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  • Ligaduras funcionais na Fisioterapia
    Publication . Magalhães, Bárbara; Carvalho, Paulo
    O texto de apoio aqui proposto têm por objetivo a criação de um auxiliar de estudo, contribuindo para uma melhor compreensão da realização de ligaduras funcionais em lesões do sistema músculo-esqueléticas. Consideramos este documento uma peça fundamental para a aquisição das competências básicas dos futuros fisioterapeutas.
  • Rehabilitation outcomes and parameters of blood flow restriction training in ACL injury: a scoping review
    Publication . Caetano, Daniel; Oliveira, Catarina; Correia, Cristiana; Barbosa, Pedro; Mesquita Montes, António; Carvalho, Paulo
    To identify the outcomes of physical function, physical fitness, training, and cuff parameters, used in BFRT in ACL rehabilitation. This scoping review was initiated on April 25th, 2020, according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Relevant literature was identified searching three main concepts: BFRT, rehabilitation and ACL injury on MEDLINE (PubMed), CENTRAL of Cochrane Library, Web of Science and PEDro. Studies looking at adults with a primary ACL injury undergoing conservative or pre/post-surgery rehabilitation with BFR or BFRT, with physical fitness and physical function as outcomes or other physical outcomes were included. Sixty-eight articles were identified and six were included. One article was added through backward tracking. All studies used BFRT in the ACL injury surgical rehabilitation. Most studies evaluated physical fitness (muscular strength and volume) however, physical function was not considered a pri mary outcome. Training and cuff parameters were heterogeneously prescribed. The existing evidence is not enough to draw definitive conclusions due to the heterogenous reported outcomes and parameters. Future investigation with standardized outcome measures and specific protocols are needed to draw conclusions on patients’ physical function, so BFRT can be used more effectively in clinical rehabilitation practice.
  • 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 saudáveis
    Publication . Lopes, Alexandre; Silva, Diogo C. F.; Torres, Rui; Carvalho, Paulo
    A 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.
  • Diagnostic ultrasound assessment of deep fascia sliding mobility in vivo: A scoping review – Part 1: Thoracolumbar and abdominal fasciae
    Publication . Soares, Hélio Rafael; Pinheiro, Ana Rita; Crasto, Carlos; Barbosa, Pedro; Dias, Nuno; Carvalho, Paulo de
    Failure of fascial sliding may occur in cases of excessive or inappropriate use, trauma, or surgery, resulting in local inflammation, pain, sensitization, and potential dysfunction. Therefore, the mechanical properties of fascial tissues, including their mobility, have been evaluated in vivo by ultra-sound (US) imaging. However, this seems to be a method that is not yet properly standardized nor validated. To identify, synthesize, and collate the critical methodological principles that have been described in the literature for US evaluation of deep fascia sliding mobility in vivo in humans. Methods: A systematic literature search was conducted on ScienceDirect, PubMed (Medline), Web of Science and B-On databases, according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. The OCEBM LoE was used to evaluate the level of evidence of each study. From a total of 104 full-text articles retrieved and assessed for eligibility, 18 papers were included that evaluate the deep fasciae of the thoracolumbar (n ¼ 4), abdominal (n ¼ 7), femoral (n ¼ 4) and crural (n ¼ 3) regions. These studies addressed issues concerning either diagnosis (n ¼ 11) or treatment benefits (n ¼ 7) and presented levels of evidence ranging from II to IV. Various terms were used to describe the outcome measures representing fascial sliding. Also, different procedures to induce fascial sliding, positioning of the individuals being assessed, and features of US devices were used. The US analysis methods included the comparison of start and end frames and the use of cross-correlation software techniques through automated tracking algorithms. These methods had proven to be reliable to measure sliding between TLF, TrA muscle-fascia junctions, fascia lata, and crural fascia, and the adjacent epimysial fascia. However, the papers presented heterogeneous terminologies, research questions, populations, and methodologies. This two-part paper reviews the evidence obtained for the thoracolumbar and abdominal fasciae (Part 1) and for the femoral and crural fasciae (Part 2). The US methods used to evaluate deep fascia sliding mobility in vivo in humans include the comparison of start and end frames and the use of cross-correlation software techniques through automated tracking algorithms. These seem reliable methods to measure sliding of some fasciae, but more studies need to be systematized to confirm their reliability for others. Moreover, specific standardized protocols are needed to assess each anatomical region as well as study if age, sex-related characteristics, body composition, or specific clinical conditions influence US results.
