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- Understanding wearable health technology use in older adults through social and psychological factorsPublication . Félix, José; Moreira, Juliana; Pereira, Soraia; Guedes, Diana; Sá, Catarina; Santos, Rubim; Faria, Brígida; Kontio, Elina; Pinheiro, Ana Rita; Sousa, Andreia S. P.; Pinheiro de Sousa, Andreia Sofia; Faria, Brigida Monica; Rubim Silva Santos, Manuel; Sousa Félix, José Manuel; Santos Moreira, Juliana; C. Guedes, Diana; Pinheiro, Ana RitaAs populations age globally, wearable health technologies offer promising solutions to support autonomy and well-being among older adults. This study explored the adoption of smart wearable systems, such as wristbands and chest sensors, for remote health monitoring among 352 older adults (aged 60–99) in Northern Portugal. Results showed that 74.4% of participants expressed interest in using wearable systems, with safety (93.9%) cited as the main benefit. Prevention (11.4%) and improved health monitoring (6.1%) were reported less frequently and should be considered secondary factors. However, barriers included discomfort (62.7%), heaviness (31.1%), and device size (32.7%), particularly in smartwatches. Chest bands were preferred when soft, lightweight, and discreet. Technology use frequency, especially smartphone usage, emerged as a key predictor of interest, as confirmed by a decision tree machine learning model with an accuracy of 71.88%. Despite low educational levels, participants demonstrated high motivation to use features such as medication reminders (83.5%), healthy habit prompts (74.2%), and appointment alerts (70.2%). Although many respondents felt reassured by the potential of continuous monitoring, some reported concerns related to anxiety (54.9%) and over-surveillance. These findings underscore the importance of balancing technological functionality with emotional comfort. The study highlights the need for user-centered design, digital literacy initiatives, and co-creation with older users to improve adherence and usability. Tailored interventions and accessible technologies can enhance health outcomes and promote independent living among aging populations.
- Electromyographic assessment of the extrinsic laryngeal muscles: Pilot and descriptive study of a vocal function assessment protocolPublication . Ribeiro, Jéssica; Araújo, André; Sousa, Andreia S. P.; Pereira, Filipa; Pinheiro de Sousa, Andreia Sofia; Guerreiro Martins Araújo, Pedro AndréThe aim of this study was to develop and test a surface electromyography (sEMG) assessment protocol to characterise the activity of the extrinsic laryngeal muscles (suprahyoid and infrahyoid) during phonatory tasks and vocal techniques. The protocol of assessment was based on electromyographic assessment guidelines and on clinical voice evaluation needs and was tested in six healthy adults with no vocal disorders. Surface electromyographic activity of suprahyoid and infrahyoid muscles was acquired during different reference tasks (rest, reading, maximum contractions) and six vocal tasks, including nasal sounds, fricatives, and semi-occluded vocal tract exercises. A laryngeal accelerometer was used for detecting the beginning and end of each exercise. The average activity during each task was normalised by the signal obtained in the incomplete swallowing task for the SHM and by the sniff technique for the IHM. The range of activation values varied across tasks, with higher percentages observed in plosive production and in the “spaghetti” technique, while nasal and fricative sounds tended to show lower activation values within the group. A consistent pattern of simultaneous activation of suprahyoid and infrahyoid muscles was observed during phonation. The protocol proved potential for clinical application in speech–language pathology as it enabled the characterisation of muscle activity in determinant muscles for vocal function. Larger samples and further validation of the time-marking system are needed. This study provides a foundation for integrating sEMG measures into functional voice assessment.
