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- From healthcare system to individuals through stroke rehabilitation pathways. Outcomes, information, and satisfaction along 12 months prospective cohort in PortugalPublication . Barbosa, Pedro Maciel; Machado, João Firmino; Ferreira, Lara Noronha; Cruz, Vitor Tedim; Szrek, Helena; Barbosa, PedroThe nature and quality of stroke survivor rehabilitation varies throughout Europe,including in Portugal, having not been widely monitored or benchmarked. This study analyses the stroke care pathway from three perspectives: healthcare system, process, and patient. The study uses data from a one-year single-center prospective cohort of first stroke patients, assessed at baseline, 3, 6, and 12 months. Care pathways and settings were described interms of organizational model, funding, patient involvement, frequency and intensity and multi-disciplinary team. Patient-level information and satisfaction were evaluated using a 10-point numeric rating scale. Kruskal – Wallis and post-hoc tests were used to compare EQ-5D-3 L, National Institute of Health Stroke Scale (NIHSS), Modified Rankin Scale (mRS), Barthel Index, Mini-Mental State Examination scores between pathways and settings. A total of 391 acute stroke patients, with a mean disability of 3.7 (mRS) and severity of 11.7(NIHSS) participated. Six pathways and eight settings were described. A lack of compliance between guidelines and care was identified. There were significant differences in the four outcomes between the six pathways (p-values 0.007 to 0.020) suggesting inefficiency and inequalities, with an inadequate level of information and patient satisfaction. After post-hoc analysis, pathways 1 and 2 showed highest outcomes (p-values 0.001 to 0.002). Within settings, short-term units showed high scores,followed by rehabilitation center, outpatient hospital, and community clinic (p-values 0.001 to 0.040).A multilevel characterization of the post-stroke rehabilitation pathway showed a more complete perspective on stroke management which may contribute to future rehabilitation and stroke policies.
- Factors associated with urinary incontinence in female weightliftersPublication . Lopes, Sofia; Becam, Manon; Pierrot, Carla; Réard, Julie; Carvalhais, Alice; Vieira, Ágata; Brochado, Gabriela; Lopes, SofiaUrinary incontinence (UI) is common among women practicing sports, particularly those involving heavy lifting or high-impact movements that increase intra-abdominal pressure. UI can negatively affect social life, self-confidence, and motivation to remain active. This study aimed to examine the associations of sociodemographic, training-related, obstetric, and surgical factors with UI in female weightlifters. This cross-sectional study included 84 French women who regularly practiced weightlifting. Participants completed a structured questionnaire collecting sociodemographic and gynecological information, as well as the Urinary Symptom Profile (USP). Data were analyzed using appropriate inferential statistical tests, including the Mann–Whitney U test, Student’s t-test, chi-square test, and Fisher’s exact test, as applicable. A 95% confidence level was adopted for all analyses. Among participants (aged 15–49 years), 51 (60.7%) reported involuntary urine leakage, and 31 (36.9%) scored 1–3 on the USP stress incontinence subscale. Most participants were non-smokers (73.8%), with a median of 3.5 years of weightlifting experience, four weekly training sessions, and six–seven competitions per year. No significant associations were found between UI and sociodemographic factors, obstetric history, previous surgeries, or training characteristics. Maximal lifts in Clean & Jerk and Snatch exercises were also similar between participants with and without UI. Slight trends suggested a higher UI prevalence among women with vaginal deliveries, episiotomies, or vaginal lacerations. Regarding athletes with and without UI, no differences were found (p > 0.05) with respect to weightlifting belt use or the breathing phase during load lifting. UI is common among female weightlifters, but in this study, was not associated with sociodemographic factors or weightlifting practices. These findings indicate that UI prevalence cannot be explained by the variables studied and highlight the need for further research into other potential contributing factors.
- Impact of shoulder pain on upper limb function: An observational study in post-stroke individualsPublication . Lopes, Sofia; Fernandes, Ângela; Lopes, Sofia; Fernandes, ÂngelaShoulder pain is a frequent complication after stroke, often associated with reduced arm function, decreased independence, and poorer quality of life. This study aimed to investigate the relationship between post-stroke shoulder pain, motor performance, functional outcomes, and spasticity to provide clinically relevant evidence for rehabilitation. We conducted an observational study including individuals who had experienced a stroke and were undergoing neurorehabilitation. Pain severity and its interference with daily activities were measured through structured clinical evaluation. Motor outcomes were assessed with standardized functional and strength tests, and spasticity was measured using a validated clinical scale. Sociodemographic and clinical variables, including time since stroke and stroke type, were also collected. The mean pain severity score was 4.82 (standard deviation 1.72). Pain severity correlated strongly with pain interference, although neither was significantly associated with motor or functional performance. Motor and functional variables were interrelated: motor recovery scores correlated positively with functional independence and grip strength, and negatively with spasticity. Time since stroke influenced outcomes, with poorer motor and functional results in participants more than two years post-event. Stroke type influenced pain, with greater interference reported in patients with ischemic stroke. No significant differences were observed between sexes. These findings highlight the multifactorial nature of shoulder pain after stroke and emphasize the importance of early and individualized rehabilitation strategies. Addressing pain, spasticity, and functional limitations together may improve long-term outcomes and quality of life for individuals living with the consequences of stroke.
