Browsing by Author "Oliveira, Raúl"
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- O efeito das ligaduras funcionais da articulação tíbio-társica na propriocepção: revisão da literaturaPublication . Esteves, José Manuel; Melo, Filipe; Oliveira, Raúl; Cabri, JanIntrodução: A ligadura funcional na articulação tíbio-társica é utilizada com fins terapêuticos ou preventivos. A sua eficácia pode ser atribuída à limitação mecânica que implica, mas também pode envolver processos neurofisiológicos relacionados com o feedback proprioceptivo. Existem instrumentos de medida que avaliam objectivamente algumas componentes da propriocepção. Objectivos: Realizar uma revisão da literatura sobre o efeito das ligaduras funcionais da articulação tíbio-társica na propriocepção. Relevância: O conhecimento sobre o tema pode constituir mais uma informação que contribui para decisão dos fisioterapeutas ou outros profissionais de saúde quanto à aplicação da ligadura funcional na articulação tíbio-társica. Metodologia: Com base numa metodologia sistemática, foi realizada uma revisão dos artigos publicados entre 1987 e 2007, pesquisados nas bases de dados referenciais PubMed e PEDro. Foram seleccionados os artigos que cumpriam com os critérios de selecção e eliminados os restantes. Resultados e discussão: Dos 66 artigos provenientes das pesquisas, foram seleccionados 10 artigos. Constatou-se que cinco artigos referem que as ligaduras funcionais não apresentam qualquer efeito sobre a propriocepção. Um estudo verificou alterações benéficas que desapareciam após o exercício físico. Dois estudos referem que a ligadura funcional poderá intervir positivamente nos sistemas proprioceptivos implicados na estabilidade dinâmica. Apenas um estudo refere que a ligadura poderá ter um efeito prejudicial sobre a propriocepção. Conclusão: Os resultados dos estudos não são unânimes quanto aos efeitos da ligadura funcional da articulação tíbio-társica na propriocepção. É necessária a realização de mais estudos com desenhos experimentais de maior qualidade metodológica.
- Hamstring muscles volume of elite football athletes assessed using magnetic resonance imagingPublication . Firmino, Telmo; Santos, F; Abrantes, F; Til Perez, L; Mascarenhas, V; Mendes, B; Vaz, João R; Oliveira, Raúl; Martins, A; Freitas, Sandro
- Hamstring stiffness pattern during contraction in healthy individuals: analysis by ultrasound-based shear wave elastographyPublication . Mendes, Bruno; Firmino, Telmo; Oliveira, Raúl; Neto, Tiago; Infante, Jorge; Vaz, João R; Freitas, SandroPurpose To assess the stiffness of hamstring muscles during isometric contractions in healthy individuals, using ultrasoundbased shear wave elastography to (1) determine the intra- and inter-day assessment repeatability, (2) characterize the stiffness of semitendinosus (ST) and biceps femoris long head (BFlh) along the contraction intensity, and (3) characterize stiffness distribution among the hamstring muscles and inter-limb symmetry. Methods Two experiments were conducted. In experiment I (n = 12), the intra-day repeatability in assessing the BFlh and ST stiffness were determined at intensities between 10–60% of maximal voluntary isometric contraction (MVIC) in a single session. In experiment II (n = 11), the stiffness of the hamstring muscles of both thighs was assessed at 20% of MVIC in the first session; and retested (for one randomly chosen thigh) in a second session. Isometric contraction of knee flexors was performed with the knee flexed at 30° and with the hip in a neutral position. Results Moderate-to-very-high intra- and inter-day repeatability was found (ICC = 0.69–0.93). The BFlh/ST stiffness ratio increased with contraction intensity. At 20% of MVIC, the ST showed the highest stiffness among the hamstring muscles (p < 0.02), with no differences between the remaining hamstring muscles (p > 0.474). No differences were found between limbs (p = 0.12). Conclusions The stiffness distribution among the hamstring muscles during submaximal isometric contractions is heterogeneous, but symmetric between limbs, and changes depending on the contraction intensity. Shear wave elastography is a reliable tool to assess the stiffness of hamstring muscles during contraction.
