Desporto surdo: avaliação fisioterapêutica e adaptação de testes de desempenho físico de membros superiores para surdoatletas

Abstract

This Ph.D. dissertation aimed to explore and understand physical therapeutic assessment in Brazilian Deaf Sports, as well as to adapt upper limb physical performance tests for athletes who are Deaf and Hard of Hearing (D/HoH). To achieve this, two complementary studies were conducted. Study I was a cross-sectional qualitative investigation using focus groups with four physical therapists working in Brazilian Deaf Sports. The discussion followed a thematic script based on the literature and was analyzed using Bardin’s (2016) Thematic Content Analysis and Braun and Clarke’s (2006) Inductive Thematic Analysis. The findings highlighted significant challenges faced by physical therapists, particularly in competitive settings, due to a lack of resources, institutional support, and communication barriers, such as the scarcity of professionals fluent in Brazilian Sign Language (Libras) and the absence of interpreters. Facilitators identified included the use of technology, lip reading, and the development of a strong therapeutic alliance. The study emphasized the need for specific strategies and institutional support to enhance physical therapeutic assessment for athletes who are D/HoH. Study II aimed to translate, adapt, and conduct face and content validation of the Modified Upper Quarter Y Balance Test (mUQYBT) and the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) into American Sign Language (ASL). The adaptation process followed a structured five-step protocol: (1) Translation into Sign Language; (2) Synthesis of Translations; (3) Back-Translation; (4) Expert Review and Development of the Pre-Final Version (PFV); and (5) Pilot Testing, Face and Content Validation, and Development of the Final Version (FV). Three translators participated in the initial stage, producing two versions in “Signed English” and one version aligned with ASL grammar and cultural nuances. Experts selected and refined the most appropriate version, incorporating adaptations such as shoulder tapping to signal test initiation and completion, as well as the use of instructional videos. Face and content validation involved 30 athletes who are D/HoH, who correctly understood and performed the tests, confirming the feasibility and validity of the adaptations. This dissertation provides a comprehensive overview of physical therapeutic assessment in Brazilian Deaf Sports and develops methodological solutions to improve the accessibility of evaluation processes. Study I identified structural, cultural, and communicational barriers, reinforcing the need for professional training and the development of tailored protocols for athletes who are D/HoH. Study II underscored the importance of linguistic and cultural adaptation in test translation, ensuring and promoting equity in physical performance assessment for athletes who are D/HoH. These findings make a significant contribution to physical therapy practice in Deaf Sports and offer a methodological model for future research in the field.