Clinical trials

This is a randomized, parallel-group pilot study that employs mixed methods (qualitative and quantitative approaches). The purpose of this study is to assess the feasibility, usability, and acceptability of an intervention with a digital component on the InControl web platform. The intervention is based on education in pain science and exercise, with the goal of managing chronic musculoskeletal pain in older adults. The intervention will be delivered through a combination of digital and in-person components and it will be compared to the usual intervention. It will also inform the design of a randomized controlled trial to evaluate the cost-effectiveness of InControl.

Cancer-related cognitive impairment (CRCI) affects a large proportion of non-central nervous system cancer survivors and can negatively impact cognitive functioning and daily life. Cognitive rehabilitation has shown promising results in addressing these difficulties. The goal of this pilot randomized controlled trial is to evaluate the feasibility, acceptability, and preliminary efficacy of the CanCOG®- Cognitive Rehabilitation in Cancer program in Portuguese adult cancer survivors with CRCI. Adult non-central nervous system cancer survivors (n=60) will be randomly assigned to receive either the CanCOG® intervention or treatment as usual. CanCOG® is a structured cognitive rehabilitation program designed to help cancer survivors manage cognitive difficulties through cognitive training exercises, psychoeducation, and compensatory strategy training. The program consists of six weekly sessions of 1 hour and 30 minutes each, delivered over six consecutive weeks. Sessions are administered in person in small groups (3-9 participants) and are led by a trained professional. The main focus of the study is to assess feasibility outcomes, including recruitment, retention, adherence to the intervention, and completion of study assessments, as well as acceptability and participant satisfaction. The study will also explore preliminary effects of the intervention on cognitive functioning (both perceived and objective), symptoms of anxiety and depression, and quality of life. Participants will complete assessments at baseline (2 weeks after the intervention), 2 weeks after the intervention, and at 3- and 6-month follow-ups. Some participants (10-15) will also take part in interviews to provide feedback on their experience with the program.

This is a single-case experimental design study enrolling individuals with chronic low back pain who will be receiving pain science education and virtual reality over 3 weeks.

This study will look at whether a simple exercise called the isometric wall squat can help lower blood pressure in adults who have both hypertension and obstructive sleep apnoea treated with CPAP. Obstructive sleep apnoea is a condition in which breathing repeatedly stops or becomes shallow during sleep, and it is closely linked to high blood pressure. Although CPAP helps treat sleep apnoea, it usually lowers blood pressure only a little, so additional non-drug strategies may be useful. The study will compare two situations in the same participants: one session of wall squat exercise and one non-exercise control session. Each participant will take part in both sessions, but the order will be random. This design helps the researchers compare blood pressure changes more fairly within the same person. Participants will first attend a familiarization session, where the study procedures will be explained and the exercise intensity will be checked. After that, they will complete the two study sessions at home, during their usual CPAP treatment visits. The sessions will be separated by at least 48 hours and completed within one week. Both sessions will be scheduled at the same time of day to reduce the effect of normal daily changes in blood pressure. The main result the researchers will measure is the average systolic blood pressure during the 12 hours after each session, using ambulatory blood pressure monitoring. This means blood pressure will be measured over time while the participant goes about normal daily activities. The researchers want to find out whether a single session of wall squat exercise produces a greater blood pressure reduction than simply resting without exercise. This study may help improve understanding of whether isometric exercise can be a practical, low-cost, home-based option to support blood pressure control in people with hypertension and CPAP-treated obstructive sleep apnoea.

Preventing lower limb injuries is a key concern in sports and physical activities. Even though injury prevention programs and pre-season screening have improved recently, these injuries still happen often. New technology might help improve traditional screening methods. The BlazePod® system offers a fresh, active way to assess function and train physical skills. This study aims to explore the link between the BlazePod® One-Leg Balance Activity (OLBA) test and the Y-Balance Test (YBT) in healthy young adults. Using kinematic analysis, we want to see if the OLBA test can serve as a preseason tool to predict ankle injuries. Participants will complete the YBT, the Weight-Bearing Lunge Test, and the OLBA test with the BlazePod® system, along with the Cumberland Ankle Instability Tool (CAIT) and a sociodemographic questionnaire. We will record all tests using the Vicon T20S 3D motion capture system and analyze the data with MOKKA software. We expect to find a significant positive correlation between the average taps in the BlazePod® test and the combined YBT score. These results could show that the OLBA test with BlazePod® is a useful way to assess ankle injury risk.

