Percepção de pais e cuidadores de crianças com deficiência sobre os serviços de reabilitação durante a pandemia da COVID-19 no Brasil / Perception of parents and caregivers of children with disabilities about rehabilitation services during the COVID-19 pandemic in Brazil

INTRODUÇÃO: Observou-se durante a pandemia do coronavírus no Brasil a suspensão das sessões de reabilitação de crianças com deficiência. OBJETIVO: Analisar o andamento das sessões de reabilitação durante a pandemia, bem como a forma de suporte que os pais/cuidadores receberam neste período. MATERIAIS E MÉTODOS: Estudo qualitativo, com delineamento transversal, conduzido on-line pela plataforma Survey Monkey. Participaram pais e cuidadores de crianças com deficiência motora de zero a quatro anos de idade, que foram recrutados através das mídias sociais. A coleta de dados ocorreu por um questionário com 17 perguntas abertas e fechadas, acessível por um período de três meses durante o período de novembro de 2020 a janeiro de 2021. RESULTADOS: Todos os questionários foram lidos na íntegra e após observada saturação das respostas, 37 foram elegíveis. A suspensão das sessões nos serviços de reabilitação variou de 2 a 9 meses. Durante este período, vinte e seis famílias receberam orientações do profissional ou da instituição para estimular a criança em casa; para os demais, que não receberam orientações, a justificativa fornecida era que deviam aguardar a retomada dos atendimentos. Dezesseis famílias tiveram dificuldades para realizar as atividades/exercícios propostos pelos profissionais de saúde em ambiente domiciliar. CONCLUSÃO: Foram identificados, através das respostas dos pais, sentimentos de preocupação e ansiedade com a suspensão dos serviços de reabilitação durante a pandemia e medo com os possíveis prejuízos no desenvolvimento neuropsicomotor das crianças. Além disso, os pais se sentiram desamparados pelos serviços de saúde e profissionais.

INTRODUCTION: During the coronavirus pandemic in Brazil, the suspension of rehabilitation sessions for children with disabilities was observed. OBJECTIVE: To analyze the progress of rehabilitation sessions during the pandemic, as well as the form of support that parents/caregivers received during this period. MATERIALS AND METHODS: Qualitative study, with a cross-sectional design, conducted online through the Survey Monkey platform. Parents and caregivers of children with motor disabilities aged zero to four years old participated, and were recruited through social media. Data collection took place by a questionnaire with 17 open and closed questions, accessible for a period of three months during the period November 2020 to January 2021. RESULTS: All questionnaires were read in full and after observing saturation of responses, 37 were eligible. The suspension of sessions in rehabilitation services ranged from 2 to 9 months. During this period, twenty-six families received guidance from the professional or the institution to stimulate the child at home, for the others who did not receive guidance, the justification provided was to wait for the resumption of care. Sixteen families had difficulties performing the activities/exercises proposed by health professionals in the home environment. CONCLUSION: Parents' responses identified feelings of concern and anxiety about the suspension of rehabilitation services during the pandemic and fear of possible damage to children's neuropsychomotor development. In addition, parents felt helpless by health services and professionals.

[Errata] Percepção de pais e cuidadores de crianças com deficiência sobre os serviços de reabilitação durante a pandemia da COVID-19 no Brasil / [Erratum] Perception of parents and caregivers of children with disabilities about rehabilitation services during the COVID-19 pandemic in Brazil

