Percorrer por autor "Silva, Marcelo Lourenço da"
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- Assessing frailty in the older : the role of bite force as an independent indicatorPublication . Ferreira, Luciano Maia Alves; Brito, José; Silva, Josie Resende Torres da; Silva, Marcelo Lourenço da; Andrade, Maia e Maia Fischel e; Júdice, André; Mendes, José João; Machado, Vanessa; Botelho, João; Regalo, Simone Cecílio HallakBackground: This study investigates the relationship between bite force and grip strength as indicators of frailty in older adults. Frailty syndrome, characterized by increased vulnerability to adverse health outcomes, poses significant challenges in geriatric care. Objectives: This research builds on previous findings linking oral health to frailty risk, emphasizing the need for targeted interventions. Methods: A total of 59 older participants, aged 60 years and older, were enrolled in this cross-sectional study conducted at the Egas Moniz School of Health and Science. The participants underwent assessments of bite force using an electric dynamometer and grip strength using a specialized device. Body composition was also measured using bioelectrical impedance analysis (BIA). Results: Statistical analysis revealed a significant positive correlation between bite force and grip strength, even after adjusting for age and body mass index (BMI). Age was significantly correlated with bite and grip force (p < 0.05), while BMI was correlated only with handgrip force but not with bite force (coefficient = −0.047, p = 0.737). Notably, bite force was found to be independent of BMI, unlike grip strength, which is generally influenced by body composition. This independence highlights the potential of bite force as a reliable and distinct marker for frailty that is not confounded by BMI-related factors. This study highlights the importance of oral health in maintaining overall well-being in older adults. Reduced bite force may indicate an increased risk of frailty, which can lead to malnutrition and decreased quality of life. These findings suggest that integrating bite force measurements into clinical assessments may improve the assessment of frailty and inform interventions aimed at improving health outcomes in the older population. Conclusions: This research provides new insights into the association between bite force and grip strength, emphasizing the unique value of bite force as an independent marker of frailty. It advocates for further studies to explore its role in geriatric care strategies.
- Effectiveness of cold-water immersion vs. massage in reducing delayed-onset muscle soreness and enhancing recovery following CrossFit® Murph Workout : randomized trialPublication . Pereira, Gabrielly Santos; Paulino, Giovana Eduarda; Almeida, Thais Helena Martins Faria de; Siqueira, Cissa Maria Ribeiro; Silva, Josie Resende Torres da; Silva, Marcelo Lourenço da; Ferreira, Luciano Maia AlvesThe Murph workout, one of the most challenging CrossFit® workouts, demands endurance and high intensity. This WOD (Workout of the Day) includes a 1-mile run, 100 pull-ups, 200 push-ups, 300 air squats, and another 1-mile run, typically performed while wearing a weighted vest. Due to its high physical demands, athletes commonly experience Delayed Onset Muscle Soreness (DOMS), characterized by increased sensitivity, fatigue, and reduced muscle function. To minimize these effects and ensure proper recovery, it is essential to adopt strategies that restore muscle function, reduce pain, and allow athletes to return to training without an elevated risk of injury. Thus, the objective of this study was to investigate the effects of massage therapy (MAS) or cold-water immersion (CWI) as a recovery intervention for DOMS in athletes following high-intensity physical activity during the CrossFit® Murph workout. For this purpose, thirty individuals with a minimum of six months of CrossFit® experience and familiarity with all exercises used in the study were recruited. Pain assessment questionnaires, including the Brief Pain Inventory (BPI) and the A-DOM questionnaire, along with a socioeconomic questionnaire, were administered before and after WOD. Additionally, pain assessments were conducted using algometry and thermographic imaging. After completing the WOD, participants were randomly assigned to one of two recovery interventions: MAS or CWI. The study results highlight the differential impacts of CWI and MAS on pain management and recovery dynamics following structured exercise. Our findings clearly demonstrate that CWI significantly reduces pain prevalence, both at rest and during exercise, as evidenced by the absence of pain reports from participants 48 hours after the intervention. While our study provides valuable insights into the effectiveness of CWI and MAS for post-exercise recovery, limitations such as the non-blinded study design and small sample size may influence the generalizability of the findings.
