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- Game-based interventions for neuropsychological assessment, training and rehabilitation: Which game-elements to use? A systematic reviewPublication . Ferreira-Brito, Filipa; Fialho, Mónica; Virgolino, Ana; Neves, Inês; Miranda, Ana Cristina; Sousa-Santos, Nuno; Caneiras, Cátia; Luís Carriço; Ana Verdelho; Osvaldo SantosGame-based interventions (GBI) have been used to promote health-related outcomes, including cognitive functions. Criteria for game-elements (GE) selection are insufficiently characterized in terms of their adequacy to patients’ clinical conditions or targeted cognitive outcomes. This study aimed to identify GE applied in GBI for cognitive assessment, training or rehabilitation. A systematic review of literature was conducted. Papers involving video games were included if: (1) presenting empirical and original data; (2) using video games for cognitive intervention; and (3) considering attention, working memory or inhibitory control as outcomes of interest. Ninety-one papers were included. A significant difference between the number of GE reported in the assessed papers and those composing video games was found (p < .001). The two most frequently used GE were: score system (79.2% of the interventions using video games; for assessment, 43.8%; for training, 93.5%; and for rehabilitation, 83.3%) and narrative context (79.2% of interventions; for assessment, 93.8%; for training, 73.9% and for rehabilitation, 66.7%). Usability assessment was significantly associated with six of the seven GE analyzed (p-values between p ≤ 0.001 and p. = 027). The use of GE that act as extrinsic motivation promotors (e.g., numeric feedback system) may jeopardize patients’ long-term adherence to interventions, mainly if associated with progressive difficulty-increase of gaming experience. Lack of precise description of GE and absence of a theoretical framework supporting GE selection are important limitations of the available clinical literature.
- Editorial: Physical Activity: An Optimizer of the Neurophysiological System?Publication . Fuentes-García, Juan Pedro; Ramirez-Campillo, Rodrigo; Garzón-Camelo, Mauricio; Castro, Maria AntónioFrom the field of neurophysiology, broadly defined as the study of the nervous system function, numerous researches have studied the central and peripheral nervous systems from whole organs to subcellular compartments. The main objective of this Research Topic was to gather studies that shed more light on the benefits of physical exercise in the neurophysiological system, from childhood to old age and from the field of health to sports or professional performance.
- Relationship between Postural Reeducation Technique During Sleep and Relaxation Technique in Sleep QualityPublication . Desouzart, Gustavo; Filgueiras, Ernesto; Matos, RuiThe common sense warn that the quality of our day depends on the quality of our previous night. Among the main factors contributing to a better sleep quality is the postural behavior during the sleep period. However, little or nothing is known about the actual influence of these behaviors on people sleep quality. This paper presents a study which aims to: i) Check if people can take on a new postural behavior during the sleep period after a training period aware of this behavior and; ii) Check if a postural recommendations can aims to induce positive changes in the perception on the indices of Sleep quality in young adults, according to ecological and environmental approach. A sample of 21560 observations, which corresponds to 595 hours of sleep hours of 24 young adults, 12 male military and 12 female undergraduate, participated in this study. The Pittsburgh Sleep Quality Index (PSQI) was used to measure the perception of sleep quality before and after six consecutive months of appliance of the Postural Intervention program. Results shown that the Postural reeducation group improved self-perception of sleep quality (from bad to good) and a significant difference between the periods of the study (p = 0.008), according to the Student's T-Test and, ideal posture while sleeping using the ideal placement and amount of pillows (1.34% to 81.48%). Findings of this study allow us to suggest to health care professionals, in particular the rehabilitation professionals, new strategies and solutions for ergonomic change in posture in bed and improve the sleep quality indices.
- Insulin resistance: a new consequence of altered carotid body chemoreflex?Publication . Conde, Silvia V.; Ribeiro, Maria J.; Melo, Bernardete F.; Guarino, Maria P.; Sacramento, Joana F.Metabolic diseases affect millions of individuals across the world and represent a group of chronic diseases of very high prevalence and relatively low therapeutic success, making them suitable candidates for pathophysiological studies. The sympathetic nervous system (SNS) contributes to the regulation of energy balance and energy expenditure both in physiological and pathological states. For instance, drugs that stimulate sympathetic activity decrease food intake, increase resting metabolic rate and increase the thermogenic response to food, while pharmacological blockade of the SNS has opposite effects. Likewise, dysmetabolic features such as insulin resistance, dyslipidaemia and obesity are characterized by a basal overactivation of the SNS. Recently, a new line of research linking the SNS to metabolic diseases has emerged with the report that the carotid bodies (CBs) are involved in the development of insulin resistance. The CBs are arterial chemoreceptors that classically sense changes in arterial blood O2 , CO2 and pH levels and whose activity is known to be increased in rodent models of insulin resistance. We have shown that selective bilateral resection of the nerve of the CB, the carotid sinus nerve (CSN), totally prevents diet-induced insulin resistance, hyperglycaemia, dyslipidaemia, hypertension and sympathoadrenal overactivity. These results imply that the beneficial effects of CSN resection on insulin action and glucoregulation are modulated by target-related efferent sympathetic nerves through a reflex that is initiated in the CBs. It also highlights modulation of CB activity as a putative future therapeutic intervention for metabolic diseases.
