Loading...
29 results
Search Results
Now showing 1 - 10 of 29
- Perfil de atividade física de pessoas com Doença Pulmonar Obstrutiva Crónica (DPOC) em PortugalPublication . Raposo, João; Pimenta, Sara; Alves-Guerreiro, José; Flora, Sofia; Caceiro, Rúben; Morais, Nuno; Oliveira, Ana; Silva, Cândida G.; Ribeiro, José; Silva, Fernando; Januário, Filipa; Carreira, Bruno P.; Rodrigues, Fátima; Marques, Alda; Cruz, JoanaIntrodução e objetivos: A participação em atividade física (AF) regular está associada a um menor risco de mortalidade e melhor qualidade de vida relacionada com a saúde. Apesar de se saber que as pessoas com Doença Pulmonar Obstrutiva Crónica (DPOC) apresentam níveis baixos de AF quando comparadas com indivíduos saudáveis da mesma idade e sexo, desconhece-se ainda a caracterização diária dos níveis de AF destas pessoas em Portugal. Este estudo teve como objetivos caracterizar o perfil de AF de pessoas com DPOC portuguesas e explorar a sua relação com características clínicas. Material e Métodos: Foi realizado um estudo observacional transversal em pessoas com DPOC clinicamente estáveis, nas regiões Centro e Lisboa e Vale do Tejo. Foram recolhidos dados sociodemográficos, antropométricos, função pulmonar [Volume Expiratório Forçado no 1º segundo (FEV1)], sintomas e exacerbações (GOLD ABCD), dispneia (modified Medical Research Council), tolerância ao exercício (teste de marcha dos 6-min) e estado de saúde (COPD Assessment Test). A AF foi avaliada através de acelerometria (ActiGraph GT3X+) durante 7 dias e consistiu em: tempo despendido em AF Moderada a Vigorosa (AFMV) e em AF Total (min/dia), e número de passos/dia. Realizou-se estatística descritiva e correlações de Spearman (ρ) entre as variáveis de AF e as medidas clínicas. Resultados: Os participantes (n=102, 82 do sexo masculino, FEV1=48±19%previsto) apresentaram uma mediana [Q1–Q3] de 20 [9–41] min/dia em AFMV, 144 [100–208] min em AF Total e realizaram 4438 [2821–6944] passos/dia. Apenas 24% dos participantes atingiram ≥7000 passos/dia e 41% os ≥30 min/dia de AFMV recomendados na literatura. O tempo despendido em AFMV e o n.º de passos/dia apresentaram correlações moderadas com a dispneia (ρ=-0.401 e ρ=0.537, respetivamente; p<0.001) e com a tolerância ao exercício (ρ=0.560 e ρ=0.525, respetivamente; p<0.001). O tempo em AFMV apresentou ainda correlação com os graus ABCD (ρ=-0.430, p<0.001). Conclusões: A maioria das pessoas com DPOC é fisicamente inativa. Os sintomas, exacerbações e tolerância ao esforço estão associados à AF nesta população e devem ser considerados em intervenções de promoção de AF.
- Kinematic Comparison and Description of the 3-Dimensional Shoulder Kinematics of 2 Shoulder Rotation TestsPublication . Pascoal, Augusto Gil; Morais, NunoObjectives: The purpose of this study was to compare shoulder external rotation range of motion (ROM) during the hand-behind-neck (HBN) test and a standard shoulder external rotation test and to describe the 3-dimensional scapular motion during the HBN test. Methods: An electromagnetic tracking device was used to assess the dominant shoulder of 14 healthy participants while performing active full ROM in a standard shoulder external rotation test in an elevated position (EREP) and in the HBN test. The humeral and scapular 3-dimensional positions at the end of EREP and HBN were compared using a paired-sample t test. A correlation analysis was performed between humeral and scapular angles to assess the contribution of scapular motion to the full shoulder ROM during the HBN test. Results: No significant differences were found between the HBN test and the EREP at the end-range of the glenohumeral external rotation (HBN: 15.6° ± 6.3° vs EREP: 23.4° ± 4.7°; P = .08) and on scapular internal-external rotation (HBN test: 21.2° ± 6.3° vs EREP: 15.6° ± 1.8°; P = .23). Significant differences were found in scapular upward rotation (HBN: 21.2° ± 6.3° vs EREP: 15.6° ± 1.8°; P b .01) and scapular spinal tilt (HBN: − 0.4° ± 2.3° vs EREP: 8.1° ± 2.1°; P b .01). There was a positive correlation between the humeral angles and scapular internal and posterior spinal tilt angles with the HBN test. Conclusions: The results of the present study showed that, in young asymptomatic participants with no known shoulder pathology, the end-range of shoulder rotation was similar in the HBN test and in a standard shoulder rotation test. During the HBN test, the scapula assumed a more internal and anterior spinal tilted position at the end-range of active shoulder external rotation. These results suggest that the HBN test may be used to assess the end-range of glenohumeral external rotation.
