secondary complication affects more than 50% among the subjects diagnosed ABSTRACTSince 1994, the University of Michigan Diabetes Research and Training Center proposed an instrument to measure neuropathies not yet adapted to use in Brazil. Then, this study aimed to adapt cross-culturally the Michigan Neuropathy Screening Instrument (MNSI) into Brazilian Portuguese, verifying its reliability. Thirty diabetic patients were initially evaluated with the adapted version after completed the essential steps to accomplish the cross-cultural adaptation. Twenty-two of them completed the procedures to repeat the measured scores after day 1 (trial 0). The repeated measurements were tested at days 2 or 3 (trial 1) by another rater (inter-rater reliability) and retested at day 20 (trial 2) by one of the attended raters (inter-test reliability). There were not great semantics, linguistics or cultural differences between two versions and excellent reliability was confirmed by intra-class correlation coefficient above 0.840. It was concluded that MNSI in the Brazilian version is reliable and it is ready to use.Keywords: diagnosis; monitoring; diabetic neuropathies. RESUMODesde 1994, o Centro de Treinamento e Pesquisa em Diabetes da Universidade de Michigan propôs um instrumento não ainda adaptado para uso no Brasil para mensurar neuropatias. O objetivo deste estudo foi adaptar transculturalmente o Michigan Neuropathy Screening Instrument (MNSI) para o Português brasileiro, verificando sua confiabilidade. Trinta pacientes diabéticos foram inicialmente avaliados pela versão adaptada depois de completados os passos essenciais para finalizar a adaptação transcultural. Vinte e dois deles completaram os procedimentos para repetir os escores medidos depois do dia 1 (ensaio 0). As medidas repetidas foram testadas nos dias 2 ou 3 (ensaio 1) por outro examinador (confiabilidade interexaminador) e retestadas no dia 20 (ensaio 2) por um dos examinadores participantes (confiabilidade interteste). Não existiam diferenças semânticas, linguísticas ou culturais entre as duas versões e excelente confiabilidade foi confirmada pelo coeficiente de correlação intra-classe acima de 0,840. Conclui-se que o MNSI na versão brasileira é confiável e está pronto para uso.Palavras-chave: diagnóstico; monitoramento; neuropatias diabéticas.

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BACKGROUND AND OBJECTIVES: Low back pain is defined as a painful disorder located between the first and the fifth lumbar vertebra, and it is considered to be an important public health problem. In Brazil, approximately 10 million people are disabled as a result of this condition. The objective this study was to assess the effects of the Pilates method on the treatment of chronic low back pain. METHODS: The present study is based on a randomized, controlled clinical trial involving 16 individuals, aged 30-60 years, of both gender, with chronic low back pain, divided into control group and experimental group, with eight individuals each. Twelve sessions of 40 minutes were performed, in which nine positions of the Pilates method were applied within the experimental group. The control group performed kinesiotherapeutic conventional exercises. The visual analog scale and the Oswestry Disability Questionnaire were used before and after the study period in both groups. RESULTS: The assessment of pain and disability in the pre-and post-evaluation periods showed no statistically significant difference. The control group also showed no statistical difference for the visual analog scale and Oswestry scores between the pre-and post-evaluation periods, whereas the experimental group showed a significant difference between the scores obtained in these two different periods for the Oswestry and visual analog scores. CONCLUSION: It is suggested that the method was effective for the group studied and proved to be suitable for the treatment of low back pain, but it did not prove superior to conventional physical therapy.

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Introduction: Muscle strength has shown different responses to the cooling of neuromuscular tissue and its behavior is still unclear. Objective: To verify the behavior of maximum grip strength before and after forearm cooling. Methods: The cooling intervention consisted of immersing the forearm up to the elbow in water cooled to 10° C. Grip strength was assessed using a dynamometer prior to cooling, immediately after immersion, and at 5, 10 and 30 minutes of forearm exposure to ambient temperature (recovery phase) concomitantly to measurement of skin surface temperature. The sample consisted of 30 healthy individuals. Results: Grip strength decreased significantly (p < 0.05) between the period prior to cooling and all the time intervals following immersion in ice water. There was also a gradual increase in grip strength during the recovery phase, with significant differences (p < 0.05) between the mean immediately after immersion and means at 5, 15 and 30 minutes after exposure to ambient temperature. Conclusion: The results indicate that immersion in ice water (10ºC) for 15 minutes significantly reduced (p < 0.05) grip strength for up to 30 minutes after forearm cooling. Strength also recovered progressively after removal of the cold stimulus. Further research is needed to obtain definitive results regarding the effects of cooling on muscle strength in healthy individuals.