- Noninvasive measurement of sciatic nerve stiffness in patients with chronic low back related leg pain using shear wave elastographyPublication . Neto, Tiago; Freitas, Sandro; Andrade, Ricardo; Vaz, João R; Mendes, Bruno; Firmino, Telmo; Bruno, Paula; Nordez, Antoine; Oliveira, RaúlObjectives—The purpose of this study was to determine whether sciatic nerve stiffness is altered in people with chronic low back–related leg pain by using shear wave elastography. Methods—In this cross-sectional study, the sciatic nerve shear wave velocity (ie, an index of stiffness) was measured in both legs of 16 participants (8 with unilateral low back–related leg pain and 8 healthy controls). Sciatic stiffness was measured during a passive ankle dorsiflexion motion performed at 28/s in an isokinetic dynamometer. The ankle range of motion and passive torque, as well as muscle activity, were also measured. Results—In people with low back–related leg pain, the affected limb showed higher sciatic nerve stiffness compared to the unaffected limb (111.3%; P5.05). However, no differences were observed between the unaffected limb of people with low back–related leg pain and the healthy controls (P5.34). Conclusions—People with chronic low back–related leg pain have interlimb differences in sciatic nerve stiffness, as measured by a safe and noninvasive method: shear wave elastography. The changes found may be related to alterations in nerve mechanical properties, which should be confirmed by future investigations.
- The immediate effects of a dynamic orthosis on gait patterns in children with unilateral spastic cerebral palsy: a kinematic analysisPublication . Martins, Maria Elisabete; Cordovil, Rita; Oliveira, Raúl; Pinho, Joana; Diniz, Ana; Vaz, João RThis study analyzes the immediate effects of wearing a Therasuit on sagittal plane lower limb angular displacements during gait in children with unilateral spastic cerebral palsy (US-CP). Seven participants (median age = 7.00 years; ranging from 5.83 to 9.00 years) with US-CP, levels I and II of the Gross Motor Function Classification System, were assessed with kinematic gait analysis in three different conditions: (A) Baseline; (B) Therasuit without elastics and (C) Therasuit with elastics. Significant improvements were observed at the hip joint of both lower limbs during most of the gait cycle in participants wearing a Therasuit, including a decrease in the flexion pattern at the initial contact and swing phase in both lower limbs, and an increase in the extension pattern in the paretic lower limb during the stance phase. At the knee joint in the paretic lower limb, significant differences were found between the baseline and Therasuit with elastics conditions on the knee angle at initial contact, and between baseline and both Therasuit conditions on the flexion angle at swing phase. However, the inter-individual variability in kinematic patterns at the knee joint was high. At the ankle joint, decreased plantar flexion at initial contact and increased dorsiflexion during stance and swing phases were observed at the Therasuit with elastics condition, helping to correct the equinus-foot in the paretic lower limb during the whole gait cycle. The Z-values showed large effect sizes particularly for most of the angular hip variables in both lower limbs and for the angular ankle variables in the paretic lower limb. The Therasuit seems to have some positive immediate effects on gait kinematics in children with spastic unilateral cerebral palsy by providing a more functional and safer gait pattern. Future investigations with larger samples are recommended to further support these findings.
- The immediate effects of Therasuit® on the gait pattern of a child with unilateral spastic cerebral palsyPublication . Martins, Maria Elisabete; Cordovil, Rita; Oliveira, Raúl; Pinho, Joana; Vaz, João RAims: This study analyzes the immediate effects of using TheraSuit® (TS) on the gait of a child with left spastic hemiplegia level II (GMFCS). Methods: Spatiotemporal gait parameters and kinematic variables in the sagittal plane were compared between baseline and TS conditions. Results: Positive effects were noted on temporal parameters in the TS condition, such as a reduced gait cadence. The analysis of angular displacements in joint angles showed that at initial contact there was a reduction in the: (i) Plantarflexion on the paretic side; (ii) Dorsiflexion on the non-paretic side; and (iii) Knee flexion angles in both limbs. Furthermore, an increase in hip and knee extension angles during stance, and a decrease in knee and hip flexion on the non-paretic limb during swing were also detected. Conclusions: Further investigations with larger samples are necessary to confirm these effects of wearing TS on gait kinematics, aiming toward providing a more functional and safer gait pattern in children with spastic hemiplegia.