This study will investigate whether two different physiotherapy exercise programs can improve physical function, balance and mental well-being in older adults living in the community in Angola. A total of 350 people aged 60 years or older will take part in the study. Participants will be randomly assigned to one of two supervised exercise programs. One group will participate in a multicomponent exercise program that includes strength, balance, walking and coordination exercises. The second group will participate in a reduced functional exercise program focused on basic strengthening, walking and simple daily activities. Both programs will be performed three times per week, with each session lasting 60 minutes, over a period of 12 weeks. Participants will be assessed before and after the exercise program. The assessments will include tests of balance, muscle strength, walking ability and questionnaires about daily activities and mental health. Information about falls, blood pressure and general health will also be collected. The goal of this study is to identify effective and safe physiotherapy strategies to help older adults maintain independence, reduce the risk of falls and support healthy ageing, especially in settings with limited health resources.

Adolescents frequently experience clinical and subclinical anxiety symptoms, yet many avoid seeking professional help. While universal interventions exist to promote help-seeking, targeted programs for adolescents with elevated anxiety symptoms remain scarce. Therefore, accessible and tailored strategies are needed to effectively promote help-seeking among this group. TOUCHminds is a web-based intervention designed to enhance help-seeking among adolescents with clinical or subclinical anxiety. The program consists of six self-guided modules featuring interactive activities (e.g., images, videos, simulation activities, and audio recordings), combined with three synchronous sessions led by a psychologist via videoconference. The intervention explicitly targets precursors of help-seeking, including mental health literacy, mental health stigma, self-compassion, readiness to change, and stage of change. This research project comprises two studies. Study I, a feasibility study involving 10 adolescents aged 15 to 17, will assess recruitment procedures, dropout rates, usage patterns, therapist fidelity, acceptability, usability, satisfaction, and preliminary effects. Study II, a randomized controlled trial (RCT), intends to include 96 adolescents randomly assigned to four groups: clinical intervention, clinical control, subclinical intervention, and subclinical control. Clinical participants are those who meet diagnostic criteria for one or more anxiety disorders, whereas subclinical participants present high self-reported anxiety but no mental disorder diagnosis. Intervention effects will based on self-report assessments conducted at pre-intervention, post-intervention (9 weeks later), and at 3-month follow-up. This research will provide evidence regarding the suitability and effectiveness of TOUCHminds in promoting help-seeking among adolescents experiencing different levels of anxiety symptoms. Findings will contribute to the field of empirically validated web-based interventions tailored specifically for adolescents.

