Browsing by Author "Almeida, Isabel"
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- An fMRI paradigm based on Williams inhibition test to study the neural substrates of attention and inhibitory controlPublication . Dores, Artemisa Rocha; Barbosa, Fernando; Carvalho, Irene P.; Almeida, Isabel; Guerreiro, Sandra; da Rocha, Benedita Martins; Cunha, Gil; Castelo Branco, Miguel; de Sousa, Liliana; Castro Caldas, AlexandreThe purpose of this study is to present an fMRI paradigm, based on the Williams inhibition test (WIT), to study attentional and inhibitory control and their neuroanatomical substrates. We present an index of the validity of the proposed paradigm and test whether the experimental task discriminates the behavioral performances of healthy participants from those of individuals with acquired brain injury. Stroop and Simon tests present similarities with WIT, but this latter is more demanding. We analyze the BOLD signal in 10 healthy participants performing the WIT. The dorsolateral prefrontal cortex, the inferior prefrontal cortex, the anterior cingulate cortex, and the posterior cingulate cortex were defined for specified region of interest analysis. We additionally compare behavioral data (hits, errors, reaction times) of the healthy participants with those of eight acquired brain injury patients. Data were analyzed with GLM-based random effects and Mann-Whitney tests. Results show the involvement of the defined regions and indicate that the WIT is sensitive to brain lesions. This WIT-based block design paradigm can be used as a research methodology for behavioral and neuroimaging studies of the attentional and inhibitory components of executive functions.
- Computer-based neuropsychological rehabilitationPublication . Dores, Artemisa Rocha; Barbosa, Fernando; Guerreiro, Sandra; Almeida, Isabel; Carvalho, Irene PalmaresNeurocognitive rehabilitation of people with acquired brain injury (ABI) is a part of neuropsychological rehabilitation that has gained increased interest in response to the growing incidence of this type of injury and to the possibility of post-injury survival, often associated with physical and cognitive deficits, as well as emotional and behavioral changes. These problems call for the need of innovative interventions that can overcome the limitations of traditional approaches to ABI.
- E a qualidade de vida? Estudo dos efeitos de um programa holístico de reabilitação neuropsicológicaPublication . Almeida, Isabel; Guerreiro, Sandra; Martins-Rocha, Benedita; Dores, Artemisa Rocha; Vicente, Selene G.; Barbosa, Fernando; Castro-Caldas, AlexandreA reabilitação após lesão cerebral adquirida (LCA) pretende minimizar os impactos dos défices na funcionalidade do indivíduo promovendo a sua Qualidade de Vida (Qvd). O objetivo deste estudo é avaliar o impacto de um programa holístico de reabilitação neuropsicológica (PHRN) nas dimensões da Qvd. Participaram 20 sujeitos com LCA, média de idades 30 anos (DP=7.62). Os participantes foram avaliados pré e pós intervenção, com intervalo de seis meses utilizando-se o Quality Of Life after Brain Injury. Para a análise usamos o t-test amostras emparelhadas, com p corrigido para comparações múltiplas. Verifica-se uma avaliação mais satisfatória após a intervenção em todas as dimensões: total [t(19)=-4.59, p =0.001], social [t(19)=-1.29, p =0.001], emocional [t(19)=-1.85, p =0.001] e físico [t(19)=-1.778, p =0.01). Os resultados sugerem que o PHRN promove melhorias em todas as dimensões da Qdv.
- Evidence-based rehabilitation after acquired brain injury: a clinical trial on a holistic neuropsychological rehabilitation programPublication . Guerreiro, Sandra; Almeida, Isabel; Rocha, Benedita Martins; Dores, Artemisa Rocha; Vicente, Selene; Castro-Caldas, Alexandre; Barbosa, FernandoComprehensive-holistic neuropsychological programs have been recommended as a practice standard during post-acute rehabilitation in order to reduce cognitive and functional disability after moderate or severe brain injury. One major challenge of clinical research is to provide systematic data for the development of evidence-based neuropsychological rehabilitation. Rehabilitation after brain injury is concerned with reducing levels of disabil ity, either through restoration, or the use of adaptive and compensatory strategies. The goal of rehabilitation is not only the remediation of cognitive impairment, but mainly the establishment of a meaningfully and satisfactory life in face of persisting limitations. Outcomes may be assessed at the level of impairment, activity or participation. This study aims to evaluate the effi cacy of the Holistic Neuropsychological Rehabilitation Program (HNRP), held in Centro de Reabilitação Professional de Gaia in cognitive perform ance, emotional stability, functional ability and quality of life.
