Browsing by Author "Moreira, Juliana"
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- 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.
- Electrodermal activity wrist-based systems: A review of validity, reliability, and responsive measuresPublication . Félix, José; Moreira, Juliana; Santos, Rubim; Sousa, AndreiaElectrodermal activity (EDA) can be defined as an electrical property of the skin, measured in the palm and sole, related to the level of conductivity, influenced by the sweat level that may depend on various stimuli. Different equipments have been used to capture EDA with high levels of reliability, validity, and responsiveness, however these values vary according to the site of measurement. The increased use of EDA wrist-based systems highlights the need of characterizing the psychometric properties of these kind of systems. The aim of this chapter is to review the validity, reliability, and responsiveness of EDA measurement in the wrist. Previous studies have demonstrated that wrist measurement present low to moderate correlations, against the gold standard systems, with moderate levels of responsiveness, while no study addressed reliability. Wrist EDA measurement could be therefore an acceptable option, however, more studies are demanded not only to assess related values of reliability, as well to best characterize validity and responsiveness measures.
- Health-related telemonitoring parameters/signals of older adults: An umbrella reviewPublication . Félix, José; Moreira, Juliana; Santos, Rubim; Kontio, Elina; Pinheiro, Ana Rita; Sousa, Andreia S. P.Aging is one of the greatest challenges in modern society. The development of wearable solutions for telemonitoring biological signals has been viewed as a strategy to enhance older adults’ healthcare sustainability. This study aims to review the biological signals remotely monitored by technologies in older adults. PubMed, the Cochrane Database of Systematic Reviews, the Web of Science, and the Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports were systematically searched in December 2021. Only systematic reviews and meta-analyses of remote health-related biological and environmental monitoring signals in older adults were considered, with publication dates between 2016 and 2022, written in English, Portuguese, or Spanish. Studies referring to conference proceedings or articles with abstract access only were excluded. The data were extracted independently by two reviewers, using a predefined table form, consulting a third reviewer in case of doubts or concerns. Eighteen studies were included, fourteen systematic reviews and four meta-analyses. Nine of the reviews included older adults from the community, whereas the others also included institutionalized participants. Heart and respiratory rate, physical activity, electrocardiography, body temperature, blood pressure, glucose, and heart rate were the most frequently measured biological variables, with physical activity and heart rate foremost. These were obtained through wearables, with the waist, wrist, and ankle being the most mentioned body regions for the device’s placement. Six of the reviews presented the psychometric properties of the systems, most of which were valid and accurate. In relation to environmental signals, only two articles presented data on this topic. Luminosity, temperature, and movement were the most mentioned variables. The need for large-scale long-term health-related telemonitoring implementation of studies with larger sample sizes was pointed out by several reviews in order to define the feasibility levels of wearable devices.
- Interlimb coordination during double support phase of gait in people with and without strokePublication . Couto, Ana G. B.; Vaz, Mário A. P.; Pinho, Liliana; Félix, José; Moreira, Juliana; Pinho, Francisco; Mesquita, Inês; Mesquita Montes, António; Crasto, Carlos; Sousa, AndreiaThis study aims to identify differences between participants with and without stroke regarding the ipsilesional and contralesional lower limbs kinematics, kinetics, muscle activity and their variability during double support phase of gait. Eleven post-stroke and thirteen healthy participants performed 10 gait trials at a self-selected speed while being monitored by an optoelectronic motion capture system, two force plates and an electromyographic system. The following outcomes were evaluated during the double support: the time and the joint position; the external mechanical work on the centre of mass; and the relative electromyographic activity. Both, contralesional/ipsilesional and dominant/non-dominant of participants with and without stroke, respectively, were evaluated during double support phase of gait in trailing or leading positions. The average value of each parameter and the coefficient of variation of the 10 trials were analysed. Post-stroke participants present bilateral decreased mechanical work on the centre of mass and increased variability, decreased contralesional knee and ankle flexion in trailing position, increased ipsilesional knee flexion in leading position and increased variability. Increased relative muscle activity was observed in post-stroke participants with decreased variability. Mechanical work on the centre of mass seems to be the most relevant parameter to identify interlimb coordination impairments in post-stroke subjects.
- Optimal multi-field functional electrical stimulation parameters for the “drinking task - reaching phase” and related upper limb kinematics repeatability in post stroke subjectsPublication . Sousa, Andreia; Silva, Cláudia; Mesquita, Inês Albuquerque; Silva, Augusta; Macedo, Rui; Imatz-Ojanguren, Eukene; Hernandez, Erik; Keller, Thierry; Moreira, Juliana; Fonseca, Pedro Filipe Pereira da; Santos, RubimNo specific guidelines for the management of functional electrical stimulation (FES) parameters in post stroke patients have been defined yet, despite its frequent use. The purpose of this study is to characterize the optimal FES parameters that assist the reaching phase of drinking task (“drinking task - reaching phase”) on post stroke subjects and to analyze the related upper limb (UL) movement quality indicators repeatability. Methods: An observational study with a test and re-test design involving ten post stroke subjects with UL dysfunction was performed. End-point and joint kinematics of contralesional UL were assessed during the “drinking task - reaching phase” with FES through a test and retest design. FES parameters were adjusted to improve UL function according to a consensus between physiotherapists‟ and patients‟ perspective. Findings: It was possible to establish reliable FES parameters that assisted the “drinking task - reaching phase”. All FES parameters presented high to very high repeatability and led to moderate to very high repeatability in almost UL movement quality indicators during the “drinking task - reaching phase”. Interpretation: These findings show that the main characteristics of FES parameters that improves patient perception of change are quiet stable, which facilitate its implementation in clinical practice by allowing consistence between intervention sessions.
