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- Prevalence, characteristics, and impact of spinal and lower limb recurrent pain at age 13Publication . Rodrigues, Elisa; Bessa, Isabel Moura; Brochado, Gabriela; Carvalho, Paulo; Talih, Makram; Pires, Catarina; Lucas, Raquel; Rodrigues, Elisa; Moura Bessa, IsabelTo compare spinal and lower limb pain in adolescents regarding prevalence, characteristics, causes, and impact. Methods: A descriptive cross-sectional study was conducted in 13-year-old adolescents (female n=2210; male n=2353) from the Portuguese Generation XXI birth cohort. Data were collected between 2018 and 2020 through personal interviews by applying the Luebeck Pain Questionnaire. The pain features examined in each anatomical location (back and lower limb) were recurrence, duration, frequency, intensity, perceived causes, and impact on school and leisure activities. Frequencies and the Chi-square test were used. Results: Questionnaires from 4563 adolescents were analysed, 57.9% had pain in the last three months (main pain in the spine: 11.6%; main pain in the lower limb: 29.0%). Of those, 69.4% and 62.4% reported recurrent pain in the spine and lower limb, respectively. Recurrent pain was more frequent in girls than in boys (spine: 80.0%; 57.0%; lower limb: 70.4%; 58.1% respectively). Pain lasted more than three months in most adolescents (spine: about 60%; lower limb: above 50%); frequency was similarly high in both regions and both sexes (girls: 47.0%; boys: 45.7% in the spine; girls: 45.7%; boys: 40.3% in the lower limb); intensity was rated as high by girls (spine: 45.5%; lower limb: 47.3%) and moderate by boys (spine: 42.0%; lower limb: 41.0%). The leading causes of pain were daily living activities, both for the spine (girls: 65.9%; boys: 76.5%) and the lower limb (girls: 62.2%; boys: 72.1%). Psychosocial causes were the second most common cause of spinal pain (girls: 25.0%; boys: 21.0%). Other causes of lower limb pain were traumatic (girls: 25.5%; boys: 16.6%) and physical factors (girls: 20.7%; boys: 23.8%). Absences from school (girls: 11.7%; boys: 4.8%) and restrictions of leisure activities (girls: 20.7%; boys: 25.2%) were more related to pain in the lower limb. Conclusion: More than half of the adolescents reported spinal or lower limb recurrent pain, which presents a higher frequency, higher intensity, and longer duration in the spine. However, lower limb pain led to more concurrent limitations.
- Electromyographic assessment of agonist and antagonist muscles related to the anterior cruciate ligament following surgical reconstruction: A cross-sectional studyPublication . Paredes, Ricardo; Pereira, Soraia; Crasto, Carlos; Guedes, Diana; Montes, António Mesquita; Alves, Leonel; Arias-Buría, José L.; C. Guedes, Diana; Mesquita Montes, AntónioFollowing anterior cruciate ligament reconstruction (ACLR), neuromuscular control alterations may persist, increasing the risk of reinjury. This study aimed to investigate electromyographic (EMG) muscle activation and the co-contraction index (CCI) of ACL-related agonist and antagonist muscles during side- hop tasks in ACLR individuals, offering novel insights into neuromuscular strategies during dynamic tasks. A cross-sectional study was conducted with 15 ACLR individuals and 15 participants without ACL injury (N-ACLR). Participants performed side-hop tasks while kinematic, kinetic, and EMG data were recorded during the preparatory and loading phases. Statistical analyses were performed at a 95 % confidence level. During ipsilateral side hops, ACLR individuals exhibited higher semitendinosus (ST) activity in the initial contact (IC) and risk phases and increased quadriceps:hamstrings (Q:H) CCI in the risk phase compared to N-ACLR (p < 0.05). In contralateral side hops, ACLR individuals demonstrated higher Q:H CCI in the preparatory phase and higher vastus lateralis:biceps femoris (VL:BF) CCI in the IC and risk phases (p < 0.05). ACLR individuals display altered neuromuscular strategies during side-hop tasks compared to N-ACLR, highlighting adaptations in muscle activation and co-contraction patterns.
