Silvana Maria Blascovi-Assis

Avaliação do equilíbrio estático de crianças e adolescentes com síndrome de Down

OBJETIVOS: Avaliar o equilibrio estatico de criancas e adolescentes com Sindrome de Down (SD) pela Biofotogrametria Computadorizada e verificar a influencia da visao nesta situacao. METODOS: Participaram 11 criancas e adolescentes com SD e 14 criancas e adolescentes de ambos os generos, neurologicamente normais que compuseram o grupo controle. Durante as filmagens, os participantes se mantiveram na posicao ortostatica com os bracos posicionados ao lado do corpo e com os pes paralelos sobre uma superficie plana. As criancas de ambos os grupos foram filmadas na vista anterior (plano frontal) e na vista de perfil direito (plano sagital) nas condicoes com visao e sem visao. Nas filmagens na condicao de olhos fechados, foram utilizados oculos de natacao totalmente vedados, com a finalidade do participante nao ter nenhuma informacao visual. O instrumento utilizado foi a Biofotogrametria Computadorizada, que serviu como referencia angular para verificar as oscilacoes do corpo em equilibrio estatico. RESULTADOS:As criancas e adolescentes com SD oscilaram mais (p<0,05) que as do grupo controle e, quando a informacao visual foi manipulada, as oscilacoes ântero-posterior e latero-lateral mostraram a existencia de diferencas significativas no equilibrio nas criancas e adolescentes com SD quando comparadas com as criancas do grupo controle (p<0,01). CONCLUSAO:O presente estudo mostrou que as criancas e adolescentes com SD oscilaram mais que as criancas do grupo controle com e sem a informacao visual nos planos ântero-posterior e latero-lateral.

Impact of delivering the news about Down syndrome on parents: life stories

This paper aimed to know and discuss a group of parents of Down syndrome children reactions and feelings and the impact of the news and diagnostic. Four couples whose children received the diagnostic of Down syndrome participated in this research. Data were collected through a semi-structured interview and the results were qualitatively analyzed, using categories. Results indicated that all four couples relate the feeling of loss of the idealized son. It can be observed from this study the need for professional capacitating because the impact of the moment the family receive the news can interfere in the familys dynamic, as well as in the childs development.

Functional performance of children with cerebral palsy from high and low socioeconomic status

OBJETIVO: Investigar la influencia del nivel socioeconomico sobre el desempeno funcional de ninos con paralisis cerebral. METODOS: Estudio transversal, con acercamiento cuantitativo. Se seleccionaron 49 ninos con diagnostico clinico de paralisis cerebral de una muestra de conveniencia, con edades entre tres y siete anos y medio, de ambos sexos, clasificadas conforme al nivel de gravedad de paralisis cerebral, con base en el Sistema de Clasificacion de la Funcion Motora Grosera. Los participantes fueron distribuidos en dos grupos de niveles socioeconomicos, alto y bajo, conforme al Criterio de Clasificacion Economica de Brasil. El desempeno funcional fue evaluado con el Inventario de Evaluacion Pediatrica de Discapacidad. Se aplico la prueba t de Student para muestras independientes a fin de comparar los promedios entre los grupos. RESULTADOS: El nivel socioeconomico no afecto el desempeno funcional de ninos con paralisis cerebral liviana. Ninos con paralisis cerebral moderada de clase economica baja presentaron escores de la funcion social inferiores (p=0,027) a los de ninos de clase alta. Ninos con paralisis cerebral grave de nivel socioeconomico bajo presentaron desempeno inferior en las habilidades de autocuidado (p=0,021) y movilidad (p=0,005). Esos ninos fueron mas dependientes respecto a la movilidad (p=0,015) que los de nivel socioeconomico alto. CONCLUSIONES: El nivel socioeconomico puede ejercer influencia en el desarrollo del nino con paralisis cerebral, debiendo ser factor de riesgo considerado en las acciones educacionales y de salud dirigidas a esa poblacion.OBJECTIVE To investigate the influence of socioeconomic status on the functional performance of children with cerebral palsy. METHODS Cross-sectional quantitative study of 49 children diagnosed with cerebral palsy from a convenience sample. Children of both genders aged three to seven and a half years were studied. They were classified according to the level of severity of cerebral palsy based on the Gross Motor Function Classification System. Participants were organized in two groups considering their high or low socioeconomic status, according to the Brazilian Economic Classification Criteria. Functional performance was assessed by the Pediatric Evaluation of Disability Inventory. The Students t-test was applied for independent samples in order to compare means between groups. RESULTS Socioeconomic status did not affect functional performance of children with mild cerebral palsy. Those with moderate cerebral palsy and low socioeconomic status presented lower social function scores (p=0.027) than those with high socioeconomic status. Children with severe cerebral palsy with low socioeconomic status presented worse performance in self-care skills (p=0.021) and mobility (p=0.005). These children were more dependent regarding mobility (p=0.015) than those with high socioeconomic status. CONCLUSIONS Socioeconomic status may influence the development process of children with cerebral palsy and must be considered as a risk factor in educational and health practices aimed at this population.

