RESUMEN
El siguiente artículo discute aspectos propios del desarrollo psicomotor (DPM) y sus alteraciones, con especial énfasis en el retraso psicomotor. Se hace referencia a las clasificaciones diagnósticas para los problemas del desarrollo como el DSMIV y el CIE 10, y se analizan sus ventajas y desventajas. También se problematiza el concepto de normalidad en tanto sinónimo de promedio estadístico en el contexto de los problemas del DPM, para considerar su dinámica y variabilidad, evitando la oposición normalidad/patología, y valorando aspectos como el sociocultural que permiten repensar la universalidad y la relatividad del DPM.
This article discusses some aspects of psychomotor development and its disorders, with special emphasis on psychomotor retardation. Diagnostic classifications of psychomotor problems, such as DSM-IV and CIE-10, are referred to and their advantages and disadvantages are analyzed. The concept of normality as a synonym for the statistical mean in the context of psychomotor disorders is also analyzed in order to consider its dynamic and variability, thereby avoiding the normality/pathology opposition, while some issues, such as the social and cultural aspects, are highlighted, making it possible to rethink the universality and relativity of psychomotor development.
Asunto(s)
Niño , Humanos , Desarrollo Infantil , Trastornos Psicomotores , Trastornos Psicomotores/clasificación , Trastornos Psicomotores/diagnósticoRESUMEN
This article discusses some aspects of psychomotor development and its disorders, with special emphasis on psychomotor retardation. Diagnostic classifications of psychomotor problems, such as DSM-IV and CIE-10, are referred to and their advantages and disadvantages are analyzed. The concept of normality as a synonym for the statistical mean in the context of psychomotor disorders is also analyzed in order to consider its dynamic and variability, thereby avoiding the normality/pathology opposition, while some issues, such as the social and cultural aspects, are highlighted, making it possible to rethink the universality and relativity of psychomotor development.
Asunto(s)
Desarrollo Infantil , Trastornos Psicomotores , Niño , Humanos , Trastornos Psicomotores/clasificación , Trastornos Psicomotores/diagnósticoRESUMEN
We evaluated the reliability of a translated Brazilian version of the Unified Huntington's Disease Rating Scale (UHDRS) to establish the reproducibility of the scale in a population that differs substantially from that on which the scale was originally validated. After a training period with the video and guidelines requested from the Huntington Study Group, we applied the UHDRS, except for the cognitive tests, to a group of 21 Brazilian patients with a molecular diagnosis of Huntington's disease (HD). We found a high degree of internal consistency of the motor section of the UHDRS (Cronbach's alpha= 0.841). There was a negative correlation between the total motor score and the functional assessment, the independence scale and the functional capacity. There was a positive correlation between these 3 scales of functional evaluation and a negative correlation between the age of onset of the disease and the number of CAG repeats. The behavioral scale and disease duration were not correlated with any factor. The clinical characteristics of this sample of patients as described by the UHDRS were roughly similar to those reported in the original validation studies and the correlations described were similar to those reported previously. We conclude that the Brazilian version of the UHDRS is reliable and valid to study patients with HD in the Brazilian setting, that this sample of Brazilian patients had clinical characteristics similar to those observed in other world regions, as expected, and that the clinical training method used for the application of the UHDRS was effective to insure a high degree of clinical reproducibility.
Asunto(s)
Enfermedad de Huntington/diagnóstico , Destreza Motora/fisiología , Examen Neurológico/normas , Trastornos Psicomotores/diagnóstico , Adulto , Anciano , Brasil , Comparación Transcultural , Femenino , Humanos , Enfermedad de Huntington/clasificación , Enfermedad de Huntington/genética , Masculino , Escala del Estado Mental/normas , Persona de Mediana Edad , Destreza Motora/clasificación , Fenotipo , Trastornos Psicomotores/clasificación , Trastornos Psicomotores/genética , Reproducibilidad de los ResultadosRESUMEN
Nosso estudo avaliou a confiabilidade da versão brasileira da escala unificada para avaliação da doença de Huntington (UHDRS) com o objetivo de estabelecer a reprodutibilidade dessa escala em uma população que difere significativamente daquela em que foi originalmente validada. Após um período de treinamento com um vídeo divulgado para esse objetivo e um manual solicitado aos idealizadores da escala, nós aplicamos a UHDRS, com exceção dos testes cognitivos, em um grupo de 21 pacientes brasileiros com diagnóstico molecular de doença de Huntington (DH). Nessa amostra nós encontramos uma elevada consistência interna na seção que avalia os sintomas motores (alfa de Cronbach= 0,841). Observamos uma correlação negativa entre o escore total da escala motora e as escalas de avaliação funcional, de independência e de capacidade funcional total; uma correlação positiva entre essas 3 últimas escalas; e uma correlação negativa entre a idade de início dos sintomas e o número de repetições CAG. As características clínicas dessa amostra de pacientes descritas segundo a UHDRS é de maneira comparativa similar às descritas nos estudos originais de validação da escala, assim como as correlações descritas são semelhantes às descritas previamente. Concluimos que a versão brasileira da UHDRS é confiável e válida para estudar pacientes com DH aqui no Brasil, que essa amostra, como era esperado, tem características semelhantes às descritas em outras regiões do mundo, e que o método utilizado para treinamento da aplicação da escala é válido.