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- Antagonist coativation in stroke vs healthy subjects during sit-to-standPublication . Silva, Augusta; Sousa, Andreia S. P.; Silva, Cláudia; Santos, Rubim; Tavares, João Manuel R. S.; Calheno, Teresa; Sousa, FilipaHigh levels og antagonista coativation is frequently found in post stroke subjects, related with postural control impairments. The bilateral postural control dysfunction expected in post-stroke subjects is due to the bilateral disposal of reticulospinal system.
- Atividade do músculo solear nos dois membros inferiores em sujeitos com acidente vascular encefálico-sub-fase média de apoio da marchaPublication . Silva, Augusta; Santos, Rubim; Sousa, FilipaO objetivo da presente investigação foi estudar as diferenças de magnitude da atividade electromiográfica do músculo solear, durante a sub-fase média de apoio da marcha, entre os dois membros inferiores em indivíduos com acidente vascular encefálico. Foi constituída uma amostra, de forma não probabilística voluntária de cinco indivíduos com alterações neuro-motoras por AVE. O sinal electromiográfico foi recolhido e tratado pelo sistema Biopac MP 150 Worksation, e o software de apoio Acqknowledge® versão 3.9. foi utilizada uma Plataforma de forças e respectivo amplificador Bertec AM6300. Foi utilizada a versão adaptada para a população portuguesa da Fugl-Meyer AssessmentfsensorimotorRecoveryafterStroke. Para determinar o onset do sinal electromiográfico foi identificado o seu valor de atividade basal. O sinal da plataforma de forças foi normalizado ao peso e à velocidade da marcha dos sujeitos. Para a análise estatística das variáveis em estudo foi utilizado o software SPPS®. O intervalo de confiança utilizado foi de 95%, com um nível de significância de 0,05. Os resultados permitem-nos verificar uma tendência para uma diminuição da atividade electromiográfica do músculo solear no membro inferior menos comprometido. Não foram encontradas diferenças estatisticamente significativas para a atividade eletromiográfica do músculo solear entre os dois membros inferiores na sub-fase média de apoio da marcha nos sujeitos com AVE.
- Análise cinemática do membro superior durante a atividade de beber em pessoas com sequelas de Acidente Vascular EncefálicoPublication . Vieira, Marisa; Santos, Rubim; Sousa, HelenaEste estudo pretende descrever todas as fases do gesto de beber num grupo de indivíduos após Acidente Vascular Encefálico (AVE), através de uma análise cinemática. Os indivíduos produziram movimentos lentos, menos suaves, com número elevado de unidades motoras e picos de velocidade com valores bastante superiores ao observado em indivíduos saudáveis e houve um grande deslocamento do tronco na fase de alcance e beber.
- Comfort and functionality of pregnant women's feet study of kinetic parameters with silicon insolesPublication . Marques, Alda; Gonçalves, Pedro; Santos, Rubim; Vilas Boas, JoãoAs gestantes, fruto das suas alterações fisiológicas e biomecânicas, constituem uma população de risco relativamente a dores ou lesões do sistema músculo-esquelético, nomeadamente, nos membros inferiores e coluna. Os objectivos deste estudo consistiram em avaliar: (i) a dor e o conforto dos pés durante a marcha: sem o uso de qualquer palmilha nas gestantes e no grupo de controlo; com a aplicação de uma palmilha de retropé e com a aplicação de uma palmilha completa (nas gestantes); (ii) a distribuição das pressões plantares e, (iii) as forças de reacção do solo nas mesmas condições experimentais. Avaliámos ainda a duração das diferentes fases do ciclo de marcha nas gestantes, com e sem palmilhas, e no grupo de controlo, sem o uso de palmilha. Os nossos resultados mostraram que: (i) as gestantes demoram mais tempo a completar a fase de apoio da marcha, (ii) têm um aumento significativo de dores nos pés, face ao grupo de controlo, (iii) as gestantes sentem menos dor e mais conforto quando realizam marcha, com palmilhas, especialmente com a palmilha completa, (iv) a palmilha completa redistribui as forças, diminui os valores de pressão e aumenta a área de contacto do pé com o solo. Os nossos resultados sugerem que, o uso da palmilha completa de silicone, durante a marcha, pode ser eficaz na melhoria da sintomatologia dolorosa e no aumento do conforto da grávida.