- Effects of 5% caffeine ultrasonophoresis on Gynoid Lipodystrophy—A randomized controlled studyPublication . Cabral, Diana Santos; Noites, Andreia; Noites, AndreiaGynoid lipodystrophy (GL) affects most women, manifesting itself from puberty to adulthood. Its multifactorial etiology generates controversy in the literature about the most suitable treatment. Several methods are used, from the smallest to the most invasive, in the search for an effective fight against the severity of GL. The positive effect of ultrasound therapy (US) in decreasing subcutaneous adipose tissue is in increasing the skin permeability of pharmacological molecules, and it has aroused interest in the effect of a combination of the two techniques on the severity of GL. However, the results of this technique associated with an exercise program are unknown. To analyze the effect of three sessions of US + 5% caffeine in association with the realization of an exercise program, in females, on the level of severity of GL in the gluteal region and on the posterior proximal third part of the thigh. Methods: A total of 36 healthy women, aged between 18 and 55, who were considered to have GL, were randomly allocated in two experimental groups and one placebo group. The placebo group (PG) performed only physical exercise during the study. Experimental group 1 (EP1) performed US with 5% caffeine alongside a physical exercise protocol and experimental group 2 (EP2) performed US with a conventional US gel alongside a physical exercise protocol. The three groups completed three intervention sessions over 3 weeks, with one session per week. In addition to the level of severity assessed by the Cellulite Several Scale (CSS), anthropometric measures, body composition, and lipid profile of the participants were evaluated. The first assessment was carried out before the intervention (M0) and the last assessment after the three interventions (M1). The results were analyzed using the ANOVA test. The Tukey test was used for multiple comparisons of the groups in all variables, except for those related to the CSS, where the Kruskal–Wallis test was used with a significance level of 0.05. A total of 29 women completed the study. There was a significant decrease inside the PG related to triglycerides (p = 0.012). In M1, all groups started to present median values below 200 mg of triglycerides. In cholesterol, a significant reduction was observed in all groups (p = 0.05). On the gluteal level at 5 cm, there was a decrease in EP1 and EP2 between M0 and M1 with p = 0.006 and p = 0.002, respectively. On the CSS there were no significant differences between groups or between moments. Three sessions of 5% caffeine and US in association with a physical exercise protocol have no effect on reducing the level of severity of GL.
- Smartphone addiction and chronic spinal pain among university students: A cross-sectional studyPublication . Oliosi, Maria Eduarda; Silva, Cláudia; Simões, Daniela; Pinheiro, Ana Rita; Silva, CláudiaCurrent smartphones are highly versatile, and their use is embedded in people’s daily lives, particularly among university students. Their overuse does not seem to be harmless, being associated with adverse effects, including musculoskeletal dysfunction. Moreover, chronic spinal pain (CSP) is increasing among university students. This study aimed to assess the prevalence of self-reported smartphone addiction (SA) and CSP among university students and analyze the association between both. A cross-sectional study was performed. Date were obtained from a sample of university students through an online self-reported questionnaire, which included the Smartphone Addiction Scale Short Version, the Numerical Pain Rating Scale, the Neck Disability Index, and the Oswestry Disability Index. Of 465 students who responded, 31% showed SA, and 26% reported CSP. Students with SA evidenced a greater prevalence of neck, thoracic, and low back pain when compared to university students without addiction. Logistic regression analysis showed a significant association between SA and CSP (OR = 2.48, 95% CI = 1.55–3.98). However, longitudinal studies are needed to establish causal relationships. This study concludes that SA and CSP are both prevalent among university students, and their association should be further analyzed and considered in preventive measures.
- Urinary incontinence in young gymnastics athletes: A scoping reviewPublication . Higounenc, Alice; Carvalhais, Alice; Vieira, Ágata; Lopes, Sofia; Vieira, ÁgataUrinary incontinence (UI) is increasingly reported among young nulliparous women, especially those engaged in high-impact sports. This may increase the risk of developing stress urinary incontinence (SUI) later in life. This scoping review aims to synthesise current evidence on UI in gymnasts, identify the gymnastics modalities with the highest prevalence of UI, and examine the outcomes measures and interventions considered for UI. Methods: A scoping review was conducted using the following databases: PubMed, Cochrane, Science Direct, Scielo, EBSCO, PEDro, and NIH. Studies published in English or Portuguese between January 2012 and May 2023 were included. Review articles, qualitative studies, and conferences abstracts were excluded. Studies were analysed according to the PRISMA-ScR framework. Results: Out of 169 identified studies, 4 were included. SUI emerged as the most prevalent type of UI, particularly in artistic and trampoline modalities. All the studies used the ICIQ-UI-SF to assess UI. Reported outcomes included prevalence of UI and SUI, impact on quality of life and athletic performance, as well as knowledge about UI and pelvic floor. No studies investigated treatments for UI. Conclusions: The prevalence of SUI is high among gymnasts (70%), especially in artistic and trampoline disciplines. Although there is outcome heterogeneity across studies, all used the ICIQ-UI-SF. There is a critical gap regarding interventions for UI in this population.
