Browsing by Author "Silva, Augusta"
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- Adequação de ferramentas e ambientes virtuais a uma carga de memória de trabalho efetiva para o processo de aprendizagemPublication . Silva, Augusta; Alexandrino, Ana S.; Silva, CláudiaPara a aprendizagem de tarefas complexas, como o raciocínio clínico em fisioterapia, é necessária uma gestão ponderada da carga da memória de trabalho, especialmente em Unidades curriculares (UCs) como a Educação Clínica (EC).
- Ajustes posturais antecipatórios no movimento de alcançar em indivíduos pós-acidente vascular encefálicoPublication . Ferreira, Sílvia; Silva, Cláudia C.; Carvalho, Paulo; Silva, Augusta; Santos, RubimPretendeu-se verificar a existência de alterações nos timings de activação dos músculos estabilizadores da omoplata em indivíduos pós-acidente vascular encefálico e a sua relação com a velocidade. Metodologia: Amostra (n = 17) dividida nos Grupos 1 (n = 10 indivíduos sem patologia) e 2 (n = 7 indivíduos pós-acidente vascular encefálico). Análise electromiográfica e cinemática no alcance de um copo. Resultados: Nas fibras inferiores do trapézio esquerdo (p = 0,043) e grande dentado bilateralmente (p = 0,028), encontraram-se diferenças entre os Grupos. Não se verificou uma relação com a velocidade. Conclusões: Foram encontrados ajustes posturais antecipatórios em alguns dos músculos.
- Análise da sequência do movimento de levantar/sentar, em indivíduos pós AVE: Estudo da relação da activação dos músculos vasto medial oblíquo e vasto lateralPublication . Gomes, Joana; Carvalho, Paulo; Santos, Rubim; Silva, Cláudia C.; Sousa, Andreia S. P.; Silva, AugustaO objectivo deste estudo foi comparar o rácio dos músculos Vasto Medial Oblíquo (VMO) e Vasto Lateral (VL), na sequência de movimento de levantar e sentar, em indivíduos sem patologia e em indivíduos com Acidente Vascular Encefálico (AVE). Pretendeu-se também verificar a sequência de activação de alguns músculos do membro inferior na sequência de movimento de levantar. Verificou-se existir diferenças significativas para afirmar que, no movimento de levantar, indivíduos com sequelas de AVE apresentam menor rácio VMO/VL no membro predominantemente atingido em relação aos indivíduos sem patologia. Diferentes sequências de activação muscular durante o movimento de levantar foram observadas.
- Ankle antagonist coactivation in the double-support phase of walking: Stroke vs. healthy subjectsPublication . Silva, Augusta; Pinheiro De Sousa, Andreia Sofia; Silva, Cláudia; Tavares, João Manuel R. S.; Santos, Rubim; Sousa, FilipaLesions at ipsilateral systems related to postural control at ipsilesional side, may justify the lower performance of stroke subjects during walking. To analyse bilateral ankle antagonist coactivation during double-support in stroke subjects. Methods: Sixteen (8 females; 8 males) subjects with a first isquemic stroke, and twenty two controls (12 females; 10 males) participated in this study. The double support phase was assessed through ground reaction forces and electromyography of ankle muscles was assessed in both limbs. Ipsilesional limb presented statistical significant differences from control when assuming specific roles during double support, being the tibialis anterior and soleus pair the one in which this atypical behavior was more pronounced. The ipsilesional limb presents a dysfunctional behavior when a higher postural control activity was demanded.
- Ankle anticipatory postural adjustments during gait initiation in healthy and post-stroke subjectsPublication . Pinheiro De Sousa, Andreia Sofia; Silva, Augusta; Santos, RubimAnticipatory postural adjustments during gait initiation have an important role in postural stability but also in gait performance. However, these first phase mechanisms of gait initiation have received little attention, particularly in subcortical post-stroke subjects, where bilateral postural control pathways can be impaired. This study aims to evaluate ankle anticipatory postural adjustments during gait initiation in chronic post-stroke subjects with lesion in the territory of middle cerebral artery. Methods: Eleven subjects with post-stroke hemiparesis with the ability to walk independently and twelve healthy controls participated in this study. Bilateral electromyographic activity of tibialis anterior, soleus and medial gastrocnemius was collected during gait initiation to assess the muscle onset timing, period of activation/deactivation and magnitude of muscle activity during postural phase of gait initiation. This phase was identified through centre of pressure signal. Post-stroke group presented only half of the tibialis anterior relative magnitude observed in healthy subjects in contralesional limb (t=2.38, p=0.027) and decreased soleus deactivation period (contralesional limb, t=2.25, p=0.04; ipsilesional limb, t=3.67, p=0.003) as well its onset timing (contralesional limb, t=3.2. p=0.005; ipsilesional limb, t=2.88, p=0.033) in both limbs. A decreased centre of pressure displacement backward (t=3.45, p=0.002) and toward the first swing limb (t=3.29, p=0.004) was observed in post-stroke subjects. These findings indicate that chronic post-stroke subjects with lesion at middle cerebral artery territory present dysfunction in ankle anticipatory postural adjustments in both limbs during gait initiation.
