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Papers by Jennifer Pires

Research paper thumbnail of Effects of physical therapy on postural imbalance depending on time since stroke: A meta-analysis

Annals of physical and rehabilitation medicine, Jul 1, 2018

upper limb motor functional recovery in acute stroke patients. These positive findings warrant fu... more upper limb motor functional recovery in acute stroke patients. These positive findings warrant further investigation of the application of non-invasive brain stimulation techniques to neurorehabilitation. Keywords Stroke rehabilitation; Physiotherapy; Non-invasive brain stimulation Disclosure of interest The author declares that he has no competing interest.

Research paper thumbnail of Effects of physical therapies aiming directly or indirectly at the recovery of balance after stroke. A meta-analysis

Annals of physical and rehabilitation medicine, Jul 1, 2018

Posters (First Part) / Annals of Physical and Rehabilitation Medicine 61S (2018) e103-e308 upper ... more Posters (First Part) / Annals of Physical and Rehabilitation Medicine 61S (2018) e103-e308 upper limb paralysis and moderate spasm, accompanied with nonfluent aphasia when came to our department; and complained that his recovery had been rather slow for about two years. In addition to the custom rehabilitation, we applied a peripheral plus central rTMS paradigm to him, which included 3 sessions of peripheral magnetic stimulation to his paralyzed right forearm, followed by a session of high frequency rTMS to the bilateral sensorimotor cortex region. The total magnetic stimulation therapy lasted about 30 min a day, and was applied 5 days/week for 4 weeks. Results After 4 weeks' treatment, the patient's Fulg-Meyer upper limb assessment (FMA) score was obviously improved (from 27 to 37 points), and the spasm was largely relieved in his right hand and arm. Conclusion Peripheral plus central rTMS might be an effective treatment for motor dysfunction of chronic stroke patients.

Research paper thumbnail of Efficiency of physical therapy on postural imbalance after stroke: study protocol for a systematic review and meta-analysis

BMJ Open, 2017

Introduction: Stroke frequently results in balance disorders, leading to lower levels of activity... more Introduction: Stroke frequently results in balance disorders, leading to lower levels of activity and a diminution in autonomy. Current physical therapies (PT) aiming to reduce postural imbalance have shown a large variety of effects with low levels of evidence. The objectives are to determine the efficiency of PT in recovering from postural imbalance in patients after a stroke and to assess which PT is more effective. Methods and analysis: We will search several databases from inception to October 2015. Only randomised controlled trials assessing PT to recover from poststroke postural imbalance in adults will be considered. Outcome measures will be the Berg Balance Scale (BBS), the Postural Assessment Scale for Stroke (PASS), the 'weight-bearing asymmetry' (WBA), the 'centre of pressure' (COP) and the 'limit of stability' (LOS). WBA, COP and LOS are measured by a (sitting or standing) static evaluation on force plate or another device. Two independent reviewers will screen titles, abstracts and full-text articles, evaluate the risk of bias and will perform data extraction. In addition to the outcomes, measures of independence will be analysed. This study will aim at determining the effects of PT on the function (WBA, COP, LOS), the activity (BBS, PASS) and the independence of patients. Subgroup analyses will be planned according to the location of brain lesion (hemispheric, brainstem or cerebellum), the time since stroke (early, late, chronic), the PT (type, main aim (direct effect or generalisation), overall duration), the type of approaches (top-down or bottom-up) and the methodological quality of studies. Ethics and dissemination: No ethical statement will be required. The results will be published in a peer-reviewed journal. This meta-analysis aims at managing the rehabilitation after postural imbalance by PT after a stroke.

