Renata Pedrolongo Basso

Description of the motor development of 3–12 month old infants with Down syndrome: The influence of the postural body position

The purpose of the present study was to describe the rate of motor development in infants with Down syndrome in the age range of 3-12 months and identify the difficulties both in performance and acquiring motor skills in prone, supine, sitting and standing positions. Nineteen infants with Down syndrome and 25 healthy full term typical infants were assessed using the Alberta Infant Motor Scale (AIMS) monthly from 3 to 12 months of age. The infants with Down syndrome achieved significant later the level of motor performance of the typical infants. In the supine posture, the performance was significantly lesser for the Down syndrome infants in comparison to the typical infants from the 3rd to 6th month and in the 8th month. In the prone, sitting and standing postures this difference is found for all the months. In conclusion, the sequence of motor development of the Down syndrome is the same as the typical infants. However infants with Down syndrome need more time to acquire skills, mainly antigravitational ones, among them the standing position.

Relationship of Bode Index to Functional Tests in Chronic Obstructive Pulmonary Disease

OBJECTIVE To determine if there is a correlation between the BODE Index and variables assessed during the Activities of Daily Living assessment, performance on lower limber tests, and peripheral muscle impairment of the upper limb in patients with chronic obstructive pulmonary disease. MATERIALS AND METHODS Ten men (aged 58 to 80 years old) with moderate to very severe obstruction were evaluated and classified by the BODE Index. They were evaluated by pulmonary ventilation (V̇E), oxygen consumption (V̇O2), and carbonic gas production (V̇CO2) on the ADL assessment; Distance Walking (DW) in the Six Minute Walking Test (6MWT) and the Six Minute Walking Test on Treadmill (6MWTT); number of repetitions in the Sit-to-Stand Test; and the Hand Grip Strength Test. Correlations were evaluated between the classification and the tests performed (Pearson and Spearman test, p<0.05). RESULTS The mean of the total score for the BODE Index was 2.80 (±1.03), with three patients scoring in the first quartile (Q1) and seven scoring in the second quartile (Q2). This Index showed a negative correlation with the 6MWTT (r=−0.86), the Sit-to-Stand Test (r=−0.66), and the Hand Grip Strength Test (r=−0.83). CONCLUSIONS Our results show that there is no correlation between the BODE Index and the ventilatory and metabolic responses in the Activities of Daily Living assessment. On the other hand, a correlation was observed between the BODE Index and the variables assessed in the 6MWTT, Sit-to-Stand Test, and Hand Grip Strength Test in moderate to very severe Chronic Obstructive Pulmonary Disease patients. This suggests that these tests can be employed as predictors of physical exercise capacity, perhaps as complementary tests to the BODE Index.

Infants with Down syndrome: Percentage and age for acquisition of gross motor skills

The literature is bereft of information about the age at which infants with Down syndrome (DS) acquire motor skills and the percentage of infants that do so by the age of 12 months. Therefore, it is necessary to identify the difference in age, in relation to typical infants, at which motor skills were acquired and the percentage of infants with DS that acquire them in the first year of life. Infants with DS (N=20) and typical infants (N=25), both aged between 3 and 12 months, were evaluated monthly using the AIMS. In the prone position, a difference of up to 3 months was found for the acquisition of the 3rd to 16th skill. There was a difference in the percentage of infants with DS who acquired the 10th to 21st skill (from 71% to 7%). In the supine position, a difference of up to one month was found from the 3rd to 7th skill; however, 100% were able to perform these skills. In the sitting position, a difference of 1-4 months was found from the 1st to 12th skill, ranging from 69% to 29% from the 9th to 12th. In the upright position, the difference was 2-3 months from the 3rd to 8th skill. Only 13% acquired the 8th skill and no other skill was acquired up to the age of 12 months. The more complex the skills the greater the difference in age between typical infants and those with DS and the lower the percentage of DS individuals who performed the skills in the prone, sitting and upright positions. None of the DS infants were able to stand without support.

Avaliação da capacidade de exercício em adolescentes asmáticos e saudáveis

Resumen pt: OBJETIVOS: Comparar o desempenho fisico e as respostas obtidas nos testes de caminhada de seis minutos (TC6) e do degrau de seis minutos (TD6) entre adol...

Teste do degrau e teste da cadeira: comportamento das respostas metábolo-ventilatórias e cardiovasculares na DPOC

OBJECTIVES: Verify the metabolic, ventilatory, cardiovascular and perceived effort responses between the isotime two minute step test (2MST) and six minute step test (6MST) with two minute sit-to-stand test (STST) in individuals with COPD. MATERIALS AND METHODS:11 men with COPD (71 ± 8 years, FEV1 = 46.1 ± 15.2% predicted), clinically stable, were evaluation by STST and 6MST associated gas analysis and blood lactate in days which were not consecutive and not coincidental. In the 6MST and 2MST, the subjects were instructed ascend-to-descend a step 20 cm in height as quickly as possible. It was recommended that in the STST was performed in a chair 46 cm high. RESULTS: In the inter-tests analysis, there was no significant difference in the metabolic, ventilatory, cardiovascular variables and delta of variation (Δ) dyspnea at the peak of both tests, and 2MST. The Δheart frequency and Δfatigue in the lower limbs were significantly higher compared to STST for 2MST. We observed moderate and strong positive correlations between oxygen consumption, Δheart frequency and performances in 2MST and 6MST, between performances in 6MST and STST, and 2MST with STST. CONCLUSION: The tests showed metabolic, ventilatory, cardiovascular and dyspnoea responses similar; and 2MST, can be alternative to assess the functional limitations of individuals with COPD severe obstruction, providing a lower cardiovascular stress and muscle fatigue compared to the STST, the peripheral metabolic requirements and postural adjustments.

