Browsing by Author "Cunha, Christine"
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- Antagonist coactivation of muscles of ankle and thigh in post-stroke vs. healthy subjects during sit-to-stand taskPublication . Pinho, Liliana; Sousa, Andreia S. P.; Silva, Cláudia; Cunha, Christine; Santos, Rubim; Tavares, João Manuel R. S.; Pereira, Soraia; Pinheiro, Ana Rita; Félix, José; Pinho, Francisco; Sousa, Filipa; Silva, AugustaThis study aims to analyse the coactivation of antagonist muscles of the thigh and ankle during the sit-to-stand task in post-stroke subjects, specifically during forward and antigravity sub-phases. A group of 18 healthy subjects and another with 18 subjects with a history of stroke participated voluntarily in this study. Bilateral surface electromyography (EMGs) of the soleus, gastrocnemius medialis, tibialis anterior, rectus femoris and biceps femoris muscles were collected synchronously with ground reaction forces (GRF) during the sit-to-stand task. The magnitude of electromyographic (EMG) activity was analysed during forward translation and antigravity sub-phases which were determined through GRF signals. The coactivation was calculated to quantify the degree of antagonist coactivation according to the role of the muscles during the task. Statistically significant values were found between antagonist coactivation on both sub-phases of the sit-to-stand task when comparing healthy and post-stroke subjects (healthy with ipsilesional (IPSI); healthy with contralesional (CONTRA); and healthy with IPSI and with CONTRA limbs) in all muscle pairs analysed (p < 0.01), except on thigh muscles (p > 0.05), in the antigravity sub-phase. When comparing IPSI with CONTRA sides in post-stroke subjects, no statistically significant differences were found. Increased values of antagonist coactivation were observed in post-stroke subjects compared to healthy subjects (both IPSI and CONTRA limb) in the two sub-phases analysed. The forward sub-phase CONTRA limb showed higher antagonist coactivation compared to IPSI, while in the antigravity sub-phase, IPSI antagonist coactivation was higher than in the CONTRA. In conclusion, post-stroke subjects presented an antagonist coactivation more dysfunctional at the ankle joint muscles compared to the thigh segment. So, it seems that the distal segment could express more accurately the central nervous system dysfunction in post-stroke subjects, despite the need for further studies to achieve a better spatiotemporal understanding of the variability on coactivation levels.
- Clinical measures for tone assessment in adults with central nervous system disorders—A scoping review in a rehabilitation contextPublication . Pinho, Liliana; Silva, Sandra; Freitas, Marta; Figueira, Vânia; Pinho, Francisco; Cunha, Christine; Sousa, Andreia S. P.; Sousa, Filipa; Silva, AugustaAssessment of muscle tone in a clinical setting is important for the physiotherapist to better analyse and establish appropriate treatments for CNS disorders. This study aims to review and summarise how to assess changes in tone in the context of adult rehabilitation. Secondarily, this study aimed to identify the central nervous system disorders, the respective variable/concept under study, and the testing procedures employed. PRISMA-ScR guidelines were followed using the “population”, “concept”, and “context” to define the eligibility criteria and to delineate the research question. PubMed®, Science Direct®, Web of Science™, and Google Scholar® databases were used to search the literature. The search included studies published between 2011 and March 2023 in Portuguese, English, French, and Spanish that assessed an adult population (>19 years) with CNS injury. Review articles, qualitative studies, conference proceedings, letters to the editor, and editorials were excluded. Initially, 1519 references were identified, of which eight met the eligibility criteria. The measurement instruments included the Modified Ashworth Scale (n = 5), the Modified Modified Ashworth Scale (n = 3), the BioTone™ system (n = 2), the Montreal Spasticity Measurement (n = 1), and the Tone Evaluation Scale (n = 1). The health conditions considered included stroke sequelae (n = 7), multiple sclerosis (n = 4), spinal cord injuries (n = 4), cerebral palsy (n = 2), brain tumour (n = 2), and traumatic brain injuries (n = 3). The concepts of spasticity (n = 7) and muscle tone (n = 2) were explored. Considering the variables spasticity and muscle tone in different CNS disorders, mainly stroke, subjective instruments were preferred compared to objective ones, with the Modified Ashworth Scale being highlighted.