- Effectiveness of Wearable Devices for Posture Correction: A Systematic Review of Evidence from Randomized and Quasi-Experimental StudiesPublication . Caixeiro, Diogo; Cordeiro, Tomás; Constantino, Leandro; Carreira, João; Mendes, Rui; Silva, Cândida G.; Castro, Maria AntónioIntroduction: The increasing development of wearable devices for postural monitoring (provide feedback on posture) or correction (mechanical or biofeedback to promote change) is partly driven by the rising prevalence of poor posture in the general population and its impact on pain perception and functional capacity. Objective: Examine the effects of wearable devices on posture correction or prevention and on related outcomes, including postural alignment, muscle activity, pain and functional performance. Methods: The review followed the PRISMA 2020 guidelines. Searches were performed in PubMed, Scopus, Web of Science, and PEDro for studies published between 2012 and 2025. Eligible studies included randomized controlled trials and quasi-experimental designs involving participants with postural deviations or at risk of developing them, who underwent interventions using wearable devices that provided vibratory, auditory, visual, or tactile biofeedback. Results: Eight studies reported immediate improvements in postural alignment, body awareness, and self-reported pain, particularly with devices providing vibratory or visual biofeedback. Functional task stability improved, and muscle activity during risky postures decreased. However, the strong heterogeneity across devices and protocols, small sample sizes, short intervention durations, and, in some cases, the lack of independent control groups limit the strength and generalizability of these findings. Conclusions: Wearable devices have potential as complementary tools in physiotherapy due to their autonomous and potentially effective nature. Nevertheless, current evidence remains insufficient to support definitive clinical recommendations.
- Functional abolition of carotid body activity restores insulin action and glucose homeostasis in rats: key roles for visceral adipose tissue and the liverPublication . Sacramento, Joana F.; Ribeiro, Maria J.; Rodrigues, Tiago; Olea, Elena; Melo, Bernardete F.; Guarino, Maria P.; Fonseca-Pinto, Rui; Ferreira, Cristiana R.; Coelho, Joana; Obeso, Ana; Seiça, Raquel; Matafome, Paulo; Conde, Silvia V.Aims/hypothesis: We recently described that carotid body (CB) over-activation is involved in the aetiology of insulin resistance and arterial hypertension in animal models of the metabolic syndrome. Additionally, we have demonstrated that CB activity is increased in animal models of insulin resistance, and that carotid sinus nerve (CSN) resection prevents the development of insulin resistance and arterial hypertension induced by high-energy diets. Here, we tested whether the functional abolition of CB by CSN transection would reverse pre-established insulin resistance, dyslipidaemia, obesity, autonomic dysfunction and hypertension in animal models of the metabolic syndrome. The effect of CSN resection on insulin signalling pathways and tissue-specific glucose uptake was evaluated in skeletal muscle, adipose tissue and liver. Methods: Experiments were performed in male Wistar rats submitted to two high-energy diets: a high-fat diet, representing a model of insulin resistance, hypertension and obesity, and a high-sucrose diet, representing a lean model of insulin resistance and hypertension. Half of each group was submitted to chronic bilateral resection of the CSN. Age-matched control rats were also used. Results: CSN resection normalised systemic sympathetic nervous system activity and reversed weight gain induced by high-energy diets. It also normalised plasma glucose and insulin levels, insulin sensitivity lipid profile, arterial pressure and endothelial function by improving glucose uptake by the liver and perienteric adipose tissue. Conclusions/interpretation: We concluded that functional abolition of CB activity restores insulin sensitivity and glucose homeostasis by positively affecting insulin signalling pathways in visceral adipose tissue and liver.
- Somatotype and Body Composition of Normal and Dysphonic Adult SpeakersPublication . Franco, Débora; Fragoso, Isabel; Andrea, Mário; Teles, Júlia; Martins, FernandoSummary: Objective. Voice quality provides information about the anatomical characteristics of the speaker. The patterns of somatotype and body composition can provide essential knowledge to characterize the individuality of voice quality. The aim of this study was to verify if there were significant differences in somatotype and body composition between normal and dysphonic speakers. Study Design. Cross-sectional study. Methods. Anthropometric measurements were taken of a sample of 72 adult participants (40 normal speakers and 32 dysphonic speakers) according to International Society for the Advancement of Kinanthropometry standards, which allowed the calculation of endomorphism, mesomorphism, ectomorphism components, body density, body mass index, fat mass, percentage fat, and fat-free mass. Perception and acoustic evaluations as well as nasoendoscopy were used to assign speakers into normal or dysphonic groups. Results. There were no significant differences between normal and dysphonic speakers in the mean somatotype attitudinal distance and somatotype dispersion distance (in spite of marginally significant differences [P < 0.10] in somatotype attitudinal distance and somatotype dispersion distance between groups) and in the mean vector of the somatotype components. Furthermore, no significant differences were found between groups concerning the mean of percentage fat, fat mass, fat-free mass, body density, and body mass index after controlling by sex. Conclusion. The findings suggested no significant differences in the somatotype and body composition variables, between normal and dysphonic speakers.
