BFMH - Teses de Doutoramento / Ph.D.Thesis
Permanent URI for this collection
Browse
Browsing BFMH - Teses de Doutoramento / Ph.D.Thesis by Field of Science and Technology (FOS) "Ciências Médicas::Outras Ciências Médicas"
Now showing 1 - 10 of 31
Results Per Page
Sort Options
- Ankel-foot orthoses : a biomechanical approach to the effects of a non-invasive therapeutical management of the gait in children with cerebral palsyPublication . Ricardo, Diogo Filipe dos Reis; João, Filipa Oliveira da SilvaThree-dimensional gait analysis methodologies are widely used to assess gait and the effects of ankle-foot orthoses (AFO) in the treatment of gait deviations in children with Cerebral Palsy (CP). However, due to the specific requirements for motion capture, AFO characteristics, and the heterogeneity of this population, the wide range of gait parameters present such variability that makes it difficult to interpret its clinical application. This PhD thesis main purpose was to investigate how those assessment methodologies could provide important and clinically relevant data regarding gait analysis with AFO. Four studies were conducted employing exploratory and experimental methods: the first study is a scoping review that presents the immediate and long-term effects of AFO in children with spastic bilateral cerebral palsy; the second study evaluates test-retest reliability of a six-degree-of-freedom marker set in key points of gait kinematics, kinetics, and time-distance parameters in children with CP; the third study demonstrates the use of the gait profile score index to quantify gait quality in children with cerebral palsy wearing several types of AFO; the last study explores two different pose estimation algorithms used to build a 3D model of a child with cerebral palsy wearing a specific AFO. Overall, the findings of our work presented in this dissertation, provided scientific data for the rehabilitation science, demonstrating that the use of gait analysis protocols specific to the characteristics of children with cerebral palsy, and to existing therapeutic interventions, offer less susceptible information to methodological errors. Further research is required to continue exploring the several methodologies to assess and analyse the gait in children with cerebral palsy to support decision making and therefore providing a more effective treatment in the rehabilitation processes.
- Association between grip strength, chronic diseases, and depressive symptomology in european middle-aged and older adultsPublication . Veiga, Diogo Miguel Carvalho Veiga; Marques, Adilson Passos da Costa; Teixeira, Pedro Jorge do Amaral de MeloBackground: Depression, as one of the leading causes of disease burden, frequently co-occurs with other diseases. Cancer seems to be strongly associated with depression more than any other disease. As an outcome of physical fitness, grip strength seems to have a protective effect on depression. This study aimed to analyse how grip strength moderates the relationship between cancer and depressive symptomatology among older European adults. Methods: Cross-sectional data from wave 8 (2019/2020), including 41666 participants (17986 men) of the population-based Survey of Health, Aging, and Retirement in Europe, were analysed. Grip strength, used as the moderator, was measured twice on each hand using a dynamometer. The EURO-D 12-item scale was used to measure depressive symptomatology. Results: Grip strength had a significant effect as a moderator in the association between cancer and depressive symptoms (male: B= -0.025, 95% CI = -0.04, -0.01; female: B = -0.02, 95% CI = -0.04, 0.00). Also, the grip strength moderation values are below 55.3kg for males and 39.4kg for females. Conclusions: Muscular fitness, as measured by grip strength, moderated the relationship between cancer and depressive symptomatology. This supports the theory that recovery programs could include physical activity, namely muscle-strengthening exercises, to prevent depression..
