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- Intervenção do Fisioterapeuta na (dis)função respiratória em Pediatria - da comunidade à agudizaçãoPublication . Tomé, David; Carvalho, Isabel; Ferraz, Catarina; Abreu, Paulo; Almeida, Sandrine; Ferreira, João José Pinto; Alexandrino, Ana Silva; Costa, Daniel; Santos, Rita; Vieira, Olga; Parreira, Verônica; Lopes, Alfredo; Moreira, Ana; Tavares, Lourdes; Garcia-Lopes, Milagros; Pinto, Frederico; Costa, Daniel; Silva, Vânia; Vieira, DanielleEste seminário pretendeu actualizar o estado da arte na abordagem da (dis)função respiratória da criança, uma vez que, nesta área, o fisioterapeuta amplificou os limites de actuação, para além do modelo biomédico. Num dos extremos encontra-se a intervenção comunitária, cujo modelo propicia a educação e promoção de saúde, privilegiando estratégias que capacitem o cuidador; no outro extremo inclui-se a intervenção do fisioterapeuta nos cuidados intensivos e na agudização da doença. A intervenção do fisioterapeuta centra-se cada vez mais numa abordagem holística, tendo como objectivo não só o tratamento da afecção do sistema que está na base da (dis)função mas também das repercussões fisiológicas, funcionais e sociais para a criança e cuidadores, sendo também responsável pela actuação sobre os factores ambientais. Desta forma, este seminário tornou-se pertinente não só para fisioterapeutas que trabalhem directamente com crianças com patologia cárdio-respiratória, mas também àqueles cujo âmbito de intervenção seja mais direccionado para outras áreas ou condições de saúde, de forma a potenciar o modelo de transporte de O2. De facto, a abordagem da (dis) função respiratória da criança deve estar implícita em qualquer processo de (re)educação, sendo fundamental em casos como a paralisia cerebral, doenças neuromusculares, alterações posturais, doenças auto-imunes, entre outras. Pelas suas importantes repercussões no sistema cárdiorespiratório da criança, torna-se fundamental alertar o fisioterapeuta para um conjunto de estratégias que potenciem a sua intervenção. O seminário pretendeu também ter um carácter multidisciplinar, contando com a presença de preletores nacionais e internacionais, referências nas várias áreas das profissões de saúde.
- Mismatch negativity in childhood temporal lobe epilepsy: a proposed paradigm for testing central auditory processingPublication . Tomé, David; Moreira, Pedro; Marques-Teixeira, João; Barbosa, Fernando; Jääskeläinen, SatuBackground: Temporal lobe epilepsy (TLE) is a neurological disorder that directly affects cortical areas responsible for auditory processing. The resulting abnormalities can be assessed using event-related potentials (ERP), which have high temporal resolution. However, little is known about TLE in terms of dysfunction of early sensory memory encoding or possible correlations between EEGs, linguistic deficits, and seizures. Mismatch negativity (MMN) is an ERP component – elicited by introducing a deviant stimulus while the subject is attending to a repetitive behavioural task – which reflects pre-attentive sensory memory function and reflects neuronal auditory discrimination and perceptional accuracy. Hypothesis: We propose an MMN protocol for future clinical application and research based on the hypothesis that children with TLE may have abnormal MMN for speech and non-speech stimuli. The MMN can be elicited with a passive auditory oddball paradigm, and the abnormalities might be associated with the location and frequency of epileptic seizures. Significance: The suggested protocol might contribute to a better understanding of the neuropsychophysiological basis of MMN. We suggest that in TLE central sound representation may be decreased for speech and non-speech stimuli. Discussion: MMN arises from a difference to speech and non-speech stimuli across electrode sites. TLE in childhood might be a good model for studying topographic and functional auditory processing and its neurodevelopment, pointing to MMN as a possible clinical tool for prognosis, evaluation, follow-up, and rehabilitation for TLE.
