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- Gait variability in anterior cruciate ligament injured athletes compared to healthy controlsPublication . Pinto, Ana Costa; Vaz, João Pedro Casaca de RochaBackground: Anterior cruciate ligament (ACL) injuries affect gait variability, motor control, and adaptability. This study examines stride-to-stride gait fluctuations in athletes with and without ACL injuries, focusing on variability as a marker of adaptability. Methods: A cross-sectional study was conducted with 15 ACL-deficient athletes and 12 healthy controls. Participants performed a 12-minute split-belt treadmill walking task, and gait variability was analyzed using Detrended Fluctuation Analysis (α-ISIs). Results: ACL-deficient athletes showed significantly lower α-ISIs values (0.78 ± 0.08) than healthy controls (0.85 ± 0.084, p = 0.045), indicating reduced gait complexity. No significant differences were found in the coefficient of variation (CV), and kinesiophobia showed a weak correlation with gait variability. Conclusions: This study demonstrated that individuals with ACL deficiency exhibit reduced gait complexity, characterized by increased randomness in variability patterns. The findings suggest that ACL deficiency impairs neuromuscular regulation, leading to compensatory gait adaptations. Despite stable variability magnitude, its temporal organization was significantly altered. These results emphasize the importance of gait complexity as a key marker for motor adaptability in ACL-deficient individuals.
- Comparison of external load variability in injured and uninjured youth elite football male athletes : a cross-sectional studyPublication . Passos, Fábio Gonçalo Sales; Vaz, João Pedro Casaca de RochaFootball's nature carries a high risk of injury, particularly given the increased amount of hard running and sprinting. This study aims to investigate the external load temporal structure between non-injured and injured football athletes, during a 10-day period prior to the injury event. A sample of 38 male youth elite football players was selected for the study. Information on their external load was gathered throughout a range of durations, and GPS data was used to gauge it. The results from linear GPS variables mean and standard deviation between the two groups weren’t statistically significant. On the other hand, the values from non-linear metrics, such as Detrended Fluctuations Analysis, showed that the alpha from the injured players was significantly lower (0.84±0.03) compared to non-injured players (0.86±0.03, p<0.05). We have observed greater randomness in the temporal structure of injured athletes. This study concludes that integrating these metrics may make GPS technology an even more effective tool for injury prevention and possible daily monitoring. Further research could include combined nonlinear measures with subjective fatigue measures to give a holistic picture of an athlete's condition with a larger sample size and other sports contexts
- Efeitos de um programa de terapia manual e exercícios terapêutico associados a um programa de exercício aeróbio de 6 semanas na disfunção temporomandibular muscularPublication . Fresco, Ana Catarina Dourado; Alves, Paula MoleirinhoIntrodução: A disfunção temporomandibular (DTM) é uma condição que pode afetar os músculos mastigatórios e conduzir ao aparecimento de dor e à diminuição da qualidade de vida. O objetivo deste estudo é a comparação dos efeitos de um programa de terapia manual e exercícios terapêuticos com um programa de terapia manual e exercícios terapêutico associado a exercício aeróbio de 6 semanas, na intensidade da dor, na amplitude de abertura oral, no limiar de tolerância de dor à pressão, na ansiedade e na qualidade de vida da saúde oral em sujeitos com DTM muscular. Metodologia: Ensaio clínico controlado, com 18 participantes diagnosticados através do Diagnostic Criteria for Temporomandibular Disorders (DC-TMD) com DTM muscular e divididos em dois grupos: G1 (26,8±7,92) com 11 participantes que realizou um programa de terapia manual e exercícios terapêuticos (uma vez por semana durante 30 minutos) e G2 (26,9±6,62) , com 7 participantes que realizou o mesmo programa de G1 (uma vez por semana durante 30 minutos) associado a exercício aeróbio de intensidade moderada (duas vezes por semana durante 30 minutos). Foi avaliada a intensidade da dor através da escala numérica da dor (NPRS), o limiar de tolerância de dor à pressão (PPT) através do algómetro, a amplitude de abertura oral máxima confortável (AMC) e forçada (AMF) através do paquímetro, a ansiedade através da Generalized Anxiety Disorder (GAD-7) e qualidade de vida relacionada com a saúde oral (QdRVSO) através da Oral Health Impact Profile (OHIP-14). O primeiro momento de avaliação (T1) foi realizado antes de se iniciar a intervenção e o segundo momento de avaliação (T2) 48h após o término do programa de 6 semanas. Resultados: Houve uma diminuição significativa da NPRS, um aumento significativo da AMC, AMF e da OHIP-14 em G1 e G2 entre T1 e T2. No PPT verificou-se um aumento significativo no masséter direito (MD) e temporal esquerdo (TE) no G1 e G2, e no masséter esquerdo (ME) e temporal direito (TD) apenas no G2. G1 e G2 apresentaram diferenças significativas no aumento do PPT, com o G2 a obter melhores resultados. Não se verificaram diferenças significativas na GAD-7. Conclusão: O programa de terapia manual e exercícios terapêuticos e o programa de terapia manual e exercícios terapêutico associado a exercício aeróbio conduziram a uma diminuição da dor, aumento de amplitude oral e melhoria da qualidade de vida ao fim de 6 semanas de intervenção. O programa de terapia manual e exercícios terapêutico associado a exercício aeróbio promoveu um maior aumento do limiar de tolerância de dor à pressão.
