Browsing by Author "Carvalho, Andreia"
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- Construct validity of markerless three-dimensional gait biomechanics in healthy older adultsPublication . Carvalho, Andreia; Vanrenterghem, Jos; Cabral, Sílvia; d'Assunção, Ana M.; Carnide, Filomena; Veloso, António P.; Moniz-Pereira, VeraBackground and aim: Gait changes due to aging can result in functional limitations and a higher risk of falls, with older adults showing alterations in joint angles and moments. Marker-based gait analysis is not widely used in clinical settings due to its complexity and discomfort, especially in older adults. Recent advances in markerless motion capture, such as Theia3D, offer a promising alternative. This study aims to assess the construct validity of a markerless motion capture system for gait analysis in healthy older adults. Methods: A cross-sectional study included 30 healthy community-dwelling older adults. Gait data were collected using marker-based and markerless motion capture systems in randomized order, with participants wearing tight-fitting minimal clothes plus 46 reflective markers attached, or their usual clothes, respectively. Joint kinematics (including range of motion) and kinetics were analyzed, and correlations between methods (Rxy) were assessed. Bland-Altman analysis was used to measure agreement. Root-mean-square differences (RMSD) were computed. Acceptable thresholds were set at ≤ 5º for kinematics and at ≤ 10 % of signal amplitude for kinetics. Results: Strong correlations (Rxy≥0.7) were found between the systems for sagittal plane kinematics (except for the pelvis), particularly for knee and ankle joints. A low agreement was detected in sagittal plane hip and pelvis kinematics, along with RMSD exceeding 5º. Weaker correlations and poor agreement were observed for transverse and frontal plane motions. Overall, strong correlations were found for kinetics, except for the joint ankle inversion-eversion moment, and poor agreement for the frontal and transverse planes. Conclusion: Overall, markerless motion capture demonstrated good construct validity for measuring sagittal plane gait lower-limb gait kinematics (excluding pelvis) and kinetics in healthy older adults. However, considering the agreement between methods and the results for the other movement planes, further validation is required before markerless and marker-based systems can be used interchangeably in gait assessments.
- Efeitos do fortalecimento do membro superior, no equilíbrio e na marcha, em idosos pós-acidente vascular cerebral: revisão sistemáticaPublication . Figueiredo, Vânia; Carvalho, Andreia; Mota, PatríciaIntrodução: A ocorrência de acidente vascular cerebral (AVC) tem uma prevalência elevada na população mais velha, sendo que 30% a 60% destes indivíduos apresentam limitações ao nível do membro superior (MS). A diminuição da amplitude e alteração dos membros superiores podem potenciar alterações ao nível do padrão de marcha, risco de queda e equilíbrio. Estudos referem que fortalecimento dos MS pode melhorar o padrão de marcha e a capacidade funcional em utentes com sequelas de AVC. O nosso objetivo foi determinar o efeito do fortalecimento do MS, na marcha, quedas e equilíbrio em pé, em adultos com 65 ou mais anos, com diagnóstico de AVC. Métodos: Pesquisaram-se publicações nas bases de dados PubMed, Cochrane Library e ScienceDirect, com inclusão de ensaios clínicos randomizados, sem limitação de data, que avaliavam o efeito do fortalecimento do MS, na marcha, quedas e equilíbrio, em pessoas com 65 anos ou mais, pós-AVC. Dois revisores, de forma cega, seleccionaram os artigos para inclusão, havendo em caso de discordância um terceiro revisor. Excluíram-se protocolos, apresentações e artigos com pontuação inferior a 5 na escala PEDro. Resultados: Foram incluídos 6 estudos, com um total de 468 participantes. O fortalecimento do MS interfere positivamente na capacidade de marcha, nomeadamente ao nível da velocidade, é eficaz na prevenção de quedas, promove melhorias no equilíbrio comparativamente ao início da intervenção. Conclusão: A inclusão do fortalecimento do MS interfere positivamente na melhoria da velocidade de marcha e equilíbrio, podendo condicionar a diminuição do risco de queda nesta população.
- Markerless three-dimensional gait analysis in healthy older adults: test–retest reliability and measurement errorPublication . Carvalho, Andreia; Vanrenterghem, Jos; Cabral, Sílvia; Assunção, Ana; Fernandes, Rita; Veloso, António P.; Moniz-Pereira, VeraIn older adults, gait analysis may detect changes that signal early disease states, yet challenges in biomechanical screening limit widespread use in clinical or community settings. Recently, a markerless method from multi-camera video data has become accessible, making screenings less challenging. This study evaluated the test-retest reliability and measurement error of markerless gait kinematics and kinetics in healthy older adults. Twenty-nine healthy older adults performed gait analysis on two occasions, at preferred walking speed, using their everyday clothes. Lower limb angles and moments were averaged from 8 gait cycles. Integrated pointwise indices [Intraclass Correlation Coefficient (ICCA,K) and Standard Error of Measurement (SEM)] were calculated for curve data, as well as ICCA,K, and SEM [95 % confidence intervals] for selected peaks. Generally, kinematic ICCs were good (>0.75) and reasonably stable throughout the gait cycle, except for the hip kinematics during the swing phase in the sagittal plane and pelvis tilt and rotation. The integrated and peaks SEM were <2.4°. The reliability of kinetics was similar (ICC>0.75), except for the transverse hip moment and abduction peak, fluctuating more during the swing than through the stance phase. SEM were < 0.07Nm/Kg. In conclusion, these results showed good overall test-retest reliability for markerless gait kinematics and kinetics for the hip, knee, and ankle joints, moderate for the pelvis angles, and error levels of ≤5°, and SEM%≤5% for the sagittal plane. This supports this method's use in assessing gait in healthy older adults, including kinetics, for which reliability data from markerless systems is difficult to find reported.