- Optimal multi-field functional electrical stimulation parameters for the “Turn on the Light” task and related upper limb kinematics repeatability in post stroke subjectsPublication . Sousa, Andreia; Mesquita, Inês Albuquerque; Silva, Cláudia; Silva, Augusta; Macedo, Rui; Imatz-Ojanguren, Eukene; Hernandez, Erik; Keller, Thierry; Moreira, Juliana; Filipe Pereira da Fonseca, Pedro; Santos, RubimTo characterize the optimal Functional Electrical Stimulation (FES) parameters that assist the “turn on the light” task (TOTL) on post stroke participants and to analyze the related upper limb (UL) kinematics repeatability.
- Postural control during turn on the light task assisted by functional electrical stimulation in post stroke subjectsPublication . Sousa, Andreia S. P.; Moreira, Juliana; Silva, Cláudia; Mesquita, Inês; Silva, Augusta; Macedo, Rui; Santos, RubimPostural control mechanisms have a determinant role in reaching tasks and are typically impaired in post-stroke patients. Functional electrical stimulation (FES) has been demonstrated to be a promising therapy for improving upper limb (UL) function. However, according to our knowledge, no study has evaluated FES infuence on postural control. This study aims to evaluate the infuence of FES UL assistance, during turning on the light task, in the related postural control mechanisms. An observational study involving ten post-stroke subjects with UL dysfunction was performed. Early and anticipatory postural adjustments (EPAs and APAs, respectively), the weight shift, the center of pressure and the center of mass (CoM) displacement were analyzed during the turning on the light task with and without the FES assistance. FES parameters were adjusted to improve UL function according to a consensus between physiotherapists’ and patients’ perspectives. The ANOVA repeated measures, Paired sample t and McNemar tests were used to compare postural control between the assisted and non-assisted conditions. When the task was assisted by FES, the number of participants that presented APAs increased (p= 0.031). UL FES assistance during turning on the light task can improve postural control in neurological patients with UL impairments.
- Powered smart textile-based exoskeleton for human support movementPublication . Ferreira, C.; Fertuzinhos, A.; Silva, R.; Ramalho, M.; Vale, B.; Silva, J.; Costa, L.; Oliveira, C.; Ramôa, A.; Aguiar, F.; Pilastri, A.; Matta, A.; Dias, P.; Sampaio, R.; Machado, D.; Costa, M.; Roças, A.; Madureira, P.; Moreira, Juliana; Pereira, J. R.; Pereira, C.; Pereira, F. B.Industrial environments require people’s physical efforts related to excessive force, poor posture, and repetitive tasks that increase the risk of developing musculoskeletal diseases. Due to the high prevalence of postural complaints and consequent global health burdens, a significant demand has been conducted to build and implement powered lower and upper limb devices for human enhancement, considering the working layout/position, anthropometric and ergonomic data to generate valuable information for posture correction guidance.
- Repeatability and temporal consistency of lower limb biomechanical variables expressing interlimb coordination during the double-support phase in people with and without stroke sequelaePublication . Couto, Ana G. B.; Vaz, Mário A. P.; Pinho, Liliana; Félix, José; Moreira, Juliana; Pinho, Francisco; Mesquita, Inês Albuquerque; Mesquita Montes, António; Crasto, Carlos; Sousa, AndreiaReliable biomechanical methods to assess interlimb coordination during the double-support phase in post-stroke subjects are needed for assessing movement dysfunction and related variability. The data obtained could provide a significant contribution for designing rehabilitation programs and for their monitorisation. The present study aimed to determine the minimum number of gait cycles needed to obtain adequate values of repeatability and temporal consistency of lower limb kinematic, kinetic, and electromyographic parameters during the double support of walking in people with and without stroke sequelae. Eleven post-stroke and thirteen healthy participants performed 20 gait trials at self-selected speed in two separate moments with an interval between 72 h and 7 days. The joint position, the external mechanical work on the centre of mass, and the surface electromyographic activity of the tibialis anterior, soleus, gastrocnemius medialis, rectus femoris, vastus medialis, biceps femoris, and gluteus maximus muscles were extracted for analysis. Both the contralesional and ipsilesional and dominant and non-dominant limbs of participants with and without stroke sequelae, respectively, were evaluated either in trailing or leading positions. The intraclass correlation coefficient was used for assessing intra-session and inter-session consistency analysis. For most of the kinematic and the kinetic variables studied in each session, two to three trials were required for both groups, limbs, and positions. The electromyographic variables presented higher variability, requiring, therefore, a number of trials ranging from 2 to >10. Globally, the number of trials required inter-session ranged from 1 to >10 for kinematic, from 1 to 9 for kinetic, and 1 to >10 for electromyographic variables. Thus, for the double support analysis, three gait trials were required in order to assess the kinematic and kinetic variables in cross-sectional studies, while for longitudinal studies, a higher number of trials (>10) were required for kinematic, kinetic, and electromyographic variables.
- Repetibilidade das variáveis relacionadas com o deslocamento de centro de pressão na posição de pé em jovens adultasPublication . Sousa, Andreia; Santos, Rubim; Moreira, Juliana; Félix, JoséA variáveis relacionadas com a deslocamento do centro de pressão têm sido utilizadas como indicadores de erro e efetividade dos mecanismos de controlo postural. Entre as diferentes formas para aceder a este tipo de variáveis, o sistema Biodex Balance System (Biodex MedicalSystems, Shirley, NY) (BBS) destaca-se pela sua facilidade de utilização em contexto clínico. Tendo em consideração o potencial deste sistema para acompanhar a evolução face a reabilitação, torna-se relevante avaliar a repetibilidade das variáveis obtidas e a sua relação com o número de medições. Avaliar repetibilidade das variáveis mensuradas pelo BBS na posição de pé e a sua relação com o número de medições em jovens adultas saudáveis.