- The pectoralis minor muscle and shoulder movement-related impairments and pain: Rationale, assessment and managementPublication . Morais, Nuno; Cruz, JoanaThe adaptive shortening or tightness of the pectoralis minor muscle (PMm) is one of the potential biomechanical mechanisms associated with altered scapular alignment at rest and scapular motion during arm elevation (scapular dyskinesis) in patients with shoulder complaints. This masterclass briefly reviews the role of the PMm in shoulder movement-related impairments and provides a critical overview of the assessment of PMm tightness and the conventional approaches to increase its resting length and extensibility. A rehabilitation approach focused on PMm stretching and simultaneous optimization of the kinematic chain of arm elevation is also discussed, hoping to improve the management of shoulder movement-related impairments and pain.
- Test-retest reliability, agreement and construct validity of the International Physical Activity Questionnaire short-form (IPAQ-sf) in people with COPDPublication . Flora, Sofia; Marques, Alda; Hipólito, Nádia; Morais, Nuno; Silva, Cândida G.; Januário, Filipa; Rodrigues, Fátima; Carreira, Bruno P.; Cruz, J.Introduction This study assessed the test-retest reliability/agreement and construct validity of the International Physical Activity Questionnaire short-form (IPAQ-sf) in patients with chronic obstructive pulmonary disease (COPD). It also explored differences in its validity according to age, sex and GOLD airflow obstruction levels. Methods 62 participants (68 ± 8 years, 53 males, FEV1 51 ± 23%pred) completed the Portuguese IPAQ-sf, wore an accelerometer for 7 days and completed a second IPAQ-sf. Test-retest reliability/agreement was assessed with Intraclass Correlation Coefficient (ICC2,1), 95% Limits of Agreement (LoA), standard error of measurement (SEM) and minimal detectable change (MDC95) for continuous variables, and percentage of agreement (%agreement) for categories (“active”/“inactive”). Validity was assessed with 95% LoA and Spearman's correlations (ρ) between IPAQ-sf 2 (METs-min/week, time in vigorous [VPA], moderate PA [MPA] and walking) and accelerometry (time in MVPA, VPA, MPA and step counts) for continuous variables; %agreement, Cohen's kappa, and sensitivity specificity and±predictive values for categories. Correlations were also performed for age, sex and GOLD airflow obstruction grades. Results Reliability was good (ICC2,1 = 0.707) with wide LoA (-6446—6409 METs-min/week). SEM and MDC95 were 1840 and 4971 METs-min/week, respectively. %agreement between the two IPAQ-sf was 84% (kappa = 0.660). Positive, moderate and significant correlations were found between IPAQ-sf and accelerometry (0.396 ≤ ρ ≤ 0.527, p < 0.001), except for VPA (p > 0.05). The strongest correlations were found in age (<65 years) and male (0.466 ≤ ρ ≤ 0.653, p < 0.05). %agreement between tools was 65% (kappa = 0.313), with high sensitivity (0.830) but low specificity (0.500). Conclusions The IPAQ-sf seems valid to be used in COPD but caution on its widespread use is recommended as its accuracy may be limited.
- Intrarater Agreement of Elbow Extension Range of Motion in the Upper Limb Neurodynamic Test 1 Using a Smartphone ApplicationPublication . Cruz, Joana; Morais, NunoTo estimate the intrarater agreement of the Compass application of a smartphone in the assessment of elbow extension range of motion (EE-ROM) at pain onset and maximum tolerable point during the Upper Limb Neurodynamic Test 1 (ULNT1).
- What Motivates Patients with COPD to Be Physically Active? A Cross-Sectional StudyPublication . Pimenta, Sara; Silva, Cândida G.; Flora, Sofia; Hipólito, Nádia; Burtin, Chris; Oliveira, Ana; Morais, Nuno; Brites-Pereira, Marcelo; Carreira, Bruno P.; Januário, Filipa; Andrade, Lília; Martins, Vitória; Rodrigues, Fátima; Brooks, Dina; Marques, Alda; Cruz, JoanaMotivation can be broadly defined as what moves people to act. Low motivation is a frequently reported factor for the reduced physical activity (PA) levels observed in patients with chronic obstructive pulmonary disease (COPD). This study assessed patients’ motives to be physically active, according to three pulmonary rehabilitation (PR) participation groups (Never PR, Previous PR and Current PR) and explored whether these motives were related to the PA levels and clinical characteristics. The motives to be physically active were assessed with the Exercise Motivation Inventory-2 (EMI-2, 14 motivational factors, five dimensions) and PA with accelerometry (PA groups: <5000 steps/day vs. ≥5000 steps/day). The clinical variables included symptoms, impact of the disease, exercise capacity and comorbidities. Ninety-two patients (67.4 ± 8.1 years, 82.6% male, forced expiratory volume in 1s (FEV1) 48.3 ± 18.9% predicted; 30.4% Never PR, 51% Previous PR and 18.5% Current PR) participated. The motivational dimensions related to health/fitness presented the highest scores (3.8 ± 1.1; 3.4 ± 1.3). The motives to be active were not significantly different between PA groups (p > 0.05) but having less symptoms and ≥two comorbidities were associated with higher scores in psychological/health and body-related motives, respectively (p < 0.05). The findings may encourage health professionals to actively explore with patients their motives to be physically active to individualise PA promotion.
