Short- and medium-term effects of manual therapy on cervical active range of motion and pressure pain sensitivity in latent myofascial pain of the upper trapezius muscle: a randomized controlled trial

Objective: The purpose of this study was to investigate effects of different manual techniques on cervical ranges of 17 motion and pressure pain sensitivity in subjects with latent trigger point of the upper trapezius muscle. 18 Methods: One hundred seventeen volunteers, with a unilateral latent trigger point on upper trapezius due to computer 19 work, were randomly divided into 5 groups: ischemic compression (IC) group (n = 24); passive stretching group (n = 20 23); muscle energy technique group (n = 23); and 2 control groups, wait-and-see group (n = 25) and placebo group 21 (n = 22). Cervical spine range of movement was measured using a cervical range of motion instrument as well as 22 pressure pain sensitivity by means of an algometer and a visual analog scale. Outcomes were assessed pretreatment, 23 immediately, and 24 hours after the intervention and 1 week later by a blind researcher. A 4 × 5 mixed repeated- 24 measures analysis of variance was used to examine the effects of the intervention and Cohen d coefficient was used. 25 Results: A group-by-time interaction was detected in all variables (P b .01), except contralateral rotation. The 26 immediate effect sizes of the contralateral flexion, ipsilateral rotation, and pressure pain threshold were large for 3 27 experimental groups. Nevertheless, after 24 hours and 1 week, only IC group maintained the effect size. 28 Conclusions: Manual techniques on upper trapezius with latent trigger point seemed to improve the cervical range of 29 motion and the pressure pain sensitivity. These effects persist after 1 week in the IC group. (J Manipulative Physiol 301 Ther 2013;xx:1-10)

The immediate effects of atlanto-occipital joint manipulation and suboccipital muscle inhibition technique on active mouth opening and pressure pain sensitivity over latent myofascial trigger points in the masticatory muscles

DESIGN: A randomized controlled trial.OB JECTIVE: To investigate the immediate effects on pressure pain thresholds over latent trigger points (TrPs) in the masseter and temporalis muscles and active mouth opening following atlanto-occipital joint thrust manipulation or a soft tissue manual intervention targeted to the suboccipital muscles. BACKGROUND : Previous studies have described hypoalgesic effects of neck manipulative interventions over TrPs in the cervical musculature. There is a lack of studies analyzing these mechanisms over TrPs of muscles innervated by the trigeminal nerve. METHODS: One hundred twenty-two volunteers, 31 men and 91 women, between the ages of 18 and 30 years, with latent TrPs in the masseter muscle, were randomly divided into 3 groups: a manipulative group who received an atlanto-occipital joint thrust, a soft tissue group who received an inhibition technique over the suboccipital muscles, and a control group who did not receive an intervention. Pressure pain thresholds over latent TrPs in the masseter and temporalis muscles, and active mouth opening were assessed pretreatment and 2 minutes posttreatment by a blinded assessor. Mixed-model analyses of variance (ANOVA) were used to examine the effects of interventions on each outcome, with group as the between-subjects variable and time as the within-subjects variable. The primary analysis was the group-by-time interaction. RESULTS: The 2-by-3 mixed-model ANOVA revealed a significant group-by-time interaction for changes in pressure pain thresholds over masseter (P<.01) and temporalis (P =.003) muscle latent TrPs and also for active mouth opening (P<.001) in favor of the manipulative and soft tissue groups. Between-group effect sizes were small. CONCLUSIONS: The application of an atlanto-occipital thrust manipulation or soft tissue technique targeted to the suboccipital muscles led to an immediate increase in pressure pain thresholds over latent TrPs in the masseter and temporalis muscles and an increase in maximum active mouth opening. Nevertheless, the effects of both interventions were small and future studies are required to elucidate the clinical relevance of these changes. LEVEL OF EVIDENCE : Therapy, level 1b. J Orthop Sports Phys Ther 2010;40(5):310-317. doi:10.2519/jospt.2010.3257. KEYWORDSDS: cervical manipulation, muscle trigger points, neck, TMJ, upper cervical.

Force and pressure analysis during occasional loaded gait

O documento em anexo encontra-se na versão pre-print (versão inicial enviada para o editor).