- The effectiveness of spinal cord stimulation combined with physiotherapy in the management of chronic pain in adults : a systematic reviewPublication . Barros, Adilia Maria Soares Porciuncula; Pereira, Gabrielly Santos; Silva, Josie Resende Torres da; Silva, Marcelo Lourenço da; Silva, Maria do Desterro da Costa e; Ferreira, Luciano Maia AlvesBackground: Chronic pain affects a significant portion of the population, and conventional treatments often prove insufficient. Spinal Cord Stimulation (SCS), a neuromodulation technique, has shown benefits in pain relief, while physiotherapy is widely employed to enhance physical function and quality of life. Although the combination of these approaches may offer synergistic effects, existing evidence is limited and fragmented. Objective: This systematic review aimed to evaluate the clinical outcomes of Spinal Cord Stimulation (SCS), with or without the association of physiotherapy, in the management of chronic pain in adults. Methodology: The review was conducted following PRISMA guidelines and the PICO strategy. A comprehensive search was performed across databases including Cochrane Library, ScienceDirect, BASE, and VHL (BVS: MEDLINE, IBECS, WPRIM, LILACS, PERIÓDICO CAPES) using MeSH terms and Boolean operators: (“Spinal Cord Stimulation” OR “Neuromodulation”) AND (“Chronic Pain” OR “Pain Management”) AND (“Physical Therapy Modalities” OR “Physiotherapy” OR “Rehabilitation”). Only studies published in English, Spanish, or Portuguese in the past 10 years were included, focusing on chronic pain and reporting outcomes related to pain reduction and functional improvement. Results: Eight studies comprising 777 patients were included. Spinal cord stimulation alone led to significant pain reductions, with responder rates above 80% and average decreases of 5–6 cm on pain scales. Improvements in quality of life and functional disability were also reported, with reductions of over 30 points in disability indices and up to 40% in opioid use. However, only one study included physiotherapy as a complementary intervention, without isolating its effects. No study directly evaluated the combined efficacy of SCS and physiotherapy, highlighting a gap in the literature. Conclusion: The findings highlight the proven effectiveness of SCS in chronic pain management but reveal a lack of studies assessing its integration with physiotherapy. Future clinical trials should address this gap to explore potential synergistic effects and optimize interdisciplinary pain treatment strategies.
- Effects of multisession prefrontal cortex tDCS or taVNS on stress, perceived stress and sleep quality : a double-blind, randomized controlled studyPublication . Reis, Laya Dalila dos; Generoso, Laura Pereira; Pereira, Gabrielly Santos; Barú, João Paulo da Silva Teixeira; Candido, Natalie Lange; Capello, Maria Gabriela Maziero; Castro, Renato Ortolani Marcondes de; Cardoso, Edvaldo José Rodrigues; Scoz, Robson Dias; Ferreira, Luciano Maia Alves; Silva, Marcelo Lourenço da; Silva, Josie Resende Torres daIntroduction: Chronic stress is a condition characterized by prolonged stimulation, leading to mental and physical weakness. It can have detrimental effects on individuals’ mental health and cognitive function, potentially causing various health issues. This article explores the potential of non-invasive neuromodulation techniques, specifically transcranial direct current stimulation (tDCS) and transcutaneous auricular vagus nerve stimulation (taVNS), in managing chronic stress and improving sleep quality.Methods: The study conducted a randomized, double-blinded, controlled trial with participants experiencing chronic stress. In total, 100 participants were randomly assigned to one of four conditions: the anodal tDCS group (n = 50), the sham tDCS group (n = 50), the taVNS group (n = 50), or the sham taVNS group (n = 50). Within each condition, participants received five sessions of either active treatment or sham treatment, with 20 min of tDCS over the dorsolateral prefrontal cortex (2 mA) for the tDCS groups, or taVNS on the left ear (20 Hz) for the taVNS groups. At baseline, post-intervention, and 4 weeks thereafter, we evaluated stress using the Lipp’s Inventory of Stress Symptoms for Adults (LSSI), perceived stress through the Perceived Stress Scale (PSS-10), and sleep quality via the Pittsburgh Sleep Quality Index (PSQI).Results: The tDCS and taVNS interventions resulted in reduced stress levels, improved sleep quality, and enhanced perception of stress.Discussion: These findings suggest that tDCS and taVNS hold promise as effective treatments for chronic stress, offering a safe and accessible approach to improving individuals’ wellbeing and overall quality of life.