- Ankle dynamic in stroke patients: agonist vs. antagonist muscle relationsPublication . Silva, Augusta; Sousa, Andreia S. P.; Tavares, João Manuel; Tinoco, Ana; Santos, Rubim; Sousa, FilipaAtypical ankle patterns of muscle activity during gait are commonly reported in patients with stroke. These findings can be due to changes between tibialis anterior (TA) and soleus (SOL) coactivation mechanisms. To compare the electromyographic activity (EMGa) of SOL and TA muscles and antagonist coactivation (C) level in the contralateral (CONTRA) and ipsilateral (IPSI) limbs to the side of the stroke lesion during stance phase of the gait cycle. Twelve subjects with a stroke episode participated in this study. The electromyographic signal of TA and SOL and ground reaction forces were acquired while subjects walked at their self-selected speed. Values of ground reaction forces were used to divide the stance phase of gait into initial contact, midstance and terminal stance. In each subphase the magnitude of TA and SOL was calculated as well as the level of the antagonist C. Although no statistical differences were found, mean values of SOL EMGa were lower in the IPSI in all stance phases in relation to the CONTRA limb, and the opposite was observed in the TA EMGa. Moreover, higher mean levels of antagonist C were only found during initial contact sub-phase in CONTRA limb and in the other sub-phases in the IPSI limb. Besides, statistical differences were observed only during midstance. Conclusion: In stroke subjects the antagonist C level during midstance of gait my reflected the dysfunction of the neuronal system over the IPSI limb.
- Ankle intrinsic stiffness in subcortical poststroke subjectsPublication . Pinheiro De Sousa, Andreia Sofia; Santos, Rubim; Silva, AugustaThe authors' purpose was to evaluate bilateral ankle intrinsic stiffness in subcortical poststroke subjects. Ten subcortical poststroke subjects and 10 healthy controls participated in this study. The ankle passive stiffness at 3 different speeds and the electromyographic activity of the soleus, the gastrocnemius, and the tibialis anterior muscles of poststroke contralesional (CONTRA) and ipsilesional (IPSI) limbs and of one limb of healthy subjects were assessed. Ankle electromyographic activity was collected to ensure that reflexive or voluntary muscle activity was not being elicited during the passive movements. A significant interaction was observed between the effects of the limb (IPSI vs. CONTRA vs. control) and ankle position, F(4, 28) = 3.285, p = .025, and between the effects of the limb and the velocity of stretch, F(2, 14) = 4.209, p = .037. While increased intrinsic stiffness was observed in the CONTRA limb of poststroke subjects at ankle neutral position when the passive stretch was applied with a velocity of 1°/s (p = .021), the IPSI limb of poststroke subjects presented increased stiffness at 20º of plantar flexion when the stretch was applied with a velocity of 5°/s (p = .009) when compared to healthy group. Subcortical poststroke subjects present increased intrinsic stiffness in both the CONTRA and IPSI limbs in specific ankle amplitudes.
- 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.
- Antagonist coativation in stroke vs healthy subjects during sit-to-standPublication . Silva, Augusta; Sousa, Andreia S. P.; Silva, Cláudia; Santos, Rubim; Tavares, João Manuel R. S.; Calheno, Teresa; Sousa, FilipaHigh levels og antagonista coativation is frequently found in post stroke subjects, related with postural control impairments. The bilateral postural control dysfunction expected in post-stroke subjects is due to the bilateral disposal of reticulospinal system.
- Atividade do músculo solear nos dois membros inferiores em sujeitos com acidente vascular encefálico-sub-fase média de apoio da marchaPublication . Silva, Augusta; Santos, Rubim; Sousa, FilipaO objetivo da presente investigação foi estudar as diferenças de magnitude da atividade electromiográfica do músculo solear, durante a sub-fase média de apoio da marcha, entre os dois membros inferiores em indivíduos com acidente vascular encefálico. Foi constituída uma amostra, de forma não probabilística voluntária de cinco indivíduos com alterações neuro-motoras por AVE. O sinal electromiográfico foi recolhido e tratado pelo sistema Biopac MP 150 Worksation, e o software de apoio Acqknowledge® versão 3.9. foi utilizada uma Plataforma de forças e respectivo amplificador Bertec AM6300. Foi utilizada a versão adaptada para a população portuguesa da Fugl-Meyer AssessmentfsensorimotorRecoveryafterStroke. Para determinar o onset do sinal electromiográfico foi identificado o seu valor de atividade basal. O sinal da plataforma de forças foi normalizado ao peso e à velocidade da marcha dos sujeitos. Para a análise estatística das variáveis em estudo foi utilizado o software SPPS®. O intervalo de confiança utilizado foi de 95%, com um nível de significância de 0,05. Os resultados permitem-nos verificar uma tendência para uma diminuição da atividade electromiográfica do músculo solear no membro inferior menos comprometido. Não foram encontradas diferenças estatisticamente significativas para a atividade eletromiográfica do músculo solear entre os dois membros inferiores na sub-fase média de apoio da marcha nos sujeitos com AVE.