Raul Oliveira

Prevalence of overweight and obesity in portuguese adolescents: Comparison of different anthropometric methods

Background: The recommended anthropometric methods to assess the weight status include body mass index (BMI), skinfold thickness, and waist circumference. However, these methods have advantages and disadvantages regarding the classification of overweight and obesity in adolescents. Aims: The study was to analyze the correlation between the measurements of BMI, skinfold thickness and waist circumference to assess overweight and obesity in Portuguese adolescents. Materials and Methods: A sample of 966 students of Portugal was used. Of them, 437 (45.2%) were males and 529 (54.8%) were females aged between 10 and 16 years. The evaluations included BMI calculation, skinfold thickness, and waist circumference measurements. Results: This study revealed a high prevalence of overweight and obesity with values ranging from 31.6%, 61.4%, and 41.1% according to the measurement of BMI, skinfold thickness, and waist circumference, respectively. The results found a high level of correlation between BMI and skinfold thickness (P < 0.001, r = 0.712), between BMI and waist circumference (P < 0.001, r = 0.884), and waist circumference and skinfold thickness (P < 0.001, r = 0.701). Conclusions: This study revealed a high prevalence of overweight and obesity in Portuguese adolescents using three different anthropometric methods, where the BMI showed the lowest values of prevalence of overweight and obesity and the skinfold thickness showed the highest values. The three anthropometric methods were highly correlated.

Reliability of the Active-Knee-Extension and Straight-Leg-Raise Tests in Subjects With Flexibility Deficits.

CONTEXT The active-knee-extension test (AKE) and the straight-leg-raise test (SLR) are widely used for flexibility assessment. A number of investigations have tested the reliability of these measures, especially the AKE. However, in most studies, the sample involved subjects with normal flexibility. In addition, few studies have determined the standard error of measurement (SEM) and minimal detectable difference (MDD), which can provide complementary and more clinically relevant information than the intraclass correlation coefficient (ICC) alone. OBJECTIVES This study aimed to determine the AKE and SLR intrarater (test-retest) reliability in subjects with flexibility deficits, as well as the correlation between the 2 tests. DESIGN Reliability study, test-retest design. SETTING Academic laboratory. SUBJECTS 102 recreationally active participants (48 male, 54 female) with no injury to the lower limbs and with flexibility deficits in the hamstrings muscle group. MAIN OUTCOMES Intrarater reliability was determined using the ICC, complemented by the SEM and MDD. MEASURES All participants performed, in each lower limb, 2 trials of the AKE and the SLR. RESULTS The ICC values found for AKE and SLR tests were, respectively, .87-.94 and .93-.97. The values for SEM were low for both tests (2.6-2.9° for AKE, 2.2-2.6° for SLR), as well as the calculated MDD (7-8° for AKE; 6-7° for SLR). A moderate to strong, and significant, correlation between AKE and SLR was determined for the dominant limb (r = .71) and the nondominant limb (r = .67). CONCLUSIONS These findings suggest that both AKE and SLR have excellent intrarater reliability. The SEMs and MDDs recorded are also very encouraging for the use of these tests in subjects with flexibility deficits.

Smart walker solutions for physical rehabilitation

In the last decade, the clinical reasoning in physical therapy has been to develop systems for physiotherapists to make clinical decisions rapidly, effectively and efficiently, in response to the increasingly complex needs of health and rehabilitation units [1]-[3]. Some studies show the importance of walking aids during rehabilitation from some diseases, and after surgery for arthroplasty in the elderly population [4], and in elderly patients with balance disorders, muscle weakness [5] or in people with diabetes mellitus [6]. Walkers are important devices that aid the rehabilitation process. The use of a walker is recommended for gait changes and imbalance due to various factors, such as surgery of the lower limbs or neurodegenerative changes, especially in the early recovery period [7].

Efficacy of suit therapy on functioning in children and adolescents with cerebral palsy: a systematic review and meta-analysis.

This systematic review and meta‐analysis presents an overview of the efficacy of suit therapy on functioning in children and adolescents with cerebral palsy (CP).

Association of obesity with chronic disease and musculoskeletal factors

INTRODUCTION overweight and obesity in adolescents are major public health problems with particular interest, because of their potential association with risk factors for development of diseases. The study aimed to determine the prevalence of overweight and obesity in adolescents in southern Portugal and investigate the association with risk factors for development of cardiovascular, respiratory and musculoskeletal diseases. METHODS the sample consisted of 966 adolescents aged 10 to 16 years. The calculation of body mass index (BMI), evaluation of blood glucose, total cholesterol and triglycerides, blood pressure, spirometry and application of low back pain (LBP) questionnaire were performed. RESULTS 178 (18.4%) adolescents were overweight and 52 (5.4%) obese. None of the variables revealed a statistically significant association with overweight and obesity. The presence of high blood pressure was observed in 200 (20.7%) individuals and hypertension in 158 (16.4%) adolescents. Overweight and obese adolescents are 2.3 times more likely to develop signs of pre-hypertension and hypertension. 559 (57.9%) students had restrictive respiratory disorders and 23 (2.4%) had obstructive disorders. Those who were overweight and obese had 0.64 probability of having restrictive respiratory disorders. CONCLUSION there was a high prevalence of overweight and obesity in Portuguese adolescents and these showed a statistically significant relationship with the development of pre-hypertension and hypertension, and restrictive respiratory disorders.

Trunk muscle activation, fatigue and low back pain in tennis players.

