A forma como as pessoas agarram os objetos, as suas implicações na saúde e na realização das atividades e tarefas do dia-a-dia e as limitações de cada preensão são importantes para a medicina, reabilitação, design de produtos, de entre muitas outras áreas. A força de preensão fornece informações importantes sobre a funcionalidade do indivíduo e ajuda na monitorização e implementação de estratégias de manutenção ou recuperação da força muscular global. O objetivo principal deste estudo é alargar a avaliação da força de preensão da mão, ampliando seu espectro para outras configurações de preensão, usadas em atividades do dia-a-dia, relacionando-as com a sua utilização funcional. Tendo como base a nova Taxonomia das Preensões, resultante de um projeto financiado pela Comissão Europeia, implementaremos três estudos. Inicialmente propomos analisar as caracteristicas das preensões da nova taxonomia e verificar se é possível serem avaliadas com o Dinamômetro G200 e o Pinchmetro P200 do Biometrics® E-Link. Seguidamente verificaremos essa possibilidade, efetuando a avaliação das preensões identificadas, em participantes saudáveis. Num segundo estudo, avaliaremos a força de preensão e pinça, nas configurações anteriormente identificadas, em participantes com patologia da mão. Os participantes serão recrutados, por conveniência, em Hospital e Clínica de Reabilitação, na região de Lisboa, Portugal. Adultos com idades compreendidas entre os 20 e os 60 anos, sem patologia da mão, integram o grupo de control. O grupo de estudo terá as mesmas caracteristicas e patologia musculoesquelética da mão ou neurológica periférica. São critérios de exclusão doenças degenerativas ou neurológicas centrais e estado de gravidez em ambos os grupos. Por fim, implementamos um estudo correlacional para verificar a possibilidade de estabelecer um quadro de valores de referência de força de preensão com diretrizes para avaliação de cada uma das preensões, os valores de força e as tarefas nas quais as preensões são executadas no dia-a-dia. O estudo encontra-se em fase de recolha de dados. Identificámos 14 preensões de mão passíveis de serem avaliadas com o Dinamômetro G200 e o Pinchmeter P200 do Biometrics® E-Link. Destas, nove são avaliadas com recurso à dinamometria sendo preensões de carácter global e cinco com recurso ao Pinchmeter pois são pinças.

Objectives: The purpose of this study was to compare shoulder external rotation range of motion (ROM) during the hand-behind-neck (HBN) test and a standard shoulder external rotation test and to describe the 3-dimensional scapular motion during the HBN test. Methods: An electromagnetic tracking device was used to assess the dominant shoulder of 14 healthy participants while performing active full ROM in a standard shoulder external rotation test in an elevated position (EREP) and in the HBN test. The humeral and scapular 3-dimensional positions at the end of EREP and HBN were compared using a paired-sample t test. A correlation analysis was performed between humeral and scapular angles to assess the contribution of scapular motion to the full shoulder ROM during the HBN test. Results: No significant differences were found between the HBN test and the EREP at the end-range of the glenohumeral external rotation (HBN: 15.6° ± 6.3° vs EREP: 23.4° ± 4.7°; P = .08) and on scapular internal-external rotation (HBN test: 21.2° ± 6.3° vs EREP: 15.6° ± 1.8°; P = .23). Significant differences were found in scapular upward rotation (HBN: 21.2° ± 6.3° vs EREP: 15.6° ± 1.8°; P b .01) and scapular spinal tilt (HBN: − 0.4° ± 2.3° vs EREP: 8.1° ± 2.1°; P b .01). There was a positive correlation between the humeral angles and scapular internal and posterior spinal tilt angles with the HBN test. Conclusions: The results of the present study showed that, in young asymptomatic participants with no known shoulder pathology, the end-range of shoulder rotation was similar in the HBN test and in a standard shoulder rotation test. During the HBN test, the scapula assumed a more internal and anterior spinal tilted position at the end-range of active shoulder external rotation. These results suggest that the HBN test may be used to assess the end-range of glenohumeral external rotation.