- Social representation of “music” in young adults: a cross-cultural studyPublication . Manchaiah, Vinaya; Zhao, Fei; Widén, Stephen; Auzenne, Jasmin; Beukes, Eldré W.; Ahmadi, Tayebeh; Tomé, David; Mahadeva, Deepthi; Krishna, Rajalakshmi; Germundsson, PerObjective: This study was aimed to explore perceptions of and reactions to music in young adults (18–25 years) using the theory of social representations (TSR). Design: The study used a cross-sectional survey design and included participants from India, Iran, Portugal, USA and UK. Data were analysed using various qualitative and quantitative methods. Study sample: The study sample included 534 young adults. Results: The Chi-square analysis showed significant differences between the countries regarding the informants’ perception of music. The most positive connotations about music were found in the responses obtained from Iranian participants (82.2%), followed by Portuguese participants (80.6%), while the most negative connotations about music were found in the responses obtained from Indian participants (18.2%), followed by Iranian participants (7.3%). The participants’ responses fell into 19 main categories based on their meaning; however, not all categories were found in all five countries. The co-occurrence analysis results generally indicate that the category “positive emotions or actions” was the most frequent category occurring in all five countries. Conclusions: The results indicate that music is generally considered to bring positive emotions for people within these societies, although a small percentage of responses indicate some negative consequences of music.
- Characterization of middle-ear condition of Oporto daycare children up-to 3 years-old: A cross sectional studyPublication . Tomé, David; Alexandrino, Ana Silva; Santos, Rita; Melo, Cristina; Costa, Daniel; Ferreira, JoãoObjective The aim of this study was to determine tympanometric values of children who attend Oporto daycare centers and further analyze any relations with host and environmental factors. Methods Cross sectional study in a randomly selected sample of 117 daycare children up-to 3-years old from Oporto. Tympanometric measures were collected. Results Children presented in left ear (LE) a mean peak pressure (PP) of −156.53 daPa and a mean compliance of 0.16 cm3. Right ear (RE) revealed a PP of −145.61 daPa and a compliance of 0.19 cm3. Normal tympanograms (type A) had a lower frequency than abnormal tympanograms (type B and type C). There was a positive association between age and compliance (LE: p = 0.016; RE: p = 0.013) and between the presence of rhinorrhea and PP (LE: p = 0.002; RE: p < 0.05). Abnormal tympanograms were more frequent in Spring (RE: p = 0.009), in younger children (LE: p = 0.03) and in children that had rhinorrhea (LE: p = 0.002; RE: p = 0.044). Healthy children had a mean PP of −125.19 daPa and a mean compliance of 0.21 cm3 in LE and a mean PP of −144.27 daPa and a mean compliance of 0.22 cm3 in RE. Conclusion Tympanometric measures presented in this paper may be applicable to Oporto daycare children up-to 3 years-old. Most of daycare children revealed abnormal tympanograms. Age, rhinorrhea and season influenced children's middle-ear condition.
- Influência da educação musical avançada na discriminação auditiva com ruído competitivoPublication . Tomé, David; Pereira, Ilídio; Dias, Ana ElisaA organização neuronal para a música e linguagem tem sido alvo de inúmeras discussões nas áreas de audiologia, neurociência e arte musical. Vários estudos têm procurado investigar a influência da prática musical na discriminação da fala com ruído competitivo. Averiguar se a prática musical frequente promove uma melhoria significativa na capacidade de discriminação tonal e vocal em ambientes ruidosos. Material e métodos: 15 estudantes de música com prática instrumental (GE) e 15 não-estudantes de música (GC) realizaram medições audiológicas de discriminação de tons puros e de fala com ruído competitivo. Todos os participantes foram submetidos a um teste de discriminação de tons puros, o teste de mudanças de limiar determinado modificado (TMLDm), e outro de discriminação de fala (TMLDm vocal), ambos na presença de ruído competitivo. Todos os participantes eram normouvintes e tinham idades entre os 16 e os 33 anos (GE, M=19.1 anos, DP=4.2; GC, M=20.1, DP=5.4). O GE superou significativamente o GC em ambos os testes (valor p < 0.05). Tanto no ouvido direito como no esquerdo no TMLDm tonal o GE obteve uma média da relação sinal-ruído de -5 dB. No TMLDm vocal, os participantes do GC erraram em média a repetição de 8 palavras perante a média de 1 falha do GE. Os resultados sugerem que a prática musical pode melhorar o desempenho na discriminação da palavra em ruído competitivo, o que permite igualmente antever um melhor processamento auditivo central.