- Fall Risk Management in Nursing Homes: A Scoping ReviewPublication . Gaspar, Cecília; Pedreira, Larissa; Reis, Neuza; Costa, Andreia; Ferreira, Ricardo; Henriques, Maria; Baixinho, Cristina LavaredaBackground: Population aging represents a growing public health challenge, with falls being one of the leading causes of morbidity, mortality, and loss of autonomy among older adults. In nursing homes, the risk is exacerbated by physical, cognitive, and environmental factors, yet which interventions are most actionable in nursing homes remains unclear, requiring effective and evidence-based prevention strategies. Objective: We aimed to map the evidence on interventions in fall risk management among institutionalized older adults, highlighting assessment, exercise, environmental, and educational strategies. Methods: A scoping review was conducted according to JBI guidelines. The search was carried out in MEDLINE, CINAHL, Scopus, Cochrane, and Web of Science. The review included studies, published between 2019 and 2024, involving older adults (≥65 years) in nursing homes, focusing on nursing interventions for fall risk management. Results: The initial search identified 1146 records across electronic databases and gray literature sources. After removing duplicates and screening titles, abstracts, and full texts, 18 studies met the inclusion criteria and were included in this scoping review. The inclusion criteria were as follows: (i) fall risk assessment, using functional and clinical scales such as the Timed Up and Go (TUG), Berg Balance Scale (BBS), Morse Fall Scale, to identify predisposing factors; (ii) exercise programs, such as the Otago Exercise Program and multicomponent training, which demonstrated benefits in strength, balance, and mobility; (iii) environmental modifications, aimed at reducing extrinsic risks and promoting safer surroundings; and (iv) educational programs, targeting professionals, residents, and families, with positive effects on adherence to preventive practices and on strengthening the safety culture. Conclusions: Effective fall risk management in nursing homes requires an integrated, multidisciplinary, and person-centered approach, with nurses playing a central role in assessment, coordination, and implementation of interventions. However, gaps remain regarding standardization, validation of assessment tools specific to the institutional context, and evaluation of long-term outcomes.
- Effects of dignity therapy on dignity and spiritual well-being in people with advanced cancer: study protocol for a randomized controlled trialPublication . Yanez, Romel; Fernandes, Ana; Sousa, Maria de; Abreu, Cinara; Alcantara, Roberta de; Guimarães, Maria; Cunha, Meire da; Magalhães, Luciana; Brito, Amalia de; Gomes, Matheus; Medeiros, Natacha de; Castro, Régia; Sixsmith, Judith; Paiva, Bianca; Torres, Débora; Johnston, Bridget; Laranjeira, CarlosBackground Dignity Therapy is a person-centered psychotherapeutic intervention designed for people approaching the end of life, fostering reflection on meaningful aspects of life and creating a testimonial legacy. Since 2011, randomized trials have demonstrated its value in addressing psychospiritual needs and preserving dignity in palliative care. However, no controlled studies have been conducted in Latin America to assess its effectiveness within local cultural contexts. Methods This is a protocol for an exploratory, randomized, parallel-group clinical trial (1:1 allocation) with an open-label design. A total of 96 hospitalized individuals with advanced cancer will participate, all receiving care from the Palliative Care Service of a university hospital in Fortaleza, Brazil. The control group will receive usual palliative care, while the intervention group will receive the same care along with Dignity Therapy, delivered in three structured sessions. Assessments will be conducted at baseline (T1), at the end of the intervention (T2), and short-term follow-up (T3). The primary outcome will be the perceived dignity impact of the intervention, measured by the Dignity Impact Scale. Secondary outcomes will include spiritual well-being, hope, anxiety, depression, and distress. Perceptions of the intervention experience will also be collected from individuals in the intervention group. The primary analysis will be performed using linear mixed models. Discussion This trial will provide evidence on the feasibility and potential benefits of Dignity Therapy in supporting dignity and spiritual well-being among individuals with advanced cancer, while also examining how the intervention performs within distinct cultural contexts that may shape perceptions of dignity and end-of-life care. Trial registration Registro Brasileiro de Ensaios Clínicos (ReBEC), RBR-8r3vzw5. Registered on 13 October 2025.
- A Low-Cost Head-Controlled and Sip-and-Puff Mouse: System Design and Preliminary FindingsPublication . Duarte, Rodrigo; Lopes, Nuno Vieira; Coelho, Paulo JorgeThis work introduces a low-cost, wearable assistive mouse designed to support digital interaction for individuals with motor impairments. The system combines inertial sensing for head-movement tracking and a pressure-based interface for simulating mouse clicks via “sip-and-puff” actions. The device enables full mouse control (pointer movement, clicks, and double-clicks) without relying on hand mobility. Preliminary evaluations, conducted with input from occupational therapy professionals, demonstrated promising usability and functionality comparable to commercial devices. The proposed solution offers a cost-effective, open-source alternative to existing adaptive technologies, with future development aimed at broader testing and integration in rehabilitation settings. Future work will include usability testing with individuals presenting real motor impairments to validate clinical applicability.