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Mélo T.R.1,2, Yamaguchi B.1, Erthal V.2, Costin A.C.S.3, Chiarello C.3, Neves E.B.4, Israel V.L.1
1Federal University of Paraná, Curitiba, Brazil, 2Campos Andrade University Center, Curitiba, Brazil, 3Vitoria Research Center, Curitiba, Brazil, 4Federal Technological University of Paraná, Curitiba, Brazil
Background: Cerebral Palsy (CP) is a non-progressive heterogeneous injury in the immature brain, with specific consequences, depending on its location. CP may causes sensory, posture and movement disorders, limiting motor skills, regular activities and child development. The rehabilitation of these children should be interdisciplinary. The use of Intensive Neuromotor protocols is one of the possibilities to increase treatment results but it is still controversial and lack of scientific evidences.
Purpose: Verify the effects of the Intensive Neuromotor Therapy (TNMI) using the Pediasuit protocol on the gross motor skills of children with CP.
Methods: A retrospective study has analyzed medical records of children treated in an Intensive Neuromotor Therapy (INMT) reference center in southern Brazil, from March of 2013 to June of 2016. PC children were evaluated on their, age, sex, topographic diagnosis, Gross Motor Functional Measure (GMFM-88), Gross Motor Function Classification System (GMFCS) total and target areas per therapeutic module. The interventions were made taking the INMT protocol, using the Pediasuit vest. Each module consisted in five weeks of physiotherapy, 5 days a week with 4 hours a day. All the data were analyzed by the Shapiro-Wilk normality test and compared to the dependent median according to the normality.
Results: 136 medical records were considered eligible for analysis results of 49 children and adolescents who underwent INMT protocol aged 1 to 14 years old (mean age 5.14 ± 3.11 years old), 25 male and 24 female. Considering the topographic diagnosis, 20 have diplegia and 29 with quadriplegia. The GMFCS was classified as II for 2 participants, GMFCS III 6 participants, GMFCS IV for 11 children and V to 24 children. They were missing the GMFCS data for 6 participants. The GMFM-88 presented non-parametric data when compared using the Wilcoxon test. Significant values were found, according to GMFM-88 overall (p: 0.002) and median values of 25-75% pre-intervention data: 22.2% (11.26% - 49.29%) and post-intervention 44.97% (20.76% - 64.48%). For lying / rolling (p: 0.022), sitting (p: 0.002), crawling / kneeling (p: 0.015), standing (p: 0.002), walking, running, jumping (p: 0.039). Only areas target did not achieve statistical difference (p = 0.066).
Conclusion(s): Comparison of averages showed percentage evolution of achievements in the gross motor skills in children after five weeks of intervention in these activities levels lying and rolling, sitting, crawling and kneeling, standing and walking, even though most of the tested children have severe motor impairment.
Implications: This study brings contributions about intensive physical therapy interventions.
Funding acknowledgements: The authors thanks the Vitória Center Research.
Topic: Disability & rehabilitation
Ethics approval: Research Ethics Committee of the Brazilian Institute of Therapies and Teaching (IBRATE) registered under CAAE: 53310116.8.0000.5229, clinical registration RBR-2st594.
All authors, affiliations and abstracts have been published as submitted.
