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- Diagnostic ultrasound assessment of deep fascia sliding mobility in vivo: A scoping review – Part 2: Femoral and crural fasciaePublication . Soares, Hélio Rafael; Pinheiro, Ana Rita; Crasto, Carlos; Barbosa, Pedro; Dias, Nuno; Carvalho, PauloFailure of fascial sliding may occur in cases of excessive or inappropriate use, trauma, or surgery, resulting in local inflammation, pain, sensitization, and potential dysfunction. Therefore, the mechanical properties of fascial tissues, including their mobility, have been evaluated in vivo by ultrasound (US) imaging. However, this seems to be a method that is not yet properly standardized nor validated. To identify, synthesize, and collate the critical methodological principles that have been described in the literature for US evaluation of deep fascia sliding mobility in vivo in humans. A systematic literature search was conducted on ScienceDirect, PubMed (Medline), Web of Science and B-On databases, according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. The OCEBM LoE was used to evaluate the level of evidence of each study. ́ From a total of 104 full-text articles retrieved and assessed for eligibility, 18 papers were included that evaluate the deep fasciae of the thoracolumbar (n ¼ 4), abdominal (n ¼ 7), femoral (n ¼ 4) and crural (n ¼ 3) regions. These studies addressed issues concerning either diagnosis (n ¼ 11) or treatment benefits (n ¼ 7) and presented levels of evidence ranging from II to IV. Various terms were used to describe the outcome measures representing fascial sliding. Also, different procedures to induce fascial sliding, positioning of the individuals being assessed, and features of US devices were used. The US analysis methods included the comparison of start and end frames and the use of cross-correlation software techniques through automated tracking algorithms. These methods had proven to be reliable to measure sliding between TLF, TrA muscle-fascia junctions, fascia lata, and crural fascia, and the adjacent epimysial fascia. However, the papers presented heterogeneous terminologies, research questions, populations, and methodologies. This two-part paper reviews the evidence obtained for the thoracolumbar and abdominal fasciae (Part 1) and for the femoral and crural fasciae (Part 2). The US methods used to evaluate deep fascia sliding mobility in vivo in humans include the comparison of start and end frames and the use of cross-correlation software techniques through automated tracking algorithms. These seem reliable methods to measure sliding of some fasciae, but more studies need to be systematized to confirm their reliability for others. Moreover, specific standardized protocols are needed to assess each anatomical region as well as study if age, sex-related characteristics, body composition, or specific clinical conditions influence US results.
- 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.
- Parkinson’s disease and cognitive-motor dual-task: is motor prioritization possible in the early stages of the disease?Publication . Fernandes, Ângela; Sousa, Andreia S. P.; Rocha, Nuno; Tavares, João Manuel R. S.The authors aimed to compare the postural phase ofgait initiation under single-task (gait initiation) and dual-task (gaitinitiation plus Stroop test) conditions in healthy subjects and insubjects with Parkinson’s disease (PD) in the early stages (Hoehnand Yahr scale<3). The postural phase of gait initiation wasassessed through the centre of pressure in single and dual task in10 healthy subjects and 9 with PD. The analysis indicated that inthe early stages of PD, an additional cognitive task did not affectthe displacement of the gait initiation. No significant effectsoccurred between the groups and within-subjects (p>.05). Also,no interaction was found between the groups and the conditions(single- and dual-task). Differences were found in the duration ofthe mediolateral postural phase (pD.003), which was higher inPD subjects than in healthy subjects. The findings suggest thatsubjects in the early stages of PD prioritize gait initiation, as theirmotor performance was similar to that of healthy subjects.
- Diagnostic ultrasound assessment of deep fascia sliding mobility in vivo: A scoping review – Part 1: Thoracolumbar and abdominal fasciaePublication . Soares, Hélio Rafael; Pinheiro, Ana Rita; Crasto, Carlos; Barbosa, Pedro; Dias, Nuno; Carvalho, Paulo deFailure of fascial sliding may occur in cases of excessive or inappropriate use, trauma, or surgery, resulting in local inflammation, pain, sensitization, and potential dysfunction. Therefore, the mechanical properties of fascial tissues, including their mobility, have been evaluated in vivo by ultra-sound (US) imaging. However, this seems to be a method that is not yet properly standardized nor validated. To identify, synthesize, and collate the critical methodological principles that have been described in the literature for US evaluation of deep fascia sliding mobility in vivo in humans. Methods: A systematic literature search was conducted on ScienceDirect, PubMed (Medline), Web of Science and B-On databases, according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. The OCEBM LoE was used to evaluate the level of evidence of each study. From a total of 104 full-text articles retrieved and assessed for eligibility, 18 papers were included that evaluate the deep fasciae of the thoracolumbar (n ¼ 4), abdominal (n ¼ 7), femoral (n ¼ 4) and crural (n ¼ 3) regions. These studies addressed issues concerning either diagnosis (n ¼ 11) or treatment benefits (n ¼ 7) and presented levels of evidence ranging from II to IV. Various terms were used to describe the outcome measures representing fascial sliding. Also, different procedures to induce fascial sliding, positioning of the individuals being assessed, and features of US devices were used. The US analysis methods included the comparison of start and end frames and the use of cross-correlation software techniques through automated tracking algorithms. These methods had proven to be reliable to measure sliding between TLF, TrA muscle-fascia junctions, fascia lata, and crural fascia, and the adjacent epimysial fascia. However, the papers presented heterogeneous terminologies, research questions, populations, and methodologies. This two-part paper reviews the evidence obtained for the thoracolumbar and abdominal fasciae (Part 1) and for the femoral and crural fasciae (Part 2). The US methods used to evaluate deep fascia sliding mobility in vivo in humans include the comparison of start and end frames and the use of cross-correlation software techniques through automated tracking algorithms. These seem reliable methods to measure sliding of some fasciae, but more studies need to be systematized to confirm their reliability for others. Moreover, specific standardized protocols are needed to assess each anatomical region as well as study if age, sex-related characteristics, body composition, or specific clinical conditions influence US results.
