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- 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.
- 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.
- 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.
- Imagética motora na reabilitação do membro superior pós AVC: uma revisão narrativaPublication . Guimarães, Alexandra; Santos, Hugo; Vieira, Ana Isabel; Nunes, Maria VâniaIntrodução: Tendo em conta que o cérebro é um órgão altamente complexo e organizado, a gravidade e o comprometimento dos défices causados por um Acidente Vascular Cerebral (AVC), dependem em grande parte da sua extensão e localização. Estes défices são o resultado da perda de circuitos neuronais ligados às funções sensoriais, motoras e cognitivas. Vários estudos clínicos indicam que o treino mental através da imagética motora (IM) parece ser eficaz quando associado à neuroreabilitação, na recuperação da função do membro superior. Objetivo: Explorar os aspetos teóricos inerentes à utilização da IM na reabilitação do membro superior pós AVC, através de uma revisão narrativa. Métodos: Pesquisa nas fontes bibliográficas através das bases de dados PubMed, EBSCOhost, CINAHL, Scopus, Web of Science e PEDro, tendo sido realizada a última pesquisa a 30 de maio de 2023. Resultados: Foram selecionados para revisão artigos RCT e revisões sistemáticas, que abordassem os efeitos da IM na função do membro superior. Conclusão: Os artigos analisados nesta revisão apontam para uma relação positiva entre os efeitos da IM e a recuperação do membro superior pós AVC, nomeadamente, quando esta técnica é combinada com a Terapia Ocupacional e a Fisioterapia, reforçando a importância de considerar a introdução do treino mental com IM nos programas de reabilitação.