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- The face of low back pain: A preliminary method for quantifying pain-related facial expressionsPublication . Parolini, Franciele; Pires, Ricardo; Santos, Sara Dereste dos; Goethel, Márcio F.; Becker, Klaus; Vilas-Boas, João Paulo; Santos, Rubim; Ervilha, Ulysses F.; Rubim Silva Santos, Manuel; Carvalho Santos Parolini, FrancieleFacial expressions of pain are essential for pain assessment, yet subjective pain reports often vary between sexes. Traditional self-report measures are prone to bias, and objective methods are needed for more reliable pain evaluation. To develop and validate a subjectivity-free automated tool to assess acute low back pain using facial expressions recorded during a functional spinal extension task. Thirty healthy adults, aged 18–40 years. Methods: Participants received intramuscular injections of hypertonic (pain) and isotonic (placebo) saline in the lumbar region during separate sessions. Facial expressions were video-recorded during a submaximal lumbar extension task and analyzed using a custom software based on Haar Cascade and Local Binary Pattern Histogram algorithms, which are techniques that do not require neither training data nor subjective labeling, contrary to what happens in deep learning solutions. The tool successfully detected significant differences in facial expressions between pain, placebo, and pain-free conditions (p < 0.001). Test–retest reliability was good (ICC = 0.85). While both sexes showed similar facial expression patterns during pain, males reported higher pain scores on the numeric rating scale (p < 0.01). Pain significantly reduced steadiness of force in both sexes. The automated tool objectively quantified facial expressions associated with acute low back pain and revealed sex-related differences in subjective pain perception. This multimodal approach integrating expression analysis, physical performance, and self-report may enhance the accuracy of pain assessment in physiotherapy settings.
- Functional ability and independence among older adults in Northern Portugal: A cross-sectional studyPublication . Moreira, Juliana; Santos, Rubim; Sousa, Andreia S. P.; Santos Moreira, Juliana; Rubim Silva Santos, Manuel; Pinheiro de Sousa, Andreia SofiaThe aging process impacts daily living activities, highlighting the need to assess functional ability to support independence in older adults. To characterize the functional ability of community-dwelling older adults in northern Portugal. Methodology: Sixty older adults, aged 60 and above, were assessed for body composition, self-reported health, medication intake, and fall history. Independence in basic and instrumental daily activities was evaluated using the Barthel Index and Lawton and Brody scale, respectively. Functional tests included handgrip strength, 10 meters walk test, five-times sit-to-stand, Timed up and go test, and one leg standing test. Participants had an average age of 67.86±6.46 years, classified as pre-obese based on body mass index, 43.95±6.77 kilograms of muscle mass, and 30% of body fat. Over half (51.6%) rated their health as poor, 88.3% took prescribed medication (average of three per day), and 36.7% had fallen in the past year. Dependence was observed in daily activities (Barthel Index: 19.86±0.35; Lawton and Brody: 22.70±1.23). Functional tests revealed a handgrip strength of 27.39±8.56 kilograms (37.21±6.06 for males, and 22.50±3.93 for females), a self-selected gait velocity of 1.78±0.19 meters/second, a time to complete the five-times sit-to-stand, the Timed up and Go and the one leg standing of 15.48±3.71, 9.32±1.99 and 30.23±23.07 seconds, respectively. While older adults in northern Portugal demonstrate mild functional impairments, their challenges in daily activities and self-perceived health from age 60 underscore the importance of early intervention strategies. Further research is needed to identify influencing factors and develop targeted interventions to enhance independence.
- Effectiveness of an intervention program for informal carers of children admitted to a rehabilitation centrePublication . Morais, Sónia; Pimenta, Rui Esteves; Morais, Carminda; Macedo, Rui; Ribeiro, Inês; Ferreira, Pedro Lopes; Pimenta, Rui; Macedo, RuiHealth literacy improves informal caregivers’ knowledge and ability to provide care. The aim of this study is to analyze the impact of a group-based intervention on the health literacy of informal caregivers of children with special health needs (SHNs). The intervention focuses on movement, hydrotherapy, walking, and relaxation, with three evaluation stages. Participants included 34 informal caregivers of children with SHNs, recruited at a Physical Medicine and Rehabilitation Service. We collected sociodemographic data of the participants and measured their health literacy through the short-form version of the European Health Literacy Survey Questionnaire (HLS-EU-Q16). Around 70% of the participants were female, with a mean age of 41.06 ± 4.98 years, and nearly 85% were married or in a de facto union. About 26% were unemployed, and more than 65% had completed secondary education or higher. The mean scores of the HLS-EU-Q16 were statistically significantly higher throughout the intervention, with differences over the evaluation stages [F(2,56) = 75.55; p < 0.05]. A structured, dynamic, and group-based intervention plan showed improvements in the health literacy of the participants, with an increase in the percentage of participants with sufficient and excellent levels of health literacy at the end of the intervention.
