Reorganização do stiffness em indivíduos com Acidente Vascular Encefálico face à intervenção em fisioterapia. Repercussões no levantar e na marcha

Introdução: A organização estrutural e funcional do sistema nervoso face à organização dos diferentes tipos de input, no âmbito da intervenção em fisioterapia, pode potenciar um controlo postural para a regulação do stiffness e com repercussões na marcha e no levantar. Objetivo: Descrever o comportamento do stiffness da tibiotársica no movimento de dorsiflexão, no membro inferior ispi e contralesional, em indivíduos após Acidente Vascular Encefálico, face a uma intervenção em fisioterapia baseada num processo de raciocínio clínico. Pretendeu-se também observar as modificações ocorridas no âmbito da atividade electromiográfica dos flexores plantares, gastrocnémio medial e solear, durante a marcha e o levantar. Métodos: Foi implementado um programa de reabilitação em 4 indivíduos com sequelas de AVE por um período de 3 meses, tendo sido avaliados no momento inicial e final (M0 e M1). O torque e a amplitude articular da tibiotársica foi monitorizada, através do dinamómetro isocinético, durante o movimento passivo de dorsiflexão, e o nível de atividade eletromiográfica registado, através de electomiografia de superfície, no solear e gastrocnémio medial. Foram estudadas as fases de aceitação de carga no STS (fase II) e na marcha (sub-fase II). Resultados: Em todos os indivíduos em estudo verificou-se que o stiffness apresentou uma modificação no sentido da diminuição em todas as amplitudes em M1. O nível de atividade eletromiográfica teve comportamentos diferentes nos vários indivíduos. Conclusão: O stiffness apontou para uma diminuição nos indivíduos em estudo entre M0 e M1. Foram registadas modificações no nível de atividade eletromiográfica sem que seja possível identificar uma tendência clara entre os dois momentos para esta variável.

The Port as a “Non Consensual” Organisation: An IC Management Perspective

This paper addresses a gap in the literature concerning the management of Intellectual Capital (IC) in a port, which is a network of independent organizations that act together in the provision of a set of services. As far as the authors are aware, this type of empirical context has been unexplored when regarding knowledge management or IC creation/destruction. Indeed, most research in IC still focus on individual firms, despite the more recent interest placed on the analysis of macro-level units such as regions or nations. In this study, we conceptualise the port as meta-organisation, which has the generic goal of economic development, both for itself and for the region where it is located. It provides us with a unique environment due to its complexity as an “organisation” composed by several organisations, connected by interdependency relationships and, typically, with no formal hierarchy. Accordingly, actors’ interests are not always aligned and in some situations their individual interests can be misaligned with the collective goals of the port. Moreover, besides having their own interests, port actors also have different sources of influence and different levels of power, which can impact on the port’s Collective Intellectual Capital (CIC). Consequently, the management of the port’s CIC can be crucial in order for its goals to be met. With this paper we intend to discuss how the network coordinator (the port authority) manages those complex relations of interest and power in order to develop collaboration and mitigate conflict, thus creating collective intellectual assets or avoiding intellectual liabilities that may emerge for the whole port. The fact that we are studying complex and dynamic processes, about which there is a lack of understanding, in a complex and atypical organisation, leads us to consider the case study as an appropriate method of research. Evidence presented in this study results from preliminary interviews and also from document analysis. Findings suggest that alignment of interests and actions, at both dyadic and networking levels, is critical to develop a context of collaboration/cooperation within the port community and, accordingly, the port coordinator should make use of different types of power in order to ensure that port’s goals are achieved.

Immediate effects of hip mobilization with movement in patients with hip osteoarthritis: A randomised controlled trial

Background Mobilization with movement (MWM) has been shown to reduce pain, increase range of motion (ROM) and physical function in a range of different musculoskeletal disorders. Despite this evidence, there is a lack of studies evaluating the effects of MWM for hip osteoarthritis (OA). Objectives To determine the immediate effects of MWM on pain, ROM and functional performance in patients with hip OA. Design Randomized controlled trial with immediate follow-up. Method Forty consenting patients (mean age 78 ± 6 years; 54% female) satisfied the eligibility criteria. All participants completed the study. Two forms of MWM techniques (n = 20) or a simulated MWM (sham) (n = 20) were applied. Primary outcomes: pain recorded by numerical rating scale (NRS). Secondary outcomes: hip flexion and internal rotation ROM, and physical performance (timed up and go, sit to stand, and 40 m self placed walk test) were assessed before and after the intervention. Results For the MWM group, pain decreased by 2 points on the NRS, hip flexion increased by 12.2°, internal rotation by 4.4°, and functional tests were also improved with clinically relevant effects following the MWM. There were no significant changes in the sham group for any outcome variable. Conclusions Pain, hip flexion ROM and physical performance immediately improved after the application of MWM in elderly patients suffering hip OA. The observed immediate changes were of clinical relevance. Future studies are required to determine the long-term effects of this intervention.