- Influence of long-term wearing of unstable shoes on compensatory control of posture: An electromyography-based analysisPublication . Pinheiro De Sousa, Andreia Sofia; Silva, Andreia; Macedo, Rui; Santos, Rubim; Tavares, João ManuelThis study investigated the influence of long-term wearing of unstable shoes (WUS) on compensatory postural adjustments (CPA) to an external perturbation. Participants were divided into two groups: one wore unstable shoes while the other wore conventional shoes for 8 weeks. The ground reaction force signal was used to calculate the anterior– posterior (AP) displacement of the centre of pressure (CoP) and the electromyographic signal of gastrocnemius medialis (GM), tibialis anterior (TA), rectus femoris (RF) and biceps femoris (BF) muscles was used to assess individual muscle activity, antagonist co-activation and reciprocal activation at the joint (TA/GM and RF/(BF + GM) pairs) and muscle group levels (ventral (TA + RF)/dorsal (GM + BF) pair) within time intervals typical for CPA. The electromyographic signal was also used to assess muscle latency. The variables described were evaluated before and after the 8-week period while wearing the unstable shoes and barefoot. Long-term WUS led to: an increase of BF activity in both conditions (barefoot and wearing the unstable shoes); a decrease of GM activity; an increase of antagonist co-activation and a decrease of reciprocal activation level at the TA/GM and ventral/dorsal pairs in the unstable shoe condition. Additionally, WUS led to a decrease in CoP displacement. However, no differences were observed in muscle onset and offset. Results suggest that the prolonged use of unstable shoes leads to increased ankle and muscle groups’ antagonist co-activation levels and higher performance by the postural control system.
- Interlimb coordination during the stance phase of gait in subjects with strokePublication . Sousa, Andreia S. P.; Silva, Augusta; Santos, Rubim; Sousa, Filipa; Tavares, João ManuelTo analyze the relation between contralesional and ipsilesional limbs in subjects with stroke during step-to-step transition of walking. Observational, transversal, analytical study with a convenience sample. Physical medicine and rehabilitation clinic. Participants: Subjects (nZ16) with poststroke hemiparesis with the ability to walk independently and healthy controls (nZ22). Interventions: Not applicable. Main Outcome Measures: Bilateral lower limbs electromyographic activity of the soleus (SOL), gastrocnemius medialis, tibialis anterior, biceps femoris, rectus femoris, and vastus medialis (VM) muscles and the ground reaction force were analyzed during double-support and terminal stance phases of gait. The propulsive impulse of the contralesional trailing limb was negatively correlated with the braking impulse of the leading limb during double support (rZ .639, PZ.01). A moderate functional relation was observed between thigh muscles (rZ .529, PZ.035), and a strong and moderate dysfunctional relation was found between the plantar flexors of the ipsilesional limb and the vastus medialis of the contralesional limb, respectively (SOL-VM, rZ .80, P<.001; gastrocnemius medialis-VM, rZ .655, PZ.002). Also, a functional moderate negative correlation was found between the SOL and rectus femoris muscles of the ipsilesional limb during terminal stance and between the SOL (rZ .506, PZ.046) and VM (rZ .518, PZ.04) muscles of the contralesional limb during loading response, respectively. The trailing limb relative impulse contribution of the contralesional limb was lower than the ipsilesional limb of subjects with stroke (PZ.02) and lower than the relative impulse contribution of the healthy limb (PZ.008) during double support. The findings obtained suggest that the lower performance of the contralesional limb in forward propulsion during gait is related not only to contralateral supraspinal damage but also to a dysfunctional influence of the ipsilesional limb.
- Influence of wearing an unstable shoe on thigh and leg muscle activity and venous response in upright standingPublication . Pinheiro De Sousa, Andreia Sofia; Tavares, João Manuel; Macedo, Rui; Rodrigues, Albano; Santos, RubimPurpose: To quantify the effect of unstable shoe wearing on muscle activity and haemodynamic response during standing. Methods: Thirty volunteers were divided into 2 groups: the experimental group wore an unstable shoe for 8 weeks, while the control group used a conventional shoe for the same period. Muscle activity of the medial gastrocnemius, tibialis anterior, rectus femoris and biceps femoris and venous circulation were assessed in quiet standing with the unstable shoe and barefoot. Results: In the first measurement there was an increase in medial gastrocnemius activity in all volunteers while wearing the unstable shoe. On the other hand, after wearing the unstable shoe for eight weeks these differences were not verified. Venous return increased in subjects wearing the unstable shoe before and after training. Conclusions: The unstable shoe produced changes in electromyographic characteristics which were advantageous for venous circulation even after training accommodation by the neuromuscular system.
