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- European Portuguese version of the Mini-BESTest: a cross-cultural adaptation and psychometric measurements in individuals with sensorimotor impairmentsPublication . Freitas, Marta; Pinho, Francisco; Cruz-Martins, Natália; Pinho, Liliana; Silva, Sandra; Figueira, Vânia; Vilas-Boas, João Paulo; Silva, Augusta; Ferreira Silva, Maria AugustaThis study aimed to translate and cross-culturally adapt the Mini-BESTest into European Portuguese and to evaluate its psychometric properties in individuals with sensorimotor impairments. A cross-sectional cross-cultural adaptation and validation study was conducted according to the COSMIN guidelines and the STROBE statement. The study included 100 participants with sensorimotor impairments who were able to walk 6 m. Cronbach’s alpha and item-total correlations were used to assess internal consistency. Interpretability was assessed by examining floor and ceiling effects and skewness. To investigate construct validity, Spearman correlation coefficients and Bland-Altman analysis were performed to compare the Berg Balance Scale and the Mini-BESTest Inter- and intra-rater reliability were assessed by calculating the ICC, SEM and MDC based on video recordings of the participants during the Mini-BESTest assessments. The European Portuguese Mini-BESTest showed good internal consistency (Cronbach’s α = 0.892) and no significant floor or ceiling effects. Excellent inter- and intra-rater reliability (ICC = 0.97) were also demonstrated, with MDC of 2.58 and 2.57, respectively. Furthermore, this instrument showed a significant correlation with the BBS (r = 0.902). Bland-Altman analysis showed small absolute differences. The European Portuguese Mini-BESTest is comparable to the original English version in terms of validity and reliability and is therefore highly recommended for use by Portuguese-speaking professionals to assess postural control.
- Presence of pain shows greater effect than tendon structural alignment during landing dynamicsPublication . Silvia, Ortega-Cebrián; Silva, Diogo C. F.; Carneiro, Daniela F.; Zárate, Victor; Alves, Leonel A. T.; Guedes, Diana C.; Zárate-Tejero, Carlos A.; Cadellans-Arróniz, Aïda; Montes, António Mesquita; Mesquita Montes, António; Silva, Diogo C. F.; C. Guedes, Diana"Eccentric loading during landing is considered a key factor in the development of patellar tendinopathy and is associated with stiff landings and patellar tendinopathy. This study aims to investigate the relationship between tendon structure, presence of pain, and sex differences in landing kinematics and kinetics during countermovement jumps (CMJ) and tuck jump tests (TJT) in professional volleyball players. Professional volleyball players aged 18 to 30 years old (14 females and 25 males) participated in a cross-sectional study. Data included the Victorian Institute of Sport Assessment Patellar Tendon (VISA-P) questionnaire; patellar tendon ultrasound characterization tissue (UTC) scans, in order to identify groups with misaligned tendon fibers (MTF) or aligned tendon fibers (ATF); and biomechanical assessments for CMJ and TJT. The joint angle (JA) at the lower limb was measured at peak ground reaction force (peak_vGRF) and maximal knee flexion (max_KF). A general linear model was used to evaluate joint JA differences between tendon alignment, pain, and sex variables. Sample t-tests compared peak_vGRF, load time, load rate, and area based on tendon alignment, pain presence, sex, and jump. The statistical significance of p-value is >0.05, and the effect size (ES) was also calculated. The MTF group revealed decreased knee JA during TJT at peak_vGRF (p = 0.01; ES = −0.66) and max_KF (p = 0.02; ES = −0.23). The presence of pain was associated with increased JA during the CMJ, particularly at peak_vGRF and max_KF for trunk, hip, and ankle joints. Females showed decreased peak_vGRF than males. Landing with misaligned tendon fibers showed longer load times compared to aligned tendon fibers (p = 0.021; ES = −0.80). The TJT exhibited a greater load rate than the CMJ (p = 0.00; ES = −0.62). Pain is a critical factor influencing greater JA during landing, particularly at the trunk, hip, and ankle joints in CMJ. Misaligned tendon fibers compromise landing dynamics by increasing trunk JA during TJT. Kinetics varied significantly by sex and jump type, while pain and tendon structure revealed limited differences. "