OBJECTIVES To analyze differences in trunk endurance time, fatigue and activation in tennis players with and without low back pain. DESIGN Observational study, cross-sectional design. METHODS Thirty-five tennis players completed an isometric trunk endurance protocol comprising four tasks (flexor, extensor and side bridge tests). LBP history was obtained through the Nordic Musculoskeletal Questionnaire. Endurance time was recorded for each test. Surface electromyographic activity was recorded bilaterally from rectus abdominis, external obliques, iliocostalis lumborum and longissimus thoracis. Average electromyographic amplitude and median frequency slopes during the tests were calculated and used as indicators of change in muscle activation and fatigue. RESULTS Asymptomatic players had greater flexor (p=0.004) and right side bridge (p=0.043) endurance times. These players produced a greater increase in avrEMG during the right side bridge test for the left ES-I (p=0.046) and right EO (p=0.008). Players with LBP in the last 7 days showed reduced activation of the left (p=0.014) and right (p=0.013) ES-I and left longissimus thoracis (ES-L, p=0.047) in the extensor test. In the left side bridge test there was a lower avrEMG slope of the left EO (p=0.024) and left RA MF slope (p=0.011). In the right side bridge test a lower left ES-I avrEMG slope was found (p=0.048). CONCLUSIONS Symptomatic players show lower activation of extensor muscles, less co-contraction patterns and less abdominal endurance. Tennis coaches and clinicians should consider these factors in their approach to players with LBP.

International Conference on Technology and Innovation in Sports, Health and Wellbeing (TISHW)

Introduction ObesiTIC is a project which aims to investigate innovative information and communication technologies resulting in a new ICT tool specifically designed for children and teenagers, in order to acquire healthy lifestyles, promoting physical activity and avoiding health and social problems associated with obesity and overweight. This is achieved through its co-design and validation with children and teens following a Living Lab approach through SPORTIS Living Lab, a European Network of Living Lab’s effective member. Objectives 1. To develop an innovative solution that would enable healthrelated behaviour changes, increase motivation, promote physical activity and reduce prolonged sedentary time in users, thanks to persuasive and ubiquitous computing techniques. 2. To be validated by SPORTIS Living Lab. Following SPORTIS aim to involve society in the innovation process, ObesiTIC will be validated by end-users (children and teenagers) combined with the development of the application and final product, in order to suit and respect all the needs and aspects of the users’ requirements. Methods A Living Lab methodology is implemented:

Designing Digital Tools for Physiotherapy

With advances in information and communication technologies (ICT), dramatic changes have been produced in physiotherapy provision. However, low adoption of the developed technologies calls attention for better theoretical model and methods for ICT design, which may fulfill the needs of physiotherapists and their patients. In this work we discuss the framework of designing ICT for physiotherapy based on some results obtained from the perspectives of physiotherapists and patients on electronic health records for physiotherapy. We underscore the importance of considering the context - the conditions in social and physical environment as well as end-users internal conditions to be in place - for a specific physiotherapy process.

Serious Games Based on Kinect and Leap Motion Controller for Upper Limbs Physical Rehabilitation

The design, implementation and tests of a system for assessment and monitoring movements, which includes the sensors from Kinect and Leap Motion Controller devices, are discussed in the present chapter. The advantages and some drawbacks of using the two devices for creating virtual environments for motor rehabilitation in which interaction of the user with virtual reality is made through natural user interfaces are described. The IoT architecture for rehabilitation environment, several serious games that our team have developed and the usability evaluation of the system are presented. Our insights, based on our research work during serious games development as well as on literature analysis, mainly focusing these on practicality of the developed serious games and on their acceptability for motor rehabilitation, are also included in the chapter. In the development of a system that includes IoT technology for movements tracking and progress evaluation during motor rehabilitation, the importance of user centered design is underscored.

Hamstring stiffness pattern during contraction in healthy individuals: analysis by ultrasound-based shear wave elastography

PurposeTo assess the stiffness of hamstring muscles during isometric contractions in healthy individuals, using ultrasound-based shear wave elastography to (1) determine the intra- and inter-day assessment repeatability, (2) characterize the stiffness of semitendinosus (ST) and biceps femoris long head (BFlh) along the contraction intensity, and (3) characterize stiffness distribution among the hamstring muscles and inter-limb symmetry.MethodsTwo experiments were conducted. In experiment I (n = 12), the intra-day repeatability in assessing the BFlh and ST stiffness were determined at intensities between 10–60% of maximal voluntary isometric contraction (MVIC) in a single session. In experiment II (n = 11), the stiffness of the hamstring muscles of both thighs was assessed at 20% of MVIC in the first session; and retested (for one randomly chosen thigh) in a second session. Isometric contraction of knee flexors was performed with the knee flexed at 30° and with the hip in a neutral position.ResultsModerate-to-very-high intra- and inter-day repeatability was found (ICC = 0.69–0.93). The BFlh/ST stiffness ratio increased with contraction intensity. At 20% of MVIC, the ST showed the highest stiffness among the hamstring muscles (p < 0.02), with no differences between the remaining hamstring muscles (p > 0.474). No differences were found between limbs (p = 0.12).ConclusionsThe stiffness distribution among the hamstring muscles during submaximal isometric contractions is heterogeneous, but symmetric between limbs, and changes depending on the contraction intensity. Shear wave elastography is a reliable tool to assess the stiffness of hamstring muscles during contraction.