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- Methodological considerations for kinematic analysis of upper limbs in healthy and poststroke adultsPublication . Mesquita, Inês; Pinheiro, Ana Rita; Correia, Miguel Fernando Paiva Velhote; Silva, Cláudia Isabel Costa daThe purpose of this study was to review the methods used to analyze the kinematics of upper limbs (ULs) of healthy and poststroke adults, namely specificities of sampling and motor tasks. A database of articles published in the last decade was compiled using the following search terms combinations: (“upper extremity” OR “upper limb” OR arm) AND (kinematics OR motion OR movement) AND (analysis OR assessment OR measurement). The articles included in this review (1) had the purpose to analyze objectively a three-dimension kinematics of ULs, (2) studied functional movements or activities of daily living (ADL) involving uppers limbs, and (3) studied healthy and/or poststroke adults. Fourteen articles were included (four studied a healthy sample, three analyzed poststroke patients, and seven examined both poststroke and healthy participants). Most of the recommended demographic and stroke information, such as some pre existing conditions to stroke, initial stroke severity, and stroke location, were not collected by all or most of the articles. Time poststroke onset was presented in all articles but showed great variability. Few articles identified anthropometric characteristics and adjusted task environment to them. Most of the samples were composed mainly by males and had a low mean age, which does not represent poststroke population. Most articles analyzed “functional movements”, namely simulations of ADL. Future research should identify the recommended information to allow an adequate stratification. Acute phase after stroke, real ADL with different complexities, and ipsilesional UL should be studied.
- Kinematic and electromyographic features of upper-limb movement performed by healthy and post-stroke patientsPublication . Silva, Rosa Mariana; Fonseca, Pedro; Pinheiro, Ana Rita; Vila-Chã, Carolina; Silva, Cláudia; Correia, Miguel Velhote; Mouta, SandraIt is extremely difficult to simplify the relation between several body parts, which perform human motion, into one set of features. Mainly, the upper-limb is capable of a wider range of actions, going from fine manipulation to prehension and grasping. Aiming to describe its complexity, several studies have been conducted in order to better understand the upper-limb specificities. However, most of studies restrain the task to pointing, reaching, or grasping, which seems not enough to explain the wide range of tasks possible to be performed in a daily scenario.
- 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.
- Co-activation of upper limb muscles during reaching in post-stroke subjects: An analysis of the contralesional and ipsilesional limbsPublication . Silva, Cláudia; Silva, Augusta; Pinheiro De Sousa, Andreia Sofia; Pinheiro, Ana Rita; Bourlinova, Catarina; Silva, Ana; Salazar, António; Borges, Carla; Crasto, Carlos; Correia, Miguel Velhote; Vilas-Boas, João Paulo; Santos, RubimThe purpose of this study was to analyze the change in antagonist co-activation ratio of upper-limb muscle pairs, during the reaching movement, of both ipsilesional and contralesional limbs of post-stroke subjects. Nine healthy and nine post-stroke subjects were instructed to reach and grasp a target, placed in the sagittal and scapular planes of movement. Surface EMG was recorded from postural control and movement related muscles. Reaching movement was divided in two sub-phases, according to proximal postural control versus movement control demands, during which antagonist co-activation ratios were calculated for the muscle pairs LD/PM, PD/AD, TRIlat/BB and TRIlat/BR. Post-stroke's ipsilesional limb presented lower co-activation in muscles with an important role in postural control (LD/PM), comparing to the healthy subjects during the first sub-phase, when the movement was performed in the sagittal plane (p<0.05). Conversely, the post-stroke's contralesional limb showed in general an increased co-activation ratio in muscles related to movement control, comparing to the healthy subjects. Our findings demonstrate that, in post-stroke subjects, the reaching movement performed with the ipsilesional upper limb seems to show co-activation impairments in muscle pairs associated to postural control, whereas the contralesional upper limb seems to have signs of impairment of muscle pairs related to movement.