- Feasibility of 3D body tracking from monocular 2D video feeds in musculoskeletal telerehabilitationPublication . Clemente, Carolina; Chambel, Gonçalo; Silva, Diogo C. F.; Montes, António Mesquita; Pinto, Joana F.; Silva, Hugo Plácido da; Mesquita Montes, António; Silva, Diogo C. F.Musculoskeletal conditions affect millions of people globally; however, conventional treatments pose challenges concerning price, accessibility, and convenience. Many telerehabilitation solutions offer an engaging alternative but rely on complex hardware for body tracking. This work explores the feasibility of a model for 3D Human Pose Estimation (HPE) from monocular 2D videos (MediaPipe Pose) in a physiotherapy context, by comparing its performance to ground truth measurements. MediaPipe Pose was investigated in eight exercises typically performed in musculoskeletal physiotherapy sessions, where the Range of Motion (ROM) of the human joints was the evaluated parameter. This model showed the best performance for shoulder abduction, shoulder press, elbow flexion, and squat exercises. Results have shown a MAPE ranging between 14.9% and 25.0%, Pearson’s coefficient ranging between 0.963 and 0.996, and cosine similarity ranging between 0.987 and 0.999. Some exercises (e.g., seated knee extension and shoulder flexion) posed challenges due to unusual poses, occlusions, and depth ambiguities, possibly related to a lack of training data. This study demonstrates the potential of HPE from monocular 2D videos, as a markerless, affordable, and accessible solution for musculoskeletal telerehabilitation approaches. Future work should focus on exploring variations of the 3D HPE models trained on physiotherapy-related datasets, such as the Fit3D dataset, and post-preprocessing techniques to enhance the model’s performance.
- Effects of a home-based pulmonary rehabilitation program in patients with Chronic Obstructive Pulmonary Disease in GOLD B group: A pilot studyPublication . Vilarinho, Rui; Serra, Lúcia; Coxo, Ricardo; Carvalho, João; Esteves, Cátia; Montes, António Mesquita; Caneiras, Cátia; Vilarinho, Rui; Mesquita Montes, AntónioPatients with chronic obstructive pulmonary disease (COPD) in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) B group can be included in pulmonary rehabilitation (PR) settings outside the hospitals. This study aimed to explore the feasibility of a home-based pulmonary rehabilitation (HBPR) program and assess its impact on patients with COPD in the GOLD B group. A real-world, pre–post intervention study was conducted with 12 weeks of HBPR (presential home visits and phone calls) using the self-management program Living Well with COPD. The 1- min sit-to-stand test (1MSTS), modified Medical Research Council Questionnaire (mMRC), COPD Assessment Test (CAT), Hospital Anxiety and Depression Scale (HADS), and London Chest Activity of Daily Living (LCADL) were used to assess the impact. Pre–post differences and correlations between changes in outcomes were calculated. In 30 patients (71.6 years, FEV1 (%) 52.8), significant improvements (p < 0.05) were observed on 1MSTS (Pre 17.2, Post 21.2), mMRC (Pre 2.0, Post 1.0), CAT (Pre 16.3, Post 9.9), HADS (Pre 14.4, Post 9.6), and LCADL (Pre 21.0, Post 15.8), with no adverse events reported. When significant, correlations between changes in outcomes were moderate or strong (0.48 ≤ ρ ≤ 0.66). HBPR can be feasible and safe, and it shows the potential to significantly improve outcomes of patients with COPD in the GOLD B group.
- The influence of artificial breast volume induction on postural stability, postural orientation, and neuromuscular control in healthy women: a cross-sectional studyPublication . Guedes, Diana C.; Carneiro, Daniela Ferreira; Alves, Leonel Agostinho Teixeira; Melo, Ana S. C.; Moreira, Juliana; Cunha, Bruno; Santos, Rubim; Noites, Andreia; Sousa, Andreia S. P.; C. Guedes, Diana; Melo, Ana; Santos Moreira, Juliana; Cunha, Bruno; Rubim Silva Santos, Manuel; Noites, Andreia; Pinheiro de Sousa, Andreia SofiaThe percentage of breast augmentations has increased in recent years alongside the frequency of implant removals. Musculoskeletal and postural disorders are often overlooked during this removal process. Research indicates that excess anterior load from breast implants can disrupt postural control and potentially lead to short- or long-term musculoskeletal dysfunction. This study aims to evaluate the immediate changes in postural control after artificial breast augmentation in healthy female volunteers. Spinal angles, the center of pressure (CoP), and electromyographic activity of the spinal muscles were recorded in the static position and during the functional reach test (FRT) without and with implants of different volumes (220 mL, 315 mL, and 365 mL). Subjective perceptions of effort, comfort, weight, and performance in the FRT were also assessed. Statistical differences were significant in the scapular elevator during the one-minute standing position (lower activation with the 220 mL implant compared to the control and 315 mL) and in the trapezius muscles during the FRT (lower activation in the upper trapezius in the 315 mL vs. control in the reach phase and 220 mL vs. control in the return phase and higher activation in the lower trapezius in the 315 and 365 mL vs. control in the reach phase). Additionally, significant differences were identified in the performance of the FRT and the associated subjective perceptions. Breast implants with sizes of 220, 315, and 365 mL can alter scapular neuromuscular control, but these differences do not seem substantial enough to result in negative biomechanical effects in the short-term analysis.