- Attempting and achieving weight loss and maintenancePublication . Rasquilha, Inês Chaparro Roque dos Santos Telo; Teixeira, Pedro Jorge do Amaral de MeloThis dissertation thought to provide a comprehensive understanding of weight loss- and maintenance-related processes among adults. Specifically, it comprises a set of five studies that were designed to i) determine the prevalence of weight control attempts and identify correlates, personal strategies, and motives underlying these attempts; ii) examine behavioral and psychological characteristics as predictors of successful weight loss and maintenance; and iii) examine psychological predictors of physical activity, a critical behavior for successful weight control. Studies I and II reflect the state of the art regarding the prevalence of weight control attempts among adults on a global and national level, respectively, showing that weight is a matter of concern to a significant portion of the adult population. Study III aimed for a more in-depth understanding of who succeeds in weight loss and maintenance, showing that there is a multiplicity of potentially successful behaviors and strategies. Subsequently, study IV showed that psychological factors underlying the weight control behaviors, such as positive body image and autonomous motivation, have a critical role in the process. Finally, study V confirmed that more autonomous forms of motivation are key for maintaining physical activity behavior over time in those trying to achieve weight loss and maintenance. The findings in this thesis highlight the need for, and importance of developing long-term individualized approaches for successful weight loss and maintenance, under the umbrella of motivation and related psychological factors. Future weight management initiatives would benefit from targeting combinations of evidence-based weight control strategies and the improvement of body image and motivation quality as potential precursors of those strategies, in order to promote long-term weight loss maintenance. Furthermore, it has become clear that weight control attempts are prevalent in Portugal and worldwide and consequently changes and trends should be monitored regularly in order to inform and advance future practice.
- Avaliação fisiológica e efeito do treino em canoístasPublication . Carrión Balbuena, Maria Helena; Alves, Francisco Jose Bessone Ferreira; Rama, Luís Manuel Pinto LopesFoi objetivo deste estudo verificar quais os indicadores fisiológicos que influenciam o desempenho em canoístas bem treinados do sexo masculino e analisar a variação da aptidão aeróbia e da aptidão anaeróbia em associação com o desempenho durante uma época desportiva. Os atletas avaliados neste estudo realizaram, num ergómetro de canoagem, uma prova progressiva máxima para determinação do V̇O2max, dos limiares ventilatórios e da velocidade aeróbia máxima (VAM) e potência aeróbia máxima (PAM); uma prova de intensidade constante à VAM e uma prova supramáxima a 110 % da VAM, para determinação do défice de oxigénio acumulado máximo (DOAM) e estudo da cinética do V̇O2 ( V̇O2k). Num primeiro estudo ( n = 17), foi validado um método alternativo de estimação do DOAM (DOAMalt) que, a partir da prova supramáxima a 110% da PAM, adiciona ao cálculo dos equivalentes energéticos de O2 da fase rápida da curva de recuperação do V̇O2, o valor dos equivalentes energéticos de O2 da cinética da lactatemia. Num segundo estudo (n = 13), verificámos que o desempenho num controlo na água de 1000m estava associado, quer a diferentes indicadores aeróbios máximos e submáximos, quer ao DOAM. Num terceiro estudo (n = 14), o desempenho num contrarrelógio de 1000m em ergómetro confirmou a dependência de indicadores aeróbios e anaeróbios, mas não se encontrou associação com os parâmetros da V̇O2k, quer na prova máxima, quer na supramáxima. Num quarto estudo (n = 9) verificou-se que, durante o macrociclo, os atletas ganharam aptidão aeróbia e anaeróbia após a fase de treino específico, tendo igualmente mostrado ganhos importantes na capacidade de desempenho avaliada pelo contrarrelógio de 1000m. Os parâmetros da V̇O2k mantiveram-se estáveis nos dois momentos de avaliação, não apresentando associação com o desempenho ou com outros indicadores aeróbios ou anaeróbios em ambos os momentos de avaliação. Este estudo comprovou a existência de um perfil marcadamente aeróbio em canoístas bem treinados, embora realce, igualmente, a existência de uma forte preparação conducente a adaptações musculares de carácter anaeróbio. Não se confirmou a existência de uma relação entre a V̇O2k e o desempenho, a aptidão aeróbia ou a anaeróbia, não mostrando este parâmetro variação ao longo do período de treino avaliado. No entanto, em 6 dos 9 canoístas avaliados encontrámos uma redução da componente lenta (variação média destes 6 casos de 38%), o que sugere alterações na dinâmica de recrutamento das unidades motoras, com aumento da capacidade oxidativa das fibras I solicitadas no exercício avaliado.
