Browsing by Author "Melo, Ana"
Now showing 1 - 5 of 5
Results Per Page
Sort Options
- Differences in trapezius muscle h-reflex between asymptomatic subjects and symptomatic shoulder pain subjectsPublication . Melo, Ana; Taylor, Janet L.; Ferreira, Ricardo; CUNHA, BRUNO; Ascenção, Manuel; Sousa, Vítor; Cruz, Eduardo B.; Vilas-Boas, J. Paulo; Sousa, Andreia S. P.In chronic shoulder pain, adaptations in the nervous system such as in motoneuron excitability, could contribute to impairments in scapular muscles, perpetuation and recurrence of pain and reduced improvements during rehabilitation. The present cross-sectional study aims to compare trapezius neural excitability between symptomatic and asymptomatic subjects. In 12 participants with chronic shoulder pain (symptomatic group) and 12 without shoulder pain (asymptomatic group), the H reflex was evoked in all trapezius muscle parts, through C3/4 nerve stimulation, and the M-wave through accessory nerve stimulation. The current intensity to evoke the maximum H reflex, the latency and the maximum peak-to-peak amplitude of both the H reflex and M-wave, as well as the ratio between these two variables, were calculated. The percentage of responses was considered. Overall, M-waves were elicited in most participants, while the H reflex was elicited only in 58–75% or in 42–58% of the asymptomatic and symptomatic participants, respectively. A comparison between groups revealed that the symptomatic group presented a smaller maximum H reflex as a percentage of M-wave from upper trapezius and longer maximal H reflex latency from the lower trapezius (p < 0.05). Subjects with chronic shoulder pain present changes in trapezius H reflex parameters, highlighting the need to consider trapezius neuromuscular control in these individuals’ rehabilitation.
- Effectiveness of specific scapular therapeutic exercises in patients with shoulder pain: a systematic review with meta-analysisPublication . Melo, Ana; Moreira, Juliana; Afreixo, Vera; Gonçalves, Daniel Moreira; Donato, Helena; Cruz, Eduardo B.; Vilas-Boas, J. Paulo; Sousa, AndreiaTherapeutic exercise has been considered a useful tool to rehabilitate shoulder pain, namely through its influence on scapular dynamics. Accordingly, the effectiveness of scapular therapeutic exercise needs to be explored. The present study aims to evaluate the effectiveness of scapular therapeutic exercises in shoulder pain and to identify the most effective exercise type (focal or multijoint) and ways of delivering them (as dose and progression). Search was conducted at EMBASE, Cochrane Library, MEDLINE via PubMed, Web of Science, PEDro (Physiotherapy Evidence Database), and trial registration databases. The meta-analysis considered randomized controlled/crossover trials that compared the effect of scapular exercises against other types of intervention in the shoulder pain, shoulder function, scapular motion, and/or muscular activity. The risk of bias was assessed through the PEDro scale. From the 8318 records identified, 8 (high to low risk of bias– scoring from 4 to 8 on the PEDro scale) were included. The overall data, before sensitivity analysis, indicated that the scapular therapeutic exercises are: a) more effective than comparators in improving shoulder function (standardized mean difference [SMD] = 0.52 [95% Cl: 0.05, 0.99], P = .03, I2 = 76%); and b) as effective as comparators in reducing shoulder pain (SMD = 0.32 [95% Cl: −0.09, 0.73], P = .13, I2 = 70%). Subgroup analysis revealed that scapular exercises are more effective in improving shoulder function when the program duration is equal to or higher than 6 weeks (SMD = 0.43 [95% Cl: 0.09, 0.76] P = .01, I2 = 21%) and/or when the maximum number of exercise repetitions per session is lower than 30 (SMD = 0.79 [95% Cl: 0.15, 1.42], P = .01, I2 = 77%). Only 1 study considered scapular motion as an outcome measure, revealing therapeutic exercise effectiveness to improve scapular range of motion. Intervention programs involving scapular therapeutic exercises are effective in improving shoulder function, presenting benefits when performed for 6 or more weeks and/or when used up to a maximum of 30 repetitions per exercise, per session.