- Impacto de um programa holístico de reabilitação neuropsicológica na qualidade de vida de pessoas com lesão cerebral adquiridaPublication . Almeida, Isabel; Guerreiro, Sandra; Martins-Rocha, Benedita; Dores, Artemisa Rocha; Vicente, Selene G.; Barbosa, Fernando; Castro-Caldas, AlexandreA reabilitação após lesão cerebral adquirida (LCA) pretende aumentar a funcionalidade do indivíduo, promovendo a sua Qualidade de Vida (QdV). O objetivo deste estudo é avaliar o impacto de um programa holístico de reabilitação neuropsicológica (PHRN) nas dimensões da QdV. Participaram 20 pessoas com LCA, média de idades 30 anos (DP = 7.62). Os participantes foram avaliados pré e pós intervenção, com intervalo de seis meses, utilizando-se o Quality of Life After Brain Injury (QOLIBRI). Para a análise usamos o t-testpara amostras emparelhadas, com p corrigido para comparações múltiplas. Verificam-se resultados significativos após a intervenção em todas as dimensões: total [t(19) = -4.59, p < .001], cognitiva [t(19) = -2.31, p = .003], self[t(19) =-5.76, p < .001],AVD (atividades de vida diária)[t(19) = -3.18, p = .001], social[t(19) = -1.29, p = .001], emocional [t(19) = -1.85, p = .001], com exceção da dimensão físico [t(19) = -1.78, p = .01]. Os resultados sugerem que a intervenção com o PHRN promove a QdV das pessoas com LCA.
- Impacto de um programa holístico de reabilitação neuropsicológica na qualidade de vida de pessoas com lesão cerebral adquiridaPublication . Almeida, Isabel; Guerreiro, Sandra; Martins-Rocha, Benedita; Dores, Artemisa Rocha; Vicente, Seline G.; Barbosa, Fernando; Castro-Caldas, AlexandreAfter acquired brain injury (ABI) rehabilitation aims to increase the individual’s functio-nality promoting their Quality of Life (QoL). The main goal of this study was to evaluate the impact of a holistic neuropsychological rehabilitation program (HNRP) on quality of life dimensions. Twenty subjects with ABI participated, mean age 30 years (SD=7.62). Participants were assessed pre and post intervention, with a six months interval, using Quality of Life After Brain Injury (QOLIBRI) A paired-sample t-test was conducted for data analyzes, with corrected p for multiple comparisons. Significant results after inter-vention were observed at all dimensions: total [t(19) = -4.59, p < .001], cognitive [t(19) = -2.31, p = .003], self[t(19) =-5.76, p < .001],DLAs(daily life activities)[t(19) = -3.18, p = .001], social[t(19) = -1.29, p = .001], emotional [t(19) = -1.85, p = .001], except on physical [t(19) = -1.78, p = .01]. Results suggest that intervention, after ABI, with the HNRP improves patients’ QoL.