- Sit-to-stand and stand-to-sit kinematics in older adults with and without functional disability: A principal component analysisPublication . Moreira, Juliana; Cunha, Bruno; Félix, José; Santos, Rubim; Sousa, Andreia S. P.; Rubim Silva Santos, Manuel; Pinheiro de Sousa, Andreia Sofia; Santos Moreira, JulianaSit- to-Stand (Sit- TS) and Stand-to-Sit (Stand- TS) transitions are essential daily movements affected by ageing and disability. This study aimed toexplore related kinematic domains in older adults with and without disability. A cross-sectional study including adults aged 60 years or older, with(n = 25) and without disability (n = 35). Comparisons between groups includedtask time, centre of mass (CoM) acceleration, postural sway and principal com-ponent (PC) scores for each task. Principal component models (PCMs) includedlower limb and trunk tridimensional joint ranges of motion, angular velocityrange, CoM displacement and velocity along each Sit-TS (flexion, momentumtransfer, extension and stabilisation) and Stand-TS (initiation, flexion, momen-tum transfer and extension) phases. Older adults with functional disability exhibited increased Sit-TS peakantero-posterior CoM acceleration (p = .02). The Sit-TS and Stand-TS PCMs in-cluded nine PCs each. In Sit-TS, the first three explained half the variance: PC1captured transverse hip and knee stabilisation kinematics, PC2 described trunkand hip frontal and transverse control during flexion, and PC3 represented sagittalknee and ankle control during momentum transfer and extension. In Stand-TS,variance was more distributed (PC1 describing frontal hip and knee flexion ve-locity, PC2 sagittal trunk and hip extension velocity, and PC3 vertical CoM veloc-ity at extension). Significant group differences emerged in PC4 (transverse kneeand frontal hip kinematics) and PC9 (sagittal and frontal trunk angular velocityranges during momentum transfer). Both transitions revealed distinct joint and trunk control de-mands. Principal components involving transverse knee, frontal hip and trunkangular velocities distinguished disability groups, with Stand-TS showing greaterdiscriminative power.
- Disrupted corticomuscular coherence and force steadiness during acute low back painPublication . Parolini, Franciele; Becker, Klaus; Ervilha, Ulysses F.; Santos, Rubim; Vilas-Boas, João Paulo; Goethel, Márcio Fagundes; Rubim Silva Santos, Manuel; Carvalho Santos Parolini, FrancieleAcute low back pain can impair motor control, yet its effects on force steadiness and cortical activity remain unclear. Thirty-three healthy adults (25 men, 8 women) performed a sustained spinal extension task at 20% of their maximum voluntary contraction under pre- and during-pain conditions induced by a hypertonic saline injection, as well as pre- and post-isotonic injection. Electromyography was recorded from the right and left longissimus muscles, and electroencephalography was collected from motor cortical areas. Spectral power in the alpha, beta, and gamma bands, along with corticomuscular and cortico-cortical coherence, was analyzed. Acute pain reduced force steadiness and altered cortical activity, with increased beta and gamma band power in the prefrontal cortex and decreased alpha power in the motor cortex. Localized changes in corticomuscular coherence were observed in the Cz region (beta and gamma bands) during pain, suggesting nociceptive modulation of corticomuscular coupling. Experimentally induced acute low back pain disrupts motor control by reducing force steadiness and modifying cortical activation patterns, highlighting the interplay between pain and neuromuscular regulation.
- Preliminary results on the efficacy of a neurocognitive training programme with multisensory integration in Major Neurocognitive DisorderPublication . Pinto, Joana O.; Dores, Artemisa R.; Peixoto, Bruno; Barbosa, Fernando; Dores, Artemisa; Pinto, Joana ONeurocognitive training was associated with positive effects on global neurocognition in patients with Major Neurocognitive Disorders (ND). However, despite evidence linking sensory deficits to neurocognitive dysfunction in the older population, no prior intervention has targeted neurocognition, including the sensation domain. To explore the efficacy of neurocognitive training with a multisensory integration (MI) component, a sample of 110 older adults was recruited from both daycare centers and nursing homes. Of these, 46 were diagnosed with mild to moderate Major ND and completed a neuropsychological assessment protocol at pre-, post-intervention, and at a 4-month follow-up. Participants were randomly assigned to four groups: NeuroRi, a hands-on neurocognitive training programme; NeuroRi with a MI component; NeuronUP a technology-based programme; and passive control group. All but the passive group completed two sessions per week with neurocognitive tasks for four months. Although this is a pilot study, the preliminary results suggest that combining NeuroRi with MI may offer potential benefits across several neurocognitive domains, including sensory-perceptual functioning in mild to moderate Major ND. However, these findings should be interpreted with caution due to the small sample size and the complex design of the study. This work provides recommendations for the neurocognitive intervention, from planning to assessing meaningful changes, while recognizing the limitations of the study and the need for further research to confirm these preliminary results.