The aim of the study is to evaluate the effect of myofascial self-release on muscle mechanical properties, performance, neuromuscular function, and injury risk reduction in young soccer players. The hypothesis is a reduction in the number of injuries in the experimental group, as well as improvements in muscle mechanical properties, performance, and neuromuscular function in young soccer players.The study will be a randomized clinical trial with a convenience sample of approximately 65 male athletes aged between 14 and 18 years, divided into control and experimental groups. Athletes with no history of injury in the three months prior to the study will be included, while those with a history of previous surgery or lower limb fractures in the past five years, or who are undergoing physiotherapy at the time of the study, will be excluded.Muscle mechanical properties (myotonometry), flexibility (sit-and-reach test), ankle dorsiflexion range of motion (Weight Bearing Lunge Test), motor control (Y Balance Test), and the reactive strength index (Myjump App) will be assessed before, immediately after, and at 8 and 16 weeks post-intervention. Myofascial self-release will be performed bilaterally on the quadriceps, hamstrings, and calves for 2 minutes per region, twice a week, using a structured massage roller. All procedures will be demonstrated beforehand during the study. For the Myoton procedure, the athlete will simply lie in a supine and prone position on the examination table. The athlete will only be asked to remain still in the "face-up" or "face-down" position, feeling only the light contact of the device's probe, which is painless and will be demonstrated beforehand. In the Y Balance Test, athletes will be asked to balance on one foot atop a grid placed on the floor, with their hands on their hips, and reach as far as possible with the non-supporting leg in three marked directions on the floor, without lifting the heel of the supporting leg. For the Ankle Range of Motion - Weight Bearing Lunge Test, the athlete will place the tested foot on a measuring tape positioned on the floor and will be instructed to touch their knee to the wall in front of them without lifting the heel of the tested foot. Three attempts will be allowed, and the longest distance from the big toe to the wall will be recorded. In the Sit-and-Reach Test, the athlete will sit on the floor with bare feet and both legs extended. They will be instructed to keep their hands side by side and try to reach the greatest possible distance on the ruler in front of them by bending forward without bending their legs, holding the position for one second to measure the distance. Three attempts will be allowed, and the greatest distance reached will be recorded. For ground reaction strength, the athlete will be asked to jump off a 40 cm high box, and as soon as their feet touch the ground, they will be encouraged to jump upward as quickly and as high as possible. In myofascial self-release, athletes in the experimental group will be asked to use the myofascial release roller for 2 minutes before training on each of the three muscle groups - anterior and posterior thigh and posterior leg. Athletes will be instructed to roll using as much pressure as possible on the roller. For the anterior thigh, they will roll across the entire front part of the thigh; for the posterior thigh, they will roll from just below the gluteal region to just above the knee; and for the posterior leg, they will roll from just below the knee to just above the heel.

* Summary Sacroiliac joint dysfunction (ASI) is an alteration in the normal biomechanics of the joint, which leads to hypomobility or hypermobility of that joint. It is one of the most common causes of misdiagnosis in low back pain and when not treated correctly, it often evolves into chronic pain (30% to 42%) and disability. Manipulating the dysfunctional ASI appears to result in benefits and significantly positive changes at various levels, in all segments of the human body. With this investigation, we intend to clarify and deepen the possible correlation between the changes that normally accompany this dysfunction, as well as its possible reversibility with its normalization. * Objectives The investigators will essentially have two main objectives: 1. Mapping of the most evident symptomatic changes, when sacroiliac joint dysfunction is present, in terms of pain and muscle tone; 2. To try to understand the immediate, global and immediate effect of ASI manipulation. * Study design Quantitative, with experimental study design, with the sample comprising individuals with SIJ dysfunction, where all participants will be randomly allocated to the experimental, control and sham groups. It will be carried out at the University of Aveiro facilities. Initially, we will assess the participants with sacroiliac dysfunction. The experimental will be manipulated, the control group will do nothing, and the sham group will be submitted to a hypothetical manipulation (sham manipulation). Consequently, the patients will be assessed again, measuring the subjective and objective degree of pain and muscle tone. \- Material and methods We will make use of: * Standing flexion test; * Sitting Flexion Test; * Faber Test; * EVA , to subjectively assess pain; * Pressure algometer, to objectively assess pain ; * MyotonPro, to assess muscle tone;

Interstitial Lung Disease (ILD) includes chronic, disabling and progressive respiratory conditions marked by lung inflammation and fibrosis. The quality of life and functionality of people with ILD is affected by a plethora of debilitating symptoms such as dyspnoea fatigue and cough. Among them, chronic cough (a cough lasting more than 8 weeks) reigns as one of the most prevalent and challenging, despite receiving far less attention from researchers than other symptoms. Chronic cough affects up to 8 out of 10 individuals with ILD and it is associated with a worse prognosis, mortality, and the need for lung transplantation. This condition showed a significant impact in people's life (e.g., urinary incontinence, speech interferences, depression, chest pain, couples sleeping in separate bedrooms, avoidance of public areas, reduced social interaction, and work absenteeism), further contributing to the decreased health-related quality of life experienced by this population. Managing chronic cough is, therefore, urgently needed. The general aim of this study is to explore the effects of a non-pharmacological cough control treatment on cough-related quality of life in people with ILD. The specific aims of this study are: i) to explore short- and mid-term effects of the non-pharmacological cough control treatment on cough related outcomes (e.g., cough frequency and intensity, dyspnoea, fatigue, cough self-efficacy, health-related quality of life and emotional status); ii) to identify (if any) adverse effects of this therapy.