- Influence of clinical and psychosocial factors on the adherence to topical treatment in psoriasisPublication . Teixeira, Ana; Teixeira, Maribel; Gaio, Rita; Torres, Tiago; Magina, Sofia; Dinis, Maria Alzira Pimenta; Sousa-Lobo, José; Almeida, Isabel; Peixoto, Miguel; Almeida, VeraPsoriasis is a common chronic inflammatory skin disease with different manifestations, affecting the quality of life at social, emotional, and professional dimensions and requiring long-term treatment. This study aimed to investigate the effect of psychosocial and clinical factors on adherence to topical treatment in psoriasis. Self-reported measures and weighing the medicines were used to assess adherence. Psychopathological symptoms were measured using the Brief Symptoms Inventory (BSI). Social and clinical factors were assessed by a sociodemographic and clinical questionnaire. Adherence to treatment with topical medication was assessed using a sample of 102 psoriasis patients. The explanatory models of adherence to topical treatment in psoriasis translated into positive associations between adherence and the education level (higher education) (p = 0.03; φ = 0.23), the single-family household (p = 0.01; φ = 0.44), active employment status (p = 0.05; φ = −0.19), familiar history of psoriasis (p = 0.04; φ = −0.21), and the presence of obsessive-compulsive symptoms (p = 0.01; d = 0.29). (4) Conclusions: In patients who present the characteristics identified that influence non-adherence, instructions should be reinforced to increase adherence. The experimental mortality (39.6%) reduced the sample size, representing a limitation of the study.
- Neuropsychological assessment from traditional to ICT-based instrumentsPublication . Almeida, Isabel; Dores, Artemisa Rocha; Pinto, Paula; Guerreiro, Sandra; Barbosa, FernandoClinical Neuropsychology can be defined as the field of knowledge dedicated to the study of brain (dys)function in its relations to cognition, emotion and behavior. The development of this applied field is associated with the recognition, from several areas of knowledge, that people’s behaviors and reactions are dependent on brain structures (Stringer, Cooley, & Christensen, 2002). This idea had been present in medical practice for several epochs, but it has gradually diminished its presence under the influence of other beliefs. World War II prompted the growth of neuropsychology as a scientific discipline, and revival of interest in brain-behavior understanding (Camargo, Bolognani, & Zuccolo, 2008). The necessity to evaluate, diagnose and rehabilitate cognitive, emotional and behavioral disorders presented by brain injured soldiers constituted a crucial moment for clinical neuropsychological practices. It created large-scale demands for neuropsychological evaluations and rehabilitation programs, promoting the development of observational and experimental studies about brain (dys)functions, and refined examination and intervention methods. In the last decades, with the development of advanced neuroimaging techniques, the knowledge of biological and biochemical basis of brain structures has progressed the understanding of mechanisms underpinning our behaviors and thoughts. These techniques have been widely diffused and used for the detection and localization of brain damage areas (Buckner, Wheeler, & Sheridan, 2001). As a consequence neuropsychological assessment had to change it’s primarily goal and focus of interest away from an emphasis on helping to identify hypothesized lesion locations. It must now assist clinicians in understanding the extension and impact of cognitive, behavioral and socio-emotional consequences of brain injury on people’s life in an integrated basis with current advances (Camargo et al., 2008).
- Significance of virtual reality-based rehabilitation in acquired brain injuryPublication . Dores, Artemisa Rocha; Mendes, Liliana; Carvalho, Irene P.; Guerreiro, Sandra; Almeida, Isabel; Barbosa, FernandoRecent research has shown the potential of Virtual Reality (VR) in the field of rehabilitation, namely neurocognitive rehabilitation. This technology will certainly revolutionize the rehabilitation of the future. Its advantages include greater ecological validity than conventional rehabilitation methods, provision of safe contexts for learning/training, the possibility of programs to be contingent on patient performance, with increasing levels of task difficulty and provision of immediate feedback, and the use of a “game factor” that promotes motivation for participation. These are important aspects in the rehabilitation of patients with acquired brain injury. Patients with this and other types of neurological injuries endure cognitive deficits that cause difficulties in independent functioning and daily-life activities. Their rehabilitation calls for systematic intervention programs that are theoretically grounded and use innovative approaches to their advantage. In this paper we present a review about the advantages of VR in the generalization of acquired skills to real-life contexts, to promote patients' functionality and quality of life, and propose an innovative program of neurocognitive rehabilitation. Research in the field shows positive effects of VR programs, but urges progress in terms of the development of techniques (e.g., facial synthesis and of more research on the impact of these interventions. Future studies should also explore the existence of neuro-anatomical correlates of behavioral changes, contributing to the investigation of the relationship between neural plasticity and behavior and providing evidence for clinical practice.