- Non-invasive neuromodulation for pain management in children and adolescents : a systematic review of randomized controlled trialsPublication . Pereira, Gabrielly Santos; Silva, Marcelo Lourenço da; Oliveira, Ana Beatriz; Ferreira, Luciano Maia AlvesPain in children and adolescents remains an underestimated and undertreated condition, with long-term physical and psychosocial consequences. Non-invasive neuromodulation has emerged as a promising, low-risk approach for managing acute and chronic pain by modulating central and peripheral neural pathways. This systematic review followed PRISMA 2020 guidelines to evaluate the efficacy, safety, and clinical applicability of non-invasive neuromodulation techniques in pediatric pain. Searches were conducted in PubMed, Embase, Scopus, Web of Science, Cochrane CENTRAL, and ScienceDirect for randomized controlled trials (RCTs) published between 2015 and 2025. Six RCTs met the inclusion criteria, encompassing percutaneous electrical nerve field stimulation (PENFS), transcutaneous auricular vagus nerve stimulation (taVNS), transcutaneous electrical acupoint stimulation (TEAS), and transcutaneous electrical nerve stimulation (TENS). Four trials reported significant reductions in pain intensity alongside improvements in functional outcomes and quality of life, particularly in functional abdominal pain and postoperative contexts. Most studies showed low or moderate risk across domains, with appropriate randomization and blinded assessment. No serious adverse events were reported, confirming an excellent safety profile. These findings support non-invasive neuromodulation as a feasible and well-tolerated adjunct to conventional pediatric pain management. Further high-quality trials are warranted to standardize protocols and explore mechanisms of neuroplasticity in the developing nervous system. PROSPERO (CRD420251170866).
- Validation of the Brazilian version of Knowledge and Attitudes of Pain questionnairePublication . Candido, Natalie Lange; Capello, Maria Gabriela Maziero; Oliveira, Guilherme Prevelato; Ferreira, Luciano Maia Alves; Generoso, Laura Pereira; Silva, Josie Resende Torres da; Silva, Marcelo Lourenço daBackground and objectives: Health professionals attitudes and beliefs about musculoskeletal pain have a negative influence on patient beliefs and outcomes. However, there is no gold standard for assessing knowledge and attitudes toward pain among these professionals. Thus, the objective of the present study was to translate, adapt and validate the Knowledge and Attitudes of Pain (KNAP) questionnaire into Brazilian Portuguese (KNAP-Br), apply the questionnaire and analyze the correlation of its results with the Neurophysiological Pain Questionnaire (NPQ). Methods: After being translated, back-translated and adapted, the NKAP-Br was applied to 60 physical therapy and medicine students for validation. The correlation between the results obtained by multiplying the scores of the questions of the NKAP-Br instrument and the NPQ was evaluated. To assess reliability, another 200 students responded to the initial KNAP-Br (T1), performed the Pain Education Program (PEP) in one week and one week after T1, the participants received access to answer the KNAP-Br end (T2). Results: Concurrent validity was assessed by the correlation between NPQ and the final KNAP-Br score. A significant correlation was found between the NPQ result (0.3 and p-value=0.0001) and the KNAP-Br score. Intragroups, 84% improved in the KNAP-Br score after studying PEP, 43.50% improved at or above the minimal detectable difference (MDD) and at or above the minimal important difference (MID). Conclusion: The questionnaire was translated and adapted respecting the Brazilian population cultural aspects and presented satisfactory reliability and construct validity, being considered valid for the assessment of knowledge and the interpretation of pain by health professionals.