- Exercício em meio aquático e capacidade funcional – um estudo em adultos mais velhosPublication . Gonçalves, Luísa; Touabet, Myriam; Vieira, Ágata; Vieira, ÁgataO treino aquático é eficaz na manutenção e melhoria da capacidade funcional em adultos mais velhos, aproveitando as propriedades físicas e hidrodinâmicas da água para contrabalançar o declínio associado ao envelhecimento. Avaliar a capacidade funcional de adultos mais velhos praticantes de exercício aquático e analisar a sua associação com caraterísticas individuais: sociodemográficas, comportamentais e estado de saúde. Foi realizado um estudo transversal analítico em 41 voluntários, com idade superior a 65 anos, que realizavam exercício aquático duas vezes por semana (Aprovação Ética nº 38/CE-IPSN/2024). As caraterísticas dos participantes foram recolhidas por questionário e a capacidade funcional (independência, mobilidade e risco de queda) foi avaliada através dos testes Five Time Sit-To-Stand (5xSTS) e Timed Up and Go (TUG). A análise estatística foi realizada (SPSS v.29.0) com um nível de significância ⍺=0,05. Com uma mediana de idade de 68 (±7,00) anos, trinta e três (80,5%) participantes eram do sexo feminino. Os participantes apresentaram uma mediana de 9,2 (± 2,74) segundos, sendo que 90,2% tinham mobilidade sem risco de queda (5xSTS), e uma mediana de 9,7 (± 3,34) segundos, sendo que 61% dos participantes eram totalmente independentes (TUG). Não foi encontrada uma associação estatisticamente significativa entre as pontuações do 5xSTS e as caraterísticas individuais (p>0,05). A idade apresentou correlação positiva moderada estatisticamente significativa (p=0,005; r=0,433) com as pontuações do TUG. Os indivíduos com défices de visão (p=0,016) ou doença física/mental (p=0,030) apresentaram pontuações superiores no TUG. A maioria dos participantes apresentou mobilidade e independência funcional, sem risco de queda. Nesta amostra, a idade avançada, os défices de visão e a presença de patologia parecem ter um impacto negativo nos níveis de capacidade funcional (TUG).
- Development and validation of a Portuguese psychologist's empathy scale: A pilot studyPublication . Cruz, Márcia; Grilo, Ana; Custódio, Susana; Dores, Artemisa R.; Silva, Carina; Alves, Paulo; Dores, ArtemisaThe systematic assessment of empathy is essential for identifying psychologists' competencies and developmental needs, ultimately contributing to more effective clinical practice. Given the multidimensional nature of empathy, comprehensive evaluation requires consideration of its cognitive, affective, and behavioural dimensions. How ever, no existing instrument is specifically validated to assess psychologists' self-perceived empathy in clinical contexts. To address this limitation, the present pilot study aimed to develop and undertake a preliminarily validation of the Portuguese Psychologists' Empathy Scale (PPES), a self-report instrument designed to assess empathy among psychologists working in Portuguese-speaking contexts across these three components. The study proceeded in two phases: item construction and initial psychometric testing. A total of 106 Portuguese psychologists completed a 57-item Likert-type instrument. Bartlett's test of sphericity was significant (χ2 (45) = 811.56, p < .001), and the KMO index (0.73) indicated moderate adequacy for factor analysis. Exploratory factor analysis revealed three core factors explaining 48% of the total variance, with strong internal consistency. A subsequent confirmatory factor analysis supported model refinement, leading to the removal of items with low factor loadings. The final PPES comprises 43 items distributed across cognitive (16), affective (16), and behavioural (11) dimensions. The findings provide encouraging preliminary evidence for the PPES, demon strating robust internal consistency and acceptable initial factorial validity. Nevertheless, further studies using independent samples and external validation procedures are required to fully establish its psychometric soundness and clinical applicability with Portuguese-speaking psychologists.
