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- The acute effects of manual and instrument-assisted cervical spine manipulation on pressure pain threshold, Pressure pain perception, and muscle-related variables in asymptomatic subjects: a randomized controlled trialPublication . Nogueira, Nuno; Campelo, Natalia; Lopes, Ângela; Torres, Rui; Sousa, Andreia S. P.; Ribeiro, FernandoThe purpose of this study was to compare the immediate effects in asymptomatic participants of manual and instrument-assisted cervical manipulation on pressure pain thresholds, pressure pain perception, and muscle mechanical properties (tone, stiffness, and elasticity) over muscles anatomically related and unrelated to the manipulated level.
- Alterações imediatas induzidas pela electroestimulação neuromuscular de baixa e média frequência no torque e na área de secção transversal do músculo reto femoral, em adultos saudáveisPublication . Lopes, Alexandre; Silva, Diogo C. F.; Torres, Rui; Carvalho, PauloA electroestimulação neuromuscular (NMES) é um recurso terapêutico amplamente utilizado pela maioria dos fisioterapeutas com o objetivo de favorecer o fortalecimento muscular, a prevenção ou a recuperação, no entanto, ainda sem consenso científico.
- Kinesiology tape increases muscle tone, stiffness, and elasticity: Effects of the direction of tape applicationPublication . Lopes, Mário; Torres, Rui; Romão, Dalila; Dias, Maria; Valerio, Sara; Espejo-Antúnez, Luís; Costa, Rui; Ribeiro, FernandoThe claim that the effects of kinesiology tape are different depending on the direction of tape application needs to be clearly ascertained. This study aimed to determine the immediate effects of two forearm kinesiology tape applications on muscle tone, stiffness, and elasticity of young individuals. Thirty-nine participants (15 men and 24 women) were randomized (1:1:1) to: the facilitatory group, receiving kinesiology tape applied from origin to insertion; the inhibitory group, receiving kinesiology tape applied from insertion to origin; or, a control group, without any intervention. The mechanical properties – tone, elasticity, and stiffness – of the forearm muscles were measured with a handheld mechanical impulse-based myotonometric device before and 30 min after the kinesiology tape application. Only the application of kinesiology tape from origin to insertion significantly increased muscle tone [16.6 (2.5) to 17.4 (3.5) Hz, p = 0.036], stiffness [318.3 (52) to 355.0 (87) N/m, p = 0.004], and elasticity [0.98 (0.1) to 1.10 (0.1), p = 0.023]. No changes were observed in both inhibitory kinesiology tape and the control group. In conclusion, kinesiology tape application has different effects depending on the direction of the taping application. The facilitatory tapping increased muscle tone, elasticity, and stiffness.
- Phonophoresis with diclofenac gel in the ankle sprainsPublication . Mendonça, C.; Torres, RuiThe ankle sprains represents one of the most frequent muscular-skeletal injuries in the physical therapy practice, specially at the acute stage, after the injury.The most common therapeutic modalities used to eliminate the pain and the inflammatory process in the acute stage are the administration of non-steroid Antiinflammatory drugs and the Ultrasound therapy. Even though the use of these type of drugs often brings some side effects related to it’s oral administration. The Transdermic administration of this drug in gel form brings some actual controversy about it’s deep penetration and therapeutic index.
- Manual but not instrument-assisted cervical manipulation reduces pain and disability in subjects with nonspecific neck pain: double-blinded, randomized clinical trialPublication . Nogueira, Nuno; Oliveira-Campelo, Natália; Torres, Rui; Sousa, Andreia S. P.; Ribeiro, FernandoThere is limited evidence comparing the effects of manual and instrumented-assisted manipulations among adults with neck pain. Our purpose was to determine the effects of a multisession regime of manual and instrument-assisted cervical manipulation on pain, disability, perception of change, and muscle properties in subjects with nonspecific neck pain. We conducted a double-blind, randomized, placebo-controlled study in 32 subjects with nonspecific neck pain. Two groups received three sessions of cervical (C3/C4) manipulation, one group manual and the other instrument-assisted, a third group received three sessions of sham manipulation, and a fourth group served as a control. Self-reported pain, pressure pain thresholds, neck disability, patient perception of change, and properties (tonus, stiffness, and elasticity) of the upper trapezius and biceps brachii were assessed at baseline, immediately after the first session and 15 days after the end of the intervention. After the end of the intervention, the percentage of changes in the visual analogue scale score, Neck Disability Index, and Patient Global Perception of Change score were significantly higher in the manual group in comparison with the other groups (p < 0.05). No between-group differences were observed in the percentage of changes in tonus, stiffness, and elasticity of the four muscles at the end of the intervention. We concluded that three sessions of C3/C4 manual manipulation improved pain and disability in subjects with nonspecific neck pain.
