ABSTRACT
Resumo gráfico: Intervenções de esportes modificados para crianças e adolescentes com deficiência: Uma revisão de escopo.
OBJETIVO: Estabelecer o escopo da literatura sobre intervenção de esportes modificados para crianças e adolescentes com deficiência. MÉTODOS: Para esta revisão de escopo, os artigos foram selecionados e as características dos estudos foram extraídas. As intervenções de esportes modificados foram descritas quanto à sua estrutura, utilizando os itens do Template for Intervention Description and Replication (TIDieR). Os componentes do tratamento foram descritos usando a linguagem do Sistema de Especificação de Tratamento de Reabilitação. Os resultados foram analisados e validados por um grupo de profissionais, utilizando a estratégia de Envolvimento do Público e do Paciente. RESULTADOS: Doze estudos foram elegíveis para inclusão, investigando intervenções para crianças com transtorno do espectro do autismo, paralisia cerebral e outras condições. A maioria dos estudos apresentou nível de evidência moderado. Os ingredientes ativos foram o treino motor repetido relacionado com o esporte e a introdução à prática esportiva através do mecanismo de "aprendizagem pela ação". O alvo da intervenção foi a capacidade de execução das habilidades motoras grossas, e os objetivos da intervenção (resultados indiretos) foram a participação em atividades físicas e diferentes funções corporais. INTERPRETAÇÃO: As principais características e estrutura da intervenção, lacunas de pesquisa e um passoapasso para implementação clínica foram apresentados para melhorar sua compreensão. São necessárias investigações futuras sobre a eficácia das intervenções de esportes modificados com estudos de melhor qualidade, incluindo resultados de participação, e estudos com crianças não deambulantes.
ABSTRACT
AIM: To establish the scope of the literature on modified sports interventions for children and adolescents with disabilities. METHOD: For this scoping review, articles were screened and the characteristics of studies were extracted. The modified sports interventions were described in terms of their structure, using the items of the Template for Intervention Description and Replication. Components of intervention treatment were described by using the language of the Rehabilitation Treatment Specification System. Results were analysed and validated by a group of professionals, using the Public and Patient Involvement strategy. RESULTS: Twelve studies were eligible for inclusion, investigating interventions for children with autism spectrum disorder, cerebral palsy, and other conditions. Most studies presented a moderate level of evidence. Active ingredients were repeated sports-related motor training and introduction to the sport through a 'learning by action' mechanism. The intervention target was gross motor skills performance, and intervention aims (indirect outcomes) were physical activity participation and different body functions. INTERPRETATION: The inclusion of stakeholders in this review helped to validate our findings about the characteristics and structure of modified sports interventions, to identify research gaps, and to provide a step process for clinical implementation. Future investigations are warranted of the effectiveness of modified sports investigations with better quality studies, including participation outcomes and studies with non-ambulant children.
ABSTRACT
Objective: To identify beliefs and knowledge about tummy time (TT) practice and its repercussions on motor development. Methods: Longitudinal study carried out with parents/caregivers of infants older than 30 days of life. Two assessments were performed. A structured interview was conducted, while the babies were between one and six months old to identify beliefs, knowledge about TT, and the motor milestone achievement expected for the age. At six to 12 months, the risk of motor development delay was tracked using the survey of well-being of young infant questionnaire (SWYC). Results: 41 families responded to the SWYC questionnaire (21 were allocated to the TT group). 31.70% reported that it was not important to put the infants in a prone position while awake, and 70.70% said they are afraid their babies would become breathless when positioned in a prone position. 85.70% of infants from the TT group showed typical development, while 55% of the control group showed atypical development for their age (p = 0.01). Only three infants from the control group were at risk of delayed motor development (p = 0.10). Conclusions: Most of the families feel insecure about proning their babies and fear breathlessness when positioned. Acquisition of motor milestones prevailed in the TT group, suggesting an association between TT practice and motor milestone achievement.
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OBJECTIVE: The aim of this study was to assess the effects of 3% of body weight loads (0%, 5%, and 10%) on treadmill gait training in subjects with Parkinson disease. DESIGN: This study used a randomized controlled single-blind trial. RESULTS: Spatiotemporal variables demonstrated significant intragroup alterations in all three groups at pretraining and posttraining, with an increase in speed (m/sec; F = 4.73, P = 0.04), stride length (m; F = 12.00, P = 0.002), and step length (m; F = 16.16, P = 0.001) and a decrease in the double-stance phase (%; F = 6.59, P = 0.02) and stance phase (%; F = 4.77, P = 0.04). Intergroup pretraining and posttraining did not exhibit significant differences (F < 2.18, P > 0.14). Angular variables showed significant intragroup alterations, with an increase in knee range of motion (F = 5.18, P = 0.03), and intergroup comparison revealed no significant changes (F = 1.87, P = 0.17). CONCLUSIONS: Posttraining improvements in speed, stride length, step length, double-stance, stance phase, and knee range of motion were observed in all groups, where no load (0%, 5%, or 10%) had any significant effect, suggesting that the influence of load did not make one experimental condition better than another. All participants benefitted from treadmill gait training, irrespective of the use of load.
