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- Gait Kinematics Analysis of Flatfoot AdultsPublication . Marouvo, Joel; Sousa, Filipa; Fernandes, Orlando; Castro, Maria António; Paszkiel, SzczepanBackground: Foot postural alignment has been associated with altered gait pattern. This study aims to investigate gait kinematic differences in flatfoot subjects’ regarding all lower limb segments compared to neutral foot subjects. Methods: A total of 31 participants were recruited (age: 23.26 yo ± 4.43; height: 1.70 m ± 0.98; weight: 75.14 kg ± 14.94). A total of 15 subjects were integrated into the flatfoot group, and the remaining 16 were placed in the neutral foot group. All of the particpants were screened using the Navicular Drop Test and Resting Calcaneal Stance Position test to characterize each group, and results were submitted to gait analysis using a MOCAP system. Results: Significant kinematic differences between groups were found for the ankle joint dorsiflexion, abduction, and internal and external rotation (p < 0.05). Additionally, significant differences were found for the knee flexion, extension, abduction, and external rotation peak values (p < 0.001). Significant differences were also found for the hip flexion, extension, external rotation, pelvis rotation values (p < 0.02). Several amplitude differences were found concerning ankle abduction/adduction, knee flexion/extension and abduction/adduction, hip flexion/extension and rotation, and pelvis rotation (p < 0.01). Conclusion: Flatfooted subjects showed kinematic changes in their gait patterns. The impact on this condition on locomotion biomechanical aspects is clinically essential, and 3D gait biomechanical analysis use could be advantageous in the early detection of health impairments related to foot posture.
- Low-Protein Diets, Malnutrition, and Bone Metabolism in Chronic Kidney DiseasePublication . Pereira, Cidália D.; Guimarães, Carla; Ribeiro, Vânia S.; Vaz, Daniela C.; Martins, Maria JoãoChronic kidney disease (CKD) has a high prevalence worldwide, with increasing incidence in low- and middle-income countries, and is associated with high morbidity and mortality, particularly from cardiovascular disease. Protein-restricted diets are one of the most widely used non-pharmacological approaches to slow the progression of CKD and prevent associated metabolic abnormalities. However, some concerns have been raised about the long-term safety of these diets, particularly with regard to patients’ nutritional status and bone and mineral disorders. Therefore, the aim of this article is to review the most recent scientific evidence on the relevance of using protein-restricted diets (with or without keto-analogue supplementation) and, in particular, their relationships with malnutrition and mineral and bone disorders in people with CKD without kidney replacement therapies. Although protein-restricted diets, especially when supplemented with keto-analogues and highly personalized and monitored, do not appear to be associated with malnutrition, research on their effects on bone and mineral disorders is scarce, deserving further investigation.
- Should Children Drink Water with Very Low Mineral Content? Implications of the Global Expansion of Water Filtration Systems and Relevance of Consumption of Water with Higher Mineralization LevelsPublication . Pereira, Cidália D.; Martins, Maria JoãoThe consumption of water with very low mineral content (W-VLMC; water with total dissolved solids below 50 mg/L), despite limited and inconsistent evidence and the resulting knowledge gaps, has not been associated with health risks for the general population. However, certain population subgroups (those eating very unbalanced diets or avoiding certain foods, engaged in prolonged periods of fasting, and/or doing prolonged or strenuous exercise as well as pregnant or breastfeeding women) should be mindful of maintaining sufficient intake of all essential minerals through their food if regularly using this type of water as their main beverage. The rapid expansion of water filtration systems—often producing W-VLMC—creates a timely and valuable opportunity to advance research on the health implications of W-VLMC intake. As these systems become increasingly common in educational settings and homes, children represent a subgroup experiencing rising exposure to W-VLMC. Additional studies are needed to assess the health effects of such exposure from early childhood. A complementary yet contrasting perspective is that the use of water intended for human consumption—with stringent quality control standards—and natural mineral waters—inherently pure, thus eliminating the need for filtration—with higher mineralization in both types of water, may provide an additional dietary source of essential minerals, especially for all the population subgroups mentioned above.
- ¿Cuáles son las prácticas y comportamientos de los mayores institucionalizados para prevenir las caídas?Publication . Baixinho, Cristina Lavareda; Dixe, Maria dos AnjosObjetivos: describir las prácticas y los comportamientos de los mayores para prevenir las caídas;; identificar prácticas de comunicación de los mayores para la prevención de caídas y asociar las prácticas y comportamientos de prevención de caídas con la edad, sexo, tiempo de institucionalización, grado de dependencia y utilización de medios auxiliares de marcha. Metodología: La muestra fue de 156 personas mayores de ambos sexos de seis residencias de ancianos que autorizaron la realización del estudio. El instrumento utilizado fue la Escala de prácticas y comportamientos de los ancianos para prevenir las caídas (α=0,881). Resultados: los ancianos son poco perseverantes en la elección de los zapatos cerrados y con suelas antideslizantes. Los hombres valoran más las prácticas y comportamientos seguros (p=0,045) que las mujeres. Los ancianos más dependientes revelan peores prácticas y comportamientos de prevención. Los mayores que utilizan auxiliares de marcha revelan mejores prácticas de comunicación (p=0,019) y mejores prácticas y comportamientos relacionados con la accesibilidad al espacio físico (p=0,012). Conclusiones: Estudios futuros deben asociar el predominio de caídas a las prácticas y comportamientos de los ancianos.
- Positive parenting by parents of children up to three years of age: development and validation of measurement scalesPublication . Oliveira Custódio Lopes, Maria da Saudade; Dixe, Maria dos AnjosThis study aimed to describe the development and validation of three multidimensional scales in which the same 30 items, distributed among five dimensions, measure parents' self-perceived confidence, difficulties and knowledge needs in the exercise of positive parenting during the first three years of the child's life. The content of the scales resulted from the literature and exploratory studies and was validated by experts. The analysis of its reliability and validity, using Pearson's correlations and Cronbach's alpha, was based on data from a questionnaire administered to a non-probabilistic sample of 1011 parents. In the dimensions and items, α-values ranged between 0.769 and 0.890 and r-coefficients were >0.37;p <0.01. It was concluded that the scales measure three variables that correspond to the practice of positive parenting and their use permits guiding nursing support.
- 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.