- Effect of taping on postoperative recovery following SaphenectomyPublication . Guerero, Raquel Michelini; Zordão, Catarina Clápis; Zampieri, Elisa Helena Subtil; Noites, Andreia; Guirro, Elaine Caldeira de Oliveira; Noites, Andreia; Noites, Andreia; Sousa, Andreia S. P.Post-surgical complications are common complications following saphenectomy surgery, and strategies to facilitate its resolution are essential for postoperative recovery. This study evaluated the effects of adhesive elastic taping on edema control in patients undergoing saphenectomy. A randomized controlled clinical trial was conducted with 40 patients of both sexes, divided into two groups: intervention (IG), which received taping immediately after surgery combined with standard compression, and a control group, which received standard treatment with compression stockings (CG). Assessments were performed preoperatively and seven days after surgery, including limb volume (indirect calculation), edema (dielectric constant analysis), Skin Elasticity Assessment (durometer), pain (Visual Analog Scale—VAS), limb functionality (Lower Extremity Functional Scale—LEFS), and ecchymosis area (Image J, version 1.51). Both groups showed a significant increase in edema postoperatively (IG: p = 0.003; CG: p = 0.001). The intervention group exhibited a trend toward volume reduction (p = 0.069), better functionality (p = 0.006)—skin elasticity was assessed using a durometer—and fewer ecchymoses (p = 0.002). Only the control group showed a significant increase in tissue firmness (p = 0.012). No significant difference in pain was observed between groups (p = 0.203). The application of taping demonstrated beneficial effects on postoperative functional recovery and ecchymosis control following saphenectomy.
- Predicting the occurrence of falls among portuguese community-dwelling adults aged 50 or older using the timed up and go testPublication . Martins, Anabela Correia; Moreira, Juliana; Silva, Catarina; Tonelo, Cláudia; Rocha, Clara; Santos Moreira, JulianaFalls are a major cause of morbidity and mortality among older adults. While the Timed Up and Go (TUG) test has recently been identified as the best predictor of falls, it should not be used in isolation to identify individuals at risk. This study aims to develop a predictive model by combining the TUG test with fall risk factors that involve intrinsic and extrinsic elements to predict future falls in Portuguese community-dwelling adults aged 50–60, 60–70, and 70 years or older. A total of 403 participants aged 50 or older completed a questionnaire on demographic information and fall risk factors, underwent the TUG test, and were monitored for 12 months to record falls. ROC curve analysis demonstrated that the TUG test alone effectively distinguished fallers from non-fallers exclusively among adults aged 50–60, with a cut-off time of 6.9 s. Multivariate logistic regression defined three predictive models based on age groups, with ROC curve results as follows: 50–60 (AUC = 0.825, cut-off = 18.1), 60–70 (AUC = 0.754, cut-off = 17.8), and 70 or older (AUC = 0.708, cut-off = 24.8). These findings are clinically significant, demonstrating that the TUG test combined with a few self-reported questions can efficiently identify individuals at risk of falling in just a few minutes, without requiring specialized equipment.
- Kinematic biomarkers of functional disability in older adultsPublication . Moreira, Juliana; Cunha, Bruno; Félix, José; Santos, Rubim; Sousa, Andreia S. P.; Santos Moreira, Juliana; Sousa Félix, José Manuel; Rubim Silva Santos, Manuel; Pinheiro de Sousa, Andreia SofiaThe Timed Up and Go (TUG) test is used to assess mobility in older adults, but its reliance on completion time limits its insight into detailed movement patterns that could serve as early indicators of functional decline. This study aimed to identify lower limb and trunk kinematic biomarkers during the TUG test that distinguish between older adults with and without functional disability, emphasizing the potential for wearable sensor applications. Sixty adults aged 60+ participated in this cross-sectional study. Three-dimensional lower limb and trunk range of motion (ROM), velocity, center of mass (CoM) displacement, and velocity were analyzed using an optoelectronic system across TUG subphases: sitto-walk, walk-forward, turn, walk-back, and turn-to-sit. Principal component analysis identified eleven principal components (PCs), explaining 84.33% of the total variance. PCs included sagittal hip and knee motion and CoM velocity during turn-to-sit and walking (PC1); tri-dimensional trunk velocity during turning, walk-back, and sit-to-walk transitions (PC2, PC4, PC6); sagittal knee and hip velocity in sit-to-walk (PC3); and frontal and transverse plane knee ROM and velocity during turning (PC5). Significant differences between functional disability groups were found for PC1 and PC4. These findings provide benchmark data for developing and validating wearable biosensors aimed at monitoring kinematic biomarkers.