INTRODUÇÃO: Observou-se durante a pandemia do coronavírus no Brasil a suspensão das sessões de reabilitação de crianças com deficiência. OBJETIVO: Analisar o andamento das sessões de reabilitação durante a pandemia, bem como a forma de suporte que os pais/cuidadores receberam neste período. MATERIAIS E MÉTODOS: Estudo qualitativo, com delineamento transversal, conduzido on-line pela plataforma Survey Monkey. Participaram pais e cuidadores de crianças com deficiência motora de zero a quatro anos de idade, que foram recrutados através das mídias sociais. A coleta de dados ocorreu por um questionário com 17 perguntas abertas e fechadas, acessível por um período de três meses durante o período de novembro de 2020 a janeiro de 2021. RESULTADOS: Todos os questionários foram lidos na íntegra e após observada saturação das respostas, 37 foram elegíveis. A suspensão das sessões nos serviços de reabilitação variou de 2 a 9 meses. Durante este período, vinte e seis famílias receberam orientações do profissional ou da instituição para estimular a criança em casa; para os demais, que não receberam orientações, a justificativa fornecida era que deviam aguardar a retomada dos atendimentos. Dezesseis famílias tiveram dificuldades para realizar as atividades/exercícios propostos pelos profissionais de saúde em ambiente domiciliar. CONCLUSÃO: Foram identificados, através das respostas dos pais, sentimentos de preocupação e ansiedade com a suspensão dos serviços de reabilitação durante a pandemia e medo com os possíveis prejuízos no desenvolvimento neuropsicomotor das crianças. Além disso, os pais se sentiram desamparados pelos serviços de saúde e profissionais.

INTRODUCTION: During the coronavirus pandemic in Brazil, the suspension of rehabilitation sessions for children with disabilities was observed. OBJECTIVE: To analyze the progress of rehabilitation sessions during the pandemic, as well as the form of support that parents/caregivers received during this period. MATERIALS AND METHODS: Qualitative study, with a cross-sectional design, conducted online through the Survey Monkey platform. Parents and caregivers of children with motor disabilities aged zero to four years old participated, and were recruited through social media. Data collection took place by a questionnaire with 17 open and closed questions, accessible for a period of three months during the period November 2020 to January 2021. RESULTS: All questionnaires were read in full and after observing saturation of responses, 37 were eligible. The suspension of sessions in rehabilitation services ranged from 2 to 9 months. During this period, twenty-six families received guidance from the professional or the institution to stimulate the child at home, for the others who did not receive guidance, the justification provided was to wait for the resumption of care. Sixteen families had difficulties performing the activities/exercises proposed by health professionals in the home environment. CONCLUSION: Parents' responses identified feelings of concern and anxiety about the suspension of rehabilitation services during the pandemic and fear of possible damage to children's neuropsychomotor development. In addition, parents felt helpless by health services and professionals.

Theoretical construction and practical research on the curriculum system of children's rehabilitation specialty in rehabilitation therapy / 中华医学教育探索杂志

This article takes the setting of children's rehabilitation specialty in the rehabilitation therapy of Xiamen Medical College as an example, and expounds that in the process of cultivating talents in children's rehabilitation, theoretically, a training model of "2.5+0.5+1" has been built closely around the training goals of "solid foundation, wide caliber and strong skills", highlighting basic pediatric courses, core skills courses for children's rehabilitation therapy and special courses for children's rehabilitation. In practice, the training of "early clinical practice and early probation" for children's rehabilitation skills is stressed. The results show that students have greatly improved their professional knowledge and practical ability, and the effect of "early clinical practice and early probation" is obvious. Among the students who choose the direction of children's rehabilitation, 95% of the students want to engage in the career of children's rehabilitation and believe that the curriculum system will be of great help to their future employment.

Implementación de un programa de Intervención terapéutica en actividades pre-deportivas y recreativas adaptadas en niños con discapacidad. El caso del Instituto Nacional de Rehabilitación

Se reporta el caso de la implementación de un programa de deporte adaptado en niños con discapacidad realizada en el Instituto Nacional de Rehabilitación con la finalidad de dar a conocer las facilidades, oportunidades, limitaciones y dificultades que se presentaron. Se inició con la elaboración de guías del programa de deporte hasta su aplicación.

SUMMARY We report the case of implementing an adapted sport program in children with disabilities in the Instituto Nacional de Rehabilitacion to make aware the opportunities, facilities, limitations and difficulties in its implementation. We started making guidelines of the sport program follow by its implementation.