- Cross-cultural adaptation and measurement properties of the Portuguese version of the Ankle Instability InstrumentPublication . Silva, Diogo C. F.; Vilas-Boas, J. Paulo; Mesquita, Cristina; Maia, José; Santos, Rubim; Peixoto, Tiago André Teixeira; Brito, Nuno; Pinheiro De Sousa, Andreia SofiaChronic ankle instability is one of the most common clinical conditions in the general population, especially in adult athletes. The cross-cultural adaptation of self-reported questionnaires that identify and classify this condition contribute to criteria standardization in research but also in rehabilitation. Aim of Study. To validate the Ankle Instability Instrument to the Portuguese population and to investigate its psychometric properties. Material and Methods. Linguistic and semantic equivalence of the original version of the Ankle Instability Instrument to the Portuguese population was firstly performed. The Portuguese version of the Ankle Instability Instrument was then applied to 81 higher education adult students, with (n = 59) and without history of ankle sprain (n = 22). Participants were evaluated two times with an interval of one week to assess the psychometric properties of the Portuguese version of the Ankle Instability Instrument. Results. In the reliability of binary responses based on the test retest, the tetrachoric correlation coefficient ranged from 0.99 to 1.00. In addition, the Kuder–Richardson coefficient was 0.79 suggesting good internal consistency. Conclusions. Test-retest showed an almost perfect match in all answers between the two moments, which seem to be related to sample characteristics. The internal consistency value was similar to the one obtained in the original version. The Portuguese version of the Ankle Instability Instrument is highly reliable and can be used in clinical practice.
- Influence of prolonged wearing of unstable shoes on upright standing postural controlPublication . Pinheiro De Sousa, Andreia Sofia; Macedo, Rui; Santos, Rubim; Sousa, Filipa; Silva, Andreia; Tavares, João M. R. S.To study the influence of prolonged wearing of unstable shoes on standing postural control in prolonged standing workers. The participants were divided into two groups: one wore unstable shoes while the other wore conventional shoes for 8 weeks. Stabilometry parameters related to centre of pressure (CoP), rambling (RM) and trembling (TR) as well as the total agonist/antagonist muscle activity, antagonist co-activation and reciprocal activation were evaluated during upright standing, before and after the 8 week period. In both moments, the subjects were evaluated wearing the unstable shoes and in barefoot. The unstable shoe condition presented increased CoP displacement related variables and decreased co-activation command compared to barefoot before and after the intervention. The prolonged wearing of unstable shoes led to: (1) reduction of medial-lateral CoP root mean square and area; (2) decreased anteroposterior RM displacement; (3) increased anteroposterior RM mean velocity and mediolateral RM displacement; (4) decreased anteroposterior TR RMS; and (5) increased thigh antagonist co-activation in the unstable shoe condition. The unstable shoe condition is associated to a higher destabilizing effect that leads to a selection of more efficient and accurate postural commands compared to barefoot. Prolonged wearing of unstable shoes provides increased effectiveness and performance of the postural control system, while wearing of unstable shoes in upright standing, that are reflected by changes in CoP related variables and by a reorganization of postural control commands.
- Ground reaction forces and plantar pressure distribution during occasional loaded gaitPublication . Castro, Marcelo Peduzzi; Abreu, Sofia; Sousa, Helena; Machado, Leandro; Santos, Rubim; Vilas Boas, JoãoThis study compared the ground reaction forces (GRF) and plantar pressures between unloaded and occasional loaded gait. The GRF and plantar pressures of 60 participants were recorded during unloaded gait and occasional loaded gait (wearing a backpack that raised their body mass index to 30); this load criterion was adopted because is considered potentially harmful in permanent loaded gait (obese people). The results indicate an overall increase (absolute values) of GRF and plantar pressures during occasional loaded gait (p < 0.05); also, higher normalized (by total weight) values in the medial midfoot and toes, and lower values in the lateral rearfoot region were observed. During loaded gait the magnitude of the vertical GRF (impact and thrust maximum) decreased and the shear forces increased more than did the proportion of the load (normalized values). These data suggest a different pattern of GRF and plantar pressure distribution during occasional loaded compared to unloaded gait.