- Childhood obesity and reduction of hours of sleep: results from cross-sectional studyPublication . Marques, Goreti; Matos, Maria; Afonso, Claúdia; Conceição, Ana Paula; Martins, Tânia; Pinto, Sara; Festas, Constança; Pinheiro, Ana RitaChildhood obesity is a prevalent condition in modern societies which can negatively impact people’s health during life. Although there are several factors contributing to obesity, sleep duration has been pointed out as an important risk factor. This study, held in the district of Porto, Portugal, aimed to analyze the association between sleep duration and the nutritional status of school-aged children studying in Portugal. 1396 students from 35 and 3 public and private schools, respectively, were contacted, of which 829 participated in this study (9.2±0.38 years old; 50.3% male; 49.7% female). Age, sex, sleep duration, height, weight and body composition were registered trough a questionnaire. According to the obtained z-score for Body Mass Index (BMI), 22.9% of the children were overweight and 15.2% were obese. The mean of sleep duration was 9.7±1.08 hours and z-score for BMI was 0.78±1.21, demonstrating a statistically significant (p<0.01) weak negative correlation (r=-0.15) between sleep duration and z-score of BMI. Results were also stratified and analyzed by sex, and the same finding was observed. Therefore, the results suggest a negative association between sleep duration and overweight/obesity in these children. Although more studies are necessary, this finding highlights the need of a global approach which includes sleep assessment and counselling when promoting an appropriate nutritional status.
- Intersegmentar orientation between trunk and lower limbs in individuals after stroke: a pilot studyPublication . Ferreira, Rosália; Calvário, Helena; Mesquita Montes, António; Pinheiro, Ana RitaPostural control, which involves stability and intersegmental orientation against gravity, is considered a prerequisite for movement to occur efficiently and in different contexts [1]. After central nervous system damage, individuals tend to demonstrate motor impairments, which can affect their functional ability in different activities, such as standing and walking [2]. These altered motor behaviours restrict voluntary, well-coordinated and effective movements, which in turn limit a person’s ability to perform everyday tasks [2]. Therefore, this study aimed at analysing the correlation between the orientation of the trunk and lower limbs of individuals after stroke during standing.
- Health-related telemonitoring parameters/signals of older adults: An umbrella reviewPublication . Félix, José; Moreira, Juliana; Santos, Rubim; Kontio, Elina; Pinheiro, Ana Rita; Sousa, Andreia S. P.Aging is one of the greatest challenges in modern society. The development of wearable solutions for telemonitoring biological signals has been viewed as a strategy to enhance older adults’ healthcare sustainability. This study aims to review the biological signals remotely monitored by technologies in older adults. PubMed, the Cochrane Database of Systematic Reviews, the Web of Science, and the Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports were systematically searched in December 2021. Only systematic reviews and meta-analyses of remote health-related biological and environmental monitoring signals in older adults were considered, with publication dates between 2016 and 2022, written in English, Portuguese, or Spanish. Studies referring to conference proceedings or articles with abstract access only were excluded. The data were extracted independently by two reviewers, using a predefined table form, consulting a third reviewer in case of doubts or concerns. Eighteen studies were included, fourteen systematic reviews and four meta-analyses. Nine of the reviews included older adults from the community, whereas the others also included institutionalized participants. Heart and respiratory rate, physical activity, electrocardiography, body temperature, blood pressure, glucose, and heart rate were the most frequently measured biological variables, with physical activity and heart rate foremost. These were obtained through wearables, with the waist, wrist, and ankle being the most mentioned body regions for the device’s placement. Six of the reviews presented the psychometric properties of the systems, most of which were valid and accurate. In relation to environmental signals, only two articles presented data on this topic. Luminosity, temperature, and movement were the most mentioned variables. The need for large-scale long-term health-related telemonitoring implementation of studies with larger sample sizes was pointed out by several reviews in order to define the feasibility levels of wearable devices.
