Maíra Seabra de Assumpção

Coativação, espasticidade, desempenho motor e funcional na paralisia cerebral

Abstract: The purpose of this study was to identify whether or not there is an association between muscle coactivation during gait, spasticity, functional abilities and gross motor behavior in children with cerebral palsy (CP) and to compare these parameters to those of children with typical development (TD). Sixteen children with TD and 23 children with CP participated of this study. The clinical instruments included: the Modified Ashworth Scale for spasticity, the Pediatric Evaluation of Disability Inventory for functional abilities and the Gross Motor Function Measure for gross motor behaviors. Using coactivation index (CI), activation of the rectus femoris and semitendinosus muscles was analyzed during the participants’gait cycles. Measures of functional abilities were related to parameters of gross motor behaviors and, therefore, providing appropriate indicators of motor changes. Contrary, the CI does not seem to be an appropriate parameter for identifying changes in gross motor behavior in children with CP of minimal severity.

Validação para o português do Maugerl CaRdiac preventiOn-Questionnaire (MICRO-Q)

BACKGROUNDnThe Maugerl CaRdiac preventiOn-Questionnaire (MICRO-Q) is a validated specific tool used to assess the knowledge of the patient with coronary disease on aspects related to the secondary prevention of coronary artery disease (CAD).nnnOBJECTIVEnTo translate, adapt and validate the MICRO-Q to Brazilian Portuguese.nnnMETHODSnTwo initial independent translations were carried out into Brazilian Portuguese. After their comparison, the reverse translation was carried out, which was reviewed by a committee and generated the final version that was tested in a pilot study. The tool was applied to 212 coronary patients, with a mean age of 60 to 71 years (standard deviation = 9.4; range: 35-86) that participated in cardiac rehabilitation programs. The internal consistency was verified by Cronbachs Alpha Coefficient, correlation through Spearmans Rho and the validity of the construct was verified through exploratory factorial analysis. The means were analyzed by comparing the scales of the correct questions in relation to variables such as age, sex, associate comorbidities, degree of schooling, family income, among others.nnnRESULTSnThe Brazilian version of the MICRO-Q has 25 questions. The reliability of this version presented a Cronbachs Alpha Coefficient of 0.64 and a Spearmans Rho of the correct answers of 0.65. The factorial analysis showed 6 factors related to the domains of knowledge of the questionnaire. The analysis of the population characteristics regarding the scales of the correct questions presented significant differences only in relation to monthly family income and degree of schooling.nnnCONCLUSIONnThe approved Brazilian version of the MICRO-Q presents adequate validity and reliability for its use in future studies.

Manual vibrocompression and nasotracheal suctioning in post-operative period of infants with heart deffects

