Lívia de Castro Magalhães

Adaptação transcultural e análise das propriedades psicométricas da versão brasileira do Perfil de Atividade Humana

The aim of the present study was to evaluate the psychometric properties in the Brazilian version of the Human Activity Profile (HAP), an instrument for the assessment of daily functions and level of physical activity. The HAP was translated into Portuguese following the recommended methodology and applied to 230 community-dwelling elderly (66.32 +/- 8.5 years) from the city of Belo Horizonte, Minas Gerais State, Brazil. The data were submitted to Rasch analysis, which detected very easy and difficult items, making it possible to employ the instrument with both frail and highly functional individuals. The separation index of 3.1 indicated that the items divided the individuals into three levels of functional ability. Of the 94 HAP items, six (6.38%) did not fit the statistical model, which jeopardized its construct validity, since the items did not fit into a continuum. Therefore, caution should be taken when employing the HAP to individuals having similar characteristics. If HAP is applied to different samples and the proportion of erratic items is still more than 5%, modification, substitution, or exclusion of those items is suggested to guarantee that HAP measures a unidimensional construct.

Adaptação do Perfil de Saúde de Nottingham: um instrumento simples de avaliação da qualidade de vida

O objetivo deste estudo foi avaliar as propriedades psicometricas da versao brasileira do Perfil de Saude de Nottingham (PSN), um instrumento generico de avaliacao da qualidade de vida. O PSN foi traduzido para o portugues, segundo metodologia recomendada, e aplicado em 215 individuos, sendo 170 idosos da comunidade (66,3 ± 8,5 anos), 30 hemiplegicos cronicos (56,4 ± 10,9 anos) e 15 parkinsonianos (59,6 ± 10,2 anos). Os dados foram submetidos a analise Rasch. Dos 38 itens do PSN, apenas dois itens (5%) nao se enquadraram no modelo estatistico, indicando que os itens colaboram para medir um constructo unidimensional. Alguns itens do PSN, no entanto, foram muito faceis para os idosos, hemiplegicos e parkinsonianos, caracterizando um efeito teto, o que pode limitar o uso da escala para individuos com niveis mais altos de habilidade. Apesar dos resultados indicarem que o instrumento se enquadra no modelo estatistico de Rash, ha necessidade de revisao dos itens, de forma a tornar o instrumento mais util clinicamente.

Activities and participation in children with developmental coordination disorder: A systematic review

PURPOSE To systematically review all literature published in peer reviewed journals from January 1995 to July 2008 in order to summarize and describe the activity limitations and participation restrictions of children with developmental coordination disorder (DCD). METHODS Multiple databases were systematically searched for articles related to DCD; only descriptive, intervention or qualitative articles were retained. Articles were coded using the International Classification of Function, Disability and Health (ICF) and descriptions of the activity and participation issues of individuals with DCD were identified. RESULTS Data analysis revealed that, from 371 articles that met inclusion criteria, only 44 (14.4%) presented any data related to activity or participation issues. Information was inconsistent and only 18 articles used published measurement tools. Most frequently cited issues were poor handwriting, difficulties playing ball games, getting dressed and participating in organized sports. CONCLUSION Evidence concerning activity and participation issues for children with DCD is limited in both volume and scope. Improved understanding of participation and of activity limitations in children with DCD is essential for clarifying diagnostic criteria, guiding assessment, and making evidence-based decisions regarding intervention. Researchers working with this population should make every effort to measure and consistently report the impact of childrens motor impairments on function.

Comparação do desempenho de atividades funcionais em crianças com desenvolvimento normal e crianças com paralisia cerebral

OBJECTIVE: To compare the pattern of self-care performance in normal children and children with cerebral palsy (CP). METHOD: 142 normal children and 33 children with CP were evaluated by 22 items from the self-care scale of the PEDI functional test. Rasch methodology transformed scores into interval measures of difficulty from 0 to 100 (logit). Spearman rank correlation coefficient compared the order of logits in the two groups. RESULTS: Eleven items showed significant differences in the logit values received. Out of these, 7 items showed relative difficulty values greater in the group of children with CP and 4 items showed relative difficulty values greater among normal children. A significant correlation was observed in the order of the 22 items displayed in the two interval scales. CONCLUSION: The results suggest that the development of self-care functional activities may be influenced by the presence of CP. These results may support assessment and intervention strategies for children with neuromotor disorders.