Efeito de um programa de exercícios segundo Pilates em indivíduos com asma controlada – controlo motor vs. função ventilatória

Introdução: Embora existam estratégias para coordenar as funções postural e ventilatória numa situação normal, isto pode não ser verdade quando a necessidade para uma das funções está aumentada, como por exemplo em patologia respiratória (asma) ou no exercício físico, em que subsistem maiores necessidades ventilatórias. O método Pilates, que foca a relação entre o corpo e a disciplina mental, visa prosperar a saúde e o bem-estar pelo enfatizar da boa postura, do alinhamento corporal e da coordenação da ventilação com o movimento. Objectivo: Comparar características de controlo motor e parâmetros ventilatórios em asmáticos controlados e indivíduos sem patologia, e verificar o efeito de um programa de exercícios segundo Pilates nesses outcomes em indivíduos com asma controlada. Métodos: Estudo quasi-experimental, com uma amostra constituída por 21 estudantes voluntários, 7 pertencentes ao “grupo sem patologia”, 7 ao “grupo controlo asmático” e 7 ao “grupo experimental asmático”. Para avaliação do timing de ativação e do padrão de recrutamento muscular no movimento rápido do membro superior foi utilizada eletromiografia de superfície do Diafragma, Eretor da Coluna, Multífidos, Oblíquo Externo, Reto Anterior e Transverso Abdominal/Oblíquo Interno. Foram também avaliados parâmetros de função ventilatória: a percentagem de volume expiratório forçado no primeiro segundo do previsto, o débito expiratório máximo instantâneo, a ventilação máxima voluntária, a pressão inspiratória máxima e a pressão expiratória máxima. As avaliações decorreram antes e após 8 semanas da aplicação de um programa de exercícios segundo Pilates no grupo experimental asmático, com exceção do grupo sem patologia que realizou apenas o primeiro momento de avaliação. Resultados: O grupo controlo asmático apresentou um timing de ativação significativamente maior do Transverso Abdominal/Oblíquo Interno e do Diafragma, em relação ao grupo sem patologia. Nos parâmetros ventilatórios, o grupo controlo asmático apresentou menores valores de percentagem de volume expiratório no primeiro segundo do previsto, de débito expiratório máximo instantâneo e de pressão expiratória máxima. Após a realização do programa de exercícios segundo Pilates verificaram-se alterações significativas no timing de activação do Eretor da Coluna, do Multífidos, do Transverso/Oblíquo Interno e do Diafragma, tendo ambos diminuído no grupo experimental asmático. Ainda, o grupo experimental asmático, em relação aos parâmetros ventilatórios, apresentou diferenças significativas no débito expiratório máximo instantâneo, na ventilação máxima voluntária e na pressão expiratória máxima, tendo ambos aumentado estes valores. Conclusão: Os asmáticos controlados parecem possuir características de controlo motor, especificamente no timing de ativação, e valores de parâmetros ventilatórios diferentes em comparação aos indivíduos sem patologia. O programa de exercícios segundo Pilates, implementado no grupo experimental asmático, parece ter influenciado positivamente esses outcomes.

Desenvolvimento de um pedómetro para telemóvel

Esta tese descreve o desenvolvimento do hardware e do software de um sistema com a capacidade de reconhecer o número de passos que uma pessoa efectua durante uma actividade física. O sistema consiste num acelerómetro controlado por um microcontrolador, que comunica com um dispositivo móvel através de Bluetooth. De modo a realizar o sistema foi necessário analisar uma vasta bibliografia, para conhecer o estado da arte desta tecnologia, entender o princípio de funcionamento do protocolo Bluetooth e os conceitos biomecânicos por detrás da marcha humana. A proposta deste trabalho apresentava como elemento diferenciador do estado da arte o uso de um acelerómetro em conjunto com sensores de pressão. Com a conjugação destes sensores pretendia-se aumentar a precisão de um equipamento que normalmente não é reconhecido por essa característica. Contudo, a indisponibilidade dos sensores de pressão levou a que o sistema só fosse constituído pelo acelerómetro. Embora, o sistema foi projectado considerando que os sensores de pressão serão incluídos num futuro desenvolvimento. Neste trabalho foram desenvolvidos dois algoritmos para detectar os passos que uma pessoa executa, com pé onde é colocado o sensor, quando caminha ou corre. Num dos testes realizados o algoritmo da “aceleração composta” detectou 84% dos passos, enquanto o algoritmo da “aceleração simples”detectou 99%. A plataforma para a interface gráfica pretendia-se que fosse um telemóvel, contudo não foi possível obter um telemóvel que suporta-se o perfil SPP (Serial Port Profile), necessário para a comunicação com o módulo Bluetooth usado. A solução passou por usar como plataforma um computador portátil com Bluetooth, para o qual foi desenvolvido a aplicação “Pedómetro ISEP” em Visual Basic. O “Pedómetro ISEP” apresenta várias funcionalidades, entre elas destaca-se o cálculo da distância percorrida, da velocidade, e das calorias consumidas, bem como, o registo desses valores em tabelas e da possibilidade de desenhar os gráficos representativos do progresso do utilizador.

