Browsing by Author "Santos, Rita"
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- Abdominal muscle activity during breathing in different postural sets in healthy subjectsPublication . Mesquita Montes, António; Gouveia, Sara; Crasto, Carlos; Melo, Cristina; Carvalho, Paulo; Santos, Rita; Vilas-Boas, João PauloThis study aims to evaluate the effect of different postural sets on abdominal muscle activity during breathing in healthy subjects. Twenty-nine higher education students (20.86 ± 1.48 years; 9 males) breathed at the same rhythm (inspiration: 2 s; expiration: 4 s) in supine, standing, tripod and 4-point-kneeling positions. Surface electromyography was performed to assess the activation intensity of rectus abdominis, external oblique and transversus abdominis/internal oblique muscles during inspiration and expiration. During both breathing phases, the activation intensity of external oblique and transversus abdominis/internal oblique was significantly higher in standing when compared to supine (p ≤ 0.001). No significant differences were found between tripod position and 4-point-kneeling positions. Transversus abdominis/internal oblique activation intensity in these positions was higher than in supine and lower than in standing. Postural load and gravitational stretch are factors that should be considered in relation to the specific recruitment of abdominal muscles for breathing mechanics.
- Abdominal muscle activity during breathing in different postures in COPD “Stage 0” and healthy subjectsPublication . Mesquita Montes, António; Maia, Joana; Crasto, Carlos; Melo, Cristina; Carvalho, Paulo; Santos, Rita; Pereira, Susana; Vilas-Boas, João PauloThis study aims to evaluate the effect of different postures on the abdominal muscle activity during breathing in subjects "at risk" for the development of chronic obstructive pulmonary disease (COPD) and healthy. Twenty-nine volunteers, divided in "At Risk" for COPD (n=16; 47.38±5.08years) and Healthy (n=13; 47.54±6.65years) groups, breathed at the same rhythm in supine, standing, tripod and 4-point-kneeling positions. Surface electromyography was performed to assess the activation intensity of rectus abdominis, external oblique and transversus abdominis/internal oblique (TrA/IO) muscles, during inspiration and expiration. From supine to standing, an increased activation of all abdominal muscles was observed in "At Risk" for COPD group; however, in Healthy group, TrA/IO muscle showed an increased activation. In both groups, the TrA/IO muscle activation in tripod and 4-point kneeling positions was higher than in supine and lower than in standing. Subjects "at risk" for the development of COPD seemed to have a specific recruitment of the superficial layer of ventrolateral abdominal wall for the synchronization of postural function and mechanics of breathing.
- Abdominal muscle activity during breathing with and without inspiratory and expiratory loads in healthy subjectsPublication . Mesquita Montes, António; Baptista, João; Crasto, Carlos; Melo, Cristina; Santos, Rita; Vilas-Boas, João PauloCentral Nervous System modulates the motor activities of all trunk muscles to concurrently regulate the intra-abdominal and intra-thoracic pressures. The study aims to evaluate the effect of inspiratory and expiratory loads on abdominal muscle activity during breathing in healthy subjects. Twenty-three higher education students (21.09±1.56years; 8males) breathed at a same rhythm (inspiration: two seconds; expiration: four seconds) without load and with 10% of the maximal inspiratory or expiratory pressures, in standing. Surface electromyography was performed to assess the activation intensity of rectus abdominis, external oblique and transversus abdominis/internal oblique muscles, during inspiration and expiration. During inspiration, transversus abdominis/internal oblique activation intensity was significantly lower with inspiratory load when compared to without load (p=0.009) and expiratory load (p=0.002). During expiration, the activation intensity of all abdominal muscles was significantly higher with expiratory load when compared to without load (p<0.05). The activation intensity of external oblique (p=0.036) and transversus abdominis/internal oblique (p=0.022) was significantly higher with inspiratory load when compared to without load. Transversus abdominis/internal oblique activation intensity was significantly higher with expiratory load when compared to inspiratory load (p<0.001). Transversus abdominis/internal oblique seems to be the most relevant muscle to modulate the intra-abdominal pressure for the breathing mechanics.
- Age effect on kinematic variables of stepping after multidirectional disturbancesPublication . Silva, Nuno; Melo, Cristina; Mesquita Montes, António; Crasto, Carlos; Santos, RitaSystems with influence on postural control suffer structural and functional changes with aging. Therefore stepping strategies against external disturbances, may have different characteristics between individuals of different age groups. Objectives: To analyze step length, step average speed and step latency on forward-backward disturbances, as well as stepping strategies after lateral disturbances. The relationship between lower limb dominance and response limb was also analyzed.
