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- Abdominal muscle activity and pelvic motion according to active straight leg raising test results in adults with and without chronic low back painPublication . Castro, Carlos; Mesquita Montes, António; Carvalho, Paulo; Cancela Carral, JM.Active Straight Leg Raise (ASLR) is a clinical test that challenges lumbopelvic stability and have been used in low back pain patients. There are reports of positive tests in asymptomatic individuals, however, it is not clear if they are false positives or a consequence of performing the test differently.
- 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 qualitativa do impacto do programa de treino metacognitivo e da cognição social em pessoas com EsquizofreniaPublication . Rocha, Nuno; Queirós, Cristina; Bravo, Ana Ribeiro; Silva, Andreia S A; Marques, António; Oliveira, Cláudia; Rocha, Susana A; Pereira, Natacha G FNeste estudo procuramos determinar a satisfação e a percepção de mudanças específicas resultantes da participação num programa de treino metacognitivo e da cognição social (TMSC) para pessoas com Esquizofrenia. Participaram 21 participantes com diagnóstico de Esquizofrenia responderam a um inquérito por questionário de administração direta com questões abertas, realizado a meio e no final do TMCS. A partir das categorias (1) Satisfação com o programa, (2) Reestruturação sócio-cognitiva e (3) Mudanças na relação eu-outro, verificamos que o programa é relevante, tem potencial para introduzir mudanças na relação com os outros e parece otimizar a cognição social. Os aspectos negativos apontados estão relacionados com a duração do programa e das sessões, e com a linguagem utilizada.
- 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.
- 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.
- Anticipatory postural adjustments during sitting reach movement in post-stroke subjectsPublication . Pereira, Soraia; Silva, Cláudia; Ferreira, Sílvia; Silva, Cláudia; Oliveira, Nuno; Santos, Rubim; Vilas Boas, João; Correia, Miguel V.The study assessed the effect of velocity of arm movement on the generation of APAs in the contralateral and ipsilateral muscles of individuals with stroke in the sitting position. In the sitting position, 10 healthy and 8 post-stroke subjects reached for an object placed at the scapular plane and mid-sternum height at self-selected and fast velocities. Electromyography was recorded from the anterior deltoid (AD), upper (UT) and lower trapezius (LT), and latissimus dorsi (LD). Kinematic analysis was used to assess peak velocity and trunk displacement. Post-stroke subjects presented a delay of APAs on both sides of the body compared to healthy subjects. Differences were found between the timing of APAs on the ipsilateral and contralateral LD and LT in both movement speeds and in the ipsilateral UT during movement of the non-affected arm at a self-selected velocity. A delay in the contralateral LD in the reaching movement with the non-affected arm at fast velocity was also observed. Trunk displacement was greater in post-stroke subjects. In the sitting position, APAs were delayed in both fast and self-selected movements on both sides in post-stroke subjects, which also presented a higher trunk displacement.
- Anticipatory postural adjustments in the shoulder girdle in the reach movement performed in standing by post-stroke subjectsPublication . Silva, Cláudia F.; Pereira, Soraia; Silva, Cláudia; Ferreira, Sílvia; Oliveira, Nuno; Santos, RubimAfter a stroke in middle cerebral artery territory, there is a high probability of dysfunction of the ventromedial pathways, mainly related with postural control mechanisms such as the anticipatory postural adjustments (APAs). According to neuroanatomical knowledge, these pathways have a predominant ipsilesional disposition, which justifies a bilateral postural control dysfunction, often neglected in rehabilitation. In order to assess this bilateral postural control dysfunction, electromyography activity was assessed in eight post-stroke and 10 healthy individuals in the anterior deltoids, the superior and lower trapezius, and the latissimus dorsi as they reached for a bottle with both upper limbs separately at a self-selected velocity and fast velocity while standing associated with trunk kinematics analysis. Through this analysis it was possible to compare the timing of APAs in scapular muscles between sides in post-stroke and with healthy individuals, and to verify if there is a relation between the timing and the displacement of the trunk in the temporal window of the APAs. Indeed, post-stroke individuals show a delayed activation of APAs on scapular girdle muscles on both ipsilesional and contralesional sides, which were not reflected in the trunk displacement.