- Chronology of neuromuscular adaptations to strength training : the role of intermuscular coordinationPublication . Santos, Paulo Duarte Guia dos; Correia, Pedro Luís Camecelha de Pezarat; Vaz, João Pedro Casaca da RochaAs adaptações na coordenação intermuscular ainda não são completamente compreendidas, embora os mecanismos subjacentes possam representar um elevado potencial explicativo para os ganhos de força após um período de treino. O propósito desta dissertação é procurar entender quais as adaptações agudas, de curta-duração e de longa-duração ao treino de força na coordenação intermuscular. Especificamente, é apresentado um conjunto de 6 estudos que permitiram uma melhor compreensão sobre alterações na coordenação intermuscular no que diz respeito: i) às respostas agudas a estímulos fatigantes, ii) às adaptações de curta-duração após um período de treino de agachamento de 6 semanas, e iii) às adaptações de longa-duração relativas à comparação de grupos com diferente experiência de treino. O Estudo I procurou retratar o estado de arte relativamente aos diferentes mecanismos de controlo dos agonistas, sinergistas e antagonistas da ação muscular entre indivíduos destreinados e experientes. Durante contrações máximas foi observado, de forma geral, um maior input neural para os músculos agonistas, enquanto que durante contrações submáximas se verificou uma maior eficiência no recrutamento para os indivíduos experientes, que também apresentaram um diferente controlo dos músculos antagonistas assim como diferentes estratégias de controlo da coordenação global durante tarefas motoras complexas. O Estudo II retratou o estado de arte sobre as adaptações agudas na coordenação intermuscular após protocolos fatigantes, nomeadamente no que diz respeito à coerência intermuscular (IMC), permitindo inferir sobre a sincronização de unidades motoras em músculos diferentes. O recrutamento sincronizado de dois músculos em diferentes bandas de frequências permitiu uma melhor compreensão sobre as respostas centrais agudas para compensar a fadiga. O Estudo III foi protocolado de forma a possibilitar uma melhor compreensão sobre as adaptações agudas à fadiga durante contrações máximas em indivíduos com diferente experiência de treino. Os indivíduos experientes apresentaram valores superiores de força máxima e rápida, e de IMC na banda-beta entre o vasto externo e o reto femoral do quadricípite. Após a fadiga, diferentes respostas dos dois grupos foram observadas na taxa de ativação do reto femoral do quadricípite, representando a importância do controlo dos músculos biarticulares durante a produção de força em tarefas multiarticulares. Os Estudos IV-VI permitiram perceber as adaptações ao treino de força de curta-duração (6 semanas) e/ou de longa-duração na coordenação intermuscular em i) tarefas multiarticulares (leg-press) durante produção de força isométrica máxima, ii) extensões do joelho durante produção de força isométrica submáxima e iii) tarefas dinâmicas durante agachamentos com diferentes cargas. Alterações no recrutamento sincronizado após 6 semanas de treino de agachamento foram observadas entre músculos com diferentes funções durante contrações isométricas máximas e submáximas. Para além disso, 6 semanas de treino modificaram o perfil carga-velocidade de agachamento, com alterações paralelas na componente espacial do recrutamento sinérgico dos músculos do membro inferior. Por sua vez, indivíduos com experiência de longa-duração também apresentaram um diferente acoplamento entre músculos em tarefas isométricas máximas e submáximas quando comparados com indivíduos com experiência de curta-duração ou destreinados, sendo isso maioritariamente associado ao recrutamento do reto femoral do quadricípite. Os indivíduos mais experientes mostraram ainda adaptações nas componentes espaciais e temporais das sinergias neuromusculares durante agachamentos dinâmicos a diferentes intensidades. Esta tese apresenta resultados pertinentes no estudo das adaptações neurais na coordenação intermuscular, sugerindo adaptações específicas em fases cronologicamente distintas do processo de treino .