- Challenges of ICT use for nurse-patient communication in Portugal: a mixed methods researchPublication . Peres, Marlene; Almeida, Raquel Simões de; Moreira, António; Simões de Almeida, RaquelThe future of digital health holds enormous potential to improve communication with patients and optimize the delivery of care. The current study aims to answer the central question of which knowledge, skills, and competencies in the use of Information and Communication Technologies (ICT), health professionals should develop to promote efficient remote communication processes with patients. A mixed-method approach was used for data collection, combining an online survey with semi-structured interviews. The study was structured into four key phases/question groups: professional context, practices related to the use of ICT in patient communication, training needs, and other relevant information. Qualitative data from open-ended responses were analysed using thematic analysis and triangulated with quantitative findings where applicable. The target population consisted of nursing professionals with patient care experience. The survey was distributed electronically, with 194 nurses fully or partially completing the questionnaire. Additionally, 24 interviews were conducted. The data shows that around 25.85% of professionals do not establish distance communication and 95.4% do not use telehealth. Telephone and cellular contact are the most used means of communication with patients (62.60%). Despite the predominance of face-to-face care, 62.5% stated that they do not experience difficulties or concerns, recognizing ICT as an increasingly integrated and advantageous tool for remote communication. Most professionals (80.1%) believe that there should be more training and courses in digital communication with patients and the use of ICT in healthcare, to address gaps in academic training. The growth of telemedicine and the digitalization of healthcare services reinforce the need for continuous professional training in this area. Most professionals have a positive perception of the opportunities created by emerging technologies, but they also express concerns about the ethical, social, safety and technical challenges that need to be addressed. The introduction of mandatory ICT courses in academic education and the implementation of continuous training are essential to prepare professionals for the challenges of telehealth and digital communication in healthcare. They emphasize the need for a well-structured digital transition, ensuring that technologies complement healthcare rather than replace human care.
- Development of a pandemic resilience competence model for healthcare professionals—individual and organisational aspectsPublication . Lorenzoni, Nina; Almeida, Raquel Simões de; Wimmer, Daniela; Simbrig, Ines; Simbrig, Ines; Moscon, Veronica; Carnelli, Fabio; Sulkowski, Nadine; Malaka, Elohor Pamela; Schober, Paul; Michel, Katharina; Sá, Vítor J.; Raich, Margit; Sá, Vítor J.; Simões de Almeida, RaquelThe COVID-19 pandemic highlighted the critical importance of resilience and adaptability at both individual and organisational levels in navigating unprecedented challenges. This study introduces a novel Pandemic Resilience Competence Model, a framework that articulates eight key competences each for individuals and organisations to enhance preparedness and response in pandemic scenarios. Employing a qualitative approach, the research identifies the essential skills and organisational capacities required to mitigate the impacts of pandemics. Using 50 semi-structured interviews with professionals and managers working in healthcare services in Austria, Germany, Italy, Portugal and the United Kingdom, the model provides actionable insights for implementing processes to improve preparedness and response in pandemic scenarios for stakeholders, including policymakers, educators, and organisational leaders. Findings highlight the interdependence of individual and organisational competences, reinforcing the need for integrated strategies to build pandemic resilience. The conclusions advocate for embedding the competences within training and development initiatives, aiming to enhance collective readiness for future global health crises.