- Calcium signaling and the novel anti-proliferative effect of the UTP-sensitive P2Y11 receptor in rat cardiac myofibroblastsPublication . Certal, Mariana; Vinhas, Adriana; Pinheiro, Ana Rita; Ferreirinha, Fátima; Barros-Barbosa, Aurora Raquel; Silva, Isabel; Costa, Maria Adelina; Correia-de-Sá, PauloDuring myocardial ischemia and reperfusion both purines and pyrimidines are released into the extracellular milieu, thus creating a signaling wave that propagates to neighboring cells via membrane-bound P2 purinoceptors activation. Cardiac fibroblasts (CF) are important players in heart remodeling, electrophysiological changes and hemodynamic alterations following myocardial infarction. Here, we investigated the role UTP on calcium signaling and proliferation of CF cultured from ventricles of adult rats. Co-expression of discoidin domain receptor 2 and -smooth muscle actin indicate that cultured CF are activated myofibroblasts. Intracellular calcium ([Ca2+]i) signals were monitored in cells loaded with Fluo-4 NW. CF proliferation was evaluated by the MTT assay. UTP and the selective P2Y4 agonist, MRS4062, caused a fast desensitizing [Ca2+]i rise originated from thapsigargin-sensitive internal stores, which partially declined to a plateau providing the existence of Ca2+ in the extracellular fluid. The biphasic [Ca2+]i response to UTP was attenuated respectively by P2Y4 blockers, like reactive blue-2 and suramin, and by the P2Y11 antagonist, NF340. UTP and the P2Y2 receptor agonist MRS2768 increased, whereas the selective P2Y11 agonist NF546 decreased, CF growth; MRS4062 was ineffective. Blockage of the P2Y11receptor or its coupling to adenylate cyclase boosted UTP-induced CF proliferation. Confocal microscopy and Western blot analysis confirmed the presence of P2Y2, P2Y4 and P2Y11 receptors. Data indicate that besides P2Y4 and P2Y2 receptors which are responsible for UTP-induced [Ca2+]i transients and growth of CF, respectively, synchronous activation of the previously unrecognized P2Y11 receptor may represent an important target for anti-fibrotic intervention in cardiac remodeling.
- Activation timing of soleus and tibialis anterior muscles during sit-to-stand and stand to sit in post-stroke vs healthy subjectsPublication . Augusta Silva; Santos, Rubim; Pinheiro De Sousa, Andreia Sofia; Pinheiro, Ana Rita; Ferraz, Joana; Tavares, João Manuel; Sousa, FilipaSit-to-stand (SitTS) and stand-to-sit (StandTS) are very important functional tasks that become compromised in stroke patients. As in other voluntary movements, they require an adequate postural control (PC) involving the generation of anticipatory postural adjustments (APAs). In order to give clues for more efficient and directed rehabilitation programs, a deeper knowledge about APAs during challenging and daily life movements is essential. To analyze the activation timing of tibialis anterior (TA) and soleus (SOL) muscles during SitTS and StandTS in healthy subjects and in post-stroke patients. Methods: Two groups participated in this study: one composed by ten healthy subjects and the other by ten subjects with history of stroke and increased H-reflex. Electromyographic activity (EMGa) of SOL and TA was analyzed during SitTS and StandTS in the ipsilateral (IPSI) and the contralateral (CONTRA) limb to the side lesion in stroke subjects, and in one limb in the healthy subjects. A force plate was used to identify the movement onset. In both sequences, in the stroke group SOL activation timing occurred prior to movement onset, contrary to the pattern observed in the healthy subjects. Statistical significant differences were found in SOL activation timings between each lower limbs of the stroke and healthy groups, but no significant differences were found between the IPSI and the CONTRA limb. The TA activation timing seems to be delayed in the CONTRA limb when compared to the healthy subjects and showed also a better organization of TA timing activation in StandTS when compared to SitTS. Compared to healthy subjects, APAs seems to be altered in both limbs of the post-stroke subjects, with the SOL activation timing being anticipated in both SitTS and StandTS.
- Eficácia de um programa específico de exercício físico no desempenho físico de indivíduos em hemodiálisePublication . Pinheiro, Ana Rita; Melo, CristinaEste estudo pretende analisar se um programa específico de exercício físico melhora o desempenho físico de indívíduos em hemdiálise. O programa de exercício foi desenhado e adaptado a cada indívíduo, por um fisioterapeuta, visando a flexibilidade, força e resistência (n=11). Após o programa verificou-se um aumento significativo da distância percorrida em 6 minutos (6-minute walk), um aumento da velocidade da marcha (gait speed) e uma maior velocidade a levantar/sentar numa cadeira (sit-to-stand-to-sit). Assim, um treino específico de exercício em casa parece melhorar o desempenho físico de indívíduos em hemodiálise.