- Differences in Mismatch Negativity (MMN) response to Pure-tone and Speech sounds in normal subjects: an additional explanationPublication . Tomé, David; Barbosa, Fernando; Marques-Teixeira, JoãoThe relation of automatic auditory discrimination, measured with MMN, with the type of stimuli has not been well established in the literature, despite its importance as an electrophysiological measure of central sound representation. In this study, MMN response was elicited by pure-tone and speech binaurally passive auditory oddball paradigm in a group of 8 normal young adult subjects at the same intensity level (75 dB SPL). The frequency difference in pure-tone oddball was 100 Hz (standard = 1 000 Hz; deviant = 1 100 Hz; same duration = 100 ms), in speech oddball (standard /ba/; deviant /pa/; same duration = 175 ms) the Portuguese phonemes are both plosive bi-labial in order to maintain a narrow frequency band. Differences were found across electrode location between speech and pure-tone stimuli. Larger MMN amplitude, duration and higher latency to speech were verified compared to pure-tone in Cz and Fz as well as significance differences in latency and amplitude between mastoids. Results suggest that speech may be processed differently than non-speech; also it may occur in a later stage due to overlapping processes since more neural resources are required to speech processing.
- Distúrbios do processamento auditivo central em crianças com epilepsia: uma revisão sistemáticaPublication . Oliveira, Mónica Sousa; Tomé, DavidO Distúrbio do Processamento Auditivo Central (DPAC) é definido como um déficit no processamento neural da informação auditiva no Sistema Nervoso Auditivo Central (SNAC) e está associado a dificuldades nas funções da linguagem, aprendizagem e comunicação de ordem superior (ASHA, 2010). A epilepsia, é uma doença cerebral não transmissível e estima-se que afete cerca de 50 milhões de pessoas em todo o mundo (World Health Organization, 2022). Na infância, a epilepsia benigna da infância com pontas centrotemporais e a epilepsia do lobo temporal são as duas formas de epilepsia mais relatadas (Boscariol et al., 2015).
- Potenciais evocados auditivos de média latência em adultos com epilepsiaPublication . Tomé, David; Jesus, Emiliana; Esteves, ManuelIntrodução Os potenciais evocados auditivos de média latência (PEAML) reflectem actividade neuronal mesencefáfica, mais precisamente da região tálamo-cortical, dos colículos inferiores e da formação reticular. A epilepsia é caracterizada por variadas manifestações anormais do comportamento cerebral, sendo descrita como uma perturbação da função cerebral, tendo origem numa descarga anómala de um conjunto ou da totalidade dos neurónios do córtice cerebral. Está documentado, que as descargas eléctricas provocadas pelas crises de epilepsia podem levar a perdas neuronais, pelo que poderão existir alterações nos PEAML. Objectivos A escassa existência de literatura sobre o tema e a não investigação na população portuguesa, originou a execução deste estudo, que teve como objectivo investigar e documentar a existência de alterações ou achados nos componentes neuronais de média latência (PEAML), numa amostra de portugueses com epilepsia. Metodologia Foram realizados PEAML a um grupo de controlo (GC) composto por 16 participantes e a um grupo clínico (GCL) de 8 participantes com epilepsia, sendo analisados os componentes Na, Pa e Na-Pa quanto à sua morfologia, latência e amplitude. Resultados A morfologia das ondas e a presença de epilepsia não estão associados, no entanto, contrariamente ao GC que evidenciou latências e amplitudes de Na, Pa e Na-Pa dentro dos padrões de normalidade, a alteração ou ausência de respostas por parte do GCL é significativa na totalidade das medidas investigadas. Conclusão Em epilepsias generalizadas e focais do lobo temporal os PEAML evidenciam alterações, tal achado poderá ser eventualmente justificado pela propagação ascendente e descendente da informação auditiva se encontrar comprometida, devido a sequelas deixadas pelas crises epilépticas nas vias auditivas mesencefálicas. As alterações verificadas foram uma morfologia anómala das ondas ou ausência das mesmas.
