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- Sensor monitoring of thermal and vascular changes during neoadjuvant treatmentPublication . Zordão, Catarina C.; Flórido, Andrezza M.; de Almeida, Tamires C.; Carrara, Hélio H. A.; Noites, Andreia; Guirro, Rinaldo R. J.; Guirro, Elaine C. O.; Noites, AndreiaThe physiological impact of neoadjuvant therapy on vascular and thermal responses in breast cancer patients remains poorly understood, despite its clinical relevance for predict‑ ing treatment outcomes and managing therapy‑related side effects. Sensor‑based monitor‑ ing technologies, such as thermography and Doppler ultrasound, provide non‑invasive approaches to assess circulatory and thermal changes, potentially serving as predictive biomarkers of therapeutic efficacy. This study aimed to evaluate vascular impairment and correlate circulatory alterations with skin surface temperature in women undergoing neoadjuvant therapy for breast cancer. A total of 38 women were enrolled and distributed into two groups: patients receiving eight cycles of neoadjuvant chemotherapy and healthy controls. Thermographic imaging was employed to measure upper‑limb surface temper‑ ature, while Doppler ultrasound assessed arterial and venous blood flow in the cubital fossa. Paired Student’s t‑tests compared experimental moments (C1, C5, C8), with normal‑ ity assessed from difference scores (∆) and results expressed as mean differences with 95% CIs (p < 0.05, two‑tailed). Associations between surface temperature and arterial blood flow were examined using simple linear regression (R2 , F‑statistic, β, p‑values). Analyses were performed in SPSS 20.0 (SPSS Inc., Chicago, IL, USA). Significant increases in sur‑ face temperature (p < 0.001) and blood flow velocity (p < 0.004) were observed in patients compared with controls prior to therapy, suggesting pre‑existing vascular and thermal dysregulation. Neoadjuvant therapy significantly altered thermal and vascular dynamics, reinforcing the utility of sensor‑based monitoring to capture subtle physiological responses during treatment.
- Novel approaches of physical therapy-based rehabilitationPublication . Noites, Andreia; Figueiredo, Ana; Sousa, Andreia S. P.; Pinheiro de Sousa, Andreia Sofia; Figueiredo, AnaThe field of physical therapy and rehabilitation sciences is currently undergoing a profound transformation. This Special Issue, titled “Novel Approaches in Physical Therapy and Rehabilitation”, was conceived to bring together cutting-edge research and evidence-based practices that are redefining the discipline, promoting knowledge exchange across research, clinical, and academic communities.
- Anorectal examination can be crucial in classifying Spinal Cord Injuries, but there is much more to explore - It is one piece of the puzzle, but not the entire puzzlePublication . Lopes, Alfredo Alexandre; Silva, Augusta; Luz, João; Lopes, Alfredo; Ferreira Silva, Maria AugustaThe International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) remain the reference framework for classifying spinal cord injury, with the absence of deep anal pressure and voluntary anal contraction defining complete injury (AIS A). Accumulating evidence, however, suggests that anorectal examination alone may not fully capture residual physiological connec-tivity in some individuals clinically classified as complete. Neurophysiological studies have reported preserved sensory, motor, or autonomic conduction despite the absence of sacral sparing on standard examination, challenging the conceptual boundaries between complete and incomplete injury. This commentary argues for a refined and integrative interpretation of neurological assessment that preserves the central role of ISNCSCI while incorporating complementary neurophysiological information and systematically collect-ed patient-reported manifestations. Rather than proposing reclassification or operational thresholds, the perspective presented is con-ceptual and hypothesis-generating. Emphasizing preserved connectivity and neuroplastic potential may enhance prognostic under-standing and support more individualized rehabilitation approaches. Future progress will depend on prospective validation studies, methodological standardization, and expert consensus to determine how multimodal information may responsibly inform classifica-tion without compromising clinical reliability
- The effect of daily walking during pregnancy on neuromuscular pain in the third trimesterPublication . Bobadilla-Agouborde, Carolina; Soto-Rodríguez, Francisco Javier; Benito-Villena, Rebeca; Mozas-Moreno, Juan; Santos, Paula Clara Ribeiro; Amezcua-Prieto, Carmen; Ribeiro Santos, Paula ClaraTo describe the frequency of neuromusculoskeletal pain across each trimester of pregnancy and assess the impact of daily walking from the second trimester on the incidence, prevalence, and daily life impact of such pain in the third trimester. A total of 192 pregnant women wearing pedometers from the beginning of the second trimester were analyzed. Daily walking activity, the frequency of back pain, pelvic girdle pain, and sciatic pain, as well as their impact on daily life, were measured. Women were categorized as physically active or inactive based on a threshold of 7000 steps/day. Back pain was the most commonly reported condition and had the greatest impact on daily life. No significant association was found between walking ≥7000 steps/day from the second trimester and the incidence or prevalence of pelvic girdle or sciatic pain in the third trimester. Additionally, no significant association was found with back pain prevalence, though the analysis suggested a possible trend in this direction. Walking ≥7000 steps/day from the second trimester was not significantly associated with musculoskeletal pain outcomes in the third trimester. While physical activity is essential for overall health, further research is needed to determine how different walking patterns and intensities may contribute to musculoskeletal pain prevention and management during pregnancy.
