Browsing by Author "Sousa, Filipa"
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- Accuracy and repeatability of the gait analysis by the WalkinSense systemPublication . P. de Castro, Marcelo; Meucci, Marco; Soares, Denise P.; Fonseca, Pedro; Borgonovo-Santos, Márcio; Sousa, Filipa; Machado, Leandro; Villas-Boas, João PauloWalkinSense is a new device designed to monitor walking. The aim of this study was to measure the accuracy and repeatability of the gait analysis performed by the WalkinSense system. Descriptions of values recorded by WalkinSense depicting typical gait in adults are also presented. A bench experiment using the Trublu calibration device was conducted to statically test the WalkinSense. Following this, a dynamic test was carried out overlapping the WalkinSense and the Pedar insoles in 40 healthy participants during walking. Pressure peak, pressure peak time, pressure-time integral, and mean pressure at eight-foot regions were calculated. In the bench experiments, the repeatability (i) among the WalkinSense sensors (within), (ii) between two WalkinSense devices, and (iii) between the WalkinSense and the Trublu devices was excellent. In the dynamic tests, the repeatability of the WalkinSense (i) between stances in the same trial (within-trial) and (ii) between trials was also excellent (ICC > 0.90). When the eight-foot regions were analyzed separately, the within-trial and between-trials repeatability was good-to-excellent in 88% (ICC > 0.80) of the data and fair in 11%. In short, the data suggest that the WalkinSense has good-to-excellent levels of accuracy and repeatability for plantar pressure variables.
- Activation timing of soleus and tibialis anterior muscles during sit-to-stand and stand to sit in post-stroke vs healthy subjectsPublication . Augusta Silva; Santos, Rubim; Pinheiro De Sousa, Andreia Sofia; Pinheiro, Ana Rita; Ferraz, Joana; Tavares, João Manuel; Sousa, FilipaSit-to-stand (SitTS) and stand-to-sit (StandTS) are very important functional tasks that become compromised in stroke patients. As in other voluntary movements, they require an adequate postural control (PC) involving the generation of anticipatory postural adjustments (APAs). In order to give clues for more efficient and directed rehabilitation programs, a deeper knowledge about APAs during challenging and daily life movements is essential. To analyze the activation timing of tibialis anterior (TA) and soleus (SOL) muscles during SitTS and StandTS in healthy subjects and in post-stroke patients. Methods: Two groups participated in this study: one composed by ten healthy subjects and the other by ten subjects with history of stroke and increased H-reflex. Electromyographic activity (EMGa) of SOL and TA was analyzed during SitTS and StandTS in the ipsilateral (IPSI) and the contralateral (CONTRA) limb to the side lesion in stroke subjects, and in one limb in the healthy subjects. A force plate was used to identify the movement onset. In both sequences, in the stroke group SOL activation timing occurred prior to movement onset, contrary to the pattern observed in the healthy subjects. Statistical significant differences were found in SOL activation timings between each lower limbs of the stroke and healthy groups, but no significant differences were found between the IPSI and the CONTRA limb. The TA activation timing seems to be delayed in the CONTRA limb when compared to the healthy subjects and showed also a better organization of TA timing activation in StandTS when compared to SitTS. Compared to healthy subjects, APAs seems to be altered in both limbs of the post-stroke subjects, with the SOL activation timing being anticipated in both SitTS and StandTS.
- Análise biomecânica da marcha e funcionalidade em crianças com Paralisia Cerebral: efeito da intervenção da fisioterapia com facilitação em tapete rolantePublication . Araújo, Daniela; Sousa, FilipaIntrodução: As crianças com Paralisia Cerebral evidenciam frequentemente alterações da sua funcionalidade global, evidenciadas nomeadamente na marcha. Diferentes protocolos de facilitação da marcha em tapete rolante têm vindo a ser alvo de estudos no sentido de clarificar a sua eficácia nesta população. Estes sugerem uma evolução positiva dos diferentes aspectos estudados (funcionalidade global, resistência cardiorespiratória, componentes da marcha), contudo utilizam diferentes metodologias e especificidades do protocolo, não existindo consenso acerca das melhores condições de utilização. Objectivo(s): O presente trabalho teve como objectivo principal avaliar o efeito da aplicação de um protocolo de marcha em tapete rolante (PMTR) em crianças com Paralisia Cerebral (PC) espástica, nos parâmetros biomecânicos da mesma e funcionalidade global. Métodos: Participaram no estudo 9 crianças com PC do tipo diplégico e hemiplégico inscritos na Associação de Paralisia Cerebral de Braga (APCB), com idades compreendidas entre os 3 e os 8 anos de idade. Cada criança foi avaliada antes e após a aplicação do PMTR, através da análise biomecânica da marcha (dinamometria e electromiografia de superfície), bem como da aplicação do teste de medida da função motora (TMFM). A amostra foi dividida em dois grupos – grupo sujeito ao protocolo de marcha em tapete rolante (GPMTR) (n=5) e grupo controlo (GC) (n=4). O protocolo em tapete rolante foi incluído nas sessões de intervenção de fisioterapia, com uma frequência semanal de 2 a 3 vezes por semana, durante um período de 10 semanas consecutivas, após o qual foram repetidas as avaliações iniciais. Resultados: A análise dos resultados permitiu verificar evoluções no GPMTR ao nível do score total da TMFM e especialmente na dimensão E, o que revelou melhorias significativas da funcionalidade motora global neste grupo. Verificaram-se ainda, em termos eletromiográficos um melhor padrão de recrutamento muscular, bem como, no que se refere à análise dinamométrica, evoluções positivas, na componente vertical das forças de reacção do solo.Conclusão: O presente estudo parece sugerir que a inclusão da facilitação da marcha em tapete rolante no plano de intervenção pode contribuir para uma melhoria nos parâmetros biomecânicos da marcha e funcionalidade global de crianças com Paralisia Cerebral do tipo diplégico e hemiplégico, com idades compreendidas entre os 3 e os 8 anos.