OBJETIVO: Verificar a repercussao da vibrocompressao manual e da aspiracao nasotraqueal sobre os parâmetros cardiorrespiratorios de frequencia cardiaca (fc) e respiratoria (fr), saturacao periferica de oxigenio (SpO2), dor e desconforto respiratorio, em lactentes no pos-operatorio de cirurgias cardiacas. METODOS: Estudo controlado e randomizado, com as avaliacoes realizadas pela mesma fisioterapeuta, em dois momentos: antes e apos o procedimento. Dividiu-se o total de lactentes, por sorteio simples, em dois grupos: Intervencao (GI), com vibrocompressao manual toracica, aspiracao nasotraqueal e repouso; e Controle (GC), com 30 minutos de repouso. Avaliaram-se os dados cardiorrespiratorios (SpO2; fc; fr), aplicando-se as escalas: Neonatal Infant Pain Scale (NIPS), para analisar a dor, e Boletim de Silvermann-Andersen (BSA), para verificar o desconforto respiratorio. Os dados foram tratados por meio de analise de variância (ANOVA) para medidas repetidas, sendo significante p<0,05. RESULTADOS: Avaliaram-se 20 lactentes cardiopatas, dez em cada grupo (sete acianoticos e tres cianoticos), com idades de zero a 12 meses. Para analisar a interacao entre o grupo e o tempo, observou-se diferenca significativa na variacao da SpO2 (p=0,016), sem alteracao nas demais variaveis. Ja o comportamento dos parâmetros nos tempos apresentou diferenca significativa apenas na variacao da fr (p=0,001). Quanto a avaliacao do efeito no grupo, nao houve diferenca estatistica em nenhum dos dados (SpO2 - p=0,77; fc - p=0,14; fr - p=0,17; NIPS - p=0,49 e BSA - p=0,51). CONCLUSOES: A vibrocompressao manual e a aspiracao nasotraqueal aplicadas em lactentes no pos-operatorio de cirurgias cardiacas nao prejudicaram a SpO2 e a fr, alem de nao desencadearem dor e desconforto respiratorio. [Registro Brasileiro de Ensaios Clinicos (ReBEC): REQ: 1467].OBJECTIVE: To evaluate the impact of manual vibrocompression and nasotracheal suctioning on heart (hr) and respiratory (rr) rates, peripheral oxygen saturation (SpO2), pain and respiratory distress in infants in the postoperative period of a cardiac surgery. METHODS: Randomized controlled trial, in which the assessments were performed by the same physiotherapist in two moments: before and after the procedure. The infants were randomly divided into two groups: Intervention (IG), with manual chest vibrocompression, nasotracheal suctioning and resting; and Control CG), with 30 minutes of rest. Cardiorespiratory data (SpO2; hr; rr) were monitored and the following scales were used: Neonatal Infant Pain Scale (NIPS), for pain evaluation, and Bulletin of Silverman-Andersen (BSA), for respiratory distress assessment. The data were verified by analysis of variance (ANOVA) for repeated measures, being significant p<0.05. RESULTS: 20 infants with heart disease, ten in each group (seven acyanotic and three cyanotic) were enrolled, with ages ranging from zero to 12 months. In the analysis of the interaction between group and time, there was a significant difference in the variation of SpO2 (p=0.016), without changes in the other variables. Considering the main effect on time, only rr showed a significant difference (p=0.001). As for the group main effect, there were no statistical differences (SpO2 - p=0.77, hr - p=0.14, rr - p=0.17, NIPS - p=0.49 and BSA - p=0.51 ). CONCLUSIONS: The manual vibrocompression and the nasotracheal suctioning applied to infants in postoperative of cardiac surgery did not altered SpO2 and rr, and did not trigger pain and respiratory distress. [Brazilian Registry of Clinical Trials (ReBEC): REQ: 1467].

Predictive equations for maximal respiratory pressures of children aged 7–10

Highlights • Predictive equations allow comparisons between children with or without changes in respiratory muscle strength.• Predictive equations facilitate the monitoring and control of physical therapy interventions.• Age and biometric measurements had little influence on the values of maximal respiratory pressures.

Proposal for a performance of physical therapy on the health of children and adolescents: a need in primary care

Objective: To develop a proposal for physical therapy in primary health aiming to systematize this service to child health and adolescent. Method: literature / research in Scielo, Lilacs and Medline. Results: the therapist not only restores, develops and retains the physical ability of the patient, also prevents diseases and promotes guidelines. Thus, we propose a performance based on three strategies: guidance, assistance and support. Conclusion: the physiotherapist in primary care can accomplish their integration into multidisciplinary team of basic health units in the matrix support programs and family health.Objetivo: elaborar uma proposta de assistencia fisioterapeutica na rede basica de saude objetivando sistematizar esse servico para a saude da crianca e do adolescente. Metodo: revisao bibliografica/pesquisa nas bases de dados Scielo, Lilacs e Medline. Resultados: o fisioterapeuta nao apenas restaura, desenvolve e conserva a capacidade fisica do paciente, como tambem previne doencas e promove orientacoes. Assim, propoe-se sua atuacao com base em tres estrategias: orientacao, assistencia e acompanhamento. Conclusao: o fisioterapeuta na atencao primaria pode efetivar sua integracao na equipe multiprofissional das UBS, no apoio matricial e programas de saude da familia.