- From social media to body image distress: Problematic internet use, exercise addiction, and enhancement drugs use across countriesPublication . Dores, Artemisa R.; Burkaukas,Julius; Dores, ArtemisaSocial media increasingly shapes body image by promoting often unattainable beauty ideals. Concurrently, targeted online marketing of image- and performance-enhancing drugs (IPEDs) exploits these vulnerabilities, intensifying anxiety and fostering maladaptive behaviours such as problematic usage of the internet (PUI), compulsive exercise, and IPEDs consumption. This study explores these behaviours across nine countries and examines how PUI, excessive exercise, and IPEDs use predict appearance anxiety, aiming to inform targeted prevention strategies for at-risk populations. A total of 3,514 participants from nine countries completed a web-based survey assessing sociodemographic data, appearance anxiety (AAI), problematic internet use (PIUQ-9), excessive exercise (EAI-R), and IPEDs intake. Appearance-related anxiety was observed in 12% of the participants, with the highest prevalence in Mexico (20.7%), Japan (13.8%) and Italy (13.6%). Median PUI scores were highest in Mexico (22.57) and Singapore (21.59). Excessive exercise was reported by 3.6% with no significant country differences. IPEDs use was reported by 28.3% of the sample, with the highest rates in Japan (60.6%). Logistic regression analyses revealed that PUI, excessive exercise and IPEDs use were significant predictors of appearance-related anxiety. The strong associations between PUI, excessive exercise, IPEDs use, and appearance anxiety underscore the complex interplay between online exposure, body image concerns and mental health. Crosscountry differences suggest that socio-cultural factors influence appearance-related anxiety. These findings highlight the need for culturally sensitive interventions and policy measures that address the impact of digital media on body image, particularly to protect vulnerable populations.
- The use of virtual environments to prevent or treat behavioral addictions: A systematic reviewPublication . Cunha, Nelson Bruno de Almeida; Peixoto, Miguel; Dores, Artemisa R.; de Faria Távora Moreira Peixoto, Miguel; Dores, ArtemisaGambling Disorder (GbD) and Gaming Disorder (GmD) are associated with negative consequences that affect personal, social, and professional/academic domains. Although various efforts have been made to prevent and treat both conditions, traditional approaches have limitations, particularly given the technological nature of the environments in which these disorders develop. The aim of this review is to examine the characteristics of Virtual Reality (VR) and Augmented Reality (AR) based interventions for primary and secondary prevention of GbD and GmD. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA). A search was conducted across PubMed, Web of Science, Scopus, and EBSCO. Study quality was assessed using the Appraisal Tool for Cross-Sectional Studies (AXIS). Twelve studies (n = 498; 32.1% female) examined VR and AR interventions for GbD and GmD. Multiple VR therapy sessions significantly reduced craving and anxiety in GbD, while educational and self-regulation approaches promoted responsible gambling. In GmD, VR/AR-based interventions reduced symptom severity, gaming time, and negative emotions, improving physical activity and coping skills. Overall, immersive technologies showed consistent therapeutic and preventive benefits across both disorders, enhancing self-regulation and reducing addictive behaviors. The findings support the feasibility, safety, and therapeutic potential of immersive technologies in managing GbD and GmD, although evidence remains insufficient to determine optimal dosage. Future research should focus on long-term interventions with larger and more diverse samples to ensure generalizable results. Studies should also assess the cost-effectiveness of VR and AR as scalable prevention tools for both disorders.