- Relationship between fatigue, physical activity and health-related factors in COPDPublication . Vieira, Ana; Dias, Diana; Miguel, Eunice; Matos, Telma; Flora, Sofia; Silva, Cândida G.; Morais, Nuno; Oliveira, Ana; Caceiro, Rúben; Silva, Fernando; Ribeiro, José; Silva, Sónia; Martins, Vitória; Valente, Carla; Burtin, Chris; Brooks, Dina; Marques, Alda; Cruz, JoanaFatigue is highly prevalent in COPD and may be associated with reduced physical activity (PA) and poor outcomes. This study explored the relationship between fatigue, objectively measured PA and health-related factors in people with COPD. Fatigue was assessed with the Checklist of Individual Strength (CIS20) and CIS20-Subjective Fatigue (CIS20-SF) and PA with Actigraph GT3X monitors (moderate-to-vigorous PA, MVPA; total PA; steps/day). Dyspnoea (modified Medical Research Council, mMRC), exercise tolerance (6-min walk distance, 6MWD), lung function (spirometry) and GOLD A-D were collected. Spearman (ρ) and Pearson (r) correlations and multiple regressions were performed. Variables entered the model if correlation≥0.2. 54 patients participated (68±7 years; 82% men) and 69% reported fatigue (CIS20-SF≥27). Fatigue was significantly correlated with MVPA, steps/day, mMRC, 6MWD, GOLD A-D and FEV1pp (Table 1). In regression models for CIS20 (p=.001; r2=.61) and CIS20-SF (p=.003; r2=.56), dyspnoea was the only significant variable. People with higher scores of fatigue present lower PA levels, although the relationship is weak. Dyspnoea appears to have the largest influence on fatigue.
- Phenotyping Adopters of Mobile Applications Among Patients With COPD: A Cross-Sectional StudyPublication . Flora, Sofia; Hipólito, Nádia; Brooks, Dina; Marques, Alda; Morais, Nuno; Silva, Cândida; Silva, Fernando; Ribeiro, José; Caceiro, Rúben; Carreira, Bruno; Burtin, Chris; Pimenta, Sara; Cruz, Joana; Oliveira, AnaEffectiveness of technology-based interventions to improve physical activity (PA) in people with COPD is controversial. Mixed results may be due to participants' characteristics influencing their use of and engagement with mobile health apps. This study compared demographic, clinical, physical and PA characteristics of patients with COPD using and not using mobile apps in daily life. Patients with COPD who used smartphones were asked about their sociodemographic and clinic characteristics, PA habits and use of mobile apps (general and PA-related). Participants performed a six-minute walk test (6MWT), gait speed test and wore an accelerometer for 7 days. Data were compared between participants using (App Users) and not using (Non-App Users) mobile apps. A sub-analysis was conducted comparing characteristics of PA–App Users and Non-Users. 59 participants were enrolled (73% Male; 66.3 ± 8.3 yrs; FEV1 48.7 ± 18.4% predicted): 59% were App Users and 25% were PA-App Users. Significant differences between App Users and Non-App Users were found for age (64.2 ± 8.9 vs. 69.2 ± 6.3yrs), 6MWT (462.9 ± 91.7 vs. 414.9 ± 82.3 m), Gait Speed (Median 1.5 [Q1–Q3: 1.4–1.8] vs. 2.0 [1.0–1.5]m/s), Time in Vigorous PA (0.6 [0.2–2.8] vs. 0.14 [0.1–0.7]min) and Self-Reported PA (4.0 [1.0–4.0] vs. 1.0 [0.0–4.0] Points). Differences between PA–App Users and Non-Users were found in time in sedentary behavior (764.1 [641.8–819.8] vs. 672.2 [581.2–749.4] min) and self-reported PA (4.0 [2.0–6.0] vs. 2.0 [0.0–4.0] points). People with COPD using mobile apps were younger and had higher physical capacity than their peers not using mobile apps. PA-App Users spent more time in sedentary behaviors than Non-Users although self-reporting more time in PA.