- Physical activity during pregnancy: Associations between levels and types of physical activity and low back pain–related disability in Portuguese pregnant womenPublication . Teixeira, Isabel; Santos, Paula Clara; Festas, Clarinda; Bernardo, Diana; Santos, Paula ClaraLow back pain (LBP) is one of the most prevalent musculoskeletal conditions during pregnancy and frequently impairs daily living activities and quality of life. The association between different levels and types of physical activity (PA) and LBP-related functional disability remains insufficiently explored. This study aimed to examine the association between PA levels and types and functional disability among pregnant women with LBP. A cross-sectional analytical study was conducted involving 192 Portuguese pregnant women. Data were collected through an online questionnaire comprising the Pregnancy Physical Activity Questionnaire and the Oswestry Disability Index (ODI). Most participants engaged predominantly in light-intensity or sedentary activity (69.1%), with minimal participation in vigorous activity (0.8%). Functional disability was generally mild (mean ODI = 11.5 ± 7.35); however, 42.2% of participants reported moderate disability and 11.0% severe disability. Advancing gestational age showed weak associations with increased domestic activity (r = 0.146, p = 0.044), decreased occupational activity (r = −0.295, p = 0.001), and higher functional disability scores (r = 0.142, p = 0.049). Parity was associated with differences in total PA levels (p = 0.005) and domestic activity (p = 0.001). Higher ODI scores were weakly associated with light-intensity and sedentary activity (r = 0.144, p = 0.047), whereas severe disability demonstrated a moderate association with sedentary behavior (r = 0.529, p = 0.014). Overall, lower levels of PA, particularly sedentary behavior, were weakly associated with higher LBP-related disability; however, the observed associations were generally weak and should be interpreted with caution considering the cross-sectional design.
- 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
- Avaliação do efeito da manipulação fascial no tratamento da dispareunia feminina: série de casosPublication . Amaro, Regina Fernandes; Moreira, Maria Helena Rodrigues; Santos, Paula Clara Ribeiro; Gabriel, Ronaldo Eugénio; Ribeiro Santos, Paula ClaraA dor pélvica atinge cerca de 30% das mulheres com vida sexual ativa e, destas, aproximadamente 50% relatam distúrbios de dispareunia. O tratamento tem como objetivo acompanhar a evolução dos sintomas dolorosos de origem mus-culoesquelética e miofascial, promovendo a melhoria da qualidade de vida das pacientes. OBJETIVO: o objetivo deste estudo é des-crever os efeitos da manipulação fascial segundo o Método Stecco, associada à massagem perineal, na intensidade da dor, na função sexual, nos níveis de risco psicológico para stress, depressão e ansiedade, bem como nas características da dor e força muscular dos músculos do assoalho pélvico. MÉTODO: A amostra foi constituída por sete mulheres participantes do curso de recuperação pós--parto, com diagnóstico de dispareunia, submetidas a uma intervenção com duração de três meses. Os instrumentos de avaliação utilizados foram a escala visual numérica da dor (EVND), o questionário McGill de dor, o FSFI-19, a escala DASS-21 e a Escala de Oxford modificada. As participantes foram avaliadas em três momentos distintos: M0 (antes da intervenção – momento de diagnóstico), M1 (um mês após o início da intervenção) e M2 (três meses após o início da intervenção). Foi realizada uma análise estatística descritiva, utilizando as frequências relativa e absoluta dos dados coletados. Para a verificação da normalidade dos dados foi utilizado o teste de Shapiro-Wilk. RESULTADOS: Os resultados indicaram reduções na dor, com diminuições entre os momentos M0–M1 e M0–M2. No Questionário de Dor de McGill, observou-se uma redução gradual da dor entre M0 e M2. No FSFI-19, o item "dor" apresentou melhora entre M0 e M1, enquanto o item "satisfação" mostrou uma diminuição entre M0 e M2; já o escore “total” da escala apresentou um leve aumento ao longo dos três momentos. Na escala DASS-21, a redução foi mais evidente no item "stress", passando de 8.3 em M0 para 5.0 em M2. Por fim, na Escala de Oxford Modificada, 71.4% das participantes apresentaram contrações de baixa intensidade no momento M0. Já nos momentos M1 e M2, observou-se uma predominância de contrações de intensidade mais satisfatória, com 42.9% das participantes atingindo grau 3 e 28.6% grau 4 em M1, e 42.9% alcançando grau 3 e outros 42.9% grau 4 em M2. CONCLU-SÃO: A combinação da manipulação fascial com a massagem perineal aplicada no tratamento da dispareunia resultou na diminuição na intensidade e nas características da dor, redução dos níveis de stress, aumento da força muscular do assoalho pélvico e melhora nos itens 'satisfação' e 'dor', além de uma redução no escore total da escala.
- 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.
- 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.