Volleyball players develop shoulder sports-related adaptations due to repetitive overhead motions. It is essential to differentiate between these sports-related adaptations and pathological patterns in clinical assessments, particularly on scapular resting posture and scapulohumeral rhythm. Using an electromagnetic tracking system, the 3D shoulder kinematics of 30 male elite asymptomatic volleyball players and a matching control group were recorded at rest and in eight humeral elevation positions, in 15-degree increments from 15 to 120 degrees. The results indicated that the dominant scapular resting posture of the volleyball group was more anteriorly tilted than the control group (Volleyball: mean = −12.02°, STD = 4.16°; Control: mean = −7.45°, STD = 5.42°; Mean difference = 4.57°; STD = 6.85°; CI95% = 2.1° to 7.1°). The scapulohumeral rhythm in the volleyball group showed greater scapular internal rotation (Volleyball: mean = 41.60°, STD = 9.14°; Control: mean = 35.60°, STD = 6.03°; mean difference = 6.02°, STD = 1.47°; CI95% = 4.80° to 7.25°) and anterior tilt (Volleyball: mean = −9.10°, STD = 5.87°; mean = −2.3°, STD = 9.18°; mean difference = 6.88°, STD = 0.66°; CI95% = 6.34° to 7.43°). These findings suggest that volleyball players have developed a sports-related scapular adaptive pattern. This information may be valuable for clinical assessment and rehabilitation planning in injured volleyball players and may aid in the decision-making process for determining a safe return-to-play after a shoulder injury.

Activities are done using the hands. With the hand’s grasps are performed on objects, grabbing, manipulating, and using them. There are 33 grasps, according to the recent European Grasp Taxonomy. Grasps are the way objects are grabbed, in a secure mode, independent of the position of the wrist, forearm or arm. To better understand the use of the hands and the grasps in the daily activities and relate it with the difficulties identified by the patients, when they have a hand pathology, we need to know in which tasks are they performed. Using a Delphi Panel, composed by 20 Occupational Therapists also Hand Therapist, considerer experts in this area, we collect data, in two rounds. For each one of the 33 grasps was created a question, with some characteristics of the grasp, such as the number of used fingers and the diameter of the grasped object. Experts were asked to identify the tasks where the grasps are used. An image of the grasp was also presented to exemplify. After the language uniformization, the elimination of tasks that doesn’t complied with the grasp’s characteristics and unification of very similar tasks, there were identify tasks used in work, leisure, and self-care activities. For each one of the grasps there were identified at least 13 tasks. It will be easier for therapists to relate the difficulties in the use of the grasps with the performance of activities in daily living.

A capacidade para localizar objetos fixos ou em movimento no espaço tridimensional depende da função visual. No indivíduo cego, as modalidades sensoriais remanescentes, nomeadamente a audição, poderiam compensar a visão na localização espacial. O objetivo deste estudo foi analisar o papel da audição no mecanismo de localização espacial por meio da habilidade de orientar de forma precisa a cabeça face à fonte sonora. Cinco adultos cegos congênitos foram comparados com cinco sujeitos videntes vendados. A tarefa consistiu na orientação da cabeça ao estímulo sonoro, emitido por sete fontes diferentes, com localização fixa. A posição tridimensional da cabeça e tronco foi registrada por um sistema de varredura eletromagnético (Flock of Birds System). Para cada som produzido foi calculado o "erro de localização". Esta medida correspondeu à diferença entre o registro da posição obtido durante o teste e durante uma posição de controle. Os resultados revelaram que nos indivíduos cegos congênitos a magnitude de erro de localização dos estímulos auditivos foi superior aos indivíduos videntes. Conclui-se que a representação mental formada com base na visão constitui um dos pré-requisitos para um bom desempenho nas tarefas espaciais.