- Cross-cultural adaptation, validity and reliability of the European Portuguese Version of the Kerlan-Jobe Orthopaedic Clinic Shoulder & Elbow Score (KJOC)Publication . Almeida, Gonçalo; Amaral, Luísa; Vilarinho, Rui; Magalhães, Bárbara; Silva, Fátima; Abreu, Verónica; Magalhães, André; Esteves, Mário; Cervaens, Mariana; Vilarinho, RuiThe Kerlan-Jobe Orthopaedic Clinic Shoulder & Elbow Score (KJOC) is used to identify dysfunctions and estimate injury risk in overhead sports athletes. Although it has been validated in several countries, a European Portuguese version is currently unavailable. This study aimed to translate, culturally adapt and assess psychometric properties (validity and reliability) of the European Portuguese KJOC (KJOC-PT). The KJOC-PT was translated and culturally adapted according to international guidelines. One hundred athletes were selected (median age 24 [IQR 17] years, 72% male) and divided into two groups: asymptomatic and symptomatic athletes. The convergent validity was assessed by correlating the KJOC-PT with the Disabilities of the Arm, Shoulder and Hand (DASH) and DASH-Sports. 31 athletes from the initial sample were considered to assess between-day reliability and agreement (Bland-Altman analysis). Floor and ceiling effects were also calculated. Sampling adequacy was assessed using the Kaiser Meyer-Olkin (KMO) test. Minor cultural and linguistic changes were made in the KJOC-PT. This version demonstrated excellent internal consistency (Cronbach’s α = 0.91 to 0.97) and moderate negative correlations for validity (KJOC-PT with DASH, rho = −0.595; with DASH-Sports, rho = −0.533, both p < 0.001). Good reliability (ICC2,1 = 0.77 to 0.89 [95%CI 0.36 to 0.96]), measurement error (SEM = 4.11 to 6.90; MDC = 11.39 to 19.13) and mean difference ranging from −0.08 ± 6.14 to 3 ± 9.17 were found. No floor effect (0%) and ceiling effects of 24.2% for the total sample (50% for asymptomatic and 5.1% for symptomatic athletes) were found. KJOC-PT is now available and is a valid and reliable instrument for use by athletes in overhead sports.
- Deep technologies and safer gambling: A systematic reviewPublication . Cardoso, Leonor G.; Barroso, Beatriz C. R.; Piccoli, Gloria; Peixoto, Miguel; Morgado, Pedro; Marques, António; Rocha, Carla; Griffiths, Mark D.; Queirós, Ricardo; Dores, Artemisa; Pereira da Silva Marques, António José; de Faria Távora Moreira Peixoto, MiguelDeep technologies combine engineering innovation and scientific findings to solve complex problems and are becoming particularly relevant to the gambling industry. With the global rise of gambling practices and the subsequent increase of gambling-related problems and disorders, deep technologies have emerged as a way to create safer online gambling environments. However, there is still limited knowledge regarding their applica bility and consequences. The present study systematically reviewed the existing literature on deep technologies in gambling environments, such as online casinos and betting platforms, and explored their potential benefits, risks, and effectiveness in promoting safer gambling experiences. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Searches were conducted in Web of Sci ence, PubMed, Scopus, EBSCO, and IEEE databases, and manually. A total of sixty-eight studies were included in the review. In general, four primary applications of deep technologies in online settings were found: (i) behavioural monitoring and feedback; (ii) predictive risk modelling; (iii) decision support and AI classifiers; and (iv) limit-setting/self-exclusion tools. They were primarily used to identify and classify problematic gambling, prompt individual action, regulate gambling behaviours, raise awareness of risk levels, promote responsible gambling practices, support research, interventions, and evaluate player protection initiatives. Together, the findings suggest that deep technologies offer ample opportunities to enhance gambler safety and reduce potential risks, although challenges may arise from their implementation, such as privacy and ethical concerns, malicious data use, misclassification of risk levels, and difficulties in large-scale application. Limitations and directions for future studies are discussed