- Design and implementation of an exercise intervention focused on postural stability, and evaluation of its impact on gait pattern and functional fitness of the older populationPublication . Ramalho, Maria de Fátima Florentino Gonçalves; Carnide, Maria Filomena Araújo da Costa Cruz; Rocha, Rita Alexandra Prior Falhas SantosConceção e implementação de um programa de exercício físico com ênfase na estabilidade postural, e avaliação dos seus efeitos no padrão de marcha e funcionalidade duma população idosa O processo de envelhecimento conduz ao declínio da funcionalidade e contribui para a prevalência e aumento da incidência de quedas na população idosa. Este fator constitui-se como um importante problema de saúde pública, relevante para o atual contexto social Europeu. O exercício físico apresenta-se como um fator determinante na prevenção e redução de quedas na população idosa, através da melhoria das capacidades físicas e pela alteração do padrão de marcha, contribuindo para a adoção de estratégias de resposta às circunstâncias relacionadas com a ocorrência de quedas. Os objetivos do presente estudo focaram-se na conceção e avaliação dos efeitos de um programa de exercício de longa duração, centrado na estabilidade postural e na melhoria da eficiência mecânica da marcha que, por sua vez, possa contribuir para o aumento da funcionalidade e autonomia da pessoa idosa. Os objetivos específicos da presente tese foram: 1 - Desenvolver uma revisão narrativa de forma a analisar as evidências mais recentes sobre os seguintes tópicos: (1) importância da funcionalidade da marcha no processo de envelhecimento ativo; (2) que parâmetros biomecânicos da marcha podem ser utilizados como expressão de funcionalidade da população idosa; e (3) se as intervenções com atividade física têm um efeito positivo nos parâmetros biomecânicos da marcha; 2 - Desenvolver um protocolo de estudo de intervenção com base num programa de exercício para a comunidade, que objetive a melhoria dos parâmetros da marcha e da funcionalidade de uma população idosa; 3 - Desenvolver um estudo quasi-experimental de forma a avaliar os efeitos de uma intervenção periodizada com base num programa de exercício para a comunidade, na melhoria dos parâmetros da marcha e da funcionalidade de uma população idosa, por comparação a uma intervenção não-periodizada; Decorrente da revisão da literatura e construção de protocolo de intervenção, foi aplicada uma intervenção com base num programa de exercício físico. Foram utilizadas metodologias específicas de avaliação biomecânica do padrão de marcha, da ocorrência de quedas, do estado de saúde, e da aptidão funcional desta população. Destacamos a importância social da intervenção que se pretende implementar na comunidade.