Desempenho funcional de crianças com paralisia cerebral de níveis socioeconômicos alto e baixo

OBJETIVO: Investigar la influencia del nivel socioeconomico sobre el desempeno funcional de ninos con paralisis cerebral. METODOS: Estudio transversal, con acercamiento cuantitativo. Se seleccionaron 49 ninos con diagnostico clinico de paralisis cerebral de una muestra de conveniencia, con edades entre tres y siete anos y medio, de ambos sexos, clasificadas conforme al nivel de gravedad de paralisis cerebral, con base en el Sistema de Clasificacion de la Funcion Motora Grosera. Los participantes fueron distribuidos en dos grupos de niveles socioeconomicos, alto y bajo, conforme al Criterio de Clasificacion Economica de Brasil. El desempeno funcional fue evaluado con el Inventario de Evaluacion Pediatrica de Discapacidad. Se aplico la prueba t de Student para muestras independientes a fin de comparar los promedios entre los grupos. RESULTADOS: El nivel socioeconomico no afecto el desempeno funcional de ninos con paralisis cerebral liviana. Ninos con paralisis cerebral moderada de clase economica baja presentaron escores de la funcion social inferiores (p=0,027) a los de ninos de clase alta. Ninos con paralisis cerebral grave de nivel socioeconomico bajo presentaron desempeno inferior en las habilidades de autocuidado (p=0,021) y movilidad (p=0,005). Esos ninos fueron mas dependientes respecto a la movilidad (p=0,015) que los de nivel socioeconomico alto. CONCLUSIONES: El nivel socioeconomico puede ejercer influencia en el desarrollo del nino con paralisis cerebral, debiendo ser factor de riesgo considerado en las acciones educacionales y de salud dirigidas a esa poblacion.OBJECTIVE To investigate the influence of socioeconomic status on the functional performance of children with cerebral palsy. METHODS Cross-sectional quantitative study of 49 children diagnosed with cerebral palsy from a convenience sample. Children of both genders aged three to seven and a half years were studied. They were classified according to the level of severity of cerebral palsy based on the Gross Motor Function Classification System. Participants were organized in two groups considering their high or low socioeconomic status, according to the Brazilian Economic Classification Criteria. Functional performance was assessed by the Pediatric Evaluation of Disability Inventory. The Students t-test was applied for independent samples in order to compare means between groups. RESULTS Socioeconomic status did not affect functional performance of children with mild cerebral palsy. Those with moderate cerebral palsy and low socioeconomic status presented lower social function scores (p=0.027) than those with high socioeconomic status. Children with severe cerebral palsy with low socioeconomic status presented worse performance in self-care skills (p=0.021) and mobility (p=0.005). These children were more dependent regarding mobility (p=0.015) than those with high socioeconomic status. CONCLUSIONS Socioeconomic status may influence the development process of children with cerebral palsy and must be considered as a risk factor in educational and health practices aimed at this population.