- Caregivers’ education vs rhinopharyngeal clearance in children with upper respiratory infections: impact on children’s health outcomesPublication . Alexandrino, Ana Silva; Santos, Rita; Melo, Cristina; Mesquita Bastos, José; Postiaux, GuyUpper Respiratory Tract Infections (URTI) are very common in children having no effective pharmacological treatment. This study aimed to compare the effect of caregivers’ health education regarding children’s respiratory infections and the effect of a rhinopharyngeal clearance protocol in children with URTI. A factorial trial was conducted in 138 children up to 3 years, attending day-care centres. Children were distributed into four groups: control group (CG) (n = 38); education group (EG) (n = 34); intervention group (IG) (n = 35); and education and intervention group (E + IG) (n = 31). A Diary of Records was kept by caregivers during 1 month. There were significant differences between groups concerning: Lower Respiratory Tract Infections (CG = 29.4%; EG = 10.7%; IG = 3.8%; E + IG = 0.0%; p = 0.014); acute otitis media (CG = 32.4%; EG = 7.1%; IG = 11.5%; E + IG = 7.7%; p = 0.014); medical consultations (CG = 70.6%; EG = 42.9%; IG = 38.5%; E + IG = 30.8%; p = 0.021); antibiotics (CG = 44.1%; EG = 7.1%; IG = 23.1%; E + IG = 15.4%; p = 0.006); days missed from day-care (CG = 55 days; EG = 22 days; IG = 14 days; E + IG = 6 days; p = 0.020); days missed from employment (CG = 31 days; EG = 20 days; IG = 5 days; E + IG = 1 day; p = 0.021); and nasal clearance techniques (CG = 41.4%; EG = 78.6%; IG = 57.7%; E + IG = 84.6%; p = 0.011).
- Characterization of middle-ear condition of Oporto daycare children up-to 3 years-old: A cross sectional studyPublication . Tomé, David; Alexandrino, Ana Silva; Santos, Rita; Melo, Cristina; Costa, Daniel; Ferreira, JoãoObjective The aim of this study was to determine tympanometric values of children who attend Oporto daycare centers and further analyze any relations with host and environmental factors. Methods Cross sectional study in a randomly selected sample of 117 daycare children up-to 3-years old from Oporto. Tympanometric measures were collected. Results Children presented in left ear (LE) a mean peak pressure (PP) of −156.53 daPa and a mean compliance of 0.16 cm3. Right ear (RE) revealed a PP of −145.61 daPa and a compliance of 0.19 cm3. Normal tympanograms (type A) had a lower frequency than abnormal tympanograms (type B and type C). There was a positive association between age and compliance (LE: p = 0.016; RE: p = 0.013) and between the presence of rhinorrhea and PP (LE: p = 0.002; RE: p < 0.05). Abnormal tympanograms were more frequent in Spring (RE: p = 0.009), in younger children (LE: p = 0.03) and in children that had rhinorrhea (LE: p = 0.002; RE: p = 0.044). Healthy children had a mean PP of −125.19 daPa and a mean compliance of 0.21 cm3 in LE and a mean PP of −144.27 daPa and a mean compliance of 0.22 cm3 in RE. Conclusion Tympanometric measures presented in this paper may be applicable to Oporto daycare children up-to 3 years-old. Most of daycare children revealed abnormal tympanograms. Age, rhinorrhea and season influenced children's middle-ear condition.
- Designing and evaluating a health education session on respiratory infections addressed to caregivers of children under three years of age attending day-care centres in Porto, Portugal: A community-based interventionPublication . Alexandrino, Ana Silva; Santos, Rita; Melo, Cristina; Bastos, José Adelino MesquitaAcute respiratory infections (ARI) are common in children, increasing the pressure on clinicians to prescribe antibiotics and affecting public health This study aimed to design a health education session (HES) for caregivers of children, and to evaluate its effects on caregivers’ needs, as well as on their knowledge and attitudes concerning ARI. A generalized model of developing, implementing and evaluating a community-based intervention was followed, including caregivers of children under three years of age. Caregivers were randomly distributed into an intervention group (IG) (n = 41) and a control group (CG) (n = 51) and the HES was administered to the IG. The caregivers’ needs as well as knowledge of and attitudes to ARI were evaluated in both groups, before (M0) and two months after the HES (M1). At M0 the caregivers from both groups had ‘some or great need’ about all HES domains; at M1 the caregivers in the IG expressed ‘no or low need’, whereas the CG maintained ‘some or great need’ about all HES domains (0.011 ≤ P ≤ .047). Concerning caregivers’ knowledge of and attitudes to ARI, at M1 there was a higher frequency of caregivers with right answers in the IG than in the CG (IG =7.5 ± 1 versus CG =6.0 ± 2; P = .000). Those differences occurred in domain (e) nasal clearance techniques, revealing a higher percentage of caregivers who used correctly nasal irrigation (P = .000), nasal aspirators (0.000 ≤P ≤ .001) and nebulization (P = .000) in IG. The HES met the caregivers’ needs regarding ARI and increased their knowledge and attitudes towards ARI, especially regarding nasal clearance techniques.
