Browsing by Author "Vilas-Boas, J. Paulo"
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- Cross-cultural adaptation and measurement properties of the Portuguese version of the Ankle Instability InstrumentPublication . Silva, Diogo C. F.; Vilas-Boas, J. Paulo; Mesquita, Cristina; Maia, José; Santos, Rubim; Peixoto, Tiago André Teixeira; Brito, Nuno; Pinheiro De Sousa, Andreia SofiaChronic ankle instability is one of the most common clinical conditions in the general population, especially in adult athletes. The cross-cultural adaptation of self-reported questionnaires that identify and classify this condition contribute to criteria standardization in research but also in rehabilitation. Aim of Study. To validate the Ankle Instability Instrument to the Portuguese population and to investigate its psychometric properties. Material and Methods. Linguistic and semantic equivalence of the original version of the Ankle Instability Instrument to the Portuguese population was firstly performed. The Portuguese version of the Ankle Instability Instrument was then applied to 81 higher education adult students, with (n = 59) and without history of ankle sprain (n = 22). Participants were evaluated two times with an interval of one week to assess the psychometric properties of the Portuguese version of the Ankle Instability Instrument. Results. In the reliability of binary responses based on the test retest, the tetrachoric correlation coefficient ranged from 0.99 to 1.00. In addition, the Kuder–Richardson coefficient was 0.79 suggesting good internal consistency. Conclusions. Test-retest showed an almost perfect match in all answers between the two moments, which seem to be related to sample characteristics. The internal consistency value was similar to the one obtained in the original version. The Portuguese version of the Ankle Instability Instrument is highly reliable and can be used in clinical practice.
- Differences in trapezius muscle h-reflex between asymptomatic subjects and symptomatic shoulder pain subjectsPublication . Melo, Ana; Taylor, Janet L.; Ferreira, Ricardo; CUNHA, BRUNO; Ascenção, Manuel; Sousa, Vítor; Cruz, Eduardo B.; Vilas-Boas, J. Paulo; Sousa, Andreia S. P.In chronic shoulder pain, adaptations in the nervous system such as in motoneuron excitability, could contribute to impairments in scapular muscles, perpetuation and recurrence of pain and reduced improvements during rehabilitation. The present cross-sectional study aims to compare trapezius neural excitability between symptomatic and asymptomatic subjects. In 12 participants with chronic shoulder pain (symptomatic group) and 12 without shoulder pain (asymptomatic group), the H reflex was evoked in all trapezius muscle parts, through C3/4 nerve stimulation, and the M-wave through accessory nerve stimulation. The current intensity to evoke the maximum H reflex, the latency and the maximum peak-to-peak amplitude of both the H reflex and M-wave, as well as the ratio between these two variables, were calculated. The percentage of responses was considered. Overall, M-waves were elicited in most participants, while the H reflex was elicited only in 58–75% or in 42–58% of the asymptomatic and symptomatic participants, respectively. A comparison between groups revealed that the symptomatic group presented a smaller maximum H reflex as a percentage of M-wave from upper trapezius and longer maximal H reflex latency from the lower trapezius (p < 0.05). Subjects with chronic shoulder pain present changes in trapezius H reflex parameters, highlighting the need to consider trapezius neuromuscular control in these individuals’ rehabilitation.
- 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.
- Influence of cleats-surface interaction on the performance and risk of injury in soccer: A systematic reviewPublication . Silva, Diogo C. F.; Santos, Rubim; Vilas-Boas, J. Paulo; Macedo, Rui; Mesquita Montes, António; Pinheiro De Sousa, Andreia SofiaTo review the influence of cleats-surface interaction on the performance and risk of injury in soccer athletes.
- Scapular motor control and upper limb movement quality in subjects with and without chronic shoulder painPublication . Melo, Ana; C. Guedes, Diana; Matias, Ricardo; Cruz, Eduardo B.; Vilas-Boas, J. Paulo; Sousa, AndreiaDespite the existence of several studies about the scapula’s position and motion, in shoulder pain conditions, there are still conflicting findings regarding scapular adaptations and reduced research about the scapula’s role during functional tasks. The present study aimed to compare scapular-related kinematic and electromyographic outcomes during different shoulder movements (with and without load) and the drinking task, between symptomatic and asymptomatic subjects. Forty subjects (divided into two groups) participated in this cross-sectional observational study. Scapulothoracic motion, scapulohumeral rhythm, and movement quality (considering trunk compensation, time-to-peak acceleration, and smoothness), as well as the relative surface electromyographic activity and muscle ratio considering the trapezius, serratus anterior, and levator scapulae (LS), were assessed. The symptomatic group presented the following: (1) changes in scapular upward rotation (p = 0.008) and winging (p = 0.026 and p = 0.005) during backward transport and drink phases; (2) increased muscle activity level of the middle trapezius (MT) in all tasks (p < 0.0001 to p = 0.039), of LS during shoulder elevation with load (p = 0.007), and of LS and LT during most of the drinking task phases (p = 0.007 to p = 0.043 and p < 0.0001 to p = 0.014, respectively); (3) a decreased serratus anterior lower portion activity level (SAlow) during shoulder lowering with load (p = 0.030) and drink phase (p = 0.047); and (4) an increased muscular ratio between scapular abductors/adductors (p = 0.005 to p = 0.036) and elevators/depressors (p = 0.008 to p = 0.028). Compared to asymptomatic subjects, subjects with chronic shoulder pain presented scapular upward rotation and winging adaptations; increased activity levels of MT, LT, and LS; decreased activity levels of SAlow; and increased scapular muscle ratios.