Study design: Longitudinal descriptive exploratory study. Objectives: Evaluate the normal width of the linea alba in first-time pregnant women during pregnancy and postpartum. Background: There are normative values on the width of the linea alba for nulliparous women, but limited knowledge about the normal width of the inter-rectus distance (IRD) in pregnant and postpartum women. Methods: Ultrasound images were recorded in 84 primiparous women, at 3 locations on the linea alba (2 cm below the umbilicus, and 2 and 5 cm above the umbilicus) and at 4-time points (gestational weeks 35-41 and 6th to 8th, 12th to 14th, and 24th to 26th weeks postpartum). The 20th and 80th percentiles were used to define the normal width of the linea alba. Results: During pregnancy, the 20th and the 80th percentile corresponded to 49-79 mm below the umbilicus, 54-86 mm at 2 cm above the umbilicus and 44-79 mm at 5 cm above the umbilicus. At 6 months postpartum, the 20th and the 80th percentile corresponded to 9-21 mm at 2 cm below the umbilicus, from 17 to 28 mm at 2 cm above the umbilicus and from 12 to 24 mm at 5 cm above the umbilicus. Conclusion: Different normative values for the width of the linea alba were found at different locations of the anterior abdominal wall. In primiparous women, the IRD may be considered "normal" up to values wider than in nulliparous.

Assessing scapular position and motion during functional arm movement patterns may add relevant information to the evaluation of the clinical status and athletic performance of overhead sports athletes’ shoulders. This study aimed to examine the three-dimensional scapular kinematics of elite volleyball players with (n = 11) and without scapular dyskinesis (n = 11) in comparison to non-athletes (n = 27). Four distinct arm elevation/depression tasks were assessed: shoulder abduction/adduction, flexion/extension, scaption, and a diagonal movement pattern mimicking throwing (proprioceptive neuromuscular facilitation diagonal 2 for flexion/extension or PNF–D2– flx/ext). Kinematic data was recorded from the spiking/dominant shoulder using an electromagnetic system (FASTRAK, Polhemus Inc., Colchester, VT, USA); MotionMonitor v9 software, Innovative Sports Training, Inc., Chicago, IL, USA). The study compared scapular rotations at 15◦ intervals of humero-thoracic (HT) angles, ranging from minimum to 120◦. Significantly different 3D scapular kinematics were observed between traditional arm motion tasks and PNF–D2 arm motion task (HT angle × task interaction effect, p < 0.001, 0.275 ≤ η2p ≤ 0.772). However, when considering the combined influence of phase, HT angle, task, and group factors, no differences were found between groups (phase × HT angle × task × group, p ≥ 0.161, 0.032 ≤ η2p ≤ 0.058). The inclusion of a functional arm movement pattern when evaluating scapular position and movement in overhead athletes does not appear to be mandatory. However, these findings are preliminary and highlight the need for more research in this area.

Diastasis recti abdominis (DRA) or increased inter-rectus distance (IRD) is characterized by the separation of the rectus abdominis muscles. It has its onset during pregnancy and the first weeks following childbirth. The reliability of the instruments used to assess this condition is unclear. There is scant knowledge on the prevalence and risk factors for development of the condition. There is little evidence on which exercises are most effective in reduction of DRA. The aims of our studies were to establish a reliable method for the assessment of the morphology of the abdominal wall, describe DRA prevalence, risk factors, and evaluate the acute response on the IRD induced by drawing-in and abdominal crunch exercises. The results of three methodological studies showed ultrasound imaging to be a reliable method for measuring IRD. The ultrasound transducer can be held relatively stationary in a clinical setting, to evaluate IRD. DRA is prevalent at 6 months postpartum, with a prevalence rate of 39%. The acute response on IRD produced by drawing-in exercise was a widening of the IRD in postpartum, while the abdominal crunch exercise induced an acute narrowing response of the IRD in pregnancy and in postpartum.