- Developement of a job rotation algorithm to reduce occupational exposure in the automotive industryPublication . Assunção, Ana Raquel Martins; Carnide, Maria Filomena Araújo Costa Cruz; Veloso, António PrietoMusculoskeletal disorders remain the most reported occupational health workplace problem, affecting workers in all sectors of economic activity. The automotive industry is one of the industries with the highest prevalence of musculoskeletal symptoms, mainly due to the biomechanical risk factors that workers are exposed to during their workday. As this industry is one of the largest industrial forces that has contributed significantly to the growth of the global economy, it is crucial to develop efficient solutions that can be implemented in workplaces to improve working conditions by eliminating or reducing workers' exposure to the main biomechanical risk factors. The present dissertation attempts to understand the short-term relationships between biomechanical risk factors and musculoskeletal symptoms in the automotive assembly line, in addition to providing an organizational strategy that uses a mathematical approach to mitigate exposure to the same risk factors and reduce the prevalence/incidence of musculoskeletal disorders. Therefore, this dissertation presents three main investigations. The first study with a cohort design determines the short-term associations between biomechanical risk factors and musculoskeletal symptoms in the upper limbs and low back in an automotive plant. The workers were divided into low and high-risk groups for various risk factors. The results suggested that workers who were in the high-risk group had a higher likelihood to report adverse effects on their musculoskeletal symptoms at the end of a work week, particularly when exposed to certain risk factors, such as: posture for symptoms in the neck, right wrist, and left shoulder. The second study proposes a mathematical formulation based on a genetic algorithm that considers the assessment of biomechanical risk factors (EAWS) in the workplace, workers’ qualifications, and organizational aspects inherent in the operation of the production line. The algorithm is based on three criteria: enhancing diversity, ensuring team homogeneity, and reducing exposure to biomechanical risk factors. The success of the algorithm in meeting these criteria has been verified. In addition, when comparing the results of the algorithm with the results of manual job rotation plans (created by a team leader), it was shown that the mathematical solution was more efficient, not only in relation to the three criteria, but also in terms of time spent on this task. Finally, the third study complements the second by comparing the results obtained via the genetic algorithm with the data obtained through the rotation plans made by team leaders of several teams on the assembly lines. Therefore, the aim of this study was to XIX evaluate the effectiveness of the algorithm in creating job rotation plans compared to the manual process of team leaders in terms of diversity, homogeneity, exposure, shift working sequence quality and matrix quality. The job rotation plans of 7 teams (89 workers) from the assembly area were included in the sample. Exposure was the only criterion that did not show significant differences between the two methods, however, all variables at the individual level showed high values in the limits of agreement. The values of diversity, homogeneity, shift working sequence quality, and matrix quality of the job rotation plan generated by the genetic algorithm were on average higher than the values of the team leaders’ job rotation plan. These results show that implementing the genetic algorithm has a promising potential to create job rotation plans that reduce musculoskeletal disorders in the automotive industry and as well as to reduce the time associated with the team leader completing this task.
- Development and validation of a newtest for assessment of plantar-flexor muscle strength in older adultsPublication . André, Helô Isa Oliveira Viana; Veloso, António Prieto; Carnide, Maria Filomena Araújo Costa CruzBackground: The Calf-raise (CR) test is often used as a screening tool to assess anklemuscle functioning in clinical practice. Most studies restrict the administration of thistest to the young adult population and, of our knowledge, no study has evaluated thevalidityand reliability of this test with elderly people. Purpose: This study aimed to develop a new field test protocol with a standardizedmeasurement of strength and power in plantar flexor muscles targeted to functionallyindependent older adults, the calf-raise senior (CRS) test, and also evaluate its reliabilityand validity. Patients and methods: Forty-one subjects aged 65 years and older of bothsexesparticipated in five different cross-sectional studies: 1) pilot (n=12); 2) inter and intra-rater agreement (n=12); 3) construct (n=41); 4) criterion validity (n=33); and 5) test–retest reliability (n=41). Different motion parameters were compared in order to defineaspecifically designed protocol for seniors. Two raters evaluated each participant twice, and the results of the same individual were compared between raters and participantstoassess the interrater and intra-rater agreement. The validity and reliability studies involvedthree testing sessions that lasted 2 weeks, including a battery of functional fitness tests, CRS test in two occasions, accelerometry, and strength assessments in an sokineticdynamometer. Results: The CRS test presented an excellent test–retest reliability (intra-class correlationcoefficient [ICC] =0.90, standard error of measurement =2.0) and interrater reliability(ICC=0.93–0.96), as well as a good intra-rater agreement (ICC =0.79–0.84). Participantswithbetter results in the CRS test were younger and presented higher levels of physical activity and functional fitness. A significant association between test results andall strength parameters (isometric, r=0.87, r=0.75; isokinetic, r=0.86, r=0.74; and rateof orcedevelopment, r=0.77, r=0.59) was shown. Conclusion: This study was successful in demonstrating that the CRS test can meet thescientific criteria of validity and reliability. The test can be a good indicator of anklestrength in older adults and proved to discriminate significantly between individualswithimproved functionality and levels of physical activity.