The impact on the life quality of children with cerebral palsy of rehabilitation based on the International Classification of Function, Disability and Health for Children and Youth / 中华物理医学与康复杂志

Objective To assess the impact of rehabilitation procedures based on the International Classification of Function,Disability and Health for Children and Youth (ICF-CY) on the life quality of children with cerebral palsy.Methods Sixty children with cerebra] palsy were randomly divided into an observation group and a control group,each of 30.The observation group received an assessment of their physical functioning,physical structure,activity participation and environmental factors,as well as family guidance based on the ICF-CY framework.The control group was evaluated and treated according to traditional methods.The experiment lasted two months.Before the treatment,as well as after one and two months,both groups were evaluated using Barthel index (BI) and the parents' satisfaction was assessed.The two groups' family training was also evaluated after two months of treatment.Results The average BI and parent satisfaction scores of the two groups were not significantly different before the intervention.After one and two months,improvement was observed on both measures in both groups,but the observation groups' ratings were higher at both time points.After the 2 months of treatment there was no significant difference between the two groups in terms of physical functioning,but the average scores on family rehabilitation,activity participation and environment factors were all significantly better for the observation group.Conclusion Treatment based on the ICF-CY framework can more effectively improve the participation of children with cerebral palsy,which should have a positive effect on their life quality.

Atividades lúdicas no atendimento multi e interdisciplinar para crianças com deficiência / Leisure activities in multi and interdisciplinary care for children with disabilities / Actividades lúdicas en la atención multi e interdisciplinaria para niños con discapacidad

O objetivo da pesquisa foi analisar as atividades lúdicas utilizadas, pela equipe multi e inter-disciplinar, na reabilitação de crianças com deficiência em uma instituição de saúde estadual de Santa Catarina. Os dados foram coletados a partir de entrevista semiestruturada e de obser-vações sistemáticas e analisados pela técnica de análise de conteúdo. Foram identificados co-mo potenciais desdobramentos lúdicos: brinquedos, jogos e brincadeiras, englobando regras explícitas ou implícitas, bem como suas características. Notou-se que as relações estabeleci-das se mostraram imprescindíveis para a concretização dos atendimentos e dos objetivos tera-pêuticos.

The objective of this research was to analyze the ludic activities used, by the multi and inter-disciplinary team, in the rehabilitation of children with disabilities in a health state institution in Santa Catarina. To collect data, semi-structured interviews and systematic observations were used. Data analysis occurred through technical content analysis. It was identified as po-tential ludic developments: toys, games and child?s play that involved explicit or implicit rules and their characteristics. It was noticed that the relations established were crucial to the concretization of the work and the therapeutic objectives.

El objetivo de la investigación fue analizar las actividades lúdicas utilizadas, por el equipo multidisciplinario e interdisciplinario, en la rehabilitación de niños con deficiencia en una institución de salud estatal de Santa Catarina. Los datos fueron colectados a partir de entrevis-ta semiestructurada y observaciones sistemáticas y, analizados por la técnica análisis de con-tenido. Fueron identificados como potenciales desdoblamientos lúdicos: juguetes, juegos y recreaciones, englobando las reglas explícitas o implícitas, así como sus características. Se observó que las relaciones establecidas se mostraron imprescindibles para la concretización de los atendimientos y de los objetivos terapéuticos.

Effect of Small Muscle Learning on Children with Autism Spectrum Disorders / 中国康复理论与实践

@#Objective To investigate the effect of small muscle learning on children with autism spectrum disorders (ASD). Methods From August, 2014 to June, 2015, 40 children of three to six years old with ASD were randomly divided into experimental group (n=20) and control group (n=20). Both groups accepted structured teaching, while the experimental group accepted small muscle learning in addition. They were assessed with Autism Treatment Evaluation Checklist (ATEC) and Psychoeducational Profile Third Edition (PEP-3) before and 3 months after treatment. Results The scores of ATEC decreased after treatment (t>2.025, P<0.05), except that of Sociability; while the scores of PEP-3 increased (t>2.026, P<0.05), except that of Characteristic Motor Behaviors and Expressive Language. There were differences in improvement of Speech/Language/Communication and total score of ATEC, and Cognitive (Verbal/Preverbal), Receptive Language, Fine Motor, Gross Motor and Visual-Motor Imitation of PEP-3 between the experimental group and the control group after treatment (t>2.258, P< 0.05). Conclusion Small muscle learning may promote the recovery of cognition, language and motor in children with ASD.

