Maria Teresa Barreiros Caetano Tomas

@estesl.ipl.pt

Sciences and Technology of Rehabilitation
Escola Superior de Tecnologia da Saude de Lisboa do IPL

Maria Teresa Barreiros Caetano Tomas


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https://researchid.co/mttomas

EDUCATION

PhD in Human Motricity speciality of Physical Activity and Health
MSc in Exercise and Health
Degree in Special Education and Rheabilitation
Degree in Physiotherapy
18

Scopus Publications

Scopus Publications

  • Neuromuscular Activation Patterns in Response to Windlass Stimulation and Biofeedback: A Surface EMG Study
    Laura Carrasco-Fernández, Álvaro Gómez-del Pino, Manuel García-Sillero, Pablo González-Cañizares, Jerónimo García-Romero, et al.
    Sports, 2026
    Background: Handball involves unilateral, high-demand actions that increase injury risk. The Windlass mechanism (WM) is a position-dependent plantar fascia tensioning system, activated by dorsiflexion of the first metatarsophalangeal joint, which increases medial longitudinal arch stiffness and contributes to foot stability. WM activation can be mechanically simulated using hallux wedges to induce controlled dorsiflexion, allowing graded engagement of the mechanism under standardized conditions. The primary aim of this study was to investigate how different wedge inclinations, with and without visual biofeedback, affect foot muscle activity during squats in elite female handball players. Methods: Seventeen elite female handball players performed squats at 65% of one-repetition maximum under six conditions combining three wedge inclinations (0°, 10°, 30°) with the presence or absence of visual biofeedback. Electromyographic activity (RMS and %MVC) of intrinsic and extrinsic foot muscles was recorded. Results: A significant increase in left abductor hallucis activation with the 10° wedge without biofeedback. Visual biofeedback significantly increased RMS and %MVC in intrinsic foot muscles and increased RMS in the left gastrocnemius (p < 0.05). No significant interaction was observed between wedge inclination and biofeedback. Conclusions: Controlled activation of the WM via hallux wedges and the use of visual biofeedback modulate foot muscle activity during squats. These strategies may be considered in training programs aimed at improving foot stability and reducing injury risk in elite female handball players.
  • Characterization of Physical Activity Levels in Female Breast Cancer Survivors: Relationship With Lymphedema (AtiLinf)
    Alice Ralheta Duarte, Carla Martinho Neto, Leonor Prates, Pablo Lobo, Maria Teresa Tomás
    Journal of Physical Activity and Health, 2025
    The development of lymphedema (LE) is a major concern in breast cancer treatment, and it is crucial to understand the best ways to prevent and treat it. Physical activity has shown to be effective, safe, and feasible in controlling complications arising from treatments, as well as improving function and quality of life in breast cancer survivors. This study aimed to investigate the relationship between physical activity with grip strength and LE development in breast cancer survivors. A cross-sectional analytical study was conducted and women who had survived breast cancer between 1 and 5 years after surgery were selected. Participants completed the International Physical Activity Questionnaire Short Form, the volume of upper limb (UL) was measured by perimetry, handgrip strength was assessed with the JAMAR dynamometer, and the Actigraph accelerometer was placed on the waist. It was found that 50% of the sample was overweight, 28.3% were obese, and 52% of the participants had grip strength below the recommended level. They had an average energy expenditure of 1.2 (0.1) metabolic equivalents, 8.3 (1.8) hours/day of sedentary activity, and spent an average of 61% of their awake time in sedentary activity per day. Significant correlations were found between grip strength on the affected side and the difference in volume between the UL (rp = −.303, P = .041) as well as between body mass index (BMI) and the difference in volume between the UL (rp = .341; P = .020). Moreover, a significant correlation between BMI and the volume of the affected UL was found (rp = .848, P = .000). BMI and grip strength of the affected side were identified as significant predictors of LE, both with P values less than .05. Although physical activity cannot directly prevent LE, it may contribute by helping to control BMI and promote higher levels of grip strength, both of which are important factors in the prediction of LE.
  • Exercise Prescription for Frail Older Adults: Impact on Handgrip Strength and Gait Speed–A Systematic Review
    Andreia Carvalho, Vânia Cerqueira Palma, Maria Teresa Tomás
    Physical and Occupational Therapy in Geriatrics, 2025
  • Therapeutic Importance of Exercise in Neuroplasticity in Adults with Neurological Pathology: Systematic Review
    Sara V Cardoso, Sofia R Fernandes, Maria T Tomás
    International Journal of Exercise Science, 2024
    Neuroplasticity is an essential mechanism by which the nervous system shapes and adapts according to functional requirements. Evidence suggests that physical exercise induces a cascade of cellular processes that favours brain plasticity. The Brain Derived Neurotrophic Factor (BDNF) is a neurotrophin closely linked to neuroplasticity that can be increased due to exercise. To verify the effects of therapeutic exercise on neuroplasticity and/or peripheral BDNF levels in neurological conditions in adults, such as stroke, Parkinson’s and Alzheimer’s diseases and mild cognitive impairment and address its clinical relevance in the treatment of neurological dysfunctions. A systematic review was carried using PUBMED, Web of Science and Scopus databases. Inclusion criteria were: randomized controlled trials or pilot studies; humans with age > 18 yrs with neurological condition; English language; score ≥ 6 in PEDro Scale (moderate to high quality). Reviews, meta-analyses and other articles that did not meet the criteria were excluded. The PRISMA methodology was applied for studies’ selection. A total of 9 studies were selected for a systematic and comprehensive analysis. According to these studies, moderate to high intensity aerobic exercise (AE), increases the level of peripheral BDNF and positively influences functional gains in neurological conditions. Larger outcomes are observed in protocols with minimum session duration of 30 minutes, frequency of 3 times/week and intervention duration of 4 weeks. Current evidence shows that moderate to high intensity AE induces neuroplasticity in neurological patients, thus being a fundamental therapeutic strategy to include in interventions aiming to repair/delay neurological dysfunctions.
  • Relationship between physical activity levels of Portuguese physical therapists and mental health during a COVID-19 pandemic: Being active is the key
    Laura Cristina Almeida, Ana Grilo, Elisabete Carolino, Maria Teresa Tomás
    Frontiers in Public Health, 2022
    IntroductionPhysical activity is essential for a healthy life and quality of life, representing a fundamental role in individuals' physical and mental health. Concomitantly, the physical therapist, through the promotion of physical activity and exercise, can improve mental health, an essential factor in the current pandemic, triggering anxiety, fear, and depression crisis.ObjectiveTo verify physical activity among Portuguese physical therapists and its association with mental health during pandemic times.MethodsAn online questionnaire was applied through social media to all Portuguese physical therapists between October 21, 2021, and January 14, 2022. It contained general characterization questions of the sample, the IPAQ-SF questionnaire to assess physical activity levels, the Goldberg General Health Questionnaire (GHQ-28), which assesses the levels of mental health and the WHO Well-Being Index (WHO-5) to assess the subjective wellbeing.ResultsThe sample totaled 286 respondents (82% female), with a mean age of 33. Of the total answers, 82% practiced physical activity, 45% had moderate levels of physical activity, and 19% vigorous. Physical therapists in these categories had lower values in the GHQ-28 and higher in the WHO-5. Those with better mental health also showed better subjective wellbeing (r = −0.571, p = 0.000).ConclusionThe data obtained showed that physical therapists mostly have moderate and vigorous levels of physical activity and that physical activity positively influences individuals' mental health and wellbeing, which proved to be a key factor due to the pandemic situation.
  • Sustainable and Active Program—Development and Application of SAVING Methodology
    Marina Almeida-Silva, Ana Monteiro, Ana Rita Carvalho, Ana Marta Teixeira, Jéssica Moreira, et al.
    International Journal of Environmental Research and Public Health, 2022
    The SAVING project aimed to create a sustainable and active aging program to promote the transition to sustainable aging in residential structures for the elderly (RSEs), developing research activities to apply the best strategies and good practices regarding the promotion of an active, healthy, and sustainable aging regarding social, economic, environmental, and pedagogic aspects. All this innovative methodology was built on a living-lab approach applied in one RSE, that was used as a case study. The results showed that the creation of the SAVING Brigade allowed not only increased reflection and mutual learning, but also created better conditions to face uncertainties and obstacles. Moreover, the use of indicators supported the basic themes and enabled comparison with other studies, between institutions or programs. Finally, the Action Plan acted as a tool for the development of previously defined strategies. It is possible to conclude that the breadth of the concept of quality of life encompasses the physical health of the individual, their psychological state, their social relationships, their perceptions, and the relationship with the characteristics of the context in which they are inserted. Therefore, active, sustainable, and healthy aging should be the goal.
  • Assessing physical activity and functional fitness level using convolutional neural networks
    Alejandro Galán-Mercant, Andrés Ortiz, Enrique Herrera-Viedma, Maria Teresa Tomas, Beatriz Fernandes, et al.
    Knowledge Based Systems, 2019
  • Physical activity and physiotherapy: perception of women breast cancer survivors
    Jackeline Rangel, Maria Teresa Tomás, Beatriz Fernandes
    Breast Cancer, 2019
  • Creating a Culture of Health in Planning and Implementing Innovative Strategies Addressing Non-communicable Chronic Diseases
    Chariklia Tziraki-Segal, Vincenzo De Luca, Silvina Santana, Rosa Romano, Giovanni Tramontano, et al.
    Frontiers in Sociology, 2019
    Ongoing demographic changes are challenging health systems worldwide especially in relation to increasing longevity and the resultant rise of non-communicable diseases (NCDs). To meet these challenges, a paradigm shift to a more proactive approach to health promotion, and maintenance is needed. This new paradigm focuses on creating and implementing an ecological model of Culture of Health. The conceptualization of the Culture of Health is defined as one where good health and well-being flourish across geographic, demographic, and social sectors; fostering healthy equitable communities where citizens have the opportunity to make choices and be co-producers of healthy lifestyles. Based on Antonovsky's Salutogenesis model which asserts that the experience of health moves along a continuum across the lifespan, we will identify the key drivers for achieving a Culture of Health. These include mindset/expectations, sense of community, and civic engagement. The present article discusses these drivers and identifies areas where policy and research actions are needed to advance positive change on population health and well-being. We highlight empirical evidence of drivers within the EU guided by the activities within the thematic Action Groups of the European Innovation Partnership on Active and Healthy Aging (EIP on AHA), focusing on Lifespan Health Promotion and Prevention of Age-Related Frailty and Disease (A3 Action Group). We will specifically focus on the effect of Culture on Health, highlighting cross-cutting drivers across domains such as innovations at the individual and community level, and in synergies with business, policy, and research entities. We will present examples of drivers for creating a Culture of Health, the barriers, the remaining gaps, and areas of future research to achieve an inclusive and sustainable asset-based community.
  • Predicting physical activity and functional fitness levels through inertial signals and EMD-based features in older adults
    Galá, n-Mercant Alejandro, Moral-Munoz Jose A., Ortiz André, s, et al.
    Frontiers in Artificial Intelligence and Applications, 2018
    Older adults are related to a reduction in the physical functionality, as a result of a musculoskeletal system degeneration. In that way, physical exercise has been stated as a suitable intervention to prevent such health problems. Therefore, an adequate assessment of the physical activity and functional fitness levels is needed to plan the individualized intervention. A broad test used to assess the functional fitness level is the 6-minutes walk test (6MWT). It has been previously measured using accelerometer sensors. In views of this background, the main aim of the present study is to use the Empirical Mode Decomposition (EMD) method to predict the physical activity and functional fitness levels of the older adults through the acceleration signals recorded by a smartphone during the 6MWT. A total of 17 participants were recruited. Anthropometric measurements (weight, height, and BMI), physical activity, and functional fitness levels from each participant were recorded. Consecutively, the EMD method was applied to determine the prediction. According to the results, the proposed method can predict the physical activity and functional fitness levels with high accuracy, even using only one cycle. Thus, the approach described in the present work could be implemented in future m-health systems to identify the physical activity profile of the older adults.
  • A 5-year follow-up of the benefits of an exercise training program in liver recipients transplanted due to familial amyloidotic polyneuropathy
    Maria Teresa Tomás, Xavier Melo, Élia Mateus, Mafalda Gonçalves, Eduardo Barroso, et al.
    Progress in Transplantation, 2018
  • Functional capacity and levels of physical activity in aging: A 3-year follow-up
    Maria Teresa Tomás, Alejandro Galán-Mercant, Elvis Alvarez Carnero, Beatriz Fernandes
    Frontiers in Medicine, 2017
  • Physiotherapy and Duchenne muscular dystrophy
    Duchenne Muscular Dystrophy Symptoms Management and Prognosis, 2015
  • Familial amyloid polyneuropathy (FAP): Clinical features, pathophysiology, and treatment
    Contemporary Issues in Peripheral Neuropathy, 2014
  • The impact of exercise training on liver transplanted familial amyloidotic polyneuropathy (FAP) patients
    Maria Teresa Tomás, Helena Santa-Clara, Paula Marta Bruno, Estela Monteiro, Margarida Carrolo, et al.
    Transplantation, 2013
  • Body composition, muscle strength, functional capacity, and physical disability risk in liver transplanted familial amyloidotic polyneuropathy patients
    Maria T. Tomás, Maria H. Santa-Clara, Estela Monteiro, Tracy Baynard, Elvis Á. Carnero, et al.
    Clinical Transplantation, 2011
  • Effects of an exercise training program in physical condition after liver transplantation in familial amyloidotic polyneuropathy: A case report
    M.T. Tomás, H. Santa-Clara, E. Monteiro, E. Barroso, L. Bettencourt Sardinha
    Transplantation Proceedings, 2011
  • Grip strength changes in familial amyloidotic polineuropathy
    Acta Medica Portuguesa, 2010