Microcefalia e outras manifestações relacionadas ao vírus Zika: impacto nas crianças, nas famílias e nas equipes de saúde

The present study aimed to present an overview of recent national and international research on the Zika virus (ZIKV), as well as to explore possible action plans focused on children, their families and the health teams involved.Therefore, the study proposes the implementation of tracking systems in order to identify, describe and characterize the potential correlates of prenatal exposure to ZIKV, divided into three lines of action: 1. Diagnostic and etiological evaluation as well as screening of developmental problems in children confirmed or suspected of prenatal ZIKV infection. 2. Investigation of the emotional impact, quality of life, coping strategies and support network of the affected children and their families. 3. Training of multidisciplinary teams to conduct assessments and intervention programs throughout these childrens development, especially in the first three years of life. In conclusion, the recent ZIKV outbreak in Brazil and several other Latin American countries places a significant burden on the health care systems: to understand the real meaning of a potential new teratogen; to unravel the pathogenic mechanisms of ZIKV, particularly in a prevention perspective; and to recognize the broad spectrum of clinical manifestations in order to devise intervention programs.O presente estudo objetivou apresentar um panorama nacional e internacional atual dos estudos sobre o virus Zika (ZIKV) e, ancorado no avanco deste conhecimento, refletir sobre planos de acao voltados para as criancas, familias e equipes de saude envolvidas. Neste sentido, o estudo propos a implementacao de sistemas de seguimento para conhecer, descrever e caracterizar aspectos que devem estar relacionados a exposicao pre-natal ao ZIKV, divididos em tres eixos de atuacao: 1. Avaliacao diagnostica e etiologica e rastreamento de problemas de desenvolvimento nas criancas incluidas como casos confirmados ou suspeitos. 2. Investigacao do impacto emocional, da qualidade de vida, das estrategias de enfrentamento e da rede de apoio as familias das criancas incluidas. 3. Capacitacao de equipes multiprofissionais para avaliar e elaborar programas de intervencao ao longo do desenvolvimento das criancas, principalmente nos tres primeiros anos de vida. Como conclusao, o presente trabalho ressalta que o sistema de assistencia a saude encontra-se diante de grandes desafios: entender o real significado de um potencial novo teratogeno; desvendar os mecanismos patogenicos do ZIKV, principalmente para o enfrentamento preventivo, e reconhecer o amplo espectro de manifestacoes clinicas para a elaboracao de programas de intervencao.

Instruments to assess quality of life in patients with heart failure

Introduction : Heart failure (HF) is a complex clinical syndrome representing the common final pathway of various heart diseases. It is characterized by low exercise tolerance, low survival rates and deteriorated quality of life. Several studies mention Quality of Life (QoL) as an important source of information on how disease truly affects patients lives. In this context, the assessment of QoL is extremely important to provide data that support the choice of a therapeutic strategy and the assessment of the effectiveness of a treatment. Objectives : This study aimed to investigate and identify the most appropriate and widely used instrument for the assessment of quality of life in patients with HF. Methods : We searched the databases of Lilacs, Medline, Pubmed, Scielo and CAPES to identify relevant articles published in English and Portuguese between 2000 and 2010. Results : We found 25 papers that described, quoted or used instruments for the assessment of QoL in patients with HF. Conclusion : The MLHFQ is the most widely used instrument to assess QoL in patients with HF. Its good metric properties have been confirmed in a large number of studies. In addition, it has a simple structure and is easy to administer, which makes it the most recommended instrument for this purpose.