- Forward trunk lean with arm support affects the activity of accessory respiratory muscles and thoracoabdominal movement in healthy individualsPublication . Mesquita Montes, António; Tam, Carolina; Crasto, Carlos; Melo, Cristina; Carvalho, Paulo; Santos, Rita; Vilarinho, Rui; Vilas-Boas, João PauloDespite the reported benefits of postures involving leaning the trunk forward with arm support for relieving dyspnea, how those postures influence the mechanics of breathing remains unclear. In response, the aim of the study reported here was to evaluate how posture (i.e., standing and sitting) and leaning the trunk forward with arm support affect the activity of accessory respiratory muscles and thoracoabdominal movement in healthy individuals. Thirty-five volunteers (15 males and 20 females) aged 18-29 years breathed with the same rhythm in standing and sitting positions while upright and while leaning the trunk forward with arm support. Surface electromyography was performed to assess the activity of accessory inspiratory (i.e., during inspiration) and abdominal (i.e., during inspiration and expiration) muscles, and a motion capture system was used to assess thoracoabdominal movement. Results revealed that upper trapezius activity was significantly lower in forward-leaning postures than in upright ones (P = 005; ηp2 = 0.311), although the activity of the sternocleidomastoideus and scalenus (P < 0.001; ηp2 = 0.427-0.529), along with the anterior-to-posterior movement of the upper ribcage (P < 0.001; ηp2 = 0.546), were significantly greater in forward-leaning postures than in upright ones. The activity of the external oblique and transversus abdominis/internal oblique was significantly lower in sitting than in standing postures (P < 0.050; ηp2 = 0.206-0.641), and though the activity of the transversus abdominis/internal oblique was significantly lower in forward-leaning than in upright postures (P ≤ 0.001; ηp2 = 0.330-0.541), a significantly greater anterior-to-posterior movement of the abdomen was observed (P < 0.001; ηp2 = 0.662). However, the magnitude of the lower ribcage's medial-to-lateral movement was significantly lower in forward-leaning than in upright postures (P = 0.039; ηp2 = 0.149). Leaning the trunk forward with arm support not only increased the use of accessory inspiratory muscles but also decreased the use of the transversus abdominis/internal oblique, which improved thoracoabdominal movement.
- Immediate effects of a rhino-pharyngeal clearance protocol in nasal obstruction and middle ear condition of children under 3 years of age with upper respiratory infections: A randomized controlled trialPublication . Alexandrino, Ana Silva; Santos, Rita; Melo, Cristina; Tomé, David; Bastos, José Mesquita; Postiaux, GuyIntroduction and objectives Children up to 2 years old are at high risk of respiratory infections and nasal irrigation is often prescribed. Yet, to date there is no sufficient knowledge about its immediate effects on the nasopharynx and middle ear. Therefore, this study aimed to analyze the effect of a rhino-pharyngeal clearance intervention protocol on nasal obstruction and middle ear condition in children under 3 years of age with URTI. Materials and methods Randomized controlled trial in a day-care centre of Porto, including 44 children randomized to Intervention Group (IG) and Control Group (CG). Nasal auscultation and tympanometry were performed at baseline (M0) as well as after the intervention (M1), which consisted of nasal irrigation (NaCl .9%) followed by a forced nasal inspiration in the IG, and after 30 min of normal activities, in the CG. Results In M1 there was a lower frequency of children classified as having an obstructed nasal sound in the IG when compared to the CG (IG = 33.3%; CG = 68.4%; p = 0.042). We also observed an improvement of mean peak pressure (PP) in the IG (Left ear: M0 = −124daPa; M1 = −92daPa; p = 0.022. Right ear: M0 = −102daPa; M1 = −77daPa; p = 0.021), which was not observed in the CG (Left ear: M0 = −105daPa; M1 = −115daPa; p = 0.485. Right ear: M0 = −105daPa; M1 = −131daPa; p = 0.105). There were no significant results concerning the compliance of the tympanic membrane. Conclusions The rhino-pharyngeal clearance improved the nasal obstruction and PP of the middle ear of children under 3 years of age with URTI.
- Impact of caregivers’ education regarding respiratory infections on the health status of day-care children: a randomized trialPublication . Alexandrino, Ana Silva; Santos, Rita; Melo, Cristina; Bastos, José MAcute respiratory infections are the most common illness in childhood, and caregivers often make an excessive use of medication and medical consultations. It is vital to design and implement educational interventions in order to minimize the burden of the disease.