- The effect of neck-specific exercise with or without a behavioral approach in chronic whiplash-associated disorders: A systematic review and meta-analysisPublication . Correia, Luís; Carvalho, Paulo; Amaral, Luísa; Esteves, Mário; Vilarinho, Rui; Cervaens, Mariana; Vilarinho, Rui; Carvalho, PauloChronic whiplash-associated disorders describe a cluster of symptoms that result from a sudden neck acceleration/deceleration movement, including pain, musculoskeletal and neurological signs, inducing functional disability. The aim of this study was to compare the effects of physiotherapy treatment based on neck-specific exercises, with or without a behavioral approach, in individuals with whiplash-associated disorders. Computerized research was performed in PubMed, PEDro, National Institute for Health and Care Excellence, and ScienceDirect to identify randomized controlled trials that evaluated the effectiveness of neck-specific exercises, with or without a behavioral approach, for chronic whiplash. For the meta-analysis, the outcomes of pain and disability were assessed. Thirteen studies were included in the systematic review, with a total of 2427 participants of both sexes, with ages between 18 and 63 years. Although interventions with a behavioral approach decreased pain and disability more significantly in 4 and 6 studies when compared to neck-specific exercises without such an approach, respectively, the meta-analysis revealed no differences between them. Although interventions for chronic whiplash-associated disorders based on neck-specific exercises with a behavioral approach seem to be more effective in reducing pain and disability, there is no quantitative difference favoring one over the other.
- Neurobiomechanical characterization of feedforward phase of gait initiation in chronic stroke: A linear and non-linear approachPublication . Freitas, Marta; Fonseca, Pedro; Alves, Leonel; Pinho, Liliana; Silva, Sandra; Figueira, Vânia; Félix, José; Pinho, Francisco; Vilas-Boas, João Paulo; Silva, Augusta; Ferreira Silva, Maria AugustaPostural control arises from the complex interplay of stability, adaptability, and dynamic adjustments, which are disrupted post-stroke, emphasizing the importance of examining these mechanisms during functional tasks. This study aimed to analyze the complexity and variability of postural control in post-stroke individuals during the feedforward phase of gait initiation. A cross-sectional study analyzed 17 post-stroke individuals and 16 matched controls. Participants had a unilateral ischemic stroke in the chronic phase and could walk independently. Exclusions included cognitive impairments, recent surgery, and neurological/orthopedic conditions. Kinematic and kinetic data were collected during 10 self-initiated gait trials to analyze centre of pressure (CoP) dynamics and joint angles (−600 ms to +50 ms). A 12-camera motion capture system (Qualisys, Gothenburg, Sweden) recorded full-body kinematics using 72 reflective markers placed on anatomical landmarks of the lower limbs, pelvis, trunk, and upper limbs. Ground reaction forces were measured via force plates (Bertec, Columbus, OH, USA) to compute CoP variables. Linear (displacement, amplitude, and velocity) and non-linear (Lyapunov exponent—LyE and multiscale entropy—MSE) measures were applied to assess postural control complexity and variability. Mann–Whitney U tests were applied (p < 0.05). The stroke group showed greater CoP displacement (p < 0.05) and reduced velocity (p = 0.021). Non-linear analysis indicated lower LyE values and reduced complexity and adaptability in CoP position and amplitude across scales (p < 0.05). In the sagittal plane, the stroke group had higher displacement and amplitude in the head, trunk, pelvis, and limbs, with reduced LyE and MSE values (p < 0.05). Frontal plane findings showed increased displacement and amplitude in the head, trunk, and ankle, with reduced LyE and MSE (p < 0.05). In the transverse plane, exaggerated rotational patterns were observed with increased displacement and amplitude in the head, trunk, pelvis, and hip, alongside reduced LyE convergence and MSE complexity (p < 0.05). Stroke survivors exhibit increased linear variability, indicating instability, and reduced non-linear complexity, reflecting limited adaptability. These results highlight the need for rehabilitation strategies that address both stability and adaptability across time scales.