- Pulmonary function and respiratory muscle strength after arthrodesis of the spine in patients who have adolescent idiopathic scoliosisPublication . Lopes, A. A.; Flores, F.; Ribeiro, F.; Oliveira, A.Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis, affecting children from the age of 10. In addition to back pain, poor self-perceived health, reduced social participation and cosmetic issues, severe thoracic curves are also strongly associated with reduced pulmonary function. When the scoliosis is severe (Cobb angles above 45–50°) and conservative treatment is not sufficient, surgical management is considered to correct the spinal deformity, maintain/enhance pulmonary function, minimize pain and morbidity. Previous studies assessing the impact of posterior spinal fusion in AIS patients have showed that pulmonary function improved, decreased, or remained unchanged after surgery. In general, the studies did not assess respiratory muscle strength, which could also be impaired due to the biomechanics changes of the spine and thoracic cage. Therefore, this study aimed to evaluate pulmonary function and respiratory muscle strength three months after corrective surgery for AIS.
- Methodological considerations in assessing interlimb coordination on poststroke gait: a scoping review of biomechanical approaches and outcomesPublication . Couto, Ana G. B.; Vaz, Mário A. P.; Pinho, Liliana; Félix, José; Silva, Sandra; Silva, Augusta; Sousa, Andreia S. P.To identify and summarize biomechanical assessment approaches in interlimb coordination on poststroke gait. Interlimb coordination involves complex neurophysiological mechanisms that can be expressed through the biomechanical output. The deepening of this concept would have a significant contribution in gait rehabilitation in patients with an asymmetric neurological impairment as poststroke adults. Poststroke adults (>19 years old), with assessment of interlimb coordination during gait, in an open context, according to the Population, Concept, Context framework. A literature search was performed in PubMed, Web of Science™, Scopus, and gray literature in Google Scholar™, according to the PRISMA-ScR recommendations. Studies written in Portuguese or English language and published between database inception and 14 November 2021 were included. Qualitative studies, conference proceedings, letters, and editorials were excluded. The main conceptual categories were “author/year”, “study design”, “participant’s characteristics”, “walking conditions”, “instruments” and “outcomes”. The search identified 827 potentially relevant studies, with a remaining seven fulfilling the established criteria. Interlimb coordination was assessed during walking in treadmill (n = 3), overground (n = 3) and both (n = 1). The instruments used monitored electromyography (n = 2), kinetics (n = 2), and kinematics (n = 4) to assess spatiotemporal parameters (n = 4), joint kinematics (n = 2), anteroposterior ground reaction forces (n = 2), and electromyography root mean square (n = 2) outcomes. These outcomes were mostly used to analyze symmetry indices or ratios, to calculate propulsive impulse and external mechanical power produced on the CoM, as well as antagonist coactivation. Assessment of interlimb coordination during gait is important for consideration of natural auto-selected overground walking, using kinematic, kinetic, and EMG instruments. These allow for the collection of the main biomechanical outcomes that could contribute to improve better knowledge of interlimb coordination assessment in poststroke patients.
- Effect of an aquatic therapy program on pain and spinal mobility in ankylosing spondylitisPublication . Correia, Mónica Susana; Lopes, Alfredo Alexandre Tomé; Silva, Francisco; Silva, Diogo; Castro, Marcelo Peduzzi deAnkylosing Spondylitis (AS) can lead to an increase in pain and is characterized by a decrease in mobility. The purpose of this study was to assess the acute and medium-term effects of a 12-week aquatic therapy program on pain and mobility in individuals with AS.
- 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.
- Handgrip strength time profile and frailty: an exploratory studyPublication . Urbano, Diana; Restivo, Maria Teresa; Barbosa, Manuel Romano; Fernandes, Ângela; Abreu, Paulo; Chousal, Maria de Fátima; Coelho, TiagoThis study aims to explore the use of force vs. time data obtained from an isometric handgrip test to match a frailty state based on the TFI score. BodyGrip, a novel prototype system, is used for handgrip strength over 10 s time interval tests. A cross-sectional study with a non-probabilistic sample of community-dwelling elderly women was conducted. The force/time data collected from the dominant handgrip strength test, together with the Tilburg Frailty Indicator (TFI) test results, were used to train artificial neural networks. Different models were tested, and the frailty matching of TFI scores reached a minimum accuracy of 75%. Despite the small sample size, the BodyGrip system appears to be a promising tool for exploring new frailty-related features. The adopted strategy foresees ultimately configuring the system to be used as an expedite mode for identifying individuals at risk, allowing an easy, quick, and frequent person-centered care approach. Additionally, it is suitable for following up of the elderly in particular, and it may assume a relevant role in the mitigation of the increase in frailty evolution during and after the imposed isolation of the COVID-19 pandemic. Further use of the system will improve the robustness of the artificial neural network algorithm.
- Muscle strength assessment of knee flexors and extensors. Comparative study between basketball, football, handball and volleyball athletesPublication . Teixeira, Jorge; Carvalho, Paulo; Moreira, Camilo; Carneiro, Ana; Santos, RubimMuscle strength of lower limbs is considered a key factor in handball, basketball, football and volleyball athletes’ performance, as support of specific motor skills and actions. One of the methods used to assess muscle strength is isokinetic dynamometry.