Distance Training for Medical Staff of Children's Rehabilitation / 中国康复理论与实践

Objective To discuss the distance training for medical staff of children's rehabilitation. Methods 15 lessions were carried out using computer software from April, 2013 to November, 2014 in our centre. 7 cooperative hospitals participated the trainings. The implemen-tation effect was surveyed after training. Results 2693 person-times attended the trainings, including 2109 person-times with living distance training and 584 person-times with video distance training. In the following sampling survey, 92.8%staff thought that the distance training was helpful to their work. 98.6%staff thought that the living distance training was better than the video distance training and 88.6%staff thought their rehabilitation level improved after the distance training. Conclusion The distance training of children's rehabilitation has the advantages of economy, convenience and celerity. It has a wide developmental prospect.

Exploration on Domestic Cerebral Palsy Rehabilitation from Experiences of American Association of China Partner Network Training Project / 中国康复理论与实践

@#China Partner Network (CPN) training project would train professionals for better management of children rehabilitation, including advanced theory and manipulation in treatment and functional assessment of children with cerebral palsy, psychological education,and orthotics as well as operation and non-operation protocols. Domestic status quo in this area and some other relevant experiences were also compared with CPN.

Investigation of Children with Cerebral Palsy in Rehabilitation and Their Families in Shenzhen / 中国康复理论与实践

@#ObjectiveTo investigate the children with cerebral palsy (CP) in rehabilitation, their families and need of society support. Methods150 children with CP in rehabilitation participated in this study. A questionnaire was designed to investigate their basic situation, family status, society concern and requirements for society support, which completed by their parents. Results150 questionnaires were completed efficiently. 75 children were firstly treated before 1 year old. The rehabilitation treatments were effective to 130 children. 126 children appeared some disorder in emotion and personality. Home education was the main rehabilitation way in 133 children. The educational background of 59.4% mothers were senior high school or below. The income was less than 60 thousand yuan in 76.7% families, but spent more than 40 thousand yuan per year on treatment in 54.7% families. One or both parents in 119 families were forced to stop working. 93.3% of them suffered emotion pressure and 56.7% lacked the knowledge about CP. 81% families thought that more social support should be offered in 6 aspects including government welfare, social security, medical institutions, psychotherapy, community services and legal aid. ConclusionAll society should pay more attention on the children with CP and provide a good rehabilitation environment for them.

Programas terapéuticos específicos en niños y jóvenes con parálisis cerebral y lesiones raquimedulares en Teletón Chile 2007-2008: evaluación mediante WeeFIM / Specific therapeutic programs in children and teens with cerebral palsy and spine lesions in Teleton Chile 2007-2008: evaluation through WeeFIM

Introduction: It is important to evaluate the effectiveness of the therapeutic endeavour, in order to improve rehabilitation programs in the motor area in patients with neuromusculoskeletal disabilities. Objective: To evaluate changes in the functional independence between admission and discharge from specific treatments in patients with cerebral palsy and spinal cord lesion, and explore whether gender, age or diagnosis, can predict the progress of children in these types of treatments. Patients and Methods: A single cohort study, consisting of 624 subjects of three years or more with cerebral palsy and 155 with spinal cord injury, attending to specific rehabilitation programs in Teletón Chile Institute from 2007-2008. In the analysis, was used the difference between the admission and discharge WeeFIM score and decision trees with p < 0.05. Results: In 264/624 of the cerebral palsy children (42.3 percent)increase discharge score; 321/624 (51.4 percent) remain the same and 39/624 (6.3 percent) decrease; in spinal cord injury 93/155 patients (60 percent) improve, 58/155 (37.4 percent) do not change and 4/155 (2.6 percent) decrease; the improvement occurs mainly in self-care activities; the decision trees show that specific treatments have best result for diplegia and hemiplegia in children under 6 years; in spinal cord injury, for thoracic bifid spine with hydrocephalus and acquired tetraplegia. Conclusion: Specific treatments have a better outcome for children with cerebral palsy hemiplegia and spine lesions, it is associated with the initial diagnosis; the age acquires predictive characteristics for children with hemiplegia and diplegias under 6 years; WeeFIM is poorly sensitive to detect changes in extreme scores and in short duration rehabilitation programs.