Research paper thumbnail of Postural stability computerized evaluation in total knee arthroplasty

Disability and Rehabilitation

Research paper thumbnail of Efeito de uma ortótese tornozelo-pé na marcha e na mobilidade após AVC - estudo clínico

Introduction : The aim of the present study was to analyze the effect of an ankle-foot orthosis o... more Introduction : The aim of the present study was to analyze the effect of an ankle-foot orthosis on walking and mobility of stroke patients with equinus and/or varus foot. Material and Methods : Nineteen subacute/chronic stroke patients with equinus and/or varus foot which were able to walk without assistance were assessed with and without an ankle-foot orthosis. Physical performance was tested with Fugl-Meyer, mobility was assessed using the timed up & go test and gait measurements were performed with a portable GAITRite system®. Results : There was a tendency of improvement on mobility and temporo-spatial parameters when using ankle-foot orthosis expressed by a timed up & go test decrease (43.00 to 39.77 s, p = 0.064), a speed improvement (32.10 to 42.00 cm/s, p = ns), a cadence increase (64.40 to 70.00 steps/ minute, p = ns), a cycle time decrease (1.86 to 1.71 s, p = ns) and a base of support decrease (14.67 to 14.55 cm, p = ns), although without significant difference. The posit...

Research paper thumbnail of Assessment of neurogenic bowel dysfunction impact after spinal cord injury using the International Classification of Functioning, Disability and Health

European journal of physical and rehabilitation medicine, Jan 9, 2018

Bowel function is frequently compromised after spinal cord injury (SCI). Regardless of this cruci... more Bowel function is frequently compromised after spinal cord injury (SCI). Regardless of this crucial importance in patients' lives, there is still scarce literature on the Neurogenic Bowel Dysfunction (NBD) deleterious impact on SCI patient's lives and only few studies correlating NBD severity with quality of life (QoL). To our knowledge there are no studies assessing the impact of NBD on the context of ICF domains. To assess NBD after SCI using ICF domains and to assess its impact in QoL. Retrospective data analysis and cross-sectional phone survey. Outpatient spinal cord injury setting. Portuguese adult spinal cord injury patients. Retrospective analysis of demographic data, lesion characteristics and bowel management methods at last inpatient discharge. Cross-sectional phone survey assessing current bowel management methods, the Neurogenic Bowel Dysfunction Score and a Likert scale questionnaire about the impact on ICF domains and QoL. 64 patients answered the questionnair...

Research paper thumbnail of Limited evidence of physical therapy on balance after stroke: A systematic review and meta-analysis

PLOS ONE

Background Stroke results in balance disorders and these directly affect autonomy and quality of ... more Background Stroke results in balance disorders and these directly affect autonomy and quality of life. The purpose of this systematic review and meta-analysis was to determine the efficacy of physical therapy (PT) on balance and postural control after stroke. Methods We included all randomized controlled trials assessing the efficacy of PT on balance and postural control in adult patients after stroke without language restriction. Medline, Embase/ Scopus, Cochrane Central Register of Controlled Trials, PEDro, Pascal, and Francis databases were searched until January 2019. Primary outcomes were balance (Berg Balance scale and Postural Assessment Scale for Stroke) and postural control with postural deviation or stability measurement in sitting or standing static evaluation. A pair of independent

Research paper thumbnail of Rehabilitation of simultaneous bilateral epiphysial fracture of proximal tibia in adolescent

BMJ case reports, Jan 30, 2018

Simultaneous and bilateral epiphysial fracture of the proximal tibia is an extremely rare injury,... more Simultaneous and bilateral epiphysial fracture of the proximal tibia is an extremely rare injury, with only 23 cases reported in the literature. In this paper, we present a 15-year-old adolescent with a simultaneous and bilateral epiphysial fracture of the proximal tibia in sport context (trampoline jump). He underwentsurgical repair with bilateral closed reduction and internal fixation, followed by outpatient rehabilitation programme during 4 months. There was a good functional outcome, without limitation in activities of daily living and with resumption of amateur sports activity. Since there are no guidelines described for this pathology, the authors suggest a rehabilitation protocol for bilateral epiphysial fractures of the proximal tibia that underwent surgical treatment previously and in which there were no complications in the acute phase.

Research paper thumbnail of How can an intestinal-type adenocarcinoma lead to neurological deficits?

