Browsing by Author "Sousa, Andreia S. P."
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- 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.
- Analysis of ground reaction force and electromyographic activity of the gastrocnemius muscle during double supportPublication . Sousa, Andreia S. P.; Santos, Rubim; Oliveira, Francisco; Carvalho, Paulo; Tavares, João ManuelPurpose: Mechanisms associated with energy expenditure during gait have been extensively researched and studied. According to the double-inverted pendulum model energy expenditure is higher during double support, as lower limbs need to work to redirect the centre of mass velocity. This study looks into how the ground reaction force (GRF) of one limb affects the muscle activity required by the medial gastrocnemius (MG) of the contralateral limb during step-to-step transition. Methods: Thirty-five subjects were monitored as to the MG electromyographic activity (EMGa) of one limb and the GRF of the contralateral limb during double support. Results: After determination of the Pearson correlation coefficient (r), a moderate correlation was observed between the MG EMGa of the dominant leg and the vertical (Fz) and anteroposterior (Fy) components of GRF of the non-dominant leg (r=0.797, p<0.0001; r=-0.807, p<0.0001) and a weak and moderate correlation was observed between the MG EMGa of the non-dominant leg and the Fz and Fy of the dominant leg, respectively (r=0.442, p=0.018; r=-0.684 p<0.0001). Conclusions: The results obtained suggest that during double support, GRF is associated with the EMGa of the contralateral MG and that there is an increased dependence between the GRF of the non-dominant leg and the EMGa of the dominant MG.
- Analysis of the shoulder complex muscle activity in the eccentric phase of a Neer protocol exercisePublication . Pinto, Mariana Soares; Macedo, Rui; Ruano, Teresa; Sousa, Andreia S. P.The stability of the shoulder complex demands the contribution of scapular and glenohumeral muscles. After rotator cuff surgical repair, the self-assisted forward elevation adapted from Neer protocol is usually performed in the rehabilitation process. Once there is a lack of information that describes the muscle activity during the descendent phase of the exercise, it is important to make this analysis and define the most effective progression for the exercise. To analyse the muscle activity variation timings and level of activity in supine and semi-sit position with short and long lever, during the descendent phase of the self-assisted forward elevation of the Neer protocol.
- 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.
- 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.
- Association between gait lower limb intra and interlimb coordination and fear of falling and falling history in older adultsPublication . Castro, Márcia; Moreira, Juliana; Sousa, Andreia S. P.; Santos Moreira, Juliana; Pinheiro de Sousa, Andreia SofiaAging often leads to a decline in intersegmental coordination, particularly in the lower limbs, which can negatively impact gait stability and symmetry. While fear of falling (FoF) and a history of falls (HoF) increase fall risk in older adults, their relationship with intra- and intersegmental coordination during gait remains understudied. This cross-sectional observational study involved 60 participants aged 60 and older. The three-dimensional range of motion of lower limb joints during gait was assessed using an optoelectronic system. Intra- and intersegmental coordination were evaluated via the Continuous Relative Phase (CRP) variable, including its mean, standard deviation, and coefficient of variation. The results showed that the HoF and FoF groups had higher mean CRP values in the left hip-knee (HOF, p = 0.004) and hip-ankle (FOF, p = 0.030) in the sagittal plane, as well as higher standard deviation values in the left knee-ankle (HOF, p = 0.006) and right hip-ankle (HOF, p = 0.004). Inter-segmental coordination differences were also observed, with higher mean CRP values between the knee joints in the sagittal plane (HOF, p = 0.046) and lower mean and standard deviation values between the ankle joints (FOF, p = 0.048 and p = 0.038, respectively). This study concludes that fear of falling and history of falling are significantly associated with altered intra- and intersegmental coordination in older adults, which may contribute to fall risk. Understanding these altered coordination patterns is crucial, as it underscores the therapeutic significance of targeting these changes, which could lead to interventions aimed at improving gait stability and reducing fall risk in elderly individuals.
- Association between the history of fall and the fear of falling on stair descent and gait transition spatiotemporal parameters and lower-limb kinematics in older adultsPublication . Teles, Ivone; Moreira, Juliana; Sousa, Andreia S. P.; Santos Moreira, Juliana; Pinheiro de Sousa, Andreia SofiaAmong older adults, there is a high incidence of history of fall (HoF), fear of falling (FoF), and falls on stair descent during gait transitions. We aim to evaluate the association between HoF and FoF on spatiotemporal and lower-limb kinematic parameters in older adults during stair descents and gait transitions. Sixty older adults (>60 years) were evaluated through an optoelectrical motion capture system during stair descents and gait transitions, using the mean value of the task velocity and time; single- and double-support time; peak downward center of mass (CoM) velocity; hip, knee, and ankle positions of ipsi and the contralateral limb; and foot clearance and foot placement, assessed through multivariate analysis of variance. FOF exhibited longer time to complete (p = 0.009) and double-support (p = 0.047) and single-support (p = 0.009) times and a reduced peak downward CoM velocity (p = 0.043). In the gait transition cycle, HOF exhibited reduced ipsi ankle angles at toe-off (p = 0.015), and FOF presented reduced ipsi ankle angles at heel-strike (p = 0.041) and toe-off (p = 0.026) and reduced contralateral ankle angles at toe-off (p = 0.022).Older adults with HoF and FoF exhibit biomechanical changes during stair descents and gait transitions, in line with the use of more conservative strategies to avoid falling.
- Bilateral proprioceptive evaluation in individuals with unilateral chronic ankle instabilityPublication . Sousa, Andreia S. P.; Leite, João; Costa, Bianca; Santos, RubimDespite extensive research on chronic ankle instability, the findings regarding proprioception have been conflicting and focused only on the injured limb. Also, the different components of proprioception have been evaluated in isolation. To evaluate bilateral ankle proprioception in individuals with unilateral ankle instability. Cohort study. Research laboratory center in a university. Patients or Other Participants: Twenty-four individuals with a history of unilateral ankle sprain and chronic ankle instability (mechanical ankle instability group, n = 10; functional ankle instability [FAI] group, n = 14) and 20 controls. Ankle active and passive joint position sense, kinesthesia, and force sense. We observed a significant interaction between the effects of limb and group for kinesthesia (F = 3.27, P = .049). Increased error values were observed in the injured limb of the FAI group compared with the control group (P = .031, Cohen d = 0.47). Differences were also evident for force sense (F = 9.31, P < .001): the FAI group demonstrated increased error versus the control group (injured limb: P < .001, Cohen d = 1.28; uninjured limb: P = .009, Cohen d = 0.89) and the mechanical ankle instability group (uninjured limb: P = .023, Cohen d = 0.76). Individuals with unilateral FAI had increased error ipsilaterally (injured limb) for inversion movement detection (kinesthesia) and evertor force sense and increased error contralaterally (uninjured limb) for evertor force sense.
- 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.