- Disfunção do Movimento em Condições Neurológicas: Avaliação e Interpretação para a Intervenção em FisioterapiaPublication . Silva, Augusta; Sousa, Andreia; Cunha, Christine; Ferreira, Rosália; Pereira, Soraia; Silva, CláudiaE-book de estudo com casos clínicos
- Immediate effects of myofascial induction of quadratus lumborum in postural orientation of standing asymptomatic subjectsPublication . Pinheiro, Ana Rita; Cunha, Christine; Fernandes, Ana Rita; Pastilha, Tiago; Nuno, Vanessa Catarino; Crasto, Carlos; Silva, Cláudia; Santos, Rubim; Carvalho, PauloStanding represents a challenging posture that requires upright orientation of body segments (Winter 1995). The thoracolumbar fascia (TLF), a complex network of fascial layers that establishes a direct relationship with several trunk muscles (Willard et al 2012), might be a privileged structure to influence standing posture, either by the direct transmission of forces to the muscle fibers (Turrina et al 2013; Willard et al 2012), influencing its tension, or by the inputs to the central nervous system, ultimately influencing body schema and motor control. Therefore, this study aimed at analyzing the immediate effects of a myofascial induction technique over TLF on the postural orientation of asymptomatic standing subjects.
- Immediate effects of suboccipital myofascial induction on postural stability: a pilot studyPublication . Pinheiro, Ana Rita; Faria, Ana; Mesquita Montes, António; Crasto, Carlos; Silva, Cláudia; Carvalho, Paulo; Santos, Rubim; Cunha, ChristineStanding is a constant postural challenge due to high position of the center of mass regarding the small size of base of support. Somatosensory, vestibular and visual inputs are crucial to preserve the upright orientation and stability]
- Reorganização dos componentes neuro-motores com influência na marcha em indivíduos com lesão do sistema nervoso centralPublication . Cunha, Christine; Silva, Augusta; Moreira, Camilo; Santos, Rubim; Silva, CláudiaVerificar a influência de um programa de intervenção em fisioterapia na actividade muscular do membro inferior predominantemente comprometido em indivíduos com lesão do sistema nervoso central ao longo das sub-fases da fase de apoio do ciclo da marcha, na fase de aceleração da componente Fy e sua respectiva contribuição muscular.
- Reorganização dos componentes neuro-motores com influência na marcha em indivíduos com lesão do sistema nervoso central - impacto funcionalPublication . Cunha, Christine; Silva, Cláudia C.Objectivo: Avaliar o impacto qualitativo de um programa de intervenção em fisioterapia, segundo o Conceito de Bobath, nas actividades e participação de dois indivíduos com lesão do Sistema Nervoso Central. Avaliar as modificações no comportamento da actividade muscular ao longo da fase de apoio do ciclo da marcha, na força de reacção ao solo e respectiva contribuição muscular. Metodologia: A avaliação realizou-se antes e após um programa de intervenção, segundo a abordagem do Conceito de Bobath, através da Classificação Internacional de Funcionalidade, Incapacidade e Saúde, electromiografia, plataforma de forças e máquina fotográfica. Resultados: Obteve-se melhorias na restrição da participação e na limitação da actividade. Verifica-se uma tendência de modificação do comportamento muscular ao longo da fase de apoio e na componente antero-posterior (Fy), mais evidente no mecanismo de aceleração. A mudança na contribuição muscular para a este mecanismo é mais evidente. Conclusão: O programa de intervenção, segundo o Conceito de Bobath, induziu mudanças positivas quanto à funcionalidade dos indivíduos, reflectindo-se na possibilidade de reorganização dos componentes neuro-motores em indivíduos com lesão do Sistema Nervoso Central.
- Stroke rehabilitation and research: consideration of the role of the cortico-reticulospinal systemPublication . Silva, Augusta; Vaughan-Graham, Julie; Silva, Claudia; Pinheiro De Sousa, Andreia Sofia; Cunha, Christine; Ferreira, Rosália; Barbosa, Pedro MacielA cerebrovascular accident, otherwise known as stroke, has the potential to damage multiple areas within the brain affecting descending motor control via a multitude of pathways resulting in a wide variety of movement problems. The cortico-reticulospinal system, one of the largest motor systems, is frequently affected, compromising its output, resulting in postural control deficits. The identification of clinically relevant instruments and scales to document and evaluate recovery in post-stroke patients is vital. However, the availability of such measures and scales which take into consideration the role of postural control as an integral component of functional movement performance are scarce. This paper will critically discuss the importance of integrating current neuroscience and motor control knowledge in order to better understand and describe the clinical presentation of persons post-stroke such that the effectiveness of stroke rehabilitation can be appropriately measured.