- EEG signatures during pregnancy and their role on parenting-related measures: scoping reviewPublication . Braga, Patrícia Vilela; Amaoui, Sofia; Lamela, Diogo; Jongenelen, Inês; Costa, Raquel; Oliveira, Jorge; Pasion, Rita; Pinto, Tiago Miguel; Paiva, Tiago Oliveira; Campos, Carlos; Campos, CarlosThis scoping review aims to map and synthesise the current research evidence targeting the electroencephalography (EEG) neural correlates during pregnancy and its association with parenting-related measures during pregnancy and postpartum period. Pregnancy is characterised by a wide range of biological changes associated with adaptation to parenthood. A growing body of literature has examined the neural correlates of pregnancy using EEG, revealing distinct patterns in pregnant females, with these EEG metrics changing throughout gestation and postpartum. Due to the heterogeneity of the evidence, the current literature lacks an organised synthesis, making it difficult to understand the neural correlates during pregnancy and their association with parentingrelated measures during pregnancy and postpartum period. Studies will be included if they contain a quantitative EEG metric in their assessment in pregnant women. Studies will be included if they involve clinical or community samples. No sociodemographic, obstetric, or health exclusion criteria will be applied. The scoping review will be conducted following the Joanna Briggs Institute’s (JBI) guidelines and will be reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Searches will be conducted in 7 databases (Cochrane for Trials and Reviews, PsycInfo, PubMed, Psychological and Behavioural Science Collection, Scopus and Web of Science Core Collection) for articles published in English, Portuguese, or Spanish with no limitation on the region or publication time frame. Two independent reviewers will screen each record following a standardised flowchart using asreview lab. Data extraction will be performed by the two reviewers using charting tables in Excel. Disagreements at any step will be resolved via consensus or by a third reviewer. Results will be reported using tables and graphs along with a descriptive analysis, according to the research questions.
- Auditory N1, N2, and MMN to pure-tone and consonant–vowel stimuli in developmental dyslexia and benign rolandic epilepsy: A progressive insight into the underlying disruptive neurophysiologyPublication . Tomé, David; Pereira, Ilídio; Vieira, Maria Celeste; Soares, Ana Paula; Barbosa, FernandoBenign rolandic epilepsy or benign epilepsy in childhood with centrotemporal spikes (BECTS) and developmental dyslexia (DD) are two of the most studied disorders in childhood. Despite decades of research, the neurophysiological mechanisms underpinning these disorders are largely unknown. Here, we use auditory event-related potentials (AERPs) to shed light on these issues, since several authors have reported the existence of language and learning impairments. AERPs reflect the activation of different neuronal populations and are suggested to contribute to the evaluation of auditory discrimination (N1), attention allocation and phonological categorization (N2), and echoic memory (mismatch negativity (MMN]). This study aims to investigate and document AERP changes in a group of children with BECTS and another group with DD. AERPs were recorded to pure-tones and consonant–vowel (CV) stimuli in an auditory oddball paradigm in eight children with BECTS, seven with DD, and 11 gender- and age-matched controls. The results revealed perceptual deficits for pure-tone and CV stimuli (pre-attentional and auditory discrimination) in DD, related to N1 reduced amplitude (p< 0.05; Fz: 2.57 μV, Cz: 2.75 μV). The BECTS group revealed no significant results for N1; however, there was an increase in N2b latency. The findings in the DD group support the anchor-deficit hypothesis as an explanation for neurolinguistic deficits. The increased N2b latency in the BECTS group could be related to a potential lack of inhibitory mechanisms of pyramidal neurons, as justified by the process of epileptogenesis.
- Association between the history of fall and the fear of falling on stair descent and gait transition spatiotemporal parameters and lower-limb kinematics in older adultsPublication . Teles, Ivone; Moreira, Juliana; Sousa, Andreia S. P.; Santos Moreira, Juliana; Pinheiro de Sousa, Andreia SofiaAmong older adults, there is a high incidence of history of fall (HoF), fear of falling (FoF), and falls on stair descent during gait transitions. We aim to evaluate the association between HoF and FoF on spatiotemporal and lower-limb kinematic parameters in older adults during stair descents and gait transitions. Sixty older adults (>60 years) were evaluated through an optoelectrical motion capture system during stair descents and gait transitions, using the mean value of the task velocity and time; single- and double-support time; peak downward center of mass (CoM) velocity; hip, knee, and ankle positions of ipsi and the contralateral limb; and foot clearance and foot placement, assessed through multivariate analysis of variance. FOF exhibited longer time to complete (p = 0.009) and double-support (p = 0.047) and single-support (p = 0.009) times and a reduced peak downward CoM velocity (p = 0.043). In the gait transition cycle, HOF exhibited reduced ipsi ankle angles at toe-off (p = 0.015), and FOF presented reduced ipsi ankle angles at heel-strike (p = 0.041) and toe-off (p = 0.026) and reduced contralateral ankle angles at toe-off (p = 0.022).Older adults with HoF and FoF exhibit biomechanical changes during stair descents and gait transitions, in line with the use of more conservative strategies to avoid falling.