Abordagem prática para execução de taludes em obras rodoviárias com recurso a pré‐corte

Este trabalho é realizado no domínio das obras de engenharia, área onde o desmonte de rocha com recurso a explosivos em obras rodoviárias é uma actividade específica e consistiu no acompanhamento e execução de três obras rodoviárias de média e grande dimensão. A necessidade de executar escavações, recorrendo a técnicas de desmonte cuidadoso de contorno, onde o plano de corte do talude final deve obedecer a requisitos de localização, alinhamento, inclinação, estabilidade e também estéticos, acrescendo a isto a necessidade de optimizar os meios envolvidos, obriga a que esta actividade seja encarada de uma forma sistematizada, visando o racional aproveitamento de recursos. A execução desta actividade requer conhecimentos no domínio das técnicas de desmonte de contorno, dos explosivos, do mecanismo de rotura de rochas, da operação de perfuração e da geomecânica dos maciços. A abordagem deste trabalho incide sobre a técnica denominada de pré‐corte e tem como objectivo encontrar uma equação característica que permita relacionar diferentes parâmetros envolvidos nesta actividade. Este objectivo é alcançado recorrendo à correlação entre equações relativas à pressão de detonação, à pressão no furo e ao espaçamento entre furos consecutivos, desenvolvidas por outros autores. Desta forma obteve‐se uma equação que relaciona parâmetros relativos ao maciço rochoso (resistência à tracção), ao explosivo (velocidade de detonação e densidade) e ao diagrama de fogo (concentração de carga – volume de explosivo e comprimento do furo – volume do furo). A comparação entre os valores destes parâmetros obtidos na produção e os obtidos com recurso à equação característica permite concluir que a sua aplicação para execução de futuras obras possibilita uma optimização dos meios envolvidos.

Phonological and articulation treatment approaches in Portuguese children with speech and language impairments: a randomized controlled intervention study

Background: In Portugal, the routine clinical practice of speech and language therapists (SLTs) in treating children with all types of speech sound disorder (SSD) continues to be articulation therapy (AT). There is limited use of phonological therapy (PT) or phonological awareness training in Portugal. Additionally, at an international level there is a focus on collecting information on and differentiating between the effectiveness of PT and AT for children with different types of phonologically based SSD, as well as on the role of phonological awareness in remediating SSD. It is important to collect more evidence for the most effective and efficient type of intervention approach for different SSDs and for these data to be collected from diverse linguistic and cultural perspectives. Aims: To evaluate the effectiveness of a PT and AT approach for treatment of 14 Portuguese children, aged 4.0–6.7 years, with a phonologically based SSD. Methods & Procedures: The children were randomly assigned to one of the two treatment approaches (seven children in each group). All children were treated by the same SLT, blind to the aims of the study, over three blocks of a total of 25 weekly sessions of intervention. Outcome measures of phonological ability (percentage of consonants correct (PCC), percentage occurrence of different phonological processes and phonetic inventory) were taken before and after intervention. A qualitative assessment of intervention effectiveness from the perspective of the parents of participants was included. Outcomes & Results: Both treatments were effective in improving the participants’ speech, with the children receiving PT showing a more significant improvement in PCC score than those receiving the AT. Children in the PT group also showed greater generalization to untreated words than those receiving AT. Parents reported both intervention approaches to be as effective in improving their children’s speech. Conclusions & Implications: The PT (combination of expressive phonological tasks, phonological awareness, listening and discrimination activities) proved to be an effective integrated method of improving phonological SSD in children. These findings provide some evidence for Portuguese SLTs to employ PT with children with phonologically based SSD

Growth pressure dependence of Cu2ZnSnSe4 properties

In this work, we show a set of growth conditions, for the two step process, with which the growth of CZTSe is successful and reproducible. The properties of the best CTZSe thin films grown by this method were examined by SEM/EDS, XRD, Raman scattering, AFM/EFM, transmittance and reflectance measurements, photoluminescence (PL) measurements and hot point probe. A broad emission band was observed in the photoluminescence spectrum of the CZTSe thin film. The band gap energy was estimated to be around 1.05 eV at room temperature, using the transmittance and reflectance data, and CZTSe samples show p-type conductivity with the hot point probe. The different characterization techniques show that we could grow single phase CZTSe thin films with our optimized process conditions.

