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- 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.
- 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.
- Avaliação isocinética dos músculos extensores e flexores do joelho em atletas de basquetebol feminino da região nortePublication . Ferreira, Samuel; Macedo, Rui; Carvalho, Paulo; Macedo, Rui; Carvalho, PauloOs desequilíbrios musculares (DM) são apontados, por alguns investigadores, como causa de uma maior incidência de lesões nos joelhos das atletas de basquetebol comparativamente ao sexo oposto. Descrever e comparar a força isocinética entre atletas de basquetebol feminino e estudantes sedentárias. A avaliação da força muscular, bem como do seu equilíbrio, é um factor de elevada importância para os fisioterapeutas, para que se consiga objectivar uma melhor recuperação do atleta e prevenir a ocorrência de lesões. Estudo observacional, analítico, transversal em que se avaliaram 38 sujeitos (Grupo A= 21 atletas federadas de basquetebol; Grupo B= 17 estudantes sedentárias) do sexo feminino. Para avaliação do Peak Torque (PT ) foi utilizado um dinamómetro isocinético da marca Biodex Medical System 3 Pro® . Foi realizada a correcção da força da gravidade na avaliação do PT concêntrico dos músculos extensores e flexores do joelho, para a velocidade angular de 60º/s (6 repetições). Verificaram-se diferenças significativas para os valores do PT e Peak Torque/Body Weight (PT /BW), enquanto que para os valores do rácio isquiotibiais/ quadricípite (Rácio I/Q) e diferenças bilaterais (DB) de força do quadricípite e isquiotibiais, não se verificaram diferenças significativas. As atletas de basquetebol feminino federado apresentam valores mais elevados de PT e PT /BW comparativamente com as estudantes sedentárias. O maior desenvolvimento da mesma musculatura é feita de uma forma equilibrada, na medida em que não altera, nas atletas, a relação I/Q nem as DB de força no sentido de um DM.
- 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.
- Effectiveness of global postural reeducation in postural changes and postural stability in young adultsPublication . Pacheco, Maria Paula; Morais, Sara; Carvalho, Paulo José; Cavalheiro, Luís; Sousa, Filipa; Carvalho, PauloPostural changes are considered a public health issue and have gathered significant interest in both research and clinical practice. To evaluate the effectiveness of Global Postural Reeducation (GPR) in improving postural changes and postural stability in healthy young adults. Additionally, this study aims to identify the main postural changes in the sample population. A longitudinal study was conducted with a sample of students (n = 38) from the 2nd and 3rd years of undergraduate programs at Coimbra Health School, divided into an experimental group (EG) with 20 subjects and a control group (CG) with 18 subjects. The EG underwent a GPR intervention, while the CG received no intervention. Postural changes were assessed using a 3D motion analysis system (Qualisys), and stabilometry was evaluated using a Bertec force platform. At baseline (T0), the groups were homogeneous regarding sample characterization variables, as well as postural and stabilometric variables (p > 0.05). After four weeks of the intervention (T1), no significant differences were observed between the EG and CG for any of the variables studied (p > 0.05). However, within-group analysis for the experimental group revealed a significant difference (p = 0.04) in anterior-posterior velocity, indicating a reduction in this parameter from T0 to T1. In the control group, a significant difference was observed (p = 0.03) in the left knee valgus, indicating a reduction in valgus alignment. GPR does not appear to be effective in improving postural changes or center of pressure displacement in healthy young students.
- 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.