Efeitos da edição de carga sobre a marcha de crianças com Hemiplegia Espástica e com desenvolvimento motor típico
INTRODUCTION: Children with Cerebral Palsy (CP) differently from children with typical motor development have different compensatory motor patterns through the demands during gait. There is also a gap for the differentiation of normal and pathological gait among children through the use of an ext...
Na minha lista:
Autor principal: | |
---|---|
Outros Autores: | |
Formato: | Dissertação |
Idioma: | por |
Publicado em: |
Brasil
|
Assuntos: | |
Endereço do item: | https://repositorio.ufrn.br/jspui/handle/123456789/25332 |
Tags: |
Adicionar Tag
Sem tags, seja o primeiro a adicionar uma tag!
|
Resumo: | INTRODUCTION: Children with Cerebral Palsy (CP) differently from children with
typical motor development have different compensatory motor patterns through the
demands during gait. There is also a gap for the differentiation of normal and
pathological gait among children through the use of an external disturbance during
locomotion, and there is a need for studies that allow a better understanding of such
differences. PURPOSE: To compare the immediate effects of loading on the gait of
children with CP and children with typical motor development during gait.
MATERIALS AND METHODS: This is a quasi-experimental study. The sample
consisted of 39 children aged five to 12 years, divided into two groups: PC group (n =
20) composed of children with PC of type spastic hemiplegic; and the DT Group (n =
19) comprised of twenty children with typical motor development. The children in the
DT group were matched for age and sex with children in the CP group. Children with
CP were classified for their level of functionality (Gross Motor Function Measure
System - GMFCS), evaluated in relation to gross motor function (Gross Motor
Function Measure - GMFM), the degree of muscle spasticity of the paretic lower limb
(Ashworth Modified Scale) and anthropometric data. The gait was evaluated by
Qualys kinematic analysis system and all volunteers performed the training protocol
on the Gait Trainner System 2® treadmill, divided into three phases: before the
addition of the load (PRÉ phase) immediately after the removal of the load (IME
phase ) and 8 minutes after the removal of the load (RET phase). The load was 60%
of the weight of the lower limb and imposed on both ankles.The gait assessment
protocol consisted of a single training session. The measures of outcomes were the
angular variables of the hip and knee joints, the maximum height of the foot and the
temporal space variables. The data were analyzed by the SPSS 20.0 program,
assigning a level of significance of 0.05. For the comparison between the phases, the
ANOVA with repeated measurements was performed in both groups. Unpaired ttests
were performed to compare the paretic limb of children with CP and the nondominant
limb of typical children at each phase of the protocol. RESULTS: In the
comparison between the phases of the protocol, the results showed that the PC
children had increased maximal flexion (P<0,001) and range of motion (P=0,013) of the paretic knee and paretic foot height (P=0,001) immediately after removal of the
load. The effects were not retained after five minutes of rest. The typical children
showed increased amplitudes of the hip (P=0,037) and knee (P=0,019) of the nondominant
limb and greater height of the foot of the non-dominant limb (P=0,009),
between phases PRE and IME. In the inter-limb comparison, greater hip flexion was
observed in the paretic limb in the PRE (P=0,001), IME (P<0,001) and RET
(P=0,001) phases when compared to the non-dominant limb. Paretic hip extension
was also higher in the PRE (P=0,015), IME (P=0,002) and RET (P=0,005) phases.
The paretic foot joint showed higher height than the foot of the non-dominant limb of
typical children, in the PRE (P<0,001), IME (P<0,001) and RET phases (P<0,001)
phases. CONCLUSION: Children with CP and children with typical motor
development presented motor adjustments through the load imposed on the paretic
limb and the non - dominant limb, respectively. Children with CP showed that despite
an altered motor pattern due to injury, new motor behavior emerged from the
remaining abilities and demands of the task, while in typical children the responses to
the load reflected the repertoire of strategies with intact motor control that these
children could adopt to overcome the resistance imposed on the limbs. |
---|