- Análise da marcha baseada numa correlação multifatorialPublication . Pinheiro De Sousa, Andreia Sofia; Tavares, João Manuel R.S.; Mendes, Emília; Sousa, FilipaA análise da marcha implica a conjugação de vários factores e a quantificação de múltiplas variáveis. Apresenta-se como objectivo deste trabalho a revisão da literatura relevante sobre o fenómeno da marcha e das suas implicações biomecânicas; nomeadamente, em termos de mecanismos propostos para interpretar a marcha que permitam estabelecer e analisar a correlação entre múltiplos factores que caracterizam adequadamente padrões cinéticos e cinemáticos, e a energia dispendida durante a marcha humana. A análise da literatura considerada permitiu obter algumas inferências relativamente aos factores mais significativos no padrão de marcha, bem como identificar alguns modelos que, embora sejam vistos como explicativos do padrão de marcha, continuam a apresentar algumas incongruências e divergências entre si.
- Análise das forças de reação do solo e atividade eletromiográfica do membro contra-lateral durante a fase de transição entre passosPublication . Pinheiro De Sousa, Andreia Sofia; Tavares, João Manuel R.S.; Sousa, Filipa; Santos, Rubim; Carvalho, Paulo; Mendes, EmíliaA procura dos mecanismos associados ao dispêndio energético durante a marcha tem sido uma questão pertinentemente discutida. As teorias da marcha dinâmica e do modelo de pêndulo entre passos oferecem propostas de mecanismos explicativos.Neste trabalho, procurou verificar-se de que modo a magnitude da componente vertical da força de reacção do solo (FRSz) está relacionada com o grau de actividade muscular recrutada pelo ventre medial do músculo gastrocnémeo (MG) do membro contra-lateral na fase de transição entre passos. Para testar os pressupostos inerentes foi utilizada uma amostra de indivíduos saudáveis do sexo feminino. Em cada indivíduo foi monitorizada a actividade electromiográfica (aEMG) do ventre medial do MG e a FRSz do membro contra-lateral durante a fase de transição entre passos. Após a aplicação do coeficiente de correlação de Spearman () verificou-se a ocorrência de uma correlação positiva estatisticamente significativa entre a aEMG e a magnitude da FRSz nos dois membros (=0.852 e =0.512). Os resultados obtidos permitem inferir que a magnitude da FRSz poderá constituir um predictor da aEMG do ventre medial do MG do membro contralatera.
- Analysis of the backpack loading efects on the human gaitPublication . Machado, Leandro; Castro, Marcelo P. de; Abreu, Sofia; Sousa, Helena; Gonçalves, Pedro; Sousa, Filipa; Santos, Rubim; Pinto, Viviana; Vaz, Mário; Vilas-Boas, João P.Gait is a simple activity of daily life and one of the main abilities of the human being. Often during leisure, labour and sports activities, loads are carried over (e.g. backpack) during gait. These circumstantial loads can generate instability and increase biomechanicalstress over the human tissues and systems, especially on the locomotor, balance and postural regulation systems. According to Wearing (2006), subjects that carry a transitory or intermittent load will be able to find relatively efficient solutions to compensate its effects.
- Analysis of the backpack loading effects on the human gaitPublication . Machado, Leandro; P. de Castro, Marcelo; Abreu, Sofia; Sousa, Helena; Gonçalves, Pedro; Sousa, Filipa; Santos, Rubim; Pinto, Viviana; Vaz, Mário; Boas, J. Paulo VilasGait is a simple activity of daily life and one of the main abilities of the human being. Often during leisure, labour and sports activities, loads are carried over (e.g. backpack) during gait. These circumstantial loads can generate instability and increase biomechanical stress over the human tissues and systems, especially on the locomotor, balance and postural regulation systems. According to Wearing (2006), subjects that carry a transitory or intermittent load will be able to find relatively efficient solutions to compensate its effects. These are dependent upon the walking distance and of the load characteristics - size, weight and location relatively to the body (Hsiang, 2002).Thus, these solutions should become a concerning factor (Koh, 2009) and a topic of scientific research, particularly in what concerns the inventory of its biomechanical effects and the possible strategies to be developed in order to minimize its effects. The aim of the present study was to analyze the effects of an occasional dorso-lombar load during the gait through the use of a backpack.
- 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 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.