- Prevalence of levator ani muscle injuries in primiparous women after delivery and their influence on pelvic floor disorders: systematic reviewPublication . Pessoa, Patrícia; Carvalho, Andreia; Mota, PatríciaBackground: Studies show a significant association between the first vaginal delivery and injuries of the levator ani muscle (LAM), which can cause pelvic floor disorders (PFDs). Objectives: This study aims to identify the prevalence of short and long-term LAM injuries after vaginal delivery in primiparous women and its influence on PFDs. Method: A systematic review was conducted according to the PRISMA methodology. The databases used were Pubmed, Cochrane, and PEDro. The quality assessment of the evidence was carried out using the Critical Appraisal Skills Programme (CASP). Both the selection of studies and their evaluation were done by two researchers and a third reviewer in cases of disagreement. Results: From the search, 57 articles were gathered, and 19 were included to match the eligibility criteria. The prevalence of avulsion of the LAM was found in association with vaginal delivery between 13% and 28% ≤ 1 year after delivery and between 16% and 29% > 1 year after delivery. Ballooning was detected between 20% and 37% ≤ 1 year, and 33% of women > 1 year after delivery, appearing to be more common when compared to avulsion. Pelvic organ prolapse (POP) was considered the most common disorder associated with injuries of the LAM, and there seems to be some connection with sexual dysfunction. Conclusion: Avulsion of the LAM and ballooning of the hiatal area have a high prevalence in primiparous women after vaginal delivery and have a strong direct relation to the development of POP.
- Ru-II(p‑cymene) compounds as effective and selective anticancer candidates with no toxicity in vivoPublication . Lenis-Rojas, Oscar A.; Robalo, Maria Paula; Tomaz, Ana Isabel; Carvalho, Andreia; Fernandes, Alexandra; Marques, Fernanda; FOLGUEIRA, MONICA; Yáñez, Julián; Vázquez-García, Digna; López-Torres, Margarita; Fernandez, Alberto; Fernandez, Jesus J.Ruthenium(II) complexes are currently considered a viable alternative to the widely used platinum complexes as efficient anticancer agents. We herein present the synthesis and characterization of half-sandwich ruthenium compounds with the general formula [Ru(p-cymene)(L-N,N)Cl][CF3SO3] (L = 3,6-di-2-pyridyl-1,2,4,5-tetrazine (1) 6,7-dimethyl-2,3-bis(pyridin-2-yl)quinoxaline (2)), which have been synthesized by substitution reactions from the precursor dimer [Ru(p-cymene)(Cl)(μ-Cl)]2 and were characterized by elemental analysis, mass spectrometry, 1H NMR, UV–vis, and IR spectroscopy, conductivity measurements, and cyclic voltammetry. The molecular structure for complex 2 was determined by single-crystal X-ray diffraction. The cytotoxic activity of these compounds was evaluated against human tumor cells, namely ovarian carcinoma A2780 and breast MCF7 and MDAMB231 adenocarcinoma cells, and against normal primary fibroblasts. Whereas the cytotoxic activity of 1 is moderate, IC50 values found for 2 are among the lowest previously reported for Ru(p-cymene) complexes. Both compounds present no cytotoxic effect in normal human primary fibroblasts when they are used at the IC50 concentration in A2780 and MCF7 cancer cells. Their antiproliferative capacity is associated with a combined mechanism of apoptosis and autophagy. A strong interaction with DNA was observed for both with a binding constant value of the same magnitude as that of the classical intercalator [Ru(phen)2(dppz)]2+. Both complexes bind to human serum albumin with moderate to strong affinity, with conditional binding constants (log Kb) of 4.88 for complex 2 and 5.18 for complex 1 in 2% DMSO/10 mM Hepes pH7.0 medium. The acute toxicity was evaluated in zebrafish embryo model using the fish embryo acute toxicity test (FET). Remarkably, our results show that compounds 1 and 2 are not toxic/lethal even at extremely high concentrations. The novel compounds reported herein are highly relevant antitumor metallodrug candidates, given their in vitro cytotoxicity toward cancer cells and the lack of in vivo toxicity.