Relação da medida da amplitude tóraco-abdominal de adolescentes asmáticos e saudáveis com seu desempenho físico

AIMS: The aims were verify the differences of amplitude thoracoabdominal by cirtometry, at the levels axillary, xiphoid and abdominal in asthmatics and healthy adolescents and to compare the difference between them. In addition correlate them with the physical exercise capacity. MATERIALS AND METHODS: Thirty eight adolescents were assessed, aged from 11 to 15 years, of both sex. Nineteen were asthmatic adolescent, which composed the asthmatic group (AG), and nineteen were health adolescents, which composed the healthy group (HG). A clinical history was provided and all subjects were submitted an anthropometric and spirometric evaluation, the six minute step test (6MST), the cirtometry, and was calculated the amplitude thoracoabdominal index (TAI). RESULTS: Significant difference (p < 0.05) was observed to TAI, between axillary and abdominal levels, and xiphoid and abdominal levels in both group. No significant difference in regard to TAI between groups. Only in the AG there was positive correlation of the total number of ascent in the 6MST with the axillary and xiphoid TAI (r = 0,57 e r = 0,50; p < 0,05). CONCLUSION: There were no difference in the thoracic and abdominal cirtometry in adolescents with intermittent and persistent mild asthma when compared with the healthy adolescents and there were correlation axillary and xiphoid TAI with the physical performance in the 6MST.

Hidrocinesioterapia no tratamento fisioterapêutico de um lactente com Síndrome de Down: estudo de caso

INTRODUCTION: The sensorial deficits presented at Down Syndrome may interfere in the posture control, movements, balance and coordination. Therefore, it the physiotherapy intervention is important. However, the literature is scarce regarding the aquatic therapy effects. OBJECTIVE: To investigate the effectiveness of hydrokinesiotherapy such as a complementary method of physiotherapy treatment in the acquisition of gross motor skills in an infant with Down Syndrome and hearing deficiency. MATERIALS AND METHODS: One infant with Down Syndrome, male, 1 year and 4 months old, with severe bilateral hearing deficiency participated of this study. The gross motor development was assessed by Alberta Infant Motor Scale (AIMS), which was applied in pre-intervention and in Step I and II post-intervention. Step I was physiotherapy intervention on the floor based on Neuroevolutive Concept. Step II was Neuroevolutive Concept plus hydrokynesiotherapy. Both the steps were conducted in 24 sessions. RESULTS: After Step I and II, there was an increase of three points in total score of AIMS, ranging from 11 to 14 and from 14 to 17, respectively. After Step I, one point increased in postures supine, sitting and standing; one and two points increased in the posture prone and sitting respectively, after Step II. CONCLUSION: Hydrokinesiotherapy improved the sensorial stimulation and control and strengthening of muscles of the trunk, reflecting a better motor performance of antigravity postures, prone and sitting.

Comparação de diferentes testes funcionais de membros inferiores em pacientes com doença pulmonar obstrutiva crônica: há concordância entre eles?

INTRODUCAO: Pacientes com Doenca Pulmonar Obstrutiva Cronica (DPOC) apresentam diminuicao da capacidade funcional, tornando imprescindivel a sua avaliacao por meio de testes fisicos funcionais. OBJETIVOS: Comparar, em pacientes com DPOC, saturacao periferica de oxigenio (SpO2), dispneia e fadiga de membros inferiores (MMII) nos testes de caminhada de seis minutos em corredor (TC6) e em pista oval (TC6Po), do degrau de seis minutos (TD6) e de sentar-e-levantar da cadeira de dois minutos (TSL). Alem disso, pretende-se verificar se ha correlacao e concordância dessas variaveis entre o TC6 e os demais testes. MATERIAIS E METODOS: Foram avaliados 11 pacientes com DPOC (71 ± 8 anos, VEF1 < 80% previsto) por meio dos testes. RESULTADOS: Na analise intertestes, nao se observaram diferencas significativas nos deltas da SpO2, dispneia (Δdispneia) e fadiga de MMII (ΔfadigaMMII). Constatou-se correlacao significante, mas nao concordância entre os menores valores da SpO2 no TC6 com os menores valores da SpO2 nos TC6Po, TD6 e TSL, sendo a media da diferenca entre as medias com ± 1,96 desvio padrao: 0,8 ± 3,5; -1,9 ± 3,5 e -2,5 ± 4,6, respectivamente; entre Δdispneia e ΔfadigaMMII no TC6 com Δdispneia e ΔfadigaMMII no TC6Po: 0,0 ± 1,0 e 0,4 ± 0,8, respectivamente; e do ΔfadigaMMII no TC6 com ΔfadigaMMII no TSL: 0,1 ± 1,1. CONCLUSAO: Os testes funcionais produziram respostas de oxigenacao e perceptuais de esforco semelhantes em magnitude. Entretanto, de acordo com as variaveis analisadas, nao foi encontrada concordância entre o TC6 com os demais testes, pelas grandes variacoes dos limites de concordância e grande variacao interindividual, assim o TC6Po, TD6 e TSL nao substitui o TC6.