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- Efeito imediato da técnica de rotação cervical grau II na sensação de posição articular em indivíduos com e sem dor não específicaPublication . Rodrigues, Elisa; Brochado, Gabriela; Moura Bessa, Isabel; Gonçalves, Paulo; Domingos, João; Crasto, CarlosA mobilização articular passiva em indivíduos com dor cervical possui eficácia reconhecida no alívio da dor e no aumento da amplitude articular, mas há poucos estudos sobre a sua influência na capacidade propriocetiva. Estudar o efeito imediato da técnica de rotação cervical grau II na sensação de posição articular, em jovens adultos com e sem dor cervical unilateral de origem não específica. Estudo quase experimental, duplamente cego, numa amostra de conveniência de 37 indivíduos (18 a 24 anos de ambos os sexos) divididos em 2 grupos: 22 sem dor e 15 com dor cervical. O instrumento Cervical Range of Motion foi utilizado para avaliar a sensação de posição articular ativa da cervical a 30⁰ de rotação, para a direita e para a esquerda, antes e imediatamente após a execução da técnica de mobilização articular de rotação cervical grau II de Maitland (quatro mobilizações de 30 segundos cada). O teste foi repetido seis vezes para cada lado. Calculou-se o erro absoluto e o erro variável utilizando-se o teste t para comparação entre os grupos e momentos com nível de significância de 5%. Apenas se observaram diferenças significativas entre grupos no erro variável na rotação esquerda após a realização da técnica e entre momentos na rotação esquerda e direita no grupo sem dor sendo, no entanto, de magnitudes iguais ou inferiores a 1⁰ em média. A técnica de rotação cervical grau II não parece produzir efeitos imediatos clinicamente relevantes na precisão e consistência do reposicionamento avaliada a 30⁰ de rotação.
- Diagnostic ultrasound assessment of deep fascia sliding mobility in vivo: A scoping review – Part 2: Femoral and crural fasciaePublication . Soares, Hélio Rafael; Pinheiro, Ana Rita; Crasto, Carlos; Barbosa, Pedro; Dias, Nuno; Carvalho, PauloFailure 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 ultrasound (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. 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.
- Repeatability and temporal consistency of lower limb biomechanical variables expressing interlimb coordination during the double-support phase in people with and without stroke sequelaePublication . Couto, Ana G. B.; Vaz, Mário A. P.; Pinho, Liliana; Félix, José; Moreira, Juliana; Pinho, Francisco; Mesquita, Inês Albuquerque; Mesquita Montes, António; Crasto, Carlos; Sousa, AndreiaReliable biomechanical methods to assess interlimb coordination during the double-support phase in post-stroke subjects are needed for assessing movement dysfunction and related variability. The data obtained could provide a significant contribution for designing rehabilitation programs and for their monitorisation. The present study aimed to determine the minimum number of gait cycles needed to obtain adequate values of repeatability and temporal consistency of lower limb kinematic, kinetic, and electromyographic parameters during the double support of walking in people with and without stroke sequelae. Eleven post-stroke and thirteen healthy participants performed 20 gait trials at self-selected speed in two separate moments with an interval between 72 h and 7 days. The joint position, the external mechanical work on the centre of mass, and the surface electromyographic activity of the tibialis anterior, soleus, gastrocnemius medialis, rectus femoris, vastus medialis, biceps femoris, and gluteus maximus muscles were extracted for analysis. Both the contralesional and ipsilesional and dominant and non-dominant limbs of participants with and without stroke sequelae, respectively, were evaluated either in trailing or leading positions. The intraclass correlation coefficient was used for assessing intra-session and inter-session consistency analysis. For most of the kinematic and the kinetic variables studied in each session, two to three trials were required for both groups, limbs, and positions. The electromyographic variables presented higher variability, requiring, therefore, a number of trials ranging from 2 to >10. Globally, the number of trials required inter-session ranged from 1 to >10 for kinematic, from 1 to 9 for kinetic, and 1 to >10 for electromyographic variables. Thus, for the double support analysis, three gait trials were required in order to assess the kinematic and kinetic variables in cross-sectional studies, while for longitudinal studies, a higher number of trials (>10) were required for kinematic, kinetic, and electromyographic variables.
- The influence of knee pain in the incapacity and proprioception in older adultsPublication . Freitas, Ana Sofia; Melo, Cristina; Montes, António Mesquita; Crasto, Carlos; Santos, RitaThe pain in the knee presents a multifactorial ethology, with age as an important risk factor. The pain in the knee might be related to changes in the proprioception of the knee. To compare the influence of the unilateral pain with the bilateral pain in the knee in the disability and proprioception in older adults.
