Jaqueline da Silva Frônio

Classificação da função motora e do desempenho funcional de crianças com paralisia cerebral

OBJECTIVE: To classify children with cerebral palsy (CP) using classification systems for mobility and manual function; to compare groups of children with CP regarding gross motor function and functional performance outcomes; and to evaluate associations between the functional classifications and the scores obtained in the outcomes that were investigated. METHODS: Thirty children with CP were classified using the Gross Motor Function Classification System (GMFCS) and the Manual Abilities Classification System (MACS), and were divided into three groups, based on their classification (mild, moderate or severe) in each of these systems. Gross motor function was documented using the Gross Motor Function Measure (GMFM-66) test, while functional abilities and the caregivers assistance regarding self-care and mobility were documented using the Pediatric Evaluation of Disability Inventory (PEDI). RESULTS: One-way ANOVA showed that the groups were significantly different regarding the GMFM-66 and PEDI results. Post-hoc comparison tests (Scheffe) revealed that the children with moderate impairment (GMFCS) had functional abilities and caregiver support that were similar to those of the mildly impaired children. However, the moderate children (MACS) were not different from the severe children. Spearman rank correlations showed strong and significant inverse associations between the functional classifications and the results from the PEDI and GMFM-66 tests. CONCLUSIONS: The results suggest that the MACS and GMFCS functional classifications are good indicators of the manual function and mobility of children with CP. These classifications may be useful in the processes of evaluation and intervention planning.OBJECTIVE: To classify children with cerebral palsy (CP) using classification systems for mobility and manual function; to compare groups of children with CP regarding gross motor function and functional performance outcomes; and to evaluate associations between the functional classifications and the scores obtained in the outcomes that were investigated. METHODS: Thirty children with CP were classified using the Gross Motor Function Classification System (GMFCS) and the Manual Abilities Classification System (MACS), and were divided into three groups, based on their classification (mild, moderate or severe) in each of these systems. Gross motor function was documented using the Gross Motor Function Measure (GMFM-66) test, while functional abilities and the caregivers assistance regarding self-care and mobility were documented using the Pediatric Evaluation of Disability Inventory (PEDI). RESULTS: One-way ANOVA showed that the groups were significantly different regarding the GMFM-66 and PEDI results. Post-hoc comparison tests (Scheffe) revealed that the children with moderate impairment (GMFCS) had functional abilities and caregiver support that were similar to those of the mildly impaired children. However, the moderate children (MACS) were not different from the severe children. Spearman rank correlations showed strong and significant inverse associations between the functional classifications and the results from the PEDI and GMFM-66 tests. CONCLUSIONS: The results suggest that the MACS and GMFCS functional classifications are good indicators of the manual function and mobility of children with CP. These classifications may be useful in the processes of evaluation and intervention planning.Objective: To classify children with cerebral palsy (CP) using classifi cation systems for mobility and manual function; to compare groups of children with CP regarding gross motor function and functional performance outcomes; and to evaluate associations between the functional classifi cations and the scores obtained in the outcomes that were investigated. Methods: Thirty children with CP were classifi ed using the Gross Motor Function Classifi cation System (GMFCS) and the Manual Abilities Classifi cation System (MACS), and were divided into three groups, based on their classifi cation (mild, moderate or severe) in each of these systems. Gross motor function was documented using the Gross Motor Function Measure (GMFM-66) test, while functional abilities and the caregivers assistance regarding self-care and mobility were documented using the Pediatric Evaluation of Disability Inventory (PEDI). Results: One-way ANOVA showed that the groups were signifi cantly different regarding the GMFM-66 and PEDI results. Post-hoc comparison tests (Scheffe) revealed that the children with moderate impairment (GMFCS) had functional abilities and caregiver support that were similar to those of the mildly impaired children. However, the moderate children (MACS) were not different from the severe children. Spearman rank correlations showed strong and signifi cant inverse associations between the functional classifi cations and the results from the PEDI and GMFM-66 tests. Conclusions: The results suggest that the MACS and GMFCS functional classifi cations are good indicators of the manual function and mobility of children with CP. These classifi cations may be useful in the processes of evaluation and intervention planning.