- The effects of different temporally structured cues on gait variability in anterior cruciate ligament injured athletesPublication . Hilário, Mafalda Sofia Pereira; Vaz, João Pedro Casaca de RochaThe anterior cruciate ligament (ACL) is essential for knee stability and proprioception. ACL injuries, often caused by non-contact valgus and internal rotation motions, lead to increased instability, altered joint pressures, and a higher risk of secondary injuries and osteoarthritis, causing a significant impact in the athlete’s career. Full restoration of neuromuscular function and gait variability remains unachieved. The purpose of this study is to investigate how different temporally structured cues affect gait patterns of acute ACL-injured athletes. Seventeen adult athletes with acute ACL-injury, were engaged in two 12-minute walking trials – one uncued trial and one cued trial – on a split-belt treadmill, at their optimal walking speed, previously calculated. A 10-minute resting period between trials. Additionally, the participants had to answer the Tampa Scale questionnaire. Inter-stride intervals were determined from a custom MATLAB code and fractal scaling obtained, through Detrended Fluctuation Analysis, was calculated. A mixed-model repeated measures ANOVA was used to identify differences between groups and conditions. The results showed that ACL-injured athletes from fractal group did not exhibit significant improvements in their temporal structure of gait patterns while walking to these cues, however isochronous group worsened it, towards to randomness, highlighting the potential clinical value of fractal cues.
- Efeito de um programa multimodal versus goteira oclusaL de 6 semanas na dor, abertura oral e qualidade de vida em adultos com disfunção temporomandibular (DTM) : um ensaio clínico controladoPublication . Mestre, Ana Marta Guerreiro; Alves, Paula MoleirinhoA disfunção temporomandibular (DTM) é uma condição de etiologia multifatorial que acomete a articulação temporomandibular (ATM), os músculos mastigatórios e estruturas associadas, impactando negativamente na qualidade de vida dos pacientes. Este estudo teve como objetivo avaliar e comparar o efeito de um programa multimodal (terapia manual combinada com exercícios terapêuticos) versus goteira oclusal, na modulação da dor, abertura oral e qualidade de vida de saúde oral (QdVRSO) no tratamento de adultos com DTM muscular com limitação da abertura oral durante 6 semanas. O ensaio clínico controlado incluiu 24 participantes com idades compreendidas entre os 18 e 50 anos, divididos em dois grupos experimentais: G1 (realizou um programa multimodal, uma vez por semana durante 30 minutos) e G2 (utilizou goteira oclusal diariamente, durante a noite). Os participantes foram avaliados em dois momentos, inicial e final, quanto à intensidade da dor, amplitude de abertura oral, limiar de tolerância de dor à pressão (PPT) e QdVRSO. Os resultados demonstraram que ambos os grupos obtiveram melhorias significativas na intensidade da dor, amplitude de abertura oral e QdVRSO, destacando a eficácia dessas abordagens conservadoras. O programa multimodal demonstrou superioridade no aumento da amplitude de abertura oral e na melhoria do PPT, enquanto a goteira oclusal apresentou maior eficácia na diminuição da intensidade da dor. A única diferença estatisticamente significativa entre os grupos foi observada no PPT, com melhorias significativas apenas no G1, o que pode indicar que o programa teve um maior contributo para a ativação das vias inibitórias descendentes de modulação da dor. Porém, os resultados demonstram que ambas as intervenções são válidas no tratamento de pacientes com DTM.
- Immediate effects of a single trampoline session on balance, postural control, gait, and muscle function in older adults : a pilot studyPublication . Silva, Sara Isabel Gomes; Godinho, Catarina Afonso; Correia, José PedroThe aging process is associated to declines in balance, postural control, gait, and neuromuscular function, increasing the risk of falls among older adults. This pilot study investigated the immediate effects of a single trampoline training session on these variables in older adults. Twenty-two participants (65-85 years old) underwent assessments, including the Timed-Up-and-Go (TUG), Five times Sit-to-Stand (5xSTS), and postural control tests, before training, after warm-up, and after trampoline training. Surface electromyography (sEMG) and force platform (FP) data were also analyzed to evaluate functional mobility, muscle activation patterns, motor control, and balance. The results demonstrated significant improvements in TUG score (p < 0.001), with enhanced neuromuscular activation in the vastus lateralis (p = 0.005), biceps femoris (p = 0.037), and lateral gastrocnemius (p = 0.041) during dynamic tasks. These findings highlight the potential of trampoline training to enhance mobility and neuromuscular responsiveness. However, no significant changes were observed in static postural control measures, indicating the need for more prolonged or frequent sessions to affect these parameters. This study concludes that trampoline training could be a safe and feasible intervention option for improving functional mobility and neuromuscular performance in older adults. Its incorporation into fall prevention programs holds promise for promoting healthy aging. Future research should explore long-term effects, optimal training protocols, and broader applications in community and clinical settings.