- The agreement between a transducer and a microphone in the analysis of a synthesized vowel—Using a laboratory model as a preliminary experimentPublication . Pestana, Pedro; Byrne, Allison; Alegria, Rita; Araújo, André; Melo, Celso; Brasil, Christina César Praça; Manso, Maria Conceição; Guerreiro Martins Araújo, Pedro AndréThe objective of this study was to assess the agreement between the acoustic parameters of synthesized vowels, as measured by a piezoelectric transducer and a microphone. The central hypothesis posited that there would be a substantial degree of concordance between the acoustic parameters obtained by these two methods. A laboratory experiment was conducted using synthesized vowels. Acoustic parameters were recorded simultaneously using a microphone and a piezoelectric transducer. Vowels were synthesized using Madde software, with variations in fundamental frequency (fo) and amplitude level. Acoustic signals were captured by a Shure MX153 T microphone and a Shadow SH712 piezoelectric transducer. Signals were recorded using a Behringer FCA1616 audio interface and analyzed using Sopran and VOXplot software. Bland–Altman plots were used for statistical comparison of acoustic parameters. The degree of agreement between the microphone and the transducer varied according to acoustic parameters. Excellent agreement was observed for jitter, mean fo, fo standard deviation, and fo range. Good agreement was found for tilt, equivalent continuous sound level, harmonics-to-noise ratio from Dejonckere, high frequency noise, minimum fo, and maximum fo. Moderate agreement was observed for slope, amplitude difference H1–H2, shimmer, harmonics-to-noise ratio, smoothed cepstral peak prominence, and period standard deviation. While there was moderate to high agreement between the two methods for several acoustic parameters, discrepancies were noted. The microphone exhibited a tendency to record slightly higher values for the majority of the parameters; however, the transducer did demonstrate heightened sensitivity for certain parameters. The findings indicate that neither method can be universally interchanged with the other, and the selection of a method should be contingent on the particular requirements of the analysis.
- Understanding wearable health technology use in older adults through social and psychological factorsPublication . Félix, José; Moreira, Juliana; Pereira, Soraia; Guedes, Diana; Sá, Catarina; Santos, Rubim; Faria, Brígida; Kontio, Elina; Pinheiro, Ana Rita; Sousa, Andreia S. P.; Pinheiro de Sousa, Andreia Sofia; Faria, Brigida Monica; Rubim Silva Santos, Manuel; Sousa Félix, José Manuel; Santos Moreira, Juliana; C. Guedes, Diana; Pinheiro, Ana RitaAs populations age globally, wearable health technologies offer promising solutions to support autonomy and well-being among older adults. This study explored the adoption of smart wearable systems, such as wristbands and chest sensors, for remote health monitoring among 352 older adults (aged 60–99) in Northern Portugal. Results showed that 74.4% of participants expressed interest in using wearable systems, with safety (93.9%) cited as the main benefit. Prevention (11.4%) and improved health monitoring (6.1%) were reported less frequently and should be considered secondary factors. However, barriers included discomfort (62.7%), heaviness (31.1%), and device size (32.7%), particularly in smartwatches. Chest bands were preferred when soft, lightweight, and discreet. Technology use frequency, especially smartphone usage, emerged as a key predictor of interest, as confirmed by a decision tree machine learning model with an accuracy of 71.88%. Despite low educational levels, participants demonstrated high motivation to use features such as medication reminders (83.5%), healthy habit prompts (74.2%), and appointment alerts (70.2%). Although many respondents felt reassured by the potential of continuous monitoring, some reported concerns related to anxiety (54.9%) and over-surveillance. These findings underscore the importance of balancing technological functionality with emotional comfort. The study highlights the need for user-centered design, digital literacy initiatives, and co-creation with older users to improve adherence and usability. Tailored interventions and accessible technologies can enhance health outcomes and promote independent living among aging populations.
