Rosa Maria de Carvalho

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.

Comparação entre parâmetros de pressões respiratórias máximas em indivíduos saudáveis

OBJECTIVE To investigate four parameters defining maximal respiratory pressures and to evaluate their correlations and agreements among those parameters for the determination of MIP and MEP. METHODS This was a cross-sectional study involving 49 healthy, well-nourished males and females. The mean age was 23.08 ± 2.5 years. Measurements were carried out using a pressure transducer, and the estimated values for the parameters peak pressure (Ppeak), plateau pressure (Pplateau), mean maximal pressure (Pmean), and pressure according to the area (Parea) were determined with an algorithm developed for the study. To characterize the study sample, we used descriptive statistics, followed by repeated measures ANOVA and Bonferroni post hoc test or by the Friedman test and the Wilcoxon post hoc test, as well as by Pearsons or Spearmans correlation coefficients, depending on the normality of the data. The agreement between the variables was assessed with Bland & Altman plots. RESULTS There were significant differences among all of the parameters studied for MIP (Ppeak = 95.69 ± 27.89 cmH₂O; Parea = 88.53 ± 26.45 cmH₂O⁻; Pplateau = 82.48 ± 25.11 cmH₂O⁻; Pmean = 89.01 ± 26.41 cmH₂O⁻; p < 0.05 for all) and for MEP (Ppeak = 109.98 ± 40.67 cmH₂O; Parea = 103.85 ± 36.63 cmH₂O; Pplateau = 98.93 ± 32.10 cmH₂O; Pmean = 104.43 ± 36.74 cmH₂O; p < 0.0083 for all). Poor agreement was found among almost all of the parameters. Higher pressure values resulted in larger differences between the variables. CONCLUSIONS The maximal respiratory pressure parameters evaluated do not seem to be interchangeable, and higher pressure values result in larger differences among the parameters.

Exhaled nitric oxide and quality of life in asthmatic teenagers

Methods Twenty-seven teenagers with asthma detected through the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire answered the ISAAC rhinitis module and underwent spirometry, FeNO measurement and evaluation of QOL through Peadiatric Asthma Quality of Life Questionnaire (PAQLQ). Student t test and Kolmogorov – Smirnov test were applied for means comparison; association measures were performed through Pearson and Spearman correlation tests; a p-value<0.05 was considered to be statistically significant.