Terminology used in research reports of developmental coordination disorder

A systematic search was performed of all articles from January 1995 to December 2005 published in peer-reviewed journals on children with developmental coordination disorder (DCD). Criteria were applied to ensure that articles included DCD so 319 articles were included in the analysis. Since the publication of a systematic search conducted in 1994, the number of publications in this field has greatly increased across countries and disciplines. The term DCD was used in 52.7% of the articles. Other terms were used less frequently: clumsy children (7.2%), developmental dyspraxia (3.5%), handwriting problems (3.1%), hand-eye coordination problems (2.8%), sensory integration dysfunction (2.5%), deficits in attention, motor control, and perception (2.5%), minor neurological dysfunction (2.2%), and several other scattered terms (23.5%). The data indicated that progress has been made in the usage of the term DCD, but a standardized approach has not yet been achieved. Without consistent use of the term DCD, there is limited communication of research results internationally, slowed progress in understanding the condition, and limited development of intervention and management programmes for children with DCD.

Análise das propriedades psicométricas da versão brasileira da escala tampa de cinesiofobia

SUMMARY The objective of this study was to examine psychometric properties of the Tampa Scale for Kinesiophobia, which was translated and adjusted according to recommended methodology. The adjusted version, the Escala Tampa para Cinesiofobia (ETC), was applied to 50 subjects with non-specific chronic lumbar pain (CLP). The Rasch analysis disclosed a reliability coefficient of 0.95 for ETC items, sug- gesting excellent construct validity. For the subjects, this coefficient was 0.80, showing a steady answer pattern. Subjects separation rates were 2.0 and 4.5 for the items, showing that patients were divided into two kinesiophobia levels, and the items were divided into five levels. Two erroneous items have been identified, showing percentages above the 5% allowed by statistical model. These results indicate a need for modification, replacement or exclusion of those items in order to assure that the instrument assesses a single-dimensional construct. On the other hand, the presence of very difficult items suggests that ETC can be administered to subjects with higher levels of kinesiophobia. These findings indicate that ECT presents a significant potential for clinical applicability in individuals with CLP; however, a careful interpretation of the results is required, especially for answers to the items regarded as erroneous.

Estudo comparativo sobre o desempenho perceptual e motor na idade escolar em crianças nascidas pré-termo e a termo

The objective of this study was to compare the perceptualmotor performance in school age children who were born preterm and full term. Two groups of children, ages 5 to 7, participated in this study. Group I had 35 children, from low-income families, born up to the 34 week of gestation and/or weight bellow 1500 g. Group II had 35 full-term children, matched by age, gender and socioeconomic status to the children in Group I. Children were tested on the Bender gestalt, the motor accuracy test and on balance and postural responses measures. The preterm group obtained significantly lower scores in the majority of the tests. These besides reinforcing the importance of the follow-up of preterm children up to school age, also indicate the need to stimulate the fine motor and postural control Devment, even among preterm children who do not show evidence of neurological impairment.

Cross-Cultural Assessment of Functional Ability

Culture and environment are known to influence performance of activities of daily living. Few functional assessments currently used in rehabilitation address the issue of cultural validity or relevance of the tasks that are used for assessment purposes. The Assessment of Motor and Process Skills (AMPS) addresses this problem by allowing the client to chose assessment tasks that are more relevant in their daily lives. We investigated the cross-cultural validity of the AMPS by contrasting test performance in subjects from two countries: the United States and Sweden. Data on 589 North American and Swedish subjects were submitted to Rasch analysis, and the results supported the validity of the AMPS in each country. Of the 35 AMPS items, only one item, Endures, differed significantly between the two samples. Overall item stability across samples indicated that the results obtained in both countries could be compared in a valid and meaningful way.