- Electromyographic assessment of the extrinsic laryngeal muscles: Pilot and descriptive study of a vocal function assessment protocolPublication . Ribeiro, Jéssica; Araújo, André; Sousa, Andreia S. P.; Pereira, Filipa; Pinheiro de Sousa, Andreia Sofia; Guerreiro Martins Araújo, Pedro AndréThe aim of this study was to develop and test a surface electromyography (sEMG) assessment protocol to characterise the activity of the extrinsic laryngeal muscles (suprahyoid and infrahyoid) during phonatory tasks and vocal techniques. The protocol of assessment was based on electromyographic assessment guidelines and on clinical voice evaluation needs and was tested in six healthy adults with no vocal disorders. Surface electromyographic activity of suprahyoid and infrahyoid muscles was acquired during different reference tasks (rest, reading, maximum contractions) and six vocal tasks, including nasal sounds, fricatives, and semi-occluded vocal tract exercises. A laryngeal accelerometer was used for detecting the beginning and end of each exercise. The average activity during each task was normalised by the signal obtained in the incomplete swallowing task for the SHM and by the sniff technique for the IHM. The range of activation values varied across tasks, with higher percentages observed in plosive production and in the “spaghetti” technique, while nasal and fricative sounds tended to show lower activation values within the group. A consistent pattern of simultaneous activation of suprahyoid and infrahyoid muscles was observed during phonation. The protocol proved potential for clinical application in speech–language pathology as it enabled the characterisation of muscle activity in determinant muscles for vocal function. Larger samples and further validation of the time-marking system are needed. This study provides a foundation for integrating sEMG measures into functional voice assessment.
- Effects of 5% caffeine ultrasonophoresis on Gynoid Lipodystrophy—A randomized controlled studyPublication . Cabral, Diana Santos; Noites, Andreia; Noites, AndreiaGynoid lipodystrophy (GL) affects most women, manifesting itself from puberty to adulthood. Its multifactorial etiology generates controversy in the literature about the most suitable treatment. Several methods are used, from the smallest to the most invasive, in the search for an effective fight against the severity of GL. The positive effect of ultrasound therapy (US) in decreasing subcutaneous adipose tissue is in increasing the skin permeability of pharmacological molecules, and it has aroused interest in the effect of a combination of the two techniques on the severity of GL. However, the results of this technique associated with an exercise program are unknown. To analyze the effect of three sessions of US + 5% caffeine in association with the realization of an exercise program, in females, on the level of severity of GL in the gluteal region and on the posterior proximal third part of the thigh. Methods: A total of 36 healthy women, aged between 18 and 55, who were considered to have GL, were randomly allocated in two experimental groups and one placebo group. The placebo group (PG) performed only physical exercise during the study. Experimental group 1 (EP1) performed US with 5% caffeine alongside a physical exercise protocol and experimental group 2 (EP2) performed US with a conventional US gel alongside a physical exercise protocol. The three groups completed three intervention sessions over 3 weeks, with one session per week. In addition to the level of severity assessed by the Cellulite Several Scale (CSS), anthropometric measures, body composition, and lipid profile of the participants were evaluated. The first assessment was carried out before the intervention (M0) and the last assessment after the three interventions (M1). The results were analyzed using the ANOVA test. The Tukey test was used for multiple comparisons of the groups in all variables, except for those related to the CSS, where the Kruskal–Wallis test was used with a significance level of 0.05. A total of 29 women completed the study. There was a significant decrease inside the PG related to triglycerides (p = 0.012). In M1, all groups started to present median values below 200 mg of triglycerides. In cholesterol, a significant reduction was observed in all groups (p = 0.05). On the gluteal level at 5 cm, there was a decrease in EP1 and EP2 between M0 and M1 with p = 0.006 and p = 0.002, respectively. On the CSS there were no significant differences between groups or between moments. Three sessions of 5% caffeine and US in association with a physical exercise protocol have no effect on reducing the level of severity of GL.