  • Effectiveness of therapeutic exercise in musculoskeletal risk factors related to swimmer’s shoulder
    Publication . Tavares, Nuno; Dias, Gonçalo; Carvalho, Paulo; Vilas-Boas, João Paulo; Castro, Maria António
    Therapeutic exercise seems to minimize musculoskeletal risk factors related to swimmer’s shoulder. However, there is an absence of a qualitative evaluation of these programs and a great variability regarding the characteristics of exercises. The objective of this review was to identify, evaluate, and compare exercise programs used to minimize musculoskeletal risk factors related to swimmer’s shoulder. PubMed, CochraneLibrary, ScienceDirect, and Medscape were searched during January 2022. The research was limited to meta-analyses, systematic reviews, and RCTs written in English, Spanish, and Portuguese without publication time. The researched papers had swimmers as the population, compared an exercise program with another program or without intervention, and had as outcomes musculoskeletal risk factor variables. Eleven articles were considered for analysis. There were three positive effects of strength programs on shoulder rotators’ strength and endurance, two positive effects of strength and stretching programs on shoulder posture, and one positive effect of a stretching program on shoulder ROM and a plyometric program on proprioception. There is high heterogeneity and little methodological quality evidence about the theme. However, strength programs with five or fewer OKC exercises performed out of the water seems to lead to better results in the swimmer’s shoulder prevention.
  • Efeitos imediatos de uma postura de Stretching Global Ativo na força e na flexibilidade
    Publication . Rodrigues, Elisa; Pontes, Ana Rita; Brochado, Gabriela; Bessa, Isabel; Carvalho, Paulo; Crasto, Carlos
  • Abdominal muscle activity and pelvic motion according to active straight leg raising test results in adults with and without chronic low back pain
    Publication . Castro, Carlos; Mesquita Montes, António; Carvalho, Paulo; Cancela Carral, JM.
    Active Straight Leg Raise (ASLR) is a clinical test that challenges lumbopelvic stability and have been used in low back pain patients. There are reports of positive tests in asymptomatic individuals, however, it is not clear if they are false positives or a consequence of performing the test differently.
  • Effect of shock wave therapy associated with aerobic exercise on cellulite: A randomized controlled trial
    Publication . Troia, Sara; Moreira, Ana Maria; Pisco, Daniela; Noites, Andreia; Vale, Ana Luísa; Carvalho, Paulo; Vilarinho, Rui
    Background Cellulite is a multifactor and controversial condition. Several methods have been explored to reduce it, not always with favorable results. Shock Wave Therapy has been shown to be effective, but the results of its association with an Aerobic Exercise Program are unknown.
  • Immediate effects of Global Active Stretching on strength and flexibility: Randomised controlled trial
    Publication . Rodrigues, Elisa; Pontes, A. R.; Brochado, G.; Bessa, Isabel; Carvalho, Paulo; Crasto, Carlos
    Global Active Stretching is a relatively recent yet little studied stretching method. It differs from the most popular methods by targeting muscle chains and integrating stretching with muscle contractions, which may eventually avoid the post-stretching reduction of strength that occurs in other methods. To verify the immediate effects of Global Active Stretching on muscle strength and flexibility in individuals with short hamstrings. A single-blind randomised controlled trial was carried out on 30 volunteers with more than 20° in the active knee extension test, randomly assigned to three groups: the experimental group (Global Active Stretching exercise); the placebo group (Global Active Stretching initial position without stretching); and the control group (lying down). The active knee extension and fingertip-to-floor tests assessed hamstring and posterior chain flexibility. Hamstring and quadriceps strength were assessed using the peak torque evaluation in the Biodex System 4PRO®. Assessments took place before and immediately after the 15-minute intervention. The ANOVA and the paired t test were used (α = 0.05). The experimental group had a significant increase in flexibility in both the fingertip-to-floor test (8.3 cm) and the active knee extension test (6.3°) when compared to the placebo and control groups (p < 0.05), while no differences in strength were observed (p > 0.05). Global Active Stretching immediately increased hamstring flexibility without significantly reducing muscle strength. Thus, individuals seeking to enhance their short-term flexibility can benefit from this programme in a single session without compromising performance.
  • Wearables for monitoring and postural feedback in the work context: A scoping review
    Publication . Figueira, Vânia; Silva, Sandra; Costa, Inês; Campos, Bruna; Salgado, João; Pinho, Liliana; Freitas, Marta; Carvalho, Paulo; Marques, João; Pinho, Francisco
    Wearables offer a promising solution for simultaneous posture monitoring and/or corrective feedback. The main objective was to identify, synthesise, and characterise the wearables used in the workplace to monitor and postural feedback to workers. The PRISMA-ScR guidelines were followed. Studies were included between 1 January 2000 and 22 March 2023 in Spanish, French, English, and Portuguese without geographical restriction. The databases selected for the research were PubMed®, Web of Science®, Scopus®, and Google Scholar®. Qualitative studies, theses, reviews, and meta-analyses were excluded. Twelve studies were included, involving a total of 304 workers, mostly health professionals (n = 8). The remaining studies covered workers in the industry (n = 2), in the construction (n = 1), and welders (n = 1). For assessment purposes, most studies used one (n = 5) or two sensors (n = 5) characterised as accelerometers (n = 7), sixaxial (n = 2) or nonaxial inertial measurement units (n = 3). The most common source of feedback was the sensor itself (n = 6) or smartphones (n = 4). Haptic feedback was the most prevalent (n = 6), followed by auditory (n = 5) and visual (n = 3). Most studies employed prototype wearables emphasising kinematic variables of human movement. Healthcare professionals were the primary focus of the study along with haptic feedback that proved to be the most common and effective method for correcting posture during work activities.