Browsing by Author "Castro-Caldas, Alexandre"
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- Action verbal fluency in Parkinson’s patientsPublication . Tello Rodrigues, Inês; Ferreira, Joaquim; Coelho, Miguel; Rosa, Mário; Castro-Caldas, AlexandreWe compared the performance of 31 non-demented Parkinson´s disease (PD) patients to 61 healthy controls in an action verbal fluency task. Semantic and phonemic fluencies, cognitive impairment and behavioural dysfunction were also assessed. The mean disease duration of PD was 9.8 years (standard deviation (SD) = 6.13). There were no age (U = 899.5, p = 0.616), gender(chi-square = 0.00, p = 1.00) or literacy (U = 956, p = 0.96) differences between the two groups. A significant difference was observed between the two groups in the action verbal fluency task (U = 406.5, p < 0.01) that was not found in the other fluency tasks. The education level was the only biographical variable that influenced the action (verb) fluency outcomes, irrespective of disease duration. Our findings suggest a correlation between the disease mechanisms in PD and a specific verb deficit, support the validity of the action (verb) fluency as an executive function measure and suggest that this task provides unique information not captured with traditional executive function tasks.
- Brain Activity during Lower-Limb Movement with Manual Facilitation: An fMRI StudyPublication . Almeida, Patrícia; Vieira, Ana Isabel; Canário, Nádia; Castelo-Branco, Miguel; Castro-Caldas, AlexandreBrain activity knowledge of healthy subjects is an important reference in the context of motor control and reeducation. While the normal brain behavior for upper-limb motor control has been widely explored, the same is not true for lower-limb control. Also the effects that different stimuli can evoke on movement and respective brain activity are important in the context of motor potentialization and reeducation. For a better understanding of these processes, a functional magnetic resonance imaging (fMRI) was used to collect data of 10 healthy subjects performing lower-limb multijoint functional movement under three stimuli: verbal stimulus, manual facilitation, and verbal +manual facilitation. Results showed that, with verbal stimulus, both lower limbs elicit bilateral cortical brain activation; with manual facilitation, only the left lower limb (LLL) elicits bilateral activation while the right lower limb (RLL) elicits contralateral activation; verbal + manual facilitation elicits bilateral activation for the LLL and contralateral activation for the RLL. Manual facilitation also elicits subcortical activation in white matter, the thalamus, pons, and cerebellum. Deactivations were also found for lower-limb movement. Manual facilitation is stimulus capable of generating brain activity in healthy subjects. Stimuli need to be specific for bilateral activation and regarding which brain areas we aim to activate.
- Categorização CIF de instrumentos de medida e intervenções utilizados na Fisioterapia em sujeitos com AVCPublication . Almeida, Patrícia; Pereira, Carla; Santos, Hugo; Martins, Anabela; Vital, Emanuel; Noronha, Teresinha; Costa, Rui; Jacobsohn, Lia; Castro-Caldas, AlexandreDe forma a melhor programar e obter resultados em investigação e planos de intervenção clínicos, no contexto da Fisioterapia, é necessária uma relação clara entre tipologias de intervenção, problemas a resolver, resultados esperados e instrumentos de avaliação aplicados. A Classificação Internacional de Funcionalidade (CIF) e os Core Sets já desenvolvidos são uma estrutura que facilita esta relação e organização. A aplicação das regras de correspondência entre as categorias da CIF, as intervenções e os instrumentos de medida poderão ser a forma facilitadora para este processo. O objetivo deste estudo é propor a categorização dos instrumentos de medida e intervenções da Fisioterapia, no contexto da reabilitação de sujeitos com Acidente Vascular Cerebral (AVC). Quarenta e três intervenções e 65 instrumentos de medida foram categorizados em 43 categorias e códigos relacionados com o movimento, pertencentes ao Core Set para AVC, de acordo com as regras de correspondência. Foi feita uma proposta inicial de categorização e a sua validação foi feita por sete Fisioterapeutas peritos no uso da CIF e em neurologia, através do método de Delphi modificado. Os resultados demonstram que os instrumentos de medida foram categorizados num total de 243 categorias de 2.º nível da CIF: “funções” – 86; “estruturas” – 11; “atividade” – 125, e “participação” – 20. As intervenções foram categorizadas num total de 223 categorias de 2.º nível da CIF: “funções” – 97; “estruturas” – 18; “atividade” – 106, e “participação” – 2. Conclui-se que é consensual, para este painel de peritos, que são os construtos das “funções do corpo” e “atividades” que melhor expressam a caracterização dos instrumentos de medida e as intervenções realizadas no contexto da Fisioterapia a sujeitos que sofreram AVC. Esta categorização deve ser validada ao nível internacional.