- The relationship between muscular strength and dance injuries: a systematic reviewPublication . Moita, João Paulo; Nunes, Alexandre; Esteves, José; Oliveira, Raúl; Xarez, LuisBACKGROUND: The physical demands placed on dancers put them at significant risk for injury, with rates similar to ones sustained by athletes in sports at the same level of performance. Muscle strength has been suggested to play a preventative role against injury in dancers. OBJECTIVE: To systematically search and examine the available evidence on the protective role of muscle strength in dance injuries. METHODS: Five electronic databases and two dance-specific science publications were screened up to September 2015. Study selection was based on a priori inclusion criteria on the relation between muscle strength components and injuries. Methodologic quality and level of evidence were assessed using the Downs and Black (DB) checklist and the Oxford Centre of Evidence- Based Medicine (OCEBM) 2011 model. RESULTS: From 186 titles found, only 8 studies met the inclusion criteria and were considered for review. Because of the significant heterogeneity of the included studies, meta-analysis was deemed inappropriate. The DB quality assessment results ranged from 18.7% to 75% (mean 42.3±16.9) and the OCEBM between 2b and 4. Some level 2b evidence from 2 studies suggested that pre-professional ballet dancers who get injured exhibit lower overall muscle strength scores on the lower extremity, and that lower extremity power gains may be associated with decreased bodily pain but not injury rate. CONCLUSIONS: Although there might be an association trend toward low muscle strength and dance injuries, the nature of that relation remains unclear, and presently the state of knowledge does not provide a solid basis for designing interventions for prevention.
- The use of a dynamic orthosis in a child with unilateral spastic Cerebral Palsy: effects on gait kinematicsPublication . Martins, Maria Elisabete; Cordovil, Rita; Oliveira, Raúl; Pinho, Joana; Vaz, João RHemiplegia is a form of spastic Cerebral Palsy in which one side of the body is affected, resulting in an atypical body posture and abnormal gait patterns. The purpose of this case-report was to provide a descriptive analysis of the immediate effects of a dynamic orthosis, the TheraSuit® (TS), in gait kinematics. A 5.88 years old child with left spastic hemiplegia, level II (GMFCS) and gait classification type III, was instructed to walk at a self-selected pace along a 10m walkway in two conditions: 1) BL (Baseline); 2) TS (wearing the TS). Two video-digital cameras (Basler piA1000-48gс GigE) and six infrared cameras (VICON T10), sampled at 100 Hz were used. Spatiotemporal parameters and lower limb joint angles were determined. For the spatiotemporal parameters, the TS reduced gait cadence (BL: 156 +/- 10.1 steps/min; TS: 132 +/- 3.4 steps/min). While the TS showed few changes in terms of the spatiotemporal parameters, the lower limb joint kinematics looked to be more affected towards a more functional gait pattern. The joints' motion looked to be altered throughout the gait cycle. At the initial contact, the TS showed i) a reduction of dorsiflexion on non-paretic side (BL: 10.2 deg +/- 3.4; TS: 9.2 deg +/- 1.5) and plantarflexion on paretic side (BL: -5.8 deg +/- 1.1; TS: 9.3 deg +/- 1.4); ii) a reduced knee flexion angle in both limbs; iii) a reduced hip flexion in the non-paretic limb. During the stance phase, the child was able to decrease the flexion pattern by showing more knee extension in the paretic limb and greater hip extension in both limbs. In the swing phase, a decrease in knee and hip flexion in the non-paretic limb was also verified. This case-report shows that TS seems to be able of changing gait kinematics toward a more functional gait pattern (i.e., reducing hip and knee flexion and the amount of plantarflexion). It was particularly clear at a distal level (i.e., ankle). The TS might be an interesting tool to implement in physical therapy programs. However, further investigation is required to better understand its short and long term effects.