Efeito da dominância lateral no desempenho da destreza manual em pessoas com síndrome de Down

Objective: To evaluate the effect of lateral dominance on manual dexterity in a group of children and adolescents with Down syndrome (DS) and to compare the results from participants with DS with people without the syndrome. Method: The study included 100 children and adolescents of both sexes with ages ranging from 7 to 9 years and 14 to 15 years. 50 people were diagnosed with DS (GDS) and 50 without the syndrome (GC). The Box and Blocks Test (BBT) was used because it allows assessment of motor activity by counting the number of blocks transferred between two divisions of a standard box. The BBT implementation is simple and does not require complex cognitive skills. Results: The number of blocks transferred per minute was lower in participants of GDS than the GC, with a clear disadvantage for manual dexterity in both hands. There was no effect of dominance in the GDS, but the GC showed better performance on the dominant side. Conclusion: The BBT was useful for the quantification of manual dexterity in people with DS as it is easy to apply and understand by people with cognitive impairment.Objetivos: Avaliar o efeito da dominância lateral na destreza manual em um grupo de criancas e adolescentes com Sindrome de Down (SD) e comparar o resultado de participantes com SD com pessoas sem a sindrome. Metodos: Participaram do estudo 100 criancas e adolescentes de ambos os sexos e idade variando de 7 a 9 anos e de 14 e 15 anos. 50 pessoas tinham diagnostico de SD (GSD) e 50 sem a sindrome (GC). O Teste Caixa e Blocos (TCB) foi usado por possibilitar avaliacao da atividade motora a partir da contagem do numero de blocos transferidos entre duas divisoes de uma caixa padronizada. O TCB e simples e sua aplicacao nao demanda habilidades cognitivas complexas. Resultados: O numero de blocos transferidos por minuto foi menor nos participantes do GSD do que os do GC, com evidente desvantagem na destreza manual para ambas as maos. Nao foi observado efeito de dominância no GSD, mas no GC este efeito foi observado com melhor desempenho no lado dominante. Conclusoes: O TCB foi util para a quantificacao da destreza manual em pessoas com SD ja que e de facil aplicacao e compreensao por pessoas com deficit cognitivo.

Artigo originalBocha adaptada: análise cinemática do arremesso e sua relação com a realidade virtualBoccia: Kinematics of the throwing and its relationship with virtual realityBocha: análisis cinemático del lanzamiento y su relación con la realidad virtual

The objectives of this study were to correlate biomechanical characteristics of the upper limb during the throw of the boccia and bowling game Kinect Sports Xbox video game from Microsoft Games Studios®. The participants were 8 athletes, 5 classified as BC2 and BC4 as 3. Measurements of the angles of wrist and elbow and the average linear velocity of the most effective pitches through footage for kinematic analysis were collected Similarities were found in the angles of wrist and elbow and the average linear velocity of pitches in both situations. Thus, it is concluded that the use of virtual reality is a factor to be considered in the training of boccia.

Bocha: análisis cinemático del lanzamiento y su relación con la realidad virtual

The objectives of this study were to correlate biomechanical characteristics of the upper limb during the throw of the boccia and bowling game Kinect Sports Xbox video game from Microsoft Games Studios®. The participants were 8 athletes, 5 classified as BC2 and BC4 as 3. Measurements of the angles of wrist and elbow and the average linear velocity of the most effective pitches through footage for kinematic analysis were collected Similarities were found in the angles of wrist and elbow and the average linear velocity of pitches in both situations. Thus, it is concluded that the use of virtual reality is a factor to be considered in the training of boccia.

Bocha adaptada: análise cinemática do arremesso e sua relação com a realidade virtual

The objectives of this study were to correlate biomechanical characteristics of the upper limb during the throw of the boccia and bowling game Kinect Sports Xbox video game from Microsoft Games Studios®. The participants were 8 athletes, 5 classified as BC2 and BC4 as 3. Measurements of the angles of wrist and elbow and the average linear velocity of the most effective pitches through footage for kinematic analysis were collected Similarities were found in the angles of wrist and elbow and the average linear velocity of pitches in both situations. Thus, it is concluded that the use of virtual reality is a factor to be considered in the training of boccia.