American Journal of Physical Medicine & Rehabilitation

Research paper thumbnail of Effects of physical therapy on postural imbalance depending on time since stroke: A meta-analysis

Annals of physical and rehabilitation medicine, Jul 1, 2018

upper limb motor functional recovery in acute stroke patients. These positive findings warrant fu... more upper limb motor functional recovery in acute stroke patients. These positive findings warrant further investigation of the application of non-invasive brain stimulation techniques to neurorehabilitation. Keywords Stroke rehabilitation; Physiotherapy; Non-invasive brain stimulation Disclosure of interest The author declares that he has no competing interest.

Research paper thumbnail of Effects of physical therapies aiming directly or indirectly at the recovery of balance after stroke. A meta-analysis

Annals of physical and rehabilitation medicine, Jul 1, 2018

Posters (First Part) / Annals of Physical and Rehabilitation Medicine 61S (2018) e103-e308 upper ... more Posters (First Part) / Annals of Physical and Rehabilitation Medicine 61S (2018) e103-e308 upper limb paralysis and moderate spasm, accompanied with nonfluent aphasia when came to our department; and complained that his recovery had been rather slow for about two years. In addition to the custom rehabilitation, we applied a peripheral plus central rTMS paradigm to him, which included 3 sessions of peripheral magnetic stimulation to his paralyzed right forearm, followed by a session of high frequency rTMS to the bilateral sensorimotor cortex region. The total magnetic stimulation therapy lasted about 30 min a day, and was applied 5 days/week for 4 weeks. Results After 4 weeks' treatment, the patient's Fulg-Meyer upper limb assessment (FMA) score was obviously improved (from 27 to 37 points), and the spasm was largely relieved in his right hand and arm. Conclusion Peripheral plus central rTMS might be an effective treatment for motor dysfunction of chronic stroke patients.

Research paper thumbnail of Efficiency of physical therapy on postural imbalance after stroke: study protocol for a systematic review and meta-analysis

BMJ Open, 2017

Introduction: Stroke frequently results in balance disorders, leading to lower levels of activity... more Introduction: Stroke frequently results in balance disorders, leading to lower levels of activity and a diminution in autonomy. Current physical therapies (PT) aiming to reduce postural imbalance have shown a large variety of effects with low levels of evidence. The objectives are to determine the efficiency of PT in recovering from postural imbalance in patients after a stroke and to assess which PT is more effective. Methods and analysis: We will search several databases from inception to October 2015. Only randomised controlled trials assessing PT to recover from poststroke postural imbalance in adults will be considered. Outcome measures will be the Berg Balance Scale (BBS), the Postural Assessment Scale for Stroke (PASS), the 'weight-bearing asymmetry' (WBA), the 'centre of pressure' (COP) and the 'limit of stability' (LOS). WBA, COP and LOS are measured by a (sitting or standing) static evaluation on force plate or another device. Two independent reviewers will screen titles, abstracts and full-text articles, evaluate the risk of bias and will perform data extraction. In addition to the outcomes, measures of independence will be analysed. This study will aim at determining the effects of PT on the function (WBA, COP, LOS), the activity (BBS, PASS) and the independence of patients. Subgroup analyses will be planned according to the location of brain lesion (hemispheric, brainstem or cerebellum), the time since stroke (early, late, chronic), the PT (type, main aim (direct effect or generalisation), overall duration), the type of approaches (top-down or bottom-up) and the methodological quality of studies. Ethics and dissemination: No ethical statement will be required. The results will be published in a peer-reviewed journal. This meta-analysis aims at managing the rehabilitation after postural imbalance by PT after a stroke.