This study aims to: i) develop an instrument that assesses the needs of informal carers of people with chronic respiratory diseases (CRD), along diseases' trajectory, and evaluate its measurement properties; ii) identify existing instruments that assess the needs of informal/family carers and their measurement properties, iii) characterize the needs of informal carers of people with CRD and iv) characterize the health literacy of informal carers of people with CRD. The first task will be a systematic review. For the second and third tasks, people with CRD, their informal carers and health professionals will be recruited via the pulmonology services from the hospitals:Unidade Local de Saúde de Gaia/Espinho, Unidade Local de Saúde da Região de Aveiro, and Unidade Local de Saúde de Entre o Douro e Vouga. On task 2, a mixed-methods study will be conducted to characterize the needs of informal carers of people with CRD, as well as their health literacy. On task 3, an instrument that assesses the needs of informal carers of people with CRD will be developed and its measurement properties will be studied. This study is urgently needed to provide meaningful support to this hidden workforce who provides most of the care to people with DRC contributing to guide meaningful supportive care to this population and their loved ones.

This study aims to i) To characterize the functional status and explore the determinants of functional status decline of people with IlD ii)To determine the measurement properties of functional status instruments in people with Interstitial lung diseases (ILD) iii) To identify the impact of ILD and the participants' perspectives on functional status through interviews iv) Explore the progression of functional status progression in people with ILD and v) Develop a multidimensional index, incorporating functional status parameters, to predict mortality in people with ILD. Patients with ILD will be recruited via the pulmonology services at hospitals, namely from Centro Hospitalar de Vila Nova de Gaia/Espinho (CHVNG/E), Centro Hospitalar do Baixo Vouga (CHBV) and Centro Hospitalar de Entre o Douro e Vouga (CHEDV). Sociodemographic, clinical characteristics (i.e., smoking habits, vital signs and symptoms), anthropometric (i.e., height and weight to compute body mass index) and general clinical data (i.e., medication, oxygen therapy, non-invasive ventilation, acute exacerbations, hospitalizations and number of hospital admissions in the last month and year, length of stay), as well as prior and follow-up spirometric measurements and arterial blood gas will be collected from clinical records for patients' characterization. Mortality and rehospitalizations will be explored during the study period. Peripheral muscle strength, functional status, daily physical activity, self-reported symptoms, functional status, impact of the disease and health-related quality of life. Qualitative data from interviews. The assessments will be conducted at 6 time points: baseline and 1 week after for instrument validation, followed by assessments every 6 months for 2 years. It is expected that: i) Functional status limitations can be comprehensively identified and measured in individuals with ILD. ii) Some measures are valid and reliable indicators of functional status in individuals with ILD. iii) Different profiles of functional status progression will be identified in individuals with ILD, including stable, slow, and fast decline. iv) A multidimensional index incorporating functional status will improve the accuracy of predicting mortality and outperform the predictive ability of the current GAP Index.

Living with chronic obstructive pulmonary disease (COPD) or interstitial lung disease (ILD) imposes enormous daily challenges, especially at advanced stages, not just to patients but also to informal caregivers. Their needs are not fully addressed by disease-modifying treatments. A key strategy to improve their well-being is the early integration of palliative care into routine management of COPD and ILD. Pulmonary rehabilitation (PR), one of the most well-established and cost-effective interventions in chronic respiratory diseases may be a suitable venue for this approach. The main goal of this randomised controlled study is to explore the effects of palliative care education as part of PR in people with COPD or ILD and informal caregivers. The primary question to be addressed is: "Does integrating education about palliative care in PR improve knowledge on this subject?". The investigators will compare PR with palliative care education (experimental) with traditional PR (control) in people with COPD or ILD and informal caregivers. The intervention will include an education session about palliative care, a "Peer-to-peer session", a "Get-apart session" and online sessions. A mixed-methods approach will be used to evaluate the outcomes. This study will provide an evidence-based insight into personalised PR with palliative care education for people with COPD or ILD and informal caregivers.