- Neuromuscular taping does not change fibularis longus latency time and postural swayPublication . Correia, Christophe; Lopes, Susana; Gonçalves, Rafael; Torres, Rui; Gonçalves, Pedro; Rodrigues, Mário; Costa, Rui; Lopes, Mário; Ribeiro, FernandoAnkle sprains are a common injury and fibularis longus plays an important role improving functional stability. Neuromuscular tape seems to improve muscle force, although little is known regarding its effect on latency time.
- The effect of kinesiology tape on knee proprioception in healthy subjectsPublication . Torres, Rui; Trindade, Raquel; Gonçalves, Rui SolesKinesiology tape can improve athletic performance; however, due to cutaneous stimulation its application can have an influence on proprioception. Objectives To determine the effects of kinesiology tape on knee proprioception applied to quadriceps, namely in the joint position sense (JPS) and in the threshold to detect passive movement (TTDPM), both immediately after and 24 h after its application. Methods Thirty young healthy participants were randomly divided into experimental and control group. In the experimental group, a kinesiology tape on the quadriceps muscle was applied. The JPS and the TTDPM of the knee was assessed before, immediately after and 24 h after the kinesiology tape intervention. Results No significant differences were found in the assessment made before intervention. The Friedman Test showed that kinesiology tape had no influence on JPS in either group over time (p > 0.05). However, the TTDPM decreased significantly immediately after and 24 h after its application (p < 0.05).
- 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.
- Effect of Kinesio® taping on static and dynamic balance after anterior cruciate ligament reconstruction: A randomized controlled trialPublication . Sousa, João; Ribeiro, Fernando; Lopes, Mário; Gonçalves, Rui Soles; Torres, RuiAnterior cruciate ligament (ACL) rupture is one of the most common knee injuries among athletes (Evans and Nielson, 2022). ACL reconstruction is, in general, the solution for the rupture of ACL; the torn ligament is replaced with a tissue graft from another surrounding functional structure of the knee (Rochmania et al., 2012). The functional changes that occur after ACL reconstruction comprise deficits of muscle power, functional performance, joint proprioception, and balance (Ageberg, 2002). Evidence shows that even several months after a successful ACL reconstruction subjects still present motor control changes, influencing knee functionality (Furlanetto et al., 2016). Kinesio Taping (KT), which consists of the application of elastic adhesive bands to the skin (Oliveira et al., 2016), is frequently used in orthopedics, sports medicine, and neurological rehabilitation (Choi et al., 2016). It is used in several areas of physiotherapy to relieve pain (Nadali et al., 2014; Pamuk and Yucesoy, 2015), promote postural correction, stimulate muscle function (Cortesi et al., 2011; Lee et al., 2016; Scarborough et al., 1999), enhance gait (Choi et al., 2016; Lee et al., 2016, Yang et al., 2015), and improve balance (Bernardelli et al., 2019, Khalili et al., 2022). Despite being a technique commonly used during sports practice and in the rehabilitation of musculoskeletal and sport injuries, KT has little and insufficient evidence supporting its use to improve balance and postural control, particularly after a major musculoskeletal injury/surgery such as ACL reconstruction (Gholami et al., 2020). Moreover, only a few studies assessed the effect of KT in patients undergoing ACL reconstruction (Balki et al., 2016, Boguszewski et al., 2013; Laborie et al., 2015). Collectively, they evaluated the effects of the KT on the range of knee motion, oedema (Balki et al., 2016; Boguszewski et al., 2013), muscle strength (Balki et al., 2016), and pain (Balki et al., 2016; Boguszewski et al., 2013; Laborie et al., 2015). It is accepted that KT stimulates proprioception through cutaneous receptors by altering somatosensory information (Tamburella et al., 2014), which consequently increases the cortical excitability of the cortical motor areas of cerebral cortex (Oliveira et al., 2016). However, it is not known whether it influences balance and postural control after ACL reconstruction. We will test the application of KT for 24 h, to determine whether KT could be used to maximize balance and postural control during the rehabilitation process or when resuming sport practice to decrease the risk of re-injury. Thus, the purpose of this study was to assess the effects of KT on balance and postural control among young adults with ACL reconstruction.
- 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.