Research paper thumbnail of Postural stability computerized evaluation in total knee arthroplasty

Disability and Rehabilitation

Research paper thumbnail of Efeito de uma ortótese tornozelo-pé na marcha e na mobilidade após AVC - estudo clínico

Introduction : The aim of the present study was to analyze the effect of an ankle-foot orthosis o... more Introduction : The aim of the present study was to analyze the effect of an ankle-foot orthosis on walking and mobility of stroke patients with equinus and/or varus foot. Material and Methods : Nineteen subacute/chronic stroke patients with equinus and/or varus foot which were able to walk without assistance were assessed with and without an ankle-foot orthosis. Physical performance was tested with Fugl-Meyer, mobility was assessed using the timed up & go test and gait measurements were performed with a portable GAITRite system®. Results : There was a tendency of improvement on mobility and temporo-spatial parameters when using ankle-foot orthosis expressed by a timed up & go test decrease (43.00 to 39.77 s, p = 0.064), a speed improvement (32.10 to 42.00 cm/s, p = ns), a cadence increase (64.40 to 70.00 steps/ minute, p = ns), a cycle time decrease (1.86 to 1.71 s, p = ns) and a base of support decrease (14.67 to 14.55 cm, p = ns), although without significant difference. The posit...

Research paper thumbnail of Assessment of neurogenic bowel dysfunction impact after spinal cord injury using the International Classification of Functioning, Disability and Health

European journal of physical and rehabilitation medicine, Jan 9, 2018

Bowel function is frequently compromised after spinal cord injury (SCI). Regardless of this cruci... more Bowel function is frequently compromised after spinal cord injury (SCI). Regardless of this crucial importance in patients' lives, there is still scarce literature on the Neurogenic Bowel Dysfunction (NBD) deleterious impact on SCI patient's lives and only few studies correlating NBD severity with quality of life (QoL). To our knowledge there are no studies assessing the impact of NBD on the context of ICF domains. To assess NBD after SCI using ICF domains and to assess its impact in QoL. Retrospective data analysis and cross-sectional phone survey. Outpatient spinal cord injury setting. Portuguese adult spinal cord injury patients. Retrospective analysis of demographic data, lesion characteristics and bowel management methods at last inpatient discharge. Cross-sectional phone survey assessing current bowel management methods, the Neurogenic Bowel Dysfunction Score and a Likert scale questionnaire about the impact on ICF domains and QoL. 64 patients answered the questionnair...

Research paper thumbnail of Limited evidence of physical therapy on balance after stroke: A systematic review and meta-analysis

PLOS ONE

Background Stroke results in balance disorders and these directly affect autonomy and quality of ... more Background Stroke results in balance disorders and these directly affect autonomy and quality of life. The purpose of this systematic review and meta-analysis was to determine the efficacy of physical therapy (PT) on balance and postural control after stroke. Methods We included all randomized controlled trials assessing the efficacy of PT on balance and postural control in adult patients after stroke without language restriction. Medline, Embase/ Scopus, Cochrane Central Register of Controlled Trials, PEDro, Pascal, and Francis databases were searched until January 2019. Primary outcomes were balance (Berg Balance scale and Postural Assessment Scale for Stroke) and postural control with postural deviation or stability measurement in sitting or standing static evaluation. A pair of independent

Research paper thumbnail of Rehabilitation of simultaneous bilateral epiphysial fracture of proximal tibia in adolescent

BMJ case reports, Jan 30, 2018

Simultaneous and bilateral epiphysial fracture of the proximal tibia is an extremely rare injury,... more Simultaneous and bilateral epiphysial fracture of the proximal tibia is an extremely rare injury, with only 23 cases reported in the literature. In this paper, we present a 15-year-old adolescent with a simultaneous and bilateral epiphysial fracture of the proximal tibia in sport context (trampoline jump). He underwentsurgical repair with bilateral closed reduction and internal fixation, followed by outpatient rehabilitation programme during 4 months. There was a good functional outcome, without limitation in activities of daily living and with resumption of amateur sports activity. Since there are no guidelines described for this pathology, the authors suggest a rehabilitation protocol for bilateral epiphysial fractures of the proximal tibia that underwent surgical treatment previously and in which there were no complications in the acute phase.

Research paper thumbnail of How can an intestinal-type adenocarcinoma lead to neurological deficits?

American Journal of Physical Medicine & Rehabilitation