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- 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.
- Forward trunk lean with arm support affects the activity of accessory respiratory muscles and thoracoabdominal movement in healthy individualsPublication . Mesquita Montes, António; Tam, Carolina; Crasto, Carlos; Melo, Cristina; Carvalho, Paulo; Santos, Rita; Vilarinho, Rui; Vilas-Boas, João PauloDespite the reported benefits of postures involving leaning the trunk forward with arm support for relieving dyspnea, how those postures influence the mechanics of breathing remains unclear. In response, the aim of the study reported here was to evaluate how posture (i.e., standing and sitting) and leaning the trunk forward with arm support affect the activity of accessory respiratory muscles and thoracoabdominal movement in healthy individuals. Thirty-five volunteers (15 males and 20 females) aged 18-29 years breathed with the same rhythm in standing and sitting positions while upright and while leaning the trunk forward with arm support. Surface electromyography was performed to assess the activity of accessory inspiratory (i.e., during inspiration) and abdominal (i.e., during inspiration and expiration) muscles, and a motion capture system was used to assess thoracoabdominal movement. Results revealed that upper trapezius activity was significantly lower in forward-leaning postures than in upright ones (P = 005; ηp2 = 0.311), although the activity of the sternocleidomastoideus and scalenus (P < 0.001; ηp2 = 0.427-0.529), along with the anterior-to-posterior movement of the upper ribcage (P < 0.001; ηp2 = 0.546), were significantly greater in forward-leaning postures than in upright ones. The activity of the external oblique and transversus abdominis/internal oblique was significantly lower in sitting than in standing postures (P < 0.050; ηp2 = 0.206-0.641), and though the activity of the transversus abdominis/internal oblique was significantly lower in forward-leaning than in upright postures (P ≤ 0.001; ηp2 = 0.330-0.541), a significantly greater anterior-to-posterior movement of the abdomen was observed (P < 0.001; ηp2 = 0.662). However, the magnitude of the lower ribcage's medial-to-lateral movement was significantly lower in forward-leaning than in upright postures (P = 0.039; ηp2 = 0.149). Leaning the trunk forward with arm support not only increased the use of accessory inspiratory muscles but also decreased the use of the transversus abdominis/internal oblique, which improved thoracoabdominal movement.
- Abdominal muscle activity during breathing with and without inspiratory and expiratory loads in healthy subjectsPublication . Mesquita Montes, António; Baptista, João; Crasto, Carlos; Melo, Cristina; Santos, Rita; Vilas-Boas, João PauloCentral Nervous System modulates the motor activities of all trunk muscles to concurrently regulate the intra-abdominal and intra-thoracic pressures. The study aims to evaluate the effect of inspiratory and expiratory loads on abdominal muscle activity during breathing in healthy subjects. Twenty-three higher education students (21.09±1.56years; 8males) breathed at a same rhythm (inspiration: two seconds; expiration: four seconds) without load and with 10% of the maximal inspiratory or expiratory pressures, in standing. Surface electromyography was performed to assess the activation intensity of rectus abdominis, external oblique and transversus abdominis/internal oblique muscles, during inspiration and expiration. During inspiration, transversus abdominis/internal oblique activation intensity was significantly lower with inspiratory load when compared to without load (p=0.009) and expiratory load (p=0.002). During expiration, the activation intensity of all abdominal muscles was significantly higher with expiratory load when compared to without load (p<0.05). The activation intensity of external oblique (p=0.036) and transversus abdominis/internal oblique (p=0.022) was significantly higher with inspiratory load when compared to without load. Transversus abdominis/internal oblique activation intensity was significantly higher with expiratory load when compared to inspiratory load (p<0.001). Transversus abdominis/internal oblique seems to be the most relevant muscle to modulate the intra-abdominal pressure for the breathing mechanics.
- Pressure biofeedback unit to assess and train lumbopelvic stability in supine individuals with chronic low back painPublication . Crasto, Carlos Filipe Barbosa; Mesquita Montes, António; Carvalho, Paulo; Carral, José Maria CancelaTo determine if pressure biofeedback unit readings are related to abdominal muscle activation and centre of pressure displacement as well as to test the effects of using it as a biofeedback tool to control lumbopelvic motion. Eighteen volunteers with chronic nonspecific low back pain (21.28 ± 1.41 years old) who performed an active straight leg raising (dynamic postural challenge) with and without pressure biofeedback. Changes in the pressure biofeedback unit and on centre of pressure displacement were assessed, as well as bilateral electromyographic abdominal muscle activity. Participants were not allowed to use a Valsalva manoeuvre. Pressure variation was not significantly correlated with abdominal muscle activity or with mediolateral centre of pressure displacement. When used as a biofeedback instrument, there was a significant increase in almost all abdominal muscles activity as well as a significant decrease in pressure variation and in mediolateral centre of pressure displacement while performing an active straight leg raising with a normal breathing pattern. Despite not being an indicator of abdominal muscle activity or mediolateral load transfer in the supine position, the pressure biofeedback unit could have great relevance when used in the clinic for biofeedback purposes in individuals with low back pain.
- The influence of aging on muscle activation timing during backward steppingPublication . Ribeiro, Vítor; Melo, Cristina; Mesquita Montes, António; Crasto, Carlos; Santos, RitaAging process seems to influence postural control negatively, which has great importance on stepping response after external perturbation. Verify the influence of aging on muscle activation timing in backward stepping, after unexpected external disturbance.
- Efeito imediato da técnica de rotação cervical grau II na sensação de posição articular em indivíduos com 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.
- Efeitos imediatos de uma postura de Stretching Global Ativo na força e na flexibilidadePublication . Rodrigues, Elisa; Pontes, Ana Rita; Brochado, Gabriela; Bessa, Isabel; Carvalho, Paulo; Crasto, Carlos