- Epistemic beliefs as a determinant in evidence-based practice in physiotherapy: a multi-country (Europe) cross-sectional online survey studyPublication . Beenena, Paul Christiaan; Filiputtic, Dario; Meyerd, Erna Rosenlund; Carballo-Costa, Lidia; Almeida, Patrícia; Alves Lopes, António; Wijcheng, Joost Egbertus Van; Castro-Caldas, AlexandrePurpose: This article assumes that, in order to improve evidence-based practice in physiotherapy, practitioners need sophisticated epistemic beliefs. Epistemic beliefs, or how physiotherapists view knowledge and how they come to this knowledge, are an important factor. A high sophistication of epistemic beliefs is linked to better handling of the complexity and uncertainty of daily practice and the variety of evidence resources associated with this practice. Materials and methods: This study explored the epistemic beliefs of physiotherapists in 10 different countries in Europe using an online survey: the Connotative Aspects of Epistemic Beliefs (CAEB). Results and conclusions: The study resulted in 1419 surveys. The epistemic beliefs proved to be of little difference between countries, showing a low to moderate sophistication in epistemic beliefs. Given the similar results between countries, this study also suggested the possibility of collaborating internationally in developing an epistemology in physiotherapy that is more suited to the complexity of current demands on health systems. The development of sophistication in epistemic beliefs should be firmly on the agenda for the education of physiotherapists.
- Hand tactile discrimination, social touch and frailty criteria in elderly people: A cross sectional observational studyPublication . Vieira, Ana Isabel; Nogueira, Dália; Reis, Elisabeth de Azevedo; Rosado, Maria Da Lapa; Nunes, Maria Vânia; Castro-Caldas, AlexandreFrailty is a common syndrome among elderly and sensory decline may exacerbate functional decline. The hand function, the manual dexterity, the performance of the daily living skills and the social interactions are determined, in a large degree, by sensory integrity. However, hand tactile sensory deterioration has been little explored in frailty. We performed a cross sectional observational study with 181 of institutionalized elders. From the initial sample we selected 50 subjects (68–99 years) who met the inclusion/exclusion criteria. Our goals were (1) to analyse the relationship between tactile discrimination (TD) of the hand, avoidance behaviours and attitudes towards social touch (BATST) and phenotype frailty criteria (unintentional weight loss, self-perception of exhaustion, decrease grip strength GS, slow walking speed, low level of physical activity), (2) to explore whether other variables can contribute to explain the differences between pre-frail and frail elders. The results showed that increasing age is related to decline of TD of the hand (p = 0.021) and to decrease in GS (p = 0.025); women have significantly lower level of GS (p = 0.001); TD decrease is correlated with higher avoidance BATST (p = 0.000) and with lower GS (p = 0.000); Lower GS corresponds to more avoidance BATST (p = 0.003). Hand TD also can differentiate frail and pre-frail elderly subjects in this sample (p = 0.037). Decreased TD of the hand may have implications on the functionality and on interpersonal relationships. TD of the hand also explains frailty levels in this sample. Hand TD should be used in assessment and intervention protocols in pre-frail and frail elders.
- Lateralization of the visual word form area in patients with alexia after strokePublication . Tello Rodrigues, Inês; Canário, Nádia; Castro-Caldas, AlexandreBackground Knowledge of the process by which visual information is integrated into the brain reading system promotes a better understanding of writing and reading models. Objective This study aimed to use functional Magnetic Resonance Imaging (fMRI) to explore whether the Blood-oxygen-level dependent (BOLD) contrast imaging patterns, of putative cortical region of the Visual Word Form Area (VWFA), are distinct in aphasia patients with moder- ate and severe alexia. Methods Twelve chronic stroke patients (5 patients with severe alexia and 7 pa- tients with moderate alexia) were included. A word categorization task was used to examine responses in the VWFA and its right homolog re- gion. Patients performed a semantic decision task in which words were contrasted with non-verbal fonts to assess the lateralization of reading ability in the ventral occipitotemporal region. Results A fixed effects (FFX) general linear model (GLM) multi-study from the contrast of patients with moderate alexia and those with severe alexia (FDR, p = 0.05, corrected for multiples comparisons using a Threshold Estimator plugin (1000 Monte Carlo simulations), was per- formed. Activation of the left VWFA was robust in patients with mod- erate alexia. Aphasia patients with severe reading deficits also activated the right homolog VWFA. Conclusions This bilateral activation pattern only in patients with severe alexia could be interpreted as a result of reduced recruitment of the left VWFA for reading tasks due to the severe reading deficit. This study provides some new insights about reading pathways and possible neuroplasti- city mechanisms in aphasia patients with alexia. Additional reports could explore the predictive value of right VWFA activation for reading recovery and aid language therapy in patients with aphasia.