Oportunidades do ambiente domiciliar para o desenvolvimento motor

OBJETIVO: Avaliar as oportunidades presentes no ambiente domiciliar para o desenvolvimento motor de lactentes. METODOS: Estudo epidemiologico de base populacional, transversal, realizado com 239 lactentes com idade entre tres e 18 meses, residentes no municipio de Juiz de Fora, MG, em 2010. Os participantes foram selecionados por amostragem aleatoria estratificada, conglomerada, em multiplos estagios. Para avaliar a qualidade e quantidade de estimulo motor no ambiente domiciliar foi utilizado o instrumento Affordance in the Home Environment for Motor Development - Infant Scale. Procedeu-se a analise bivariada com aplicacao do teste qui-quadrado, seguida de regressao logistica multinomial para verificar a associacao entre as oportunidades presentes no domicilio e fatores biologicos, comportamentais, demograficos e socioeconomicos. RESULTADOS: As oportunidades de estimulacao ambiental foram relativamente baixas. Na analise bivariada, para a faixa etaria de tres a nove meses, foi encontrada associacao com os fatores: ordem de nascimento (p = 0,06), classificacao socioeconomica (p = 0,08), renda mensal (p = 0,06) e renda per capita (p = 0,03). No modelo de regressao, prevaleceu a classificacao socioeconomica (RC = 7,46; p = 0,03). Para a faixa etaria de dez a 18 meses, os fatores associados, na analise bivariada, foram: estado civil materno (p < 0,01), convivio da crianca com o pai (p = 0,08), chefe da familia (p = 0,04), numero de pessoas no domicilio (p = 0,05), escolaridade materna (p < 0,01) e paterna (p < 0,01), classificacao socioeconomica (p < 0,01) e renda per capita (p = 0,03). No modelo de regressao, o estado civil materno (RC = 4,83; p = 0,02), escolaridade materna (RC = 0,29; p = 0,03) e paterna (RC = 0,33; p = 0,04) permaneceram associados as oportunidades de estimulacao ambiental. CONCLUSOES: A uniao estavel dos pais, maior escolaridade materna e paterna e maior nivel economico foram os fatores associados as melhores oportunidades de estimulacao motora no lar.

Opportunities in the home environment for motor development

OBJETIVO: Avaliar as oportunidades presentes no ambiente domiciliar para o desenvolvimento motor de lactentes. METODOS: Estudo epidemiologico de base populacional, transversal, realizado com 239 lactentes com idade entre tres e 18 meses, residentes no municipio de Juiz de Fora, MG, em 2010. Os participantes foram selecionados por amostragem aleatoria estratificada, conglomerada, em multiplos estagios. Para avaliar a qualidade e quantidade de estimulo motor no ambiente domiciliar foi utilizado o instrumento Affordance in the Home Environment for Motor Development - Infant Scale. Procedeu-se a analise bivariada com aplicacao do teste qui-quadrado, seguida de regressao logistica multinomial para verificar a associacao entre as oportunidades presentes no domicilio e fatores biologicos, comportamentais, demograficos e socioeconomicos. RESULTADOS: As oportunidades de estimulacao ambiental foram relativamente baixas. Na analise bivariada, para a faixa etaria de tres a nove meses, foi encontrada associacao com os fatores: ordem de nascimento (p = 0,06), classificacao socioeconomica (p = 0,08), renda mensal (p = 0,06) e renda per capita (p = 0,03). No modelo de regressao, prevaleceu a classificacao socioeconomica (RC = 7,46; p = 0,03). Para a faixa etaria de dez a 18 meses, os fatores associados, na analise bivariada, foram: estado civil materno (p < 0,01), convivio da crianca com o pai (p = 0,08), chefe da familia (p = 0,04), numero de pessoas no domicilio (p = 0,05), escolaridade materna (p < 0,01) e paterna (p < 0,01), classificacao socioeconomica (p < 0,01) e renda per capita (p = 0,03). No modelo de regressao, o estado civil materno (RC = 4,83; p = 0,02), escolaridade materna (RC = 0,29; p = 0,03) e paterna (RC = 0,33; p = 0,04) permaneceram associados as oportunidades de estimulacao ambiental. CONCLUSOES: A uniao estavel dos pais, maior escolaridade materna e paterna e maior nivel economico foram os fatores associados as melhores oportunidades de estimulacao motora no lar.