Introducción: Es importante evaluar la efectividad del quehacer terapéutico, con el fin de mejorar los programas de rehabilitación en el área motora de los pacientes con discapacidades neuromusculoesqueléticas. Objetivo: Evaluar cambios en la independencia funcional entre ingreso y alta de tratamientos específicos en pacientes con parálisis cerebral y lesión medular, y explorar si el género, edad y diagnóstico, permiten pronosticar el progreso de los niños en este tipo de tratamientos. Pacientes y Método: Estudio de cohorte única, constituida por 624 sujetos de 3 años o más con parálisis cerebral y 155 con lesión medular, asistentes a programas específicos de rehabilitación de Instituto Teletón Chile en 2007-2008. En el análisis, se usó diferencia de puntaje de WeeFIM entre ingreso y alta, y árboles de decisión con p < 0,05. Resultados: En parálisis cerebral 264/624 (42,3 por ciento) de los niños, aumenta puntaje de alta; 321/624 (51,4 por ciento) permanece igual y 39/624 (6,3 por ciento) desmejora; en lesión medular 93/155 pacientes (60 por ciento) mejora, 58/155 (37,4 por ciento) no cambia y 4/155 (2,6 por ciento) desmejora; la mejoría se produce principalmente en actividades de autocuidado; los árboles de decisión indican que los tratamientos específicos tendrían mejor resultado para diplejías y hemiplejias en menores de 6 años; en lesión medular, para espina bífida torácica con hidrocefalia y tetraplejia. Conclusiones: Los tratamientos específicos tienen mejor resultado para niños con hemiplejia por parálisis cerebral y alteraciones raquimedulares altas; el aumento del puntaje, está asociado al diagnóstico inicial; la edad adquiere carácter predictivo para niños con hemiplejias y diplejías menores de 6 años; WeeFIM es poco sensible para detectar cambios en puntajes extremos y en programas de rehabilitación de corta duración.

Effect of Structured Intelligence Training System on Ability of Children with Brain Injury / 中国康复理论与实践

@#ObjectiveTo observe the effects of structured intelligence training system on the ability of children with brain injury. Methods100 children with brain injury were divided in the structured intelligence training (SI) group (n=50) and the routine training (R) group. They were assessed with Comprehensive Function Assessment for Disabled Children. ResultsThe scores of Comprehensive Function Assessment for Disabled Children in both groups improved after training, and improved more in SI group than in R group (P＜0.01), especially in the items of cognition, self-management and social adaptation (P＜0.05). ConclusionThe structured intelligence training system may improve the ability of children with brain injury.

Logistic Regression Analysis of Rehabilitation Needs of Children with Mental Retardation in Beijing / 中国康复理论与实践

@#Objective To analyze the social and family factors influencing rehabilitation of mental retarded children.Methods 237 children diagnosed as mental retardation in 2004 in Beijing were researched with Self-designed Questionnaires and data were analyzed by Cross-tabs and Logistic Regression statistical method.Results The analysis showed that the degree of disabilities (P<0.001), education received (P<0.05), and the attitude from community to these children (P<0.05), were factors influencing rehabilitation of mental retarded children.Conclusion The degree of disabilities is the most important influencing factor to rehabilitation of mental retarded children; the mild or moderate mental cases can get good rehabilitation in a better community and family environment. The attitude to these children from community can make a great help to the rehabilitation.