Proposta de atuação da fisioterapia na saúde da criança e do adolescente: uma necessidade na atenção básica

Objective: To develop a proposal for physical therapy in primary health aiming to systematize this service to child health and adolescent. Method: literature / research in Scielo, Lilacs and Medline. Results: the therapist not only restores, develops and retains the physical ability of the patient, also prevents diseases and promotes guidelines. Thus, we propose a performance based on three strategies: guidance, assistance and support. Conclusion: the physiotherapist in primary care can accomplish their integration into multidisciplinary team of basic health units in the matrix support programs and family health.Objetivo: elaborar uma proposta de assistencia fisioterapeutica na rede basica de saude objetivando sistematizar esse servico para a saude da crianca e do adolescente. Metodo: revisao bibliografica/pesquisa nas bases de dados Scielo, Lilacs e Medline. Resultados: o fisioterapeuta nao apenas restaura, desenvolve e conserva a capacidade fisica do paciente, como tambem previne doencas e promove orientacoes. Assim, propoe-se sua atuacao com base em tres estrategias: orientacao, assistencia e acompanhamento. Conclusao: o fisioterapeuta na atencao primaria pode efetivar sua integracao na equipe multiprofissional das UBS, no apoio matricial e programas de saude da familia.

Vibrocompresión manual y aspiración nasotraqueal en el post-operatorio de lactantes cardiópatas

OBJETIVO: Verificar a repercussao da vibrocompressao manual e da aspiracao nasotraqueal sobre os parâmetros cardiorrespiratorios de frequencia cardiaca (fc) e respiratoria (fr), saturacao periferica de oxigenio (SpO2), dor e desconforto respiratorio, em lactentes no pos-operatorio de cirurgias cardiacas. METODOS: Estudo controlado e randomizado, com as avaliacoes realizadas pela mesma fisioterapeuta, em dois momentos: antes e apos o procedimento. Dividiu-se o total de lactentes, por sorteio simples, em dois grupos: Intervencao (GI), com vibrocompressao manual toracica, aspiracao nasotraqueal e repouso; e Controle (GC), com 30 minutos de repouso. Avaliaram-se os dados cardiorrespiratorios (SpO2; fc; fr), aplicando-se as escalas: Neonatal Infant Pain Scale (NIPS), para analisar a dor, e Boletim de Silvermann-Andersen (BSA), para verificar o desconforto respiratorio. Os dados foram tratados por meio de analise de variância (ANOVA) para medidas repetidas, sendo significante p<0,05. RESULTADOS: Avaliaram-se 20 lactentes cardiopatas, dez em cada grupo (sete acianoticos e tres cianoticos), com idades de zero a 12 meses. Para analisar a interacao entre o grupo e o tempo, observou-se diferenca significativa na variacao da SpO2 (p=0,016), sem alteracao nas demais variaveis. Ja o comportamento dos parâmetros nos tempos apresentou diferenca significativa apenas na variacao da fr (p=0,001). Quanto a avaliacao do efeito no grupo, nao houve diferenca estatistica em nenhum dos dados (SpO2 - p=0,77; fc - p=0,14; fr - p=0,17; NIPS - p=0,49 e BSA - p=0,51). CONCLUSOES: A vibrocompressao manual e a aspiracao nasotraqueal aplicadas em lactentes no pos-operatorio de cirurgias cardiacas nao prejudicaram a SpO2 e a fr, alem de nao desencadearem dor e desconforto respiratorio. [Registro Brasileiro de Ensaios Clinicos (ReBEC): REQ: 1467].OBJECTIVE: To evaluate the impact of manual vibrocompression and nasotracheal suctioning on heart (hr) and respiratory (rr) rates, peripheral oxygen saturation (SpO2), pain and respiratory distress in infants in the postoperative period of a cardiac surgery. METHODS: Randomized controlled trial, in which the assessments were performed by the same physiotherapist in two moments: before and after the procedure. The infants were randomly divided into two groups: Intervention (IG), with manual chest vibrocompression, nasotracheal suctioning and resting; and Control CG), with 30 minutes of rest. Cardiorespiratory data (SpO2; hr; rr) were monitored and the following scales were used: Neonatal Infant Pain Scale (NIPS), for pain evaluation, and Bulletin of Silverman-Andersen (BSA), for respiratory distress assessment. The data were verified by analysis of variance (ANOVA) for repeated measures, being significant p<0.05. RESULTS: 20 infants with heart disease, ten in each group (seven acyanotic and three cyanotic) were enrolled, with ages ranging from zero to 12 months. In the analysis of the interaction between group and time, there was a significant difference in the variation of SpO2 (p=0.016), without changes in the other variables. Considering the main effect on time, only rr showed a significant difference (p=0.001). As for the group main effect, there were no statistical differences (SpO2 - p=0.77, hr - p=0.14, rr - p=0.17, NIPS - p=0.49 and BSA - p=0.51 ). CONCLUSIONS: The manual vibrocompression and the nasotracheal suctioning applied to infants in postoperative of cardiac surgery did not altered SpO2 and rr, and did not trigger pain and respiratory distress. [Brazilian Registry of Clinical Trials (ReBEC): REQ: 1467].