Oportunidades del ambiente domiciliar para el desarrollo motor

OBJETIVO: Avaliar as oportunidades presentes no ambiente domiciliar para o desenvolvimento motor de lactentes. METODOS: Estudo epidemiologico de base populacional, transversal, realizado com 239 lactentes com idade entre tres e 18 meses, residentes no municipio de Juiz de Fora, MG, em 2010. Os participantes foram selecionados por amostragem aleatoria estratificada, conglomerada, em multiplos estagios. Para avaliar a qualidade e quantidade de estimulo motor no ambiente domiciliar foi utilizado o instrumento Affordance in the Home Environment for Motor Development - Infant Scale. Procedeu-se a analise bivariada com aplicacao do teste qui-quadrado, seguida de regressao logistica multinomial para verificar a associacao entre as oportunidades presentes no domicilio e fatores biologicos, comportamentais, demograficos e socioeconomicos. RESULTADOS: As oportunidades de estimulacao ambiental foram relativamente baixas. Na analise bivariada, para a faixa etaria de tres a nove meses, foi encontrada associacao com os fatores: ordem de nascimento (p = 0,06), classificacao socioeconomica (p = 0,08), renda mensal (p = 0,06) e renda per capita (p = 0,03). No modelo de regressao, prevaleceu a classificacao socioeconomica (RC = 7,46; p = 0,03). Para a faixa etaria de dez a 18 meses, os fatores associados, na analise bivariada, foram: estado civil materno (p < 0,01), convivio da crianca com o pai (p = 0,08), chefe da familia (p = 0,04), numero de pessoas no domicilio (p = 0,05), escolaridade materna (p < 0,01) e paterna (p < 0,01), classificacao socioeconomica (p < 0,01) e renda per capita (p = 0,03). No modelo de regressao, o estado civil materno (RC = 4,83; p = 0,02), escolaridade materna (RC = 0,29; p = 0,03) e paterna (RC = 0,33; p = 0,04) permaneceram associados as oportunidades de estimulacao ambiental. CONCLUSOES: A uniao estavel dos pais, maior escolaridade materna e paterna e maior nivel economico foram os fatores associados as melhores oportunidades de estimulacao motora no lar.

Influência da posição do objeto na frequência de alcances manuais em lactentes com desenvolvimento típico

The aim of this study was to evaluate the frequency of reaching in the period of three to five months of age and if the object presentation position has an influence on it. Thirteen typically developing infants were assessed at three, four, and five months of age. The frequency of reaching was evaluated with the infants in the supine position, with the object presented at midline, right, and left axillary lines. The procedure was shot and further analyzed to determine all reaching numbers at the presentation positions. For analysis, the Friedman and Wilcoxons tests were used, considering a 5% significance level. The mean reaching frequencies increased at the fifth month, with a statistically significant difference being found between the third and fifth (p=0.011) and between the fourth and fifth months (p=0.008). The amount of reaching at midline also significantly increased between the third and the fifth (p=0.011), the fourth and the fifth months (p=0,025), and a trend towards differentiation was identified between the third and fourth months (p=0,058). At three months, reaching frequency showed a trend towards differentiation (p=0.066) between the axillary line (right or left) and at midline. No significant differences between the positions were identified at the fourth and fifth months. In conclusion, the frequency of reaching increases significantly from three to five months, and the object presentation position seems to influence the initial stage of acquisition of this skill.