- Indicators and instruments to assess components of disability in community-dwelling older adults: a systematic reviewPublication . Moreira, Juliana Santos; Melo, Ana; Santos, Rubim; Pinheiro De Sousa, Andreia SofiaThe epidemiological demands of aging point to the need for characterizing older adults regarding health and disability. This systematic review aims to summarize the indicators (instruments) identifying different components of disability as a result of aging exposition in community-dwelling older adults, considering the International Classification of Functioning, Disability, and Health framework. Taking the PRISMA 2020 recommendations as a reference, studies with community-dwelling older adults, reporting the development and/or age disability modifications were included. Two reviewers analyzed the observational studies searched in the MEDLINE, CINAHL, Web of Science, Scopus, and Embase databases. Of the 137 potentially eligible studies, 49 were included in this review. Several indicators (instruments) demonstrated older adults’ disabilities according to the different domains of the ICF. Objective measures assessed Body Structures, Body Functions, and Environmental Factors and included handgrip strength (dynamometry, n = 8), cognitive function (Mini-Mental State examination, n = 7), gait speed (walk test, n = 6), and endurance (Chair stand-test, n = 4). Self-reported measures assessed Activities and Participation, but not the Body Structures, and included the basic and instrumental activities of daily living (ADL) (the Katz Index of ADL, n = 4 studies, the Lawton and Brody Instrumental ADL, n = 4 studies). The summary of the measures gathered can guide researchers and health professionals to select indicators (instruments) to assess and monitor older adults’ disabilities resulting from aging exposition, to support the development of new wearables, and to provide improvements to the existing ones, allowing the tailored assessment of different health and disability dimensions.
- Scapular motor control and upper limb movement quality in subjects with and without chronic shoulder painPublication . Melo, Ana; C. Guedes, Diana; Matias, Ricardo; Cruz, Eduardo B.; Vilas-Boas, J. Paulo; Sousa, AndreiaDespite the existence of several studies about the scapula’s position and motion, in shoulder pain conditions, there are still conflicting findings regarding scapular adaptations and reduced research about the scapula’s role during functional tasks. The present study aimed to compare scapular-related kinematic and electromyographic outcomes during different shoulder movements (with and without load) and the drinking task, between symptomatic and asymptomatic subjects. Forty subjects (divided into two groups) participated in this cross-sectional observational study. Scapulothoracic motion, scapulohumeral rhythm, and movement quality (considering trunk compensation, time-to-peak acceleration, and smoothness), as well as the relative surface electromyographic activity and muscle ratio considering the trapezius, serratus anterior, and levator scapulae (LS), were assessed. The symptomatic group presented the following: (1) changes in scapular upward rotation (p = 0.008) and winging (p = 0.026 and p = 0.005) during backward transport and drink phases; (2) increased muscle activity level of the middle trapezius (MT) in all tasks (p < 0.0001 to p = 0.039), of LS during shoulder elevation with load (p = 0.007), and of LS and LT during most of the drinking task phases (p = 0.007 to p = 0.043 and p < 0.0001 to p = 0.014, respectively); (3) a decreased serratus anterior lower portion activity level (SAlow) during shoulder lowering with load (p = 0.030) and drink phase (p = 0.047); and (4) an increased muscular ratio between scapular abductors/adductors (p = 0.005 to p = 0.036) and elevators/depressors (p = 0.008 to p = 0.028). Compared to asymptomatic subjects, subjects with chronic shoulder pain presented scapular upward rotation and winging adaptations; increased activity levels of MT, LT, and LS; decreased activity levels of SAlow; and increased scapular muscle ratios.
- The influence of artificial breast volume induction on postural stability, postural orientation, and neuromuscular control in healthy women: a cross-sectional studyPublication . Guedes, Diana C.; Carneiro, Daniela Ferreira; Alves, Leonel Agostinho Teixeira; Melo, Ana S. C.; Moreira, Juliana; Cunha, Bruno; Santos, Rubim; Noites, Andreia; Sousa, Andreia S. P.; C. Guedes, Diana; Melo, Ana; Santos Moreira, Juliana; Cunha, Bruno; Rubim Silva Santos, Manuel; Noites, Andreia; Pinheiro de Sousa, Andreia SofiaThe percentage of breast augmentations has increased in recent years alongside the frequency of implant removals. Musculoskeletal and postural disorders are often overlooked during this removal process. Research indicates that excess anterior load from breast implants can disrupt postural control and potentially lead to short- or long-term musculoskeletal dysfunction. This study aims to evaluate the immediate changes in postural control after artificial breast augmentation in healthy female volunteers. Spinal angles, the center of pressure (CoP), and electromyographic activity of the spinal muscles were recorded in the static position and during the functional reach test (FRT) without and with implants of different volumes (220 mL, 315 mL, and 365 mL). Subjective perceptions of effort, comfort, weight, and performance in the FRT were also assessed. Statistical differences were significant in the scapular elevator during the one-minute standing position (lower activation with the 220 mL implant compared to the control and 315 mL) and in the trapezius muscles during the FRT (lower activation in the upper trapezius in the 315 mL vs. control in the reach phase and 220 mL vs. control in the return phase and higher activation in the lower trapezius in the 315 and 365 mL vs. control in the reach phase). Additionally, significant differences were identified in the performance of the FRT and the associated subjective perceptions. Breast implants with sizes of 220, 315, and 365 mL can alter scapular neuromuscular control, but these differences do not seem substantial enough to result in negative biomechanical effects in the short-term analysis.