Estudo do desenvolvimento da função motora aos 8 e 12 meses de idade em crianças pré-termo e a termo

OBJECTIVE: To compare the development of motor function in children born preterm with those born at term, at 8 and 12 months of age. To investigate the relation of motor function quality at the age of 8 months with motor ability at 12 months. METHOD: Thirty-two children participated in this study: 16 were born preterm (risk group) and 16 were born at term (control group). The spontaneous movements of the children were assessed at 8 months and their mobility skills and independence were assessed at 12 months (corrected ages for the preterm group), using standardized developmental tests (AIMS and PEDI, respectively). Data were analysed using independent t-tests (between-group comparison) and Pearson correlation coefficients (within-group comparison). RESULTS: There was no significant difference in motor function, between those born preterm with those born at term, either at 8 or at 12 months of age. In the control group, there was significant association (r=0.67; p=0.004) between movement at 8 months and mobility skills at 12 months. In the risk group, there was significant relationship between skills and independence in mobility, at 12 months corrected age (r=0.80; p=0.0001). CONCLUSION: Preterm born children, without other disorders and with age correction, might show a similar motor development as those born at term. The path for the acquisition of motor abilities in preterm born children appears to differ among those infants. Language: ptObjective: To compare the development of motor function in children born preterm with those born at term, at 8 and 12 months of age. To investigate the relation of motor function quality at the age of 8 months with motor ability at 12 months. Method: Thirty-two children participated in this study: 16 were born preterm (risk group) and 16 were born at term (control group). The spontaneous movements of the children were assessed at 8 months and their mobility skills and independence were assessed at 12 months (corrected ages for the preterm group), using standardized developmental tests (AIMS and PEDI, respectively). Data were analysed using independent t-tests (between-group comparison) and Pearson correlation coefficients (within-group comparison). Results: There was no significant difference in motor function, between those born preterm with those born at term, either at 8 or at 12 months of age. In the control group, there was significant association (r=0.67; p=0.004) between movement at 8 months and mobility skills at 12 months. In the risk group, there was significant relationship between skills and independence in mobility, at 12 months corrected age (r=0.80; p=0.0001). Conclusion: Preterm born children, without other disorders and with age correction, might show a similar motor development as those born at term. The path for the acquisition of motor abilities in preterm born children appears to differ among those infants.

Cross-cultural adaptation of the Developmental Coordination Disorder Questionnaire for brazilian children

BACKGROUND: Developmental Coordination Disorder (DCD) is considered a major health problem among school-aged children worldwide. Although there are several instruments to identify children with DCD, none of them are translated into Portuguese and validated to be used in Brazil. OBJECTIVES: Considering that a parent questionnaire is a simple and effective method to screen children with DCD, this study describes the adaptation of the Developmental Coordination Disorder Questionnaire (DCDQ) and the pilot testing with Brazilian children. METHODS:Translation of the DCDQ into Portuguese was conducted according to current guidelines for cross-cultural adaptation of instruments. The questionnaire was completed by parents of 15 children with motor coordination problems and parents of 30 children who were typically developing, matched for age. Five parents randomly selected from each group completed the questionnaire twice, to examine test-retest reliability. The parents opinion regarding the quality of the questionnaire was recorded. RESULTS: 91% of Brazilian parents reported no difficulty in completing the DCDQ. Examination of psychometric properties revealed that two items had limitations due to cultural differences. After item substitution, sensitivity increased from 0.66 to 0.73 and test-retest reliability from 0.95 to 0.97. Internal consistency also increased from 0.91 to 0.92. CONCLUSIONS:The translated instrument shows potential as a screening tool for children in Brazil and should be further examined. Research with a larger sample is needed in order to define cut-off scores and verify the instruments validity and clinical utility. The use of the DCDQ will allow the comparison of epidemiological data from different countries.