- Effects of Noise Frequency on Performance and Well-BeingPublication . Sousa, Jorge; Monteiro, Raquel; Tomé, David; Rodrigues, MatildeThe features of occupational noise, in particular sound pressure levels, the type of noise and its frequency can be related to several physiological and non-physiological effects. However, studies about the influence of occupational noise on non-physiological effects are still scarce. The aim of this study was to investigate effect of intermittent sound patterns with different frequency on subjects’ performance and well-being. Five conditions were simulated and tested through an experimental study: Standard Condition (C0); Industrial noise with alert sounds at 500 Hz (C1); Industrial noise with alert sounds at 1000 Hz (C2); Industrial noise with alert sounds at 2000 Hz (C3); Industrial noise with alert sounds at 3000 Hz (C4). The noise levels were fixed at 45 ± 0.3 dB (A) in C0, and in 68 ± 0.5 dB (A) in the other conditions. The influence of noise on participants’ attention and short-term memory was assessed with the serial recall and response inhibition tests. Discomfort, stress and annoyance were accessed using Visual Analog Scales (VAS). Sixteen undergraduate students were included in this study (8 male; age: M = 22.25 yrs; SD = 0.7 yrs). Higher discomfort, stress and annoyance perceptions were found in condition C4; however, for task performance, no significant differences were found between conditions. This study provided important insights about the influence of different noise frequencies on subject’s performance and well-being. Future research should involve workers and how they react in the field to these conditions.
- Immediate effects of a rhino-pharyngeal clearance protocol in nasal obstruction and middle ear condition of children under 3 years of age with upper respiratory infections: A randomized controlled trialPublication . Alexandrino, Ana Silva; Santos, Rita; Melo, Cristina; Tomé, David; Bastos, José Mesquita; Postiaux, GuyIntroduction and objectives Children up to 2 years old are at high risk of respiratory infections and nasal irrigation is often prescribed. Yet, to date there is no sufficient knowledge about its immediate effects on the nasopharynx and middle ear. Therefore, this study aimed to analyze the effect of a rhino-pharyngeal clearance intervention protocol on nasal obstruction and middle ear condition in children under 3 years of age with URTI. Materials and methods Randomized controlled trial in a day-care centre of Porto, including 44 children randomized to Intervention Group (IG) and Control Group (CG). Nasal auscultation and tympanometry were performed at baseline (M0) as well as after the intervention (M1), which consisted of nasal irrigation (NaCl .9%) followed by a forced nasal inspiration in the IG, and after 30 min of normal activities, in the CG. Results In M1 there was a lower frequency of children classified as having an obstructed nasal sound in the IG when compared to the CG (IG = 33.3%; CG = 68.4%; p = 0.042). We also observed an improvement of mean peak pressure (PP) in the IG (Left ear: M0 = −124daPa; M1 = −92daPa; p = 0.022. Right ear: M0 = −102daPa; M1 = −77daPa; p = 0.021), which was not observed in the CG (Left ear: M0 = −105daPa; M1 = −115daPa; p = 0.485. Right ear: M0 = −105daPa; M1 = −131daPa; p = 0.105). There were no significant results concerning the compliance of the tympanic membrane. Conclusions The rhino-pharyngeal clearance improved the nasal obstruction and PP of the middle ear of children under 3 years of age with URTI.