- Physical activity level in women with primary dysmenorrhea: A cross-sectional observational studyPublication . Naia, Zeltia; Santos, Paula Clara; Bello, Olalla; Santos, Paula ClaraPrimary dysmenorrhea (PD), menstrual pain in the absence of pathology, is the main cause of gynecological consultation in young women. There are many studies that suggest a possible relationship between a low level of physical activity (PA) and a greater intensity of menstrual pain, and others that find no relationship between these variables. To identify the level of PA and menstrual pain intensity among women with PD, as well as the relationship between these variables. An observational, cross-sectional study was carried out on a cohort of adult population. Data collection instrument was an online self-administered questionnaire. Main variables were pain intensity (Numeric Rating Scale; McGill Pain Questionnaire, short version) and PA level (International Physical Activity Questionnaire). A total number of 216 responses from the total responses obtained were considered PD cases. A 38% of women did not perform any intense PA during the last 7 days, and a 32.4% did not perform any moderate PA. No significant differences were found in menstrual pain intensity during the three last menstruations among women who performed PA, moderate, or intense. Nor were significant differences found between women who performed PA less than 3 days a week, compared with those ones who did it at least three times a week, or more. Menstrual pain intensity does not differ between the types of PA. A large number of participants did not perform any PA in the last 7 days.
- Therapeutic physical exercise for Dysmenorrhea: A scoping reviewPublication . Rigal, Philippine; Bonnet, Salomé; Vieira, Ágata; Carvalhais, Alice; Lopes, Sofia; Lopes, Sofia; Vieira, ÁgataDysmenorrhea affects many women of reproductive age. Physical exercise has been used as an effective intervention for pain reduction and to improve well-being. Physiotherapy, involving movement and exercise, can be effective in relieving menstrual pain and provide additional benefits. The aim is to identify therapeutic physical exercise program and exercise protocols used to reduce pain among these women. A scoping review was conducted in accordance with Joanna Briggs Institute’s methodology, using the PCC acronym. Articles were sourced from: PubMed, Cochrane Library, PEDro and ScienceDirect, covering studies published between 1 January 2013 and 30 April 2023, representing the period we considered most appropriate at the time the study was initiated. Qualitative studies, books, book chapters, systematic reviews, meta-analyses and review articles were excluded. Studies were analyzed according to the PRISMA-ScR framework. 3325 studies were identified, but only 9 were included. Considerable variation was observed in the types and parameters of the exercise program across studies, including differences in duration, intensity, number of repetitions and series. The findings of this study highlight that aerobic training, particularly among women in their 20s, emerged as the most frequently utilized form of therapeutic physical exercise for alleviating menstrual pain in the studies reviewed. This suggests that aerobic exercise may hold significant promise as a non-pharmacological intervention for managing dysmenorrhea.