- Reliability and validity of the european portuguese version of the social touch questionnairePublication . Vieira, Ana Isabel; Ramos, Ana Vanessa; Cavalheiro, Luís Manuel; Almeida, Patrícia; Nogueira, Dália; Reis, Elisabeth; Nunes, Maria Vânia; Castro-Caldas, AlexandreSocial touch is essential for physical and emotional well-being. However, different meanings can be attributed to physical contact during social interactions and may generate bonding or avoidant behaviors. This personal and unique experience is not usually taken into account in health and social care services. The aim of this study is to produce a valid and reliable European Portuguese version of the Social Touch Questionnaire (STQ, Wilhelm et al. in Biol Psychol 58:181–202, 2001. doi:10.1016/S0301-0511(01)00113-2). The STQ is a self-report questionnaire for adolescents and adults measuring behaviors and attitudes towards social touch. The original version was translated into European Portuguese using a forward-back translation process and its feasibility was examined. To evaluate the psychometric properties, a total of 242 Portuguese university students participated in the study (21.3 ± 3.8 years). The STQ was considered feasible, showed adequate internal consistency (Cronbach’s a = .734), and the test–retest correlation with the STQ items demonstrated a high concordance between the tests over a two-week interval (ICC = .990; n = 50). Validity tests were performed, comparing the total score of the STQ with that of the anxiety and avoidance subscales of the Social Interaction and Performance Anxiety and Avoidance Scale (SIPAAS). A very significant conceptual convergence was confirmed between the STQ and with the SIPAAS-Anxiety (r = .64; p\.0001) and with the SIPAAS-Avoidance (r = .59; p\.0001). The exploratory factor analysis, with Promax rotation, revealed 3 factors: dislike of physical touch, liking of familiar physical touch and liking of public physical touch (Cronbach’s alphas ranged from .68 to .75). Psychometric properties confirmed the adaptation of the STQ to the Portuguese culture. It is a reliable and valid self-report questionnaire and it appears to be a useful tool to assess behaviors and attitudes towards social touch.
- “To talk or not to talk”- an rTMS study about naming during stimulationPublication . Tello Rodrigues, Inês; Castelo-Branco, M; Castro-Caldas, Alexandre
- Unisensory and multisensory Self-referential stimulation of the lower limb: An exploratory fMRI study on healthy subjectsPublication . Vieira, Ana Isabel; Almeida, Patrícia; Canário, Nádia; Castelo-Branco, Miguel; Nunes, Maria Vânia; Castro-Caldas, AlexandreBackground: The holistic view of the person is the essence of the physiotherapy. Knowledge of approaches that develop the whole person promotes better patient outcomes. Multisensory Selfreferential stimulation, more than a unisensory one, seems to produce a holistic experience of the Self (“Core-Self”). Objectives: (1) To analyze the somatotopic brain activation during unisensory and multisensorial Self-referential stimulus; and (2) to understand if the areas activated by multisensorial Self-referential stimulation are the ones responsible for the “Core-Self.” Methods: An exploratory functional magnetic resonance imaging (fMRI) study was performed with 10 healthy subjects, under the stimulation of the lower limbs with three Self-referential stimuli: unisensory auditory-verbal, unisensory tactile-manual, and multisensory, applying the unisensory stimuli simultaneously. Results: Unisensory stimulation elicits bilateral activations of the temporoparietal junction (TPJ), of the primary somatosensory cortex (S1), of the primary motor cortex (BA4), of the premotor cortex (BA6) and of BA44; multisensory stimulation also elicits activity in TPJ, BA4, and BA6, and when compared with unisensory stimuli, activations were found in: (1) Cortical and subcortical midline structures—BA7 (precuneus), BA9 (medial prefrontal cortex), BA30 (posterior cingulated), superior colliculum and posterior cerebellum; and (2) Posterior lateral cortex—TPJ, posterior BA13 (insula), BA19, and BA37. Bilateral TPJ is the one that showed the biggest activation volume. Conclusion: This specific multisensory stimulation produces a brain activation map in regions that are responsible for multisensory Self-processing and may represent the Core- Self. We recommend the use of this specific multisensory stimulation as a physiotherapy intervention strategy that might promote the Self-reorganization.