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- Scapular motor control and upper limb movement quality in subjects with and without chronic shoulder painPublication . Melo, Ana; C. Guedes, Diana; Matias, Ricardo; Cruz, Eduardo B.; Vilas-Boas, J. Paulo; Sousa, AndreiaDespite the existence of several studies about the scapula’s position and motion, in shoulder pain conditions, there are still conflicting findings regarding scapular adaptations and reduced research about the scapula’s role during functional tasks. The present study aimed to compare scapular-related kinematic and electromyographic outcomes during different shoulder movements (with and without load) and the drinking task, between symptomatic and asymptomatic subjects. Forty subjects (divided into two groups) participated in this cross-sectional observational study. Scapulothoracic motion, scapulohumeral rhythm, and movement quality (considering trunk compensation, time-to-peak acceleration, and smoothness), as well as the relative surface electromyographic activity and muscle ratio considering the trapezius, serratus anterior, and levator scapulae (LS), were assessed. The symptomatic group presented the following: (1) changes in scapular upward rotation (p = 0.008) and winging (p = 0.026 and p = 0.005) during backward transport and drink phases; (2) increased muscle activity level of the middle trapezius (MT) in all tasks (p < 0.0001 to p = 0.039), of LS during shoulder elevation with load (p = 0.007), and of LS and LT during most of the drinking task phases (p = 0.007 to p = 0.043 and p < 0.0001 to p = 0.014, respectively); (3) a decreased serratus anterior lower portion activity level (SAlow) during shoulder lowering with load (p = 0.030) and drink phase (p = 0.047); and (4) an increased muscular ratio between scapular abductors/adductors (p = 0.005 to p = 0.036) and elevators/depressors (p = 0.008 to p = 0.028). Compared to asymptomatic subjects, subjects with chronic shoulder pain presented scapular upward rotation and winging adaptations; increased activity levels of MT, LT, and LS; decreased activity levels of SAlow; and increased scapular muscle ratios.
- 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.
- 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. "