- EEG Neurofeedback active athlete students : a methodological aproachPublication . Domingues, Christophe dos Santos; Pereira, José Henriques Fuentes GomesNeurofeedback training is a recent technique in sport and the protocols for its application in improving sports performance are based largely on existing protocols in non-athletic populations or there is still not enough robustness to be a valid protocol for safe replication. Based on this existing gap, several protocols increasing the individual alpha band were proposed to improve performance in active and athlete students. In addition to the protocols, it was also proposed to verify the behaviour of the other frequency bands during the increase of the individual alpha band training and if the effects persist after one month of the last training session. This dissertation is composed of four studies where three of these studies were based on the best protocols to be applied (the first one tried to understand if the effects of a protocol performed to a non-athletic population would be equal when submitted to an athletic population, the second one tried to figure out which was the best weekly training frequency to attain the best results, and the third one sought to understand whether the place where the collection were performed, conditioned the final results) and were submitted to peer-reviewed journals. The fourth study is divided into two minor studies (one that demonstrates the behaviour of the other frequency bands during training and another that tries to see if the effects persist after a month). The total sample was 74 subjects (60 active or athlete students and 14 sedentary). Each study was conducted on 30 active or athlete students over 5 to 8 weeks of a supervised neurofeedback training and were composed of an experimental group and a control group. Exception for study 1 where the sample consisted of 45 subjects (two experimental groups and a control group) and had a duration between 8 to10 weeks. There were 12 training sessions that consisted of 25 min. It was verified that the active or athlete students had different results from the sedentary when applied the same protocol (study 1), the most frequent protocol is the one that has better results compared to all the other protocols(study 2) and that to carry out sessions in an environment with intermittent noise or without noise does not present differences in active or athlete students (study 3). Additionally, it was verified that the less frequent bands tend to increase with the training and the opposite occurs with the most frequent bands. It was also concluded that individual alpha band training and performance testing persist after one month.
- EEG neurofeedback in active athlete students : a methodological approachPublication . Domingos, Christophe dos Santos; Pereira, José Henrique Fuentes GomesNeurofeedback training is a recent technique in sport and the protocols for its application in improving sports performance are based largely on existing protocols in non-athletic populations or there is still not enough robustness to be a valid protocol for safe replication. Based on this existing gap, several protocols increasing the individual alpha band were proposed to improve performance in active and athlete students. In addition to the protocols, it was also proposed to verify the behaviour of the other frequency bands during the increase of the individual alpha band training and if the effects persist after one month of the last training session. This dissertation is composed of four studies where three of these studies were based on the best protocols to be applied (the first one tried to understand if the effects of a protocol performed to a non-athletic population would be equal when submitted to an athletic population, the second one tried to figure out which was the best weekly training frequency to attain the best results, and the third one sought to understand whether the place where the collection were performed, conditioned the final results) and were submitted to peer-reviewed journals. The fourth study is divided into two minor studies (one that demonstrates the behaviour of the other frequency bands during training and another that tries to see if the effects persist after a month). The total sample was 74 subjects (60 active or athlete students and 14 sedentary). Each study was conducted on 30 active or athlete students over 5 to 8 weeks of a supervised neurofeedback training and were composed of an experimental group and a control group. Exception for study 1 where the sample consisted of 45 subjects (two experimental groups and a control group) and had a duration between 8 to10 weeks. There were 12 training sessions that consisted of 25 min. It was verified that the active or athlete students had different results from the sedentary when applied the same protocol (study 1), the most frequent protocol is the one that has better results compared to all the other protocols (study 2) and that to carry out sessions in an environment with intermittent noise or without noise does not present differences in active or athlete students (study 3). Additionally, it was verified that the less frequent bands tend to increase with the training and the opposite occurs with the most frequent bands. It was also concluded that individual alpha band training and performance testing persist after one month.