Browsing by Author "Freitas, Marta"
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- Biomechanical assessment methods used in chronic stroke: A scoping review of non-linear approachesPublication . Freitas, Marta; Pinho, Francisco; Pinho, Liliana; Silva, Sandra; Figueira, Vânia; Vilas-Boas, João Paulo; Silva, AugustaNon-linear and dynamic systems analysis of human movement has recently become increasingly widespread with the intention of better reflecting how complexity affects the adaptability of motor systems, especially after a stroke. The main objective of this scoping review was to summarize the non-linear measures used in the analysis of kinetic, kinematic, and EMG data of human movement after stroke. PRISMA-ScR guidelines were followed, establishing the eligibility criteria, the population, the concept, and the contextual framework. The examined studies were published between 1 January 2013 and 12 April 2023, in English or Portuguese, and were indexed in the databases selected for this research: PubMed®, Web of Science®, Institute of Electrical and Electronics Engineers®, Science Direct® and Google Scholar®. In total, 14 of the 763 articles met the inclusion criteria. The non-linear measures identified included entropy (n = 11), fractal analysis (n = 1), the short-term local divergence exponent (n = 1), the maximum Floquet multiplier (n = 1), and the Lyapunov exponent (n = 1). These studies focused on different motor tasks: reaching to grasp (n = 2), reaching to point (n = 1), arm tracking (n = 2), elbow flexion (n = 5), elbow extension (n = 1), wrist and finger extension upward (lifting) (n = 1), knee extension (n = 1), and walking (n = 4). When studying the complexity of human movement in chronic post-stroke adults, entropy measures, particularly sample entropy, were preferred. Kinematic assessment was mainly performed using motion capture systems, with a focus on joint angles of the upper limbs.
- 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.
- European Portuguese version of the Mini-BESTest: a cross-cultural adaptation and psychometric measurements in individuals with sensorimotor impairmentsPublication . Freitas, Marta; Pinho, Francisco; Cruz-Martins, Natália; Pinho, Liliana; Silva, Sandra; Figueira, Vânia; Vilas-Boas, João Paulo; Silva, Augusta; Ferreira Silva, Maria AugustaThis study aimed to translate and cross-culturally adapt the Mini-BESTest into European Portuguese and to evaluate its psychometric properties in individuals with sensorimotor impairments. A cross-sectional cross-cultural adaptation and validation study was conducted according to the COSMIN guidelines and the STROBE statement. The study included 100 participants with sensorimotor impairments who were able to walk 6 m. Cronbach’s alpha and item-total correlations were used to assess internal consistency. Interpretability was assessed by examining floor and ceiling effects and skewness. To investigate construct validity, Spearman correlation coefficients and Bland-Altman analysis were performed to compare the Berg Balance Scale and the Mini-BESTest Inter- and intra-rater reliability were assessed by calculating the ICC, SEM and MDC based on video recordings of the participants during the Mini-BESTest assessments. The European Portuguese Mini-BESTest showed good internal consistency (Cronbach’s α = 0.892) and no significant floor or ceiling effects. Excellent inter- and intra-rater reliability (ICC = 0.97) were also demonstrated, with MDC of 2.58 and 2.57, respectively. Furthermore, this instrument showed a significant correlation with the BBS (r = 0.902). Bland-Altman analysis showed small absolute differences. The European Portuguese Mini-BESTest is comparable to the original English version in terms of validity and reliability and is therefore highly recommended for use by Portuguese-speaking professionals to assess postural control.
- Medidas de avaliação motora em indivíduos após AVC nas fases aguda e sub-aguda – scoping reviewPublication . Freitas, Marta; Pinho, Francisco; Pinho, Liliana; Figueira, Vânia; Silva, Sandra; Sousa, Andreia; Silva, AugustaAs alterações biomecânicas nos indivíduos após Acidente Vascular Cerebral (AVC) podem ser avaliadas em contexto clínico, com recurso a testes e escalas validadas, ou em contexto laboratorial através de uma análise instrumentada quantitativa e objetiva. Identificar e sumariar os instrumentos de avaliação, e respetivas tarefas motoras, utilizados na análise do movimento humano, nas fases aguda e subaguda recente, após AVC. Seguiu-se o protocolo PRISMA Extension for Scoping Reviews(PRISMA-ScR) e a estratégia “população”, “conceito” e “contexto” (PCC), para a definição da questão de pesquisa nas bases de dados PubMed®, Science Direct®, Web of Science®e Google Scholar®. Incluíram-se estudos publicados entre 2018 e 2022, em português e inglês, que descrevessem os instrumentos de avaliação clínicos e laboratoriais utilizados, e a tarefa motora associada, em indivíduos >19 anos, considerando até 3 meses após AVC. Excluíram-se artigos de revisão, estudos qualitativos, conference proceedings, cartas ao editor e editoriais. Foram selecionados 302 artigos, dos quais 15 foram elegíveis. A marcha (n=9), o sit to stand(n=2) e funções relacionadas com o membro superior(n=4) foram avaliadas por diferentes instrumentos clínicos (Functional Ambulation Categories; Functional Independence Measure; Fulgl-Meyer Assessment;) e laboratoriais (sistemas de captura de imagem (VICON, EXFH20, GoPro Hero5); plataformas de forças AMTI INc e AccuGait®). O Functional Ambulation Categoriese a Fulgl-Meyer Assessmentforam os instrumentos mais aplicados na análise clínica e o sistema de captura de imagem VICON na análise cinemática quantitativa. A tarefa motora mais estudada foi a marcha. Dada a evolução da tecnologia na procura de soluções viáveis para a tomada de decisão em contexto de reabilitação, sugerem-se estudos que privilegiam a avaliação em contexto real.
- Wearables for monitoring and postural feedback in the work context: A scoping reviewPublication . Figueira, Vânia; Silva, Sandra; Costa, Inês; Campos, Bruna; Salgado, João; Pinho, Liliana; Freitas, Marta; Carvalho, Paulo; Marques, João; Pinho, FranciscoWearables offer a promising solution for simultaneous posture monitoring and/or corrective feedback. The main objective was to identify, synthesise, and characterise the wearables used in the workplace to monitor and postural feedback to workers. The PRISMA-ScR guidelines were followed. Studies were included between 1 January 2000 and 22 March 2023 in Spanish, French, English, and Portuguese without geographical restriction. The databases selected for the research were PubMed®, Web of Science®, Scopus®, and Google Scholar®. Qualitative studies, theses, reviews, and meta-analyses were excluded. Twelve studies were included, involving a total of 304 workers, mostly health professionals (n = 8). The remaining studies covered workers in the industry (n = 2), in the construction (n = 1), and welders (n = 1). For assessment purposes, most studies used one (n = 5) or two sensors (n = 5) characterised as accelerometers (n = 7), sixaxial (n = 2) or nonaxial inertial measurement units (n = 3). The most common source of feedback was the sensor itself (n = 6) or smartphones (n = 4). Haptic feedback was the most prevalent (n = 6), followed by auditory (n = 5) and visual (n = 3). Most studies employed prototype wearables emphasising kinematic variables of human movement. Healthcare professionals were the primary focus of the study along with haptic feedback that proved to be the most common and effective method for correcting posture during work activities.