Subject(s)
Exercise Therapy , Gait Disorders, Neurologic/physiopathology , Gait Disorders, Neurologic/rehabilitation , Parkinson Disease/physiopathology , Parkinson Disease/rehabilitation , Adult , Aged , Female , Humans , Knee Joint/physiopathology , Male , Middle Aged , Range of Motion, Articular , Single-Blind MethodABSTRACT
OBJECTIVE: The aim of this study was to analyze the effects of inclined treadmill training on the kinematic characteristics of gait in subjects with hemiparesis. DESIGN: A blind, randomized, controlled study was conducted with 28 subjects divided into two groups: the control group, submitted to partial body weight-support treadmill gait training with no inclination, and the experimental group, which underwent partial body weight-support treadmill training at 10% of inclination. All volunteers were assessed for functional independence, motor function, balance, and gait before and after the 12 training sessions. RESULTS: Both groups showed posttraining alterations in balance (P < 0.001), motor function (P < 0.001), and functional independence (P = 0.002). Intergroup differences in spatiotemporal differences were observed, where only the experimental group showed posttraining alterations in velocity (P = 0.02) and paretic step length (P = 0.03). Angular variables showed no significant differences in either group. CONCLUSIONS: In subjects with hemiparesis, the addition of inclination is a stimulus capable of enhancing the effects of partial body weight-support treadmill gait training.
Subject(s)
Exercise Test/methods , Exercise Therapy/instrumentation , Gait Disorders, Neurologic/rehabilitation , Paresis/rehabilitation , Adult , Aged , Biomechanical Phenomena , Body Weight , Exercise Therapy/methods , Female , Follow-Up Studies , Gait/physiology , Gait Disorders, Neurologic/etiology , Humans , Male , Middle Aged , Multivariate Analysis , Paresis/etiology , Reference Values , Risk Assessment , Severity of Illness Index , Single-Blind Method , Stroke/complications , Stroke Rehabilitation , Task Performance and Analysis , Time Factors , Treatment OutcomeABSTRACT
Our purpose in this study was to analyze the immediate effects of locomotor gait training with different loads on a treadmill on the kinematic parameters of gait in children with Spastic Hemiparetic Cerebral Palsy (SHCP), as well as investigating which load prompted the most adequate motor responses to promote the propulsion of the Paretic Lower Limb (PLL). This case report included 3 children of both sexes, aged 8-12 years. The children walked on the treadmill with loads on their ankles that corresponded to 40, 50 and 60% of the weight of the Lower Limb (LL), on 3 different non-consecutive days. The kinematic parameters were assessed during the pre-training phase (PTPH) and immediately after training (PHI). The spatiotemporal variables did not change immediately after gait training with the aforementioned loads. On the other hand, we observed wider joint angles in the hip and knee during the swing phase immediately after training, especially with a load of 60% of the weight of the lower limb. These findings indicate that the 60% load is the most appropriate to prompt immediate changes in the joint kinematics of the PLL. These alterations can be important in improving propulsion during the swing phase of gait in children with SHCP...
El objetivo de este estudio fue analizar los efectos inmediatos del entrenamiento locomotor en la estera con diferentes cargas, sobre los parámetros cinemáticos de la marcha de niños con parálisis cerebral hemipléjica espástica (PCHE), e investigar cómo la carga promueve respuestas motoras más adecuadas para favorecer la propulsión del Miembro Inferior Parético (MIP). Participaron de este caso, 3 niños de ambos sexos, con edades de 8-12 años. Los niños realizaron entrenamiento en la estera rodante con carga en los tobillos equivalente a 40, 50 y 60% del peso de la miembro (MI), en 3 días distintos y no consecutivos. Los parámetros cinemáticos fueron evaluados en las fases de pre entrenamiento (FPT), e inmediatamente después del entrenamiento (FI). Las variables espacio-temporales no cambiaron inmediatamente después del ejercicio de marcha con carga. Sin embargo, fue observado aumento de los ángulos articulares de la cadera y la rodilla durante la fase de balanceo inmediatamente después del entrenamiento, especialmente con carga de 60% del peso de la extremidad inferior. Estos resultados indican que la carga de 60% es la más apropiada para solicitar cambios inmediatos en la cinemática articular del MIP. Tales cambios pueden ser importantes para fomentar la propulsión durante la fase de balanceo de la marcha de niños con PCHE...
O objetivo deste estudo foi analisar os efeitos imediatos do treino locomotor na esteira com diferentes cargas, sobre os parâmetros cinemáticos da marcha de crianças com Paralisia Cerebral Hemiparética Espástica (PCHE), e investigar qual carga promove repostas motoras mais adequadas para favorecer a propulsão do Membro Inferior Parético (MIP). Participaram deste relato de caso 3 crianças de ambos os sexos, com idades de 8-12 anos. As crianças realizaram treino na esteira com carga nos tornozelos equivalentes a 40, 50 e 60% do peso do Membro Inferior (MI), em 3 dias diferentes e não consecutivos. Os parâmetros cinemáticos foram avaliados nas fases pré-treinamento (FPT) e imediatamente após o treino (FI). As variáveis espaço-temporais não sofreram alterações imediatamente após o treino de marcha com carga. Por outro lado, foi observado aumento dos ângulos articulares de quadril e joelho durante a fase de balanço imediatamente após o treino, principalmente com carga de 60% do peso do membro inferior. Estes achados indicam que a carga de 60% seja a mais apropriada para solicitar alterações imediatas na cinemática articular do MIP. Tais alterações podem ser importantes para favorecer a propulsão durante a fase de balanço da marcha de crianças com PCHE...