- Could socks play an active role in ankle sprain prevention? A preliminary investigationPublication . Torres, Rui; Mesquita, InêsAnkle sprain represents about 10% to 30% of all recorded musculoskeletal injuries, and is one of the most prevalent injuries in sports. Thus, any type of intervention based on prevention is extremely important to reduce its incidence. Aim of Study. To compare the immediate effect of three different types of socks, namely standard, compression, and Prevent Sprain Technology (PST) socks, on the dynamic unipodal balance and ankle joint position sense in healthy participants. Forty-two healthy adults, aged 20.34 ± 1.69 years old, volunteered to participate in the study. Participants were randomly assessed using three different sock models. The main measured outcomes selected for this study were the dynamic balance using the Biodex Balance System®, and the active ankle joint repositioning movement through the Biodex System Pro 4®. We used the Friedman test to compare the variables under study among the three conditions, with Dunn’s post-hoc analysis and a significance level of 0.05. In the Biodex Balance System® the participants had a lower Global Instability Index value with the PST socks compared to compression socks (p = 0.031), and standard socks (p = 0.005), but only lower anteroposterior (p = 0.042) and mediolateral (p = 0.026) instability indices when compared to standard socks. Regarding the ankle joint position sense, subjects with PST socks revealed lower absolute errors compared to standard socks (p = 0.007), smaller minimum errors compared to compression socks (p = 0.049), and smaller maximum errors compared to compression socks (p = 0.049) and standard socks (p = 0.008). Analysis of relative errors revealed a significant miss regarding the target joint position at higher inversion angles only with standard socks (which is potentially more dangerous) when compared to PST socks (p = 0.031), which error tends to be at lower inversion angles (which is potentially less dangerous). The PST socks seem to have a global positive influence on the mechanisms underlying the dynamic unipodal balance and active joint position sense, which could be an important tool for ankle sprain prevention.
- Cross-cultural adaptation and validation of the european portuguese version of the Western Ontario Shoulder Instability Index (WOSI)Publication . Torres, Rui; Faria, Sara Isabel; Cavalheiro, Luís Manuel; Ferreira, Pedro Lopes; Gonçalves, Rui SolesThe Western Ontario Shoulder Instability Index (WOSI) is a self-administered questionnaire specifically used to determine the impact of shoulder instability on quality of life. The aim of this study was to translate the WOSI into European Portuguese and analyze its validity and reliability in a population with shoulder instability. The WOSI was translated and culturally adapted from its original version into European Portuguese (WOSIPT). Internal consistency and test-retest analyses were conducted to determine the level of reliability of the scale. WOSI-PT, QuickDASH, and SF-12 questionnaires were applied to 81 patients with symptomatic shoulder instability to assess validity, and reliability was tested by randomly selecting 50 patients within 72 hours using a test-retest design. The reliability of the WOSI-PT was very high, with Cronbach´s alpha equal to 0.97 and an intraclass correlation coefficient of 0.98. Regarding the construct validity, the correlation between the WOSI-PT and QuickDASH was high and negative (-0.79). The correlations between WOSI-PT and SF-12 were positive, respectively, moderate with physical (0.66) and low with mental (0.34) health. WOSI-PT is a reliable and valid instrument for assessing the functional impact of shoulder joint instability on quality of life.
- The effects of adding a six-month Pilates exercise program to three months of traditional community-based pulmonary rehabilitation in individuals with COPD: A prospective cohort studyPublication . Barbosa, Marisela; Melo, Cristina; Torres, RuiPilates exercise may complement traditional pulmonary rehabilitation in individuals with chronic obstructive pulmonary disease (COPD). The objective was to analyze the effects of adding a six-month Pilates exercise program to a three-month pulmonary rehabilitation for individuals with COPD. Thirty-five participants with COPD (GOLD B) were assigned to the intervention (n=14) or control (n=21) group. Both groups received an initial three months of a pulmonary rehabilitation program. The intervention group further underwent six months of pilates. Participants were evaluated at baseline and at three, six, and nine months. Lung function and strength of respiratory muscles were defined as primary outcomes. Secondary outcomes included cardiac, physical function, and exacerbation episodes. There were no consistent statistically significant differences between groups for the lung function outcomes (p<0.05). Maximal inspiratory and expiratory pressure increased significantly at three months in both groups (p<0.05). It was significantly superior in the intervention group at nine months for maximal inspiratory pressure (p=0.005) and six and nine months for maximal expiratory pressure (p=0.027 and p<0.001, respectively). Changes in muscle strength (knee extension and handgrip) were comparable between groups (p>0.05), but exercise-induced fatigue and balance were significantly superior in the intervention group at the six- and nine-month follow-ups (p<0.05). Pilates exercise programs may be implemented to augment traditional pulmonary rehabilitation with the goal of improving the strength of respiratory muscles. Adding a Pilates exercise program to pulmonary rehabilitation resulted in superior strength of respiratory muscles, higher resistance to exercise-induced fatigue, and improved balance.