- A Diagonal Movement Pattern of Arm Elevation and Depression in Overhead Throwing Athletes: An Exploratory Kinematic Analysis for Clinical ApplicationPublication . Morais, Nuno; Ferreira, Joana; Gordo, Jéssica; Vilas-Boas, J. Paulo; Pascoal, Augusto GilAssessing scapular position and motion during functional arm movement patterns may add relevant information to the evaluation of the clinical status and athletic performance of overhead sports athletes’ shoulders. This study aimed to examine the three-dimensional scapular kinematics of elite volleyball players with (n = 11) and without scapular dyskinesis (n = 11) in comparison to non-athletes (n = 27). Four distinct arm elevation/depression tasks were assessed: shoulder abduction/adduction, flexion/extension, scaption, and a diagonal movement pattern mimicking throwing (proprioceptive neuromuscular facilitation diagonal 2 for flexion/extension or PNF–D2– flx/ext). Kinematic data was recorded from the spiking/dominant shoulder using an electromagnetic system (FASTRAK, Polhemus Inc., Colchester, VT, USA); MotionMonitor v9 software, Innovative Sports Training, Inc., Chicago, IL, USA). The study compared scapular rotations at 15◦ intervals of humero-thoracic (HT) angles, ranging from minimum to 120◦. Significantly different 3D scapular kinematics were observed between traditional arm motion tasks and PNF–D2 arm motion task (HT angle × task interaction effect, p < 0.001, 0.275 ≤ η2p ≤ 0.772). However, when considering the combined influence of phase, HT angle, task, and group factors, no differences were found between groups (phase × HT angle × task × group, p ≥ 0.161, 0.032 ≤ η2p ≤ 0.058). The inclusion of a functional arm movement pattern when evaluating scapular position and movement in overhead athletes does not appear to be mandatory. However, these findings are preliminary and highlight the need for more research in this area.
- Interesses e necessidades de formação em Fisioterapia Cardiorrespiratória em Portugal: Um estudo do GIFCR-APFISIOPublication . Cruz, Joana; Almeida, Miguel; Pinto, Joana; Morais, Nuno; Silva, Alexandre; Barbosa, Marisela; Azevedo, Natália; Gagulic, Sandra; Oliveira, Ana; Machado, Filipa; Jácome, Cristina; Marques, AldaIntrodução e objetivos: A educação profissional permite aos fisioterapeutas manter, desenvolver e melhorar os conhecimentos e competências necessários à prestação de serviços de elevada qualidade. A Fisioterapia Cardiorrespiratória (FCR) é uma das áreas em crescimento em Portugal e no mundo, sendo fundamental adequar a oferta formativa às necessidades da prática clínica. Este estudo pretendeu identificar as necessidades e interesses de formação dos fisioterapeutas e estudantes na área da FCR. Materiais e Métodos: O Grupo de Interesse em Fisioterapia Cardiorrespiratória da Associação Portuguesa de Fisioterapeutas (GIFCR-APFISIO) desenvolveu e realizou um inquérito online (google forms) entre março–abril 2018 a fisioterapeutas e estudantes de Fisioterapia em Portugal, com interesse/prática em FCR, a fim de se: 1) conhecer a tipologia e área(s) de formação preferencial/necessária; 2) identificar questões práticas (regime, duração, local, custo). O inquérito foi divulgado através do Facebook do GIFCR-APFISIO e via e-mail aos associados da APFISIO, escolas e instituições de saúde. Foi realizada análise descritiva. Resultados: 193 pessoas (32±9 anos; 155 mulheres; 21 estudantes) responderam ao inquérito. As tipologias de formação preferenciais foram: cursos (n=155), workshops (n=100) e encontros com especialistas/masterclasses (n=74). As áreas preferenciais foram: raciocínio clínico em FCR (n=126), reabilitação respiratória ou cardíaca no doente crónico (n=102 e n=90) ou agudo (n=84 e n=70), fisiologia do exercício avançada (n=89) e avaliação do doente respiratório (n=83) ou cardíaco (n=75). O regime de formação presencial foi o mais votado, idealmente aos fins-de-semana (n=126) ou em regime ‘pós-laboral e fim-de-semana’ (n=105), com duração de 2–3 dias (n=146). Um custo entre 100–300€ foi considerado adequado (n=144). As regiões consideradas preferenciais para formação foram Lisboa (n=79), Porto (n=60) e Aveiro (n=40). Conclusões: Com base nestes resultados, o GIFCR-APFISIO organizou já 2 cursos e 1 jornadas de atualização em FCR. Estes dados irão permitir adequar a oferta formativa às necessidades de fisioterapeutas e estudantes de fisioterapia, em Portugal.
- «
- 1 (current)
- 2
- 3
- »