Influence of selenization pressure on the growth of Cu2ZnSnSe4 films from stacked metallic layers

Cu2ZnSnSe4 (CZTSe) is a p-type semiconductor with a high absorption coefficient, 104 to 105 cm-1, and is being seen as a possible replacement for Cu(In,Ga)Se2 in thin film solar cells. Yet, there are some fundamental properties of CZTSe that are not well known, one of them is its band gap. In order to resolve its correct value it is necessary to improve the growth conditions to ensure that single phase crystalline thin films are obtained. One of the problems encountered when growing CZTSe is the loss of Sn through evaporation of SnSe. Stoichiometric films are then difficult to obtain and usually there are other phases present. One possible way to overcome this problem is to increase the pressure of growth of CZTSe. This can be done by introducing an atmosphere of an inert gas like Ar or N2. In this work we report the results of morphological, structural and optical studies of the properties of CZTSe thin films grown by selenization of DC magnetron sputtered metallic layers under different Ar pressures. The films are analysed by SEM/EDS, Raman scattering and XRD.

Ground reaction forces and plantar pressure distribution during occasional loaded gait

This study compared the ground reaction forces (GRF) and plantar pressures between unloaded and occasional loaded gait. The GRF and plantar pressures of 60 participants were recorded during unloaded gait and occasional loaded gait (wearing a backpack that raised their body mass index to 30); this load criterion was adopted because is considered potentially harmful in permanent loaded gait (obese people). The results indicate an overall increase (absolute values) of GRF and plantar pressures during occasional loaded gait (p < 0.05); also, higher normalized (by total weight) values in the medial midfoot and toes, and lower values in the lateral rearfoot region were observed. During loaded gait the magnitude of the vertical GRF (impact and thrust maximum) decreased and the shear forces increased more than did the proportion of the load (normalized values). These data suggest a different pattern of GRF and plantar pressure distribution during occasional loaded compared to unloaded gait.

Distributed computer-controlled systems: the DEAR-COTS approach

This paper proposes a new architecture targeting real-time and reliable Distributed Computer-Controlled Systems (DCCS). This architecture provides a structured approach for the integration of soft and/or hard real-time applications with Commercial O -The-Shelf (COTS) components. The Timely Computing Base model is used as the reference model to deal with the heterogeneity of system components with respect to guaranteeing the timeliness of applications. The reliability and availability requirements of hard real-time applications are guaranteed by a software-based fault-tolerance approach.

Supporting real-time distributed computer-controlled systems with multi-hop P-NET networks

Fieldbus communication networks aim to interconnect sensors, actuators and controllers within process control applications. Therefore, they constitute the foundation upon which real-time distributed computer-controlled systems can be implemented. P-NET is a fieldbus communication standard, which uses a virtual token-passing medium-access-control mechanism. In this paper pre-run-time schedulability conditions for supporting real-time traffic with P-NET networks are established. Essentially, formulae to evaluate the upper bound of the end-to-end communication delay in P-NET messages are provided. Using this upper bound, a feasibility test is then provided to check the timing requirements for accessing remote process variables. This paper also shows how P-NET network segmentation can significantly reduce the end-to-end communication delays for messages with stringent timing requirements.

An architecture for reliable distributed computer-controlled systems

In Distributed Computer-Controlled Systems (DCCS), both real-time and reliability requirements are of major concern. Architectures for DCCS must be designed considering the integration of processing nodes and the underlying communication infrastructure. Such integration must be provided by appropriate software support services. In this paper, an architecture for DCCS is presented, its structure is outlined, and the services provided by the support software are presented. These are considered in order to guarantee the real-time and reliability requirements placed by current and future systems.

A communication support for real-time distributed computer controlled systems

In this paper, we analyse the ability of P-NET [1] fieldbus to cope with the timing requirements of a Distributed Computer Control System (DCCS), where messages associated to discrete events should be made available within a maximum bound time. The main objective of this work is to analyse how the network access and queueing delays, imposed by P-NET’s virtual token Medium Access Control (MAC) mechanism, affect the realtime behaviour of the supported DCCS.

JamLab: augmenting sensornet testbeds with realistic and controlled interference generation

Radio interference drastically affects the performance of sensor-net communications, leading to packet loss and reduced energy-efficiency. As an increasing number of wireless devices operates on the same ISM frequencies, there is a strong need for understanding and debugging the performance of existing sensornet protocols under interference. Doing so requires a low-cost flexible testbed infrastructure that allows the repeatable generation of a wide range of interference patterns. Unfortunately, to date, existing sensornet testbeds lack such capabilities, and do not permit to study easily the coexistence problems between devices sharing the same frequencies. This paper addresses the current lack of such an infrastructure by using off-the-shelf sensor motes to record and playback interference patterns as well as to generate customizable and repeat-able interference in real-time. We propose and develop JamLab: a low-cost infrastructure to augment existing sensornet testbeds with accurate interference generation while limiting the overhead to a simple upload of the appropriate software. We explain how we tackle the hardware limitations and get an accurate measurement and regeneration of interference, and we experimentally evaluate the accuracy of JamLab with respect to time, space, and intensity. We further use JamLab to characterize the impact of interference on sensornet MAC protocols.