Translation and measurement properties of the Portuguese-Brazil version of the Hammersmith Infant Neurological Examination (HINE-Br).

OBJECTIVE: The current study aimed to translate the Hammersmith Infant Neurological Examination (HINE) into Brazilian Portuguese and analyze the reliability of the translated version for a population of Brazilian infants. METHODS: This was a methodological study, approved by the Ethics Committee, carried out between June 2020 and May 2021. HINE is a standardized clinical neurological examination used for the early detection of cerebral palsy. The quantitative section, "neurological examination", contains 26 items scored from 0 to 3 points, divided into five categories: cranial nerve function, posture, movements, muscle tone and reflexes, and reactions. The HINE translation followed four steps: translation, synthesis, back-translation, and evaluation by an expert committee. To verify the reliability of the HINE-Br (Portuguese-Brazil version) two independent examiners evaluated 43 infants, between 3 and 22 months of age. Internal consistency was verified by Cronbach's Alpha coefficient and interrater reliability by the intraclass correlation coefficient (ICC). RESULTS: The translated version was similar to the original version and a few semantic and idiomatic adjustments were necessary. Appropriate internal consistency (Alpha=0.91) was found for the 26 items of the HINE-Br, as well as strong interrater reliability for the total score (ICC2.1=0.95), and also for the five categories (ICC2.1=0.83-0.95). CONCLUSIONS: The HINE-Br presents adequate rates of internal consistency and interrater reliability, and can be used for the evaluation of children at risk for cerebral palsy, between 3 and 24 months of age, by pediatricians and pediatric physical therapists.

Characterization of environmental factors in children and adolescents with cerebral palsy in Minas Gerais: Participa Minas.

OBJECTIVE: To characterize the environmental factors of children and adolescents with Cerebral Palsy (CP) in the state of Minas Gerais (MG), Brazil. METHODS: This is a cross-sectional study involving 164 caregivers of children/adolescents with CP, aged 1-14 years. The Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS) were used to classify the participants' functioning, and environmental factors were evaluated by an on-line questionnaire that examined products and technologies, physical environment, services, and systems. A descriptive analysis was performed using percentage and frequency. RESULTS: Most participants had bilateral CP (66.9%) and 45% of them were spastic. Levels II and V of the GMFCS and MACS were the most frequent. About half (49.4%) used anticonvulsants, 27.4% underwent botulinum toxin application, and 29% went through orthopedic surgery in the lower limbs. Among the participants, 71.3% used orthoses in the lower limbs, and 51.8% used the public health care system. Most had access to physiotherapy (91.5%), but found difficulties to access interventions with other professionals, such as psychologists (28%) and nutritionists (37.8%). The school was the most frequently adapted environment (78%), and had the highest level of structural adaptation (42.7%). CONCLUSIONS: The results of this study suggest that the barriers to access health services and barriers to the physical environment may impact participation and social inclusion.

Analysis of the Brazilian-Portuguese Content on Autism Spectrum Disorder Available on YouTube Videos.

AIMS: Information about Autism Spectrum Disorder (ASD) is available in different videos on YouTube. However, these videos might present inaccurate or outdated information. The aims of this study were to 1) identify characteristics of Brazilian-Portuguese videos about ASD (i.e., type of content, number of views, likes, and dislikes); 2) analyze the content of informative videos about ASD, by assessing their trustworthiness and overall quality; and 3) investigate the most popular topics of informative videos about ASD over time. METHODS: This is a cross-sectional study that investigated Brazilian-Portuguese ASD content on YouTube. Videos were selected by two examiners and categorized as experiential or informative. The Discern checklist and the Global Quality Score (GQS) were used to analyze the trustworthiness and quality of informative videos. RESULTS: In total, 216 videos were analyzed, of which 19.5% and 85% were classified as experiential and informative, respectively. The majority of informative videos presented moderate trustworthiness and quality. Videos about ASD clinical aspects were the most popular. CONCLUSION: YouTube offers a large number of experiential and informative videos on ASD. However, some of these videos fail to present reliable and additional sources of information for stakeholders. Efforts to promote knowledge translation about ASD on YouTube are necessary.

Translation and measurement properties of the Portuguese-Brazil version of the Hammersmith Infant Neurological Examination (HINE-Br) / Tradução e propriedades de medida da versão Português-Brasil do Hammersmith Infant Neurological Examination (HINE-Br)

ABSTRACT Objective: The current study aimed to translate the Hammersmith Infant Neurological Examination (HINE) into Brazilian Portuguese and analyze the reliability of the translated version for a population of Brazilian infants. Methods: This was a methodological study, approved by the Ethics Committee, carried out between June 2020 and May 2021. HINE is a standardized clinical neurological examination used for the early detection of cerebral palsy. The quantitative section, "neurological examination", contains 26 items scored from 0 to 3 points, divided into five categories: cranial nerve function, posture, movements, muscle tone and reflexes, and reactions. The HINE translation followed four steps: translation, synthesis, back-translation, and evaluation by an expert committee. To verify the reliability of the HINE-Br (Portuguese-Brazil version) two independent examiners evaluated 43 infants, between 3 and 22 months of age. Internal consistency was verified by Cronbach's Alpha coefficient and interrater reliability by the intraclass correlation coefficient (ICC). Results: The translated version was similar to the original version and a few semantic and idiomatic adjustments were necessary. Appropriate internal consistency (Alpha=0.91) was found for the 26 items of the HINE-Br, as well as strong interrater reliability for the total score (ICC2.1=0.95), and also for the five categories (ICC2.1=0.83-0.95). Conclusions: The HINE-Br presents adequate rates of internal consistency and interrater reliability, and can be used for the evaluation of children at risk for cerebral palsy, between 3 and 24 months of age, by pediatricians and pediatric physical therapists.

RESUMO Objetivo: Traduzir o Hammersmith Infant Neurological Examination (HINE) para o português brasileiro e analisar a confiabilidade da versão traduzida em lactentes brasileiros. Métodos: Estudo metodológico, aprovado por Comitê de Ética, realizado entre junho de 2020 e maio de 2021. O HINE é um exame clínico neurológico padronizado, utilizado para detecção precoce de paralisia cerebral. A seção quantitativa, "exame neurológico", contém 26 itens pontuados de 0 a 3, divididos em 5 categorias: função dos nervos cranianos; postura; movimentos; tônus muscular e reflexos; e reações. A tradução do HINE seguiu quatro etapas: tradução; síntese; retrotradução; e avaliação por um comitê de especialistas. Dois examinadores independentes avaliaram 43 lactentes, entre 3 e 22 meses, utilizando a versão HINE-Br (versão em português brasileiro), para verificar sua confiabilidade. A consistência interna foi verificada pelo coeficiente Alpha de Cronbach e a confiabilidade interexaminadores pelo coeficiente de correlação intraclasse (CCI). Resultados: A versão traduzida foi semelhante à versão original e poucos ajustes semânticos e idiomáticos foram necessários. Encontrou-se consistência interna adequada (Apha=0,91) para os 26 itens do HINE-Br, bem como forte confiabilidade interexaminadores para o escore total (CCI2,1=0,95) e também para as cinco categorias (CCI2,1=0,83-0,95). Conclusões: O HINE-Br apresenta índices adequados de consistência interna e confiabilidade interexaminadores, podendo ser utilizada para avaliação de crