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- Surface electromyographic amplitude normalization methods: a reviewPublication . Pinheiro De Sousa, Andreia Sofia; Tavares, João Manuel R. S.The electromyogram is the summation of the motor unit action potentials occurringduring contraction measured at a given electrode location. The voltage potential of thesurface electromyographic signal detected by electrodes strongly depends on severalfactors, varying between individuals and also over time within an individual. Thus, theamplitude of the EMG signal itself is not useful in group comparisons, or to follow eventsover a long period of time. The fact that the recorded electromyographic amplitude isnever absolute is mainly because impedance varies between the active muscle fibers andelectrodes and its value is unknown. The EMG signal is highly variable and is dependentupon many factors. Thus, the amplitude of the temporally processed electromyographycan only be used to assess short-term changes in the activity of a single muscle from thesame individual when the electrode setup has not been altered. To allow comparison ofactivity between different muscles, across time, and between individuals, the EMG signalshould be normalized, i.e. expressed in relation to a reference value obtained duringstandardized and reproducible conditions. Notwithstanding the importance of electromyographic amplitude normalization,studies on functional activities, such as gait, do not seem to show a uniformmethodology. Taking this into account, the main purpose of this chapter is to review anddiscuss different normalization procedures to relate the most appropriate method forspecific situations, based on how the normalization method might influence datainterpretation. In addition, this review supports the development of proper normalizationprocedures for biomechanical studies of functional activities like human gait.
- The role of unstable shoe constructions for the improvement of postural controlPublication . Pinheiro De Sousa, Andreia Sofia; Tavares, João Manuel R. S.Postural control has been defined as the control of the bodys position in space for the purposes of balance and orientation. Given the mechanical instability of the human body system, the neural process involved in stability organization and body orientation in space is necessary almost all motor actions. To manage movement variability, the postural control system presents a high adaptability in response to changing task and environment demands. The main sensory systems contribute to the development of an internal representation of body posture that is continuously updated based on multisensory feedback and is used to forward commands to control body position in space. For example, understanding the importance of proprioceptive information, and how ankle muscles can influence changes of support and stability that could improve postural control is of significant relevance. The purpose of this chapter is to review and discuss the short and long term influence of wearing an unstable shoe construction on postural control. The review provides instinctive knowledge that can be used during rehabilitation to improve motor performance. It also aims to provide a significant insight into areas that have been dedicated to the implementation of preventive measures, such as ergonomy.
- Do shoulder motor control impairments remain in the year following the last pain episode?Publication . Pinheiro De Sousa, Andreia Sofia; Macedo, RuiThe high dependency of the shoulder complex on muscle control for mid-range stability supports the evidence demonstrating that most ab normal biomechanics and overuse injuries that occur in this region are related to alterations in the function of the scapular-stabilizing muscles (Ciubotariu et al., 2004; Kuhn et al., 1995). Changes in motor control have been claimed to be at the origin, but also in the perpetuation, of the injury/pain if the altered motor strategy or movement leads to excessive loading of tissues. On the other hand, ac cording to the pain adaptation theory, the pain experience is associated with an adaptation in motor behaviour that involves redistribution of ac tivity within and between muscles at multiple levels of the motor system with potential long-term consequences (Hodges et al., 2011). There is evi dence that pain results in gradual decrease in the motor unit discharge rate (Ervilha et al., 2005) via central mechanisms’ adaptation (Thunberg et al., 2002), both in related muscles (Graven-Nielsen et al., 1997) as well as in synergistic and antagonist muscles (Ciubotariu et al., 2004). Specifi cally, studies on shoulder pain demonstrated decreased magnitude and delayed activation of the serratus anterior (SA) (David et al., 2000) and the lower trapezius (LT) muscles (Ludewig et al., 2000) and increased 1 PhD) Escola Superior da Tecnologia de Saúde do Porto, Área Científica de Fisioterapia, Centro de Estudos de Movimento e Atividade Humana, Vila Nova de Gaia, Portugal. 2 (PhD) Escola Superior da Tecnologia de Saúde do Porto, Área Científica de Fisioterapia, Centro de Estudos de Movimento e Atividade Humana, Vila Nova de Gaia, Portugal. 268 Andreia S.P. Sousa and Rui Macedo upper trapezius’ (UT) activity (Ludewig et al., 2000). Also, a bilateral re organization in the coordination among the divisions of the trapezius muscle was demonstrated in response to induced muscle pain (Falla et al., 2007). Despite the known relation between pain and motor control, the treatment of pain is unlikely to be sufficient to restore motor control. Studies involving motor control in low back pain found that many as pects of the motor adaptation persist after the resolution of the pain (MacDonald et al., 2009). To the best of our knowledge, no study evaluat ed shoulder motor control between shoulder pain episodes in tasks in volving mainly concentric activity, but also in tasks involving mainly ex centric activity. Considering that impairments in trunk motor control be tween pain episodes (Ferreira et al., 2004; Hodges et al., 1996) can be re stored with motor relearning strategies (Tsao et al., 2007) and that these changes persist after cessation of training (Tsao et al., 2008), it is im portant to identify shoulder motor control impairments between pain ep isodes to guide effective motor relearning strategies. The purpose of the present study is to evaluate shoulder motor con trol expressed to muscle timings during raised and lowered scaption in subjects with shoulder pain episodes in the last year but currently with out pain.
- Fisioterapia na comunidadePublication . Clara, Paula
- Fisioterapia na prevenção de quedas do adulto mais velho: Proposta de Modelo de Intervenção nos Cuidados de Saúde PrimáriosPublication . Casaca, Ana Catarina; Silva, Ana Luís; Silva, Ana Rita; Martins, Anabela Correia; Pinto, Bernardo; Melo, Cristina; Silva, Madalena Gomes da; Conde, Monserrat; Santos, Paula Clara; Barbosa, Pedro Maciel; Pereira, Paulo; Moniz, Rubina
- Analysis and quantification of upper-limb movement in motor rehabilitation after strokePublication . Silva, R. Mariana; Sousa, Emanuel; Fonseca, Pedro; Pinheiro, Ana Rita; Silva, Cláudia; Correia, Miguel V.; Mouta, SandraIt is extremely difficult to reduce the relations between the several body parts that perform human motion to a simplified set of features. Therefore, the study of the upper-limb functionality is still in development, partly due to the wider range of actions and strategies for motor execution. This, in turn, leads to inconsistent upper-limb movement parameterization. We propose a methodology to assess and quantify the upper-limb motor execution. Extracting key variables from different sources, we intended to quantify healthy upper-limb movement and use these parameters to quantify motor execution during rehabilitation after stroke. In order to do so, we designed an experimental setup defining a workspace for the execution of the action recording kinematic data. Results reveal an effect of object and instruction on the timing of upper-limb movement, indicating that the spatiotemporal analysis of kinematic data can be used as a quantification parameter for motor rehabilitation stages and methods.
- Programa de exercícios baseado no método de pilates clínico na qualidade de vida e na satisfação com a vida em mulheres idosas com incontinência urináriaPublication . Santos, Paula Clara; Macedo, C.; Bastos, A.; Susana, M.; Mendes, P.; Ferreira, M. S.O envelhecimento populacional tem sido apresentado nos demográficos, como um dos fenómenos mais importantes do século XXI. O envelhecimento humano traduz-se na mudança progressiva da estrutura biológica e psicossocial que se inicia antes do nascimento e desenvolve-se ao longo da vida devendo ser, por isso, compreendido como um processo natural e integrante do ciclo da vida.
- Influência de um programa de exercícios na qualidade de vida de indivíduos com Espondilite AnquilosantePublication . Lopes, Sofia; Santos, Paula Clara; Fernandes, Humberto; Mesquita, CristinaA Espondilite Anquilosante (EA) pertence ao grupo das espondilartopias seronegativas das doenças reumáticas, sendo uma doença crónica, sistémica e inflamatória das articulações axiais, afetando especialmente a articulação sacroilíaca e a coluna lombar.
- Impact of clinical pilates on satisfaction with life of women with urinary incontinencePublication . Santos, Paula Clara; Lopes, Sofia; Teixiera, Ricardo João; Macedo, Carla; Azevedo, Rogério; Mesquita, CristinaThe high prevalence of urinary incontinence is a problem of public health due to its physical, psychological, social and economic effects. It affects predominantly all age female gender and may influence satisfaction with life. Clinical Pilates has been studied in healthy subjects and seems to have positive effects on the psychological and general well-being. However, this method lacks evidence upon its effect on women with urinary incontinence. This study aims to assess the impact of a Clinical Pilates exercise-based program on the perception of contraction of pelvic floor muscles and in satisfaction with life of women with urinary incontinence. A quasi-experimental investigation has been carried out with a 60 women sample distributed by an Experimental Group (EG; n=30) and a Control Group (CG; n=30). Participants were aged ≥ 50 years, diagnosed with stress and mixed urinary incontinence, grade ≥ 3 in the Modified Oxford Grading Scale. EG performed 60 minutes classes of Clinical Pilates based exercises twice a week for ten weeks. CG had no intervention. Pelvic floor efficacy was assessed through Broome’s Self-Efficacy Scale and satisfaction with life through Satisfaction with Life Scale. Descriptive statistics and the Inferential Statistics were used. The T-Student test, the Wilcoxon and the Mann-Whitney tests were used in case of abnormality with α = 0.05). The results showed that the Clinical Pilates exercise-based program had positive effects on the contraction of pelvic floor muscles, total score [79(10.48) vs 35.9(11.44); p < 0.001] in both Broome’s sub-scales, A [80.71(9.29) vs 35.36(18.57); p < 0.001] and B [77.6(11.06) vs 35.36(18.57); p = 0.02] and in satisfaction with life [24.00(8.00) vs 16.00 (8.00); p < 0.001]. In conclusion, Clinical Pilates has positively influenced participants’ perception of pelvic floor muscles contraction and satisfaction with life.
- Treino neuromuscular facial na funcionalidade e qualidade de vida de pessoas com Paralisia de BellPublication . Ferreira, Margarida Susete; Firmino-Machado, João; Saavedra, Mariana; Santos, Paula ClaraA paralisia facial periférica (PFP) é uma mononeuropatia do sétimo par craniano que resulta numa paresia ou paralesia da face ipsilateral. A PFP abrange múltiplas etiologias, sendo a forma idiopática ou paralisia de Bell responsável por aproximadamente 2/3 de todas as PFP, devendo por isso ser considerada no diagnóstico diferencial.
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