Vibrocompressão manual e aspiração nasotraqueal no pós-operatório de lactentes cardiopatas

OBJETIVO: Verificar a repercussao da vibrocompressao manual e da aspiracao nasotraqueal sobre os parâmetros cardiorrespiratorios de frequencia cardiaca (fc) e respiratoria (fr), saturacao periferica de oxigenio (SpO2), dor e desconforto respiratorio, em lactentes no pos-operatorio de cirurgias cardiacas. METODOS: Estudo controlado e randomizado, com as avaliacoes realizadas pela mesma fisioterapeuta, em dois momentos: antes e apos o procedimento. Dividiu-se o total de lactentes, por sorteio simples, em dois grupos: Intervencao (GI), com vibrocompressao manual toracica, aspiracao nasotraqueal e repouso; e Controle (GC), com 30 minutos de repouso. Avaliaram-se os dados cardiorrespiratorios (SpO2; fc; fr), aplicando-se as escalas: Neonatal Infant Pain Scale (NIPS), para analisar a dor, e Boletim de Silvermann-Andersen (BSA), para verificar o desconforto respiratorio. Os dados foram tratados por meio de analise de variância (ANOVA) para medidas repetidas, sendo significante p<0,05. RESULTADOS: Avaliaram-se 20 lactentes cardiopatas, dez em cada grupo (sete acianoticos e tres cianoticos), com idades de zero a 12 meses. Para analisar a interacao entre o grupo e o tempo, observou-se diferenca significativa na variacao da SpO2 (p=0,016), sem alteracao nas demais variaveis. Ja o comportamento dos parâmetros nos tempos apresentou diferenca significativa apenas na variacao da fr (p=0,001). Quanto a avaliacao do efeito no grupo, nao houve diferenca estatistica em nenhum dos dados (SpO2 - p=0,77; fc - p=0,14; fr - p=0,17; NIPS - p=0,49 e BSA - p=0,51). CONCLUSOES: A vibrocompressao manual e a aspiracao nasotraqueal aplicadas em lactentes no pos-operatorio de cirurgias cardiacas nao prejudicaram a SpO2 e a fr, alem de nao desencadearem dor e desconforto respiratorio. [Registro Brasileiro de Ensaios Clinicos (ReBEC): REQ: 1467].OBJECTIVE: To evaluate the impact of manual vibrocompression and nasotracheal suctioning on heart (hr) and respiratory (rr) rates, peripheral oxygen saturation (SpO2), pain and respiratory distress in infants in the postoperative period of a cardiac surgery. METHODS: Randomized controlled trial, in which the assessments were performed by the same physiotherapist in two moments: before and after the procedure. The infants were randomly divided into two groups: Intervention (IG), with manual chest vibrocompression, nasotracheal suctioning and resting; and Control CG), with 30 minutes of rest. Cardiorespiratory data (SpO2; hr; rr) were monitored and the following scales were used: Neonatal Infant Pain Scale (NIPS), for pain evaluation, and Bulletin of Silverman-Andersen (BSA), for respiratory distress assessment. The data were verified by analysis of variance (ANOVA) for repeated measures, being significant p<0.05. RESULTS: 20 infants with heart disease, ten in each group (seven acyanotic and three cyanotic) were enrolled, with ages ranging from zero to 12 months. In the analysis of the interaction between group and time, there was a significant difference in the variation of SpO2 (p=0.016), without changes in the other variables. Considering the main effect on time, only rr showed a significant difference (p=0.001). As for the group main effect, there were no statistical differences (SpO2 - p=0.77, hr - p=0.14, rr - p=0.17, NIPS - p=0.49 and BSA - p=0.51 ). CONCLUSIONS: The manual vibrocompression and the nasotracheal suctioning applied to infants in postoperative of cardiac surgery did not altered SpO2 and rr, and did not trigger pain and respiratory distress. [Brazilian Registry of Clinical Trials (ReBEC): REQ: 1467].