- Principal component analysis of gait Continuous Relative Phase (CRP): Uncovering lower limb coordination biomarkers for functional disability in older adultsPublication . Moreira, Juliana; Alves, Leonel A. T.; Sousa, Rúben Oliveira; Castro, Márcia; Santos, Rubim; Sousa, Andreia S. P.; Pinheiro de Sousa, Andreia Sofia; Rubim Silva Santos, Manuel; Santos Moreira, JulianaSymmetry in gait coordination reflects the balanced timing and movement between lower limb joints, which are essential for efficient locomotion and functional independence in older adults. Although gait coordination is recognized as a key indicator of aging-related adaptations and functional decline, most studies rely on isolated measures without fully addressing symmetry in intra- and interlimb coordination. This study aimed to identify principal components of gait coordination symmetry and their association with functional disability in older adults. A cross-sectional study assessed 60 community-dwelling older adults (60+), stratified by functional disability (35 non-disabled; 25 disabled). The threedimensional range of motion of lower limb joints was assessed during the gait cycle using an optoelectronic system. Intra- and intersegmental coordination was assessed by the continuous relative phase (CRP), a nonlinear measure that captures both timing and movement relationships between joint angles. Principal component analysis was applied to CRP means and coefficients-of-variation (CV) to identify key coordination principal components (PC). Of eight PC explaining 78.86% of variance, only the PC1 distinguished disability status (p = 0.007, d = 0.66). This component included sagittal-plane intrasegmental CRP mean and CV for the knee–ankle and hip–ankle. This study is novel in combining CRP-derived measures of intra- and interlimb symmetry with principal component analysis to distinguish functional disability in older adults. The findings indicate that sagittal-plane intrasegmental CRP symmetry may serve a relevant biomarker of gait impairment. By linking kinematic coordination features to functional disability, this approach complements clinical assessments and supports early identification of mobility decline in older adults.
- Towards an automated approach for understanding problematic gamingPublication . Afonso, Ana Paula; Fonseca, Manuel J.; Cardoso, Joana; Vázquez, BeltránVideo games have become increasingly popular worldwide, attracting billions of gamers across diverse demographics. While studies have highlighted their potential benefits, concerns about problematic gaming behaviors have also emerged. Conditions such as Internet Gaming Disorder (IGD) have been recognized by major health organizations, necessitating accurate diagnostic tools. However, existing methods, primarily reliant on self-report questionnaires, face challenges in accuracy and consistency. This paper proposes a novel technological approach to provide gaming behavior indicators, aiming to offer precise insights into gamer behavior and emotion regulation. To attain this objective, we investigate quantifiable gaming behavior metrics using automated, unobtrusive, and easily accessible methods. Our approach encompasses the analysis of behavioral telemetry data collected from online gaming platforms and incorporates automated extraction of gamer emotional states from face video recordings during gameplay. To illustrate the metrics and visualizations and demonstrate our method’s application we collected data from two amateur and two professional gamers, all of whom played Counter-Strike2 on PC. Our approach offers objective insights into ingame gamer behavior, helping health professionals in the identification of patterns that may be difficult to discern through traditional assessment methods. Preliminary assessments of the proposed methodology demonstrate its potential usefulness in providing valuable insights about gaming behavior and emotion regulation. By leveraging automated data collection and visualization analysis techniques, our approach offers a more comprehensive understanding of gamer behavior, which could enhance diagnostic accuracy and inform interventions for individuals at risk of problematic gaming behaviors. Our findings demonstrate the valuable insights obtainable from a tool that collects telemetry data, emotion regulation metrics, and gaming patterns. This tool, utilizing specific indicators, can support healthcare professionals in diagnosing IGD and tracking therapeutic progress, potentially addressing challenges linked to conventional IGD assessment methods. Furthermore, this initial data can provide therapists with detailed information on each player’s problematic behaviors and gaming habits, enabling the development of personalized treatments tailored to individual needs. Future research endeavors will focus on refining the methodology and extending its application in clinical settings to facilitate more comprehensive diagnostic practices and tailored interventions for individuals at risk of problematic gaming behaviors.
- N170 in attention deficit hyperactivity disorder: Systematic reviewPublication . Barroso, Beatriz C. R.; Vieira, Luísa; Pinto, Joana O.; Almeida, Rita; Pinto, Joana OAttention deficit hyperactivity disorder (ADHD) seems to encompass impaired emotional recognition and face processing, whose underlying mechanisms are yet to be uncovered. The N170 is an event-related potential sensitive to facial expressions, being often associated with perception and attention. Thus, this work aims to summarise and meta-analyse the literature focused on N170 modulation by ADHD. Empirical studies measuring N170 in both ADHD and healthy individuals were identified following the Preferred Reporting Items for Systematic Reviews and Meta-analysis. Fourteen studies were included in the review. Eight studies were meta-analysed and no overall significant results were found between healthy and ADHD individuals. Moderation analysis by valence revealed no differences between groups for positive and negative valence. Neutral valence yielded more negative N170 amplitudes in ADHD than in healthy individuals. Altogether, findings suggest that neurophysiological processing of emotional faces is generally unimpaired in ADHD individuals. Further, it may be that ambiguous faces’ processing is more demanding in individuals with ADHD. Limitations of the included studies are the variability of the tasks employed and the lacking information about the specific symptoms and medication washout. Directions for future studies are discussed.