- Scapular muscle dynamic stiffness of asymptomatic subjects and subjects with chronic shoulder pain, at rest and isometric contraction conditionsPublication . Melo, Ana S. C.; Pinheiro de Sousa, Andreia Sofia; Montóia, Bárbara; Cruz, Eduardo B.; Vilas-Boas, J. Paulo; Sousa, Andreia S. P.Muscle stiffness had a crucial role in joint stability, particularly, at the shoulder complex. Although changes in upper trapezius muscle stiffness have been described for shoulder pain, contradictory findings have been obtained. Also, existing data regarding scapular muscles are, majorly, about trapezius. Myotonometry is a method used to assess stiffness; however, the reliability values of scapular muscle stiffness through this method have not been assessed in shoulder pain conditions. The present study aims to compare scapular muscles’ stiffness (trapezius, serratus anterior, and levator scapulae) between subjects with and without chronic shoulder pain and to evaluate the related test-retest reliability. Twenty-two symptomatic and twenty-two asymptomatic subjects participated in a cross-sectional study. The dynamic muscular stiffness of scapular muscles, at rest and during an isometric contraction, was measured bilaterally with myotonometry, in two moments. The differences in bilateral averaged values between symptomatic and asymptomatic subjects and the effect of the group (group presenting pain in the dominant or non-dominant side, and asymptomatic group) and of the limb (unilateral painful or asymptomatic limb, and bilateral asymptomatic limbs) were investigated. Test-retest intra-rater reliability was determined. An effect of the group was observed at rest, for middle trapezius stiffness, and during contraction, for middle and lower trapezius stiffness. For middle trapezius, increased values were observed in the group presenting pain in non-dominant side comparing to both groups or to group presenting pain in dominant side. The intraclass correlation coefficient, majorly, ranged between 0.775 and 0.989. Participants with pain in the non-dominant side presented an increased middle trapezius’ stiffness. Globally, high reliability was observed for scapular muscles dynamic stiffness.
- The influence of different soccer cleat type on kinetic, kinematic and neuromuscular ankle variables in artificial turfPublication . Silva, Diogo C. F.; Santos, Rubim; Vilas-Boas, J. Paulo; Macedo, Rui; Mesquita Montes, António; Pinheiro De Sousa, Andreia SofiaLateral ankle sprain is the most prevalent injury in soccer athletes. Enhanced by the variety of soccer cleats and by increased use of artificial turf, the interaction between the ground and the footwear has taken high importance as a lateral ankle sprain risk factor. The higher incidence of injuries in the second half of the match reflects the need of studying this interaction during tasks involving muscle fatigue. To evaluate the influence of different soccer cleats on kinetic, kinematic and neuromuscular ankle variables in artificial turf under two conditions: with and without fatigue of lateral ankle dynamic stabilizers. Study design: Experimental study within-subjects design. Twenty-four healthy athletes participated in this study. All subjects performed three sets of five medial-lateral unipodal jumps, each one with one of three models of cleats (Turf, Hard and Firm ground) on two conditions: with and without fatigue induced by the isokinetic dynamometer. The electromyographic activity of long and short peroneal heads, ground reaction forces and the movement of the rear-foot were collected and used to calculate kinematic (ankle eversion/inversion, centre of pressure displacement and velocity), kinetic (loading rate of the ground reaction forces) and neuromuscular variables (activation time of peroneal muscles). With the exception of decreased peroneal activation time with the Hard ground model (without fatigue vs. with fatigue), no statistically significant differences were identified in the ankle variables, between cleats, neither between the two evaluated conditions. In healthy soccer athletes, the contributor variables for ankle sprain were not influenced by the kind of soccer cleat in a functional test on a third generation artificial turf.
- The influence of shoulder position during multi-joint exercises in the relative scapular muscles activity in symptomatic and asymptomatic conditionsPublication . Carneiro, Ana Sofia; Vilas-Boas, J. Paulo; Cruz, Eduardo B.; Macedo, Rui; Ferreira, Sílvia B. e; Sousa, AndreiaScapular muscles changes, as increased upper trapezius activity and decreased middle and lower trapezius and serratus anterior muscle activity, have been demonstrated in shoulder pain specific or non-specific conditions. Shoulder external rotation exercises have been recommended to improve scapular activity in shoulder pain. To evaluate the relative scapular muscles activity during multi-joint exercises combining shoulder external rotation, trunk rotation and scapular squeeze. Forty-one participants with and without shoulder pain were assessed in a cross-sectional study. They performed isometric multi-joint exercises at 0∘ and 90∘ of shoulder abduction with and without support. The relative activity of upper, middle, and lower trapezius and serratus anterior (upper/middle and lower portions) was measured through electromyography. The scapular muscular balance was assessed by the ratio between relative activity of the upper trapezius and the other muscles. Both groups presented similar results. The exercise at 90∘ abduction led to increased relative muscle activity against maximal voluntary contraction in both groups for upper trapezius (with support: 4% MVIC, p= 0.001 or 15% MVIC, p< 0.0001; and without support: 11% MVIC, p< 0.0001 or 13%, p< 0.0001, for asymptomatic and symptomatic group, respectively) and lower trapezius (with support: 66% MVIC, p< 0.0001 or 62% MVIC, p< 0.0001, for asymptomatic and symptomatic group.