- The influence of upper limb lever in muscle activity of scapular stabilizers in push-up position on the wallPublication . Carvalho, Paulo; Mesquita Montes, António; Crasto, Carlos; Barbosa, Pedro; Peres, PatríciaThe push-up has been extensively studied regarding scapular stabilizers. However, certain variations of push-up position still need further study. To analyze the influence of different levers of the upper limb - hands and forearms support - in muscle activity of scapular stabilizers in push-up position on the wall, as well as to analyze the electromyographic differences between protraction and retraction phases of the scapulas.
- Diagnostic ultrasound assessment of deep fascia sliding mobility in vivo: A scoping review – Part 1: Thoracolumbar and abdominal fasciaePublication . Soares, Hélio Rafael; Pinheiro, Ana Rita; Crasto, Carlos; Barbosa, Pedro; Dias, Nuno; Carvalho, Paulo deFailure 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.
- Immediate effects of Global Active Stretching on strength and flexibility: Randomised controlled trialPublication . Rodrigues, Elisa; Pontes, A. R.; Brochado, G.; Bessa, Isabel; Carvalho, Paulo; Crasto, CarlosGlobal 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.
- Interlimb coordination during double support phase of gait in people with and without strokePublication . Couto, Ana G. B.; Vaz, Mário A. P.; Pinho, Liliana; Félix, José; Moreira, Juliana; Pinho, Francisco; Mesquita, Inês; Mesquita Montes, António; Crasto, Carlos; Sousa, AndreiaThis study aims to identify differences between participants with and without stroke regarding the ipsilesional and contralesional lower limbs kinematics, kinetics, muscle activity and their variability during double support phase of gait. Eleven post-stroke and thirteen healthy participants performed 10 gait trials at a self-selected speed while being monitored by an optoelectronic motion capture system, two force plates and an electromyographic system. The following outcomes were evaluated during the double support: the time and the joint position; the external mechanical work on the centre of mass; and the relative electromyographic activity. Both, contralesional/ipsilesional and dominant/non-dominant of participants with and without stroke, respectively, were evaluated during double support phase of gait in trailing or leading positions. The average value of each parameter and the coefficient of variation of the 10 trials were analysed. Post-stroke participants present bilateral decreased mechanical work on the centre of mass and increased variability, decreased contralesional knee and ankle flexion in trailing position, increased ipsilesional knee flexion in leading position and increased variability. Increased relative muscle activity was observed in post-stroke participants with decreased variability. Mechanical work on the centre of mass seems to be the most relevant parameter to identify interlimb coordination impairments in post-stroke subjects.
- A influência da imobilização do joelho na cinemática do membro contralateralPublication . Santos, M.; Lopes, Alfredo; Mesquita, I.; Crasto, CarlosA marcha é influenciada por um conjunto multifatorial resultante da interação ou do processo de organização própria de sistemas neurais e mecânicos. Estes sistemas estão envolvidos no controlo de movimentos rítmicos durante a locomoção originando padrões complexos e variáveis, permitindo um trabalho diferencial dos músculos dos membros inferiores em extensão e outro em flexão, refletindo-se numa maior dominância centrada no controlo do membro em flexão. Apesar da marcha ser extremamente robusta quer a alterações ambientais, quer a alterações físicas, desconhece-se até que ponto a indução da manutenção permanente em extensão do joelho pode influenciar os ângulos articulares do membro contralateral.
- Changes in co-contraction magnitude during functional tasks following anterior cruciate ligament reconstruction: A systematic reviewPublication . Paredes, Ricardo; Crasto, Carlos; Mesquita Montes, António; Arias-Buría, José L.Anterior cruciate ligament reconstruction (ACLR) is a common orthopedic surgery procedure whose incidence has increased over the past few decades. Nevertheless, it is believed that neuromuscular control remains altered from the early stages after ACLR to later years. Therefore, the aim of this study was to systematically evaluate the magnitude of co-contraction during functional tasks in subjects with unilateral ACLR. A systematic review design was followed. The search strategy was conducted in PubMed, Scopus, EBSCO, PEDro, Cochrane Library, and Web of Science databases from inception to March 2024. The inclusion criteria involved studies using electromyography (EMG) data to calculate muscle pair activation via the co-contraction index (CCI) in ACLR individuals during functional tasks. The Preferred Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and study quality was evaluated using National Institutes of Health (NIH) Study Quality Assessment Tools. The search strategy found a total of 792 studies, of which 15 were included in this systematic review after reviewing the eligibility criteria. The magnitude of co-contraction was assessed in a total of 433 ACLR individuals and 206 controls during functional tasks such as hop, drop-land, step-up/step-down, and gait. Overall, approximately 79.6% of individuals who had undergone ACLR exhibited increased levels of co-contraction magnitude in the ACLR limb, while 8.5% showed low co-contraction levels. The findings of the review suggest that, during functional tasks, most individuals who have undergone ACLR exhibit changes of co-contraction magnitude in the involved limb.