RESUMEN
Objetivo descrever a capacidade funcional de crianças com paralisia cerebral que realizavam atendimentos de Fisioterapia e Fisioterapia e Fonoaudiologia. Métodos estudo descritivo, de caráter transversal, composto por 14 crianças com PC do tipo quadriplegia espástica (6 realizavam Fisioterapia e 8 Fisioterapia e Fonoaudiologia). Foram utilizados para avaliação o Inventário de Avaliação Pediátrica de Incapacidade (PEDI) e o Sistema de Classificação da Função Motora Grossa (GMFCS). As associações entre as variáveis categóricas foram analisadas por meio do teste exato de Fisher. Comparações entre médias foram realizadas utilizando-se o teste t de Student. Resultados não se obteve melhora estatisticamente significante nas áreas de autocuidado, mobilidade e função social entre os dois grupos nos domínios de habilidade funcional e assistência ao cuidador. Conclusão as crianças do grupo Fisioterapia tiveram escores funcionais mais elevados que as do grupo Fisioterapia associado à Fonoaudiologia, mas não houve diferença estatisticamente significante entre os grupos. Isso se deu, provavelmente, devido ao reduzido número de participantes, à diversidade de quadros clínicos que a patologia pode apresentar e a possíveis diferenças na intervenção fisioterapêutica realizada nos dois estados, que possuem situações socioeconômicas bem diversas. .
Purpose to describe the functional capacity of children with cerebral palsy who performed the care of Physical Therapy Specialty and Speech, Language and Hearing Sciences. Methods a cross sectional observational study, comprising 14 children with spastic quadriplegic (6 performed Physiotherapy and 8 performed Physiotherapy and Speech therapy). The Pediatric Evaluation of Disability Inventory (PEDI) and the Manual Abilities Classification System (GMFCS) were used to evaluate them. The associations between categorical variables were analyzed using Fisher exact test. Comparisons between means were performed using the Student t test. Results we didn’t obtain statistically significant improvement in the areas of self-care, mobility and social function between the two groups in the fields of functional skills and caregiver assistance. Conclusion the Physiotherapy group of children had higher functional scores than those in the Physiotherapy group associated with Speech Therapy, but there was no statistically significant difference between the groups. This was probably due to the small number of participants, the diversity of clinical presentation and possible differences of Physical Therapy intervention conducted in two states with very different socioeconomic situations. .
RESUMEN
BACKGROUND: It continues to be a challenge for clinicians to identify preterm infants likely to experience subsequent neurodevelopmental deficits. The Test of Infant Motor Performance (TIMP) and the assessment of spontaneous general movements (GMs) are the only reliable diagnostic and predictive tools for the functionality of the developing nervous system, if applied before term. AIM: To determine to what extent singular preterm assessments of motor performance can predict the neurodevelopmental outcome in 14-month olds. METHODS: Thirty-seven preterm infants born <34weeks gestational age were recruited for the study at the NICU of the São Lucas University Hospital, Porto Alegre, RS, Brazil. At 34weeks, their GMs were assessed; and the Test of Infant Motor Performance (TIMP) was applied. A prospective design was used to examine (A) the association between the GM assessment and the TIMP; and (B) the relation between GMs or the TIMP and the developmental status at 14months, assessed by means of Alberta Infant Motor Scales (AIMS) and the Pediatric Evaluation of Disability Inventory (PEDI). RESULTS: Nineteen infants (41%) had abnormal GMs; only one scored within the TIMP average range. Hence, GMs and TIMP were not related. Children with cramped-synchronized GMs at 34weeks preterm had a lower AIMS centile rank than those with poor repertoire or normal GMs. There was a marginal association between cramped-synchronized GMs and a lower PEDI mobility score. CONCLUSIONS: A single preterm GM assessment is only fairly to moderately associated with the 14-month motor development. The TIMP is not suitable as a complementary assessment tool at such a young age.