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- 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.
- Efeito do gelo no momento máximo de força durante o movimento concêntrico de extensão do joelhoPublication . Duarte, Raquel; Macedo, RuiA crioterapia é um método comummente usado no tratamento de lesões como coadjuvante na reeducação muscular (JUTTE et al., 2001; OSBAHR et al. 2002; NIEDA, MICHOLOVITZ, 1996; SWENSON et al., 1996). Devido ao efeito analgésico do frio, numa fase sub-aguda, a aplicação crioterápica permite iniciar o exercício mais precocemente (SWENSON et al., 1996; BORGMEYER et al., 2004), todavia, as propriedades termodinâmicas da crioterapia podem afectar a habilidade do músculo gerar tensão (NIEDA, MICHOLOVITZ, 1996).
- 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.
- Aprendizagem baseada em problemas em Fisioterapia: 4 anos de evolução do curriculum de Fisioterapia da Escola Superior de Tecnologias da SaúdePublication . Macedo, RuiProblemática: A regulamentação relativa ao processo de Bolonha plasma um conjunto de concepções sobre o ensino superior que se estendem desde o processo de ensino/aprendizagem até aos diferentes níveis da sua organização, seja ao nível macro nomeadamente através da consagração do sistema binário, até ao nível micro, na especificação da tipologia das horas de contacto.
- Petrha+: A serious game to enhance physiotherapy students' clinical reasoningPublication . Macedo, Rui; Silva, Cláudia; Albouy, Bruno; F. San Juan, Alejandro; Pystynen, TiinaRole play and simulated patients are tools frequently used in undergraduate physiotherapy courses to help students gain familiarity with what they will find in future real-life encounters. However, these approaches have limitations when it comes to delivering diversity and repetition to a large number of students and are mostly bounded to the school’s premises. Web-based virtual patient software can help to overcome these shortcomings as they equally require students to go through most of the steps of the physiotherapy process, and simultaneously offer unlimited diversity of cases and repetition opportunities and can be delocalized from physical schools. PETRHA + is an Erasmus+ strategic partnership of European high education institutions aiming at the improvement of a web-based serious game prototype designed to enhance physiotherapy students’ clinical reasoning using virtual patients. The objective of this chapter is the presentation of the background context that led to the development of the serious game, its design features, functions, and ongoing and future developments.
- 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.
- Shoulder muscle recruitment in subjects with previous episodes of painPublication . Cabral, Andréa; Sousa, Andreia S. P.; Pinheiro, Rita; Macedo, RuiThe shoulder complex joint is an extremely mobile joint and its stability is guaranteed mainly by the glenohumeral and scapular muscles. The recruitment patterns of these muscles play an important role in the coordination of scapular motion during humeral elevation. Some studies report that the muscles recruitment patterns are altered in the presence of pain. To analyze the muscle activation timings and the recruitment temporal sequence of the shoulder complex muscles during shoulder elevation in the scapular plane, in subjects with and without previous history of shoulder pain.
- Petrha – Physiotherapy ETraining Re-HabilitationPublication . Macedo, Rui; Noites, Andreia; Jesus, Ângelo; Sanjuan, Alejandro; Albouy, Bruno; Melo, CristinaPETRHA (Physiotherapy E-Training Re- Habilitation), é um projeto europeu para desenvolvimento de um jogo sério on-line de casos clínicos virtuais, destinado a ser utilizado por estudantes e profissionais de Fisioterapia no treino de competências clínicas.
- The use of FES as a strategy to improve upper limb function in stroke. What is missing?Publication . Sousa, Andreia; Silva, Cláudia; Mesquita, Inês; Silva, Augusta; Macedo, Rui; Santos, RubimStroke is the main cause of adult disability that leads to significant impairment of upper limb (UL) function. However, despite the various rehabilitation strategies, only 5-20% recover completely. This data point to the need of improving stroke intervention methods.
- Representações sociais e profissionais de docentes de fisioterapia como componente do Ethos escolarPublication . Macedo, RuiProblemática- É grande a diversidade de elementos que caracterizam e que contribuem para a individualidade e identidade de cada instituição de ensino superior, isto é, que lhe conferem o seu Ethos. As características físicas, geográficas e demográficas, os aspectos sócio-históricos das suas organizações, bem como o conjunto de elementos inter-relacionados e interdependentes evocáveis a partir de perspectivas de análise burocrática, política e cultural traduzem a multidimensionalidade do Ethos. Nessa multidimensionalidade, nem todos elementos que contribuem para a diversidade têm igual impacto nos diferentes fenómenos observados e nos diferentes papeis desempenhados por essas instituições, nomeadamente no desenvolvimento da identidade profissional dos estudantes. É na dimensão educativa do Ethos escolar, em grande medida constituída pelo seu curriculum, explícito e oculto, que se situam os principais elementos com pertinência para a socializacão académica dos estudantes. Os diferentes níveis do curriculum são influenciados pela cultura e identidade das profissões para as quais as instituições conferem a formação pré-graduada. O elevado grau de autonomia dos docentes nas instituições de ensino superior onde são ministrados os cursos de Fisioterapia confere a oportunidade para que as representações que esses docentes possuem acerca da Fisioterapia e dos Fisioterapeutas, influenciem as diferentes fases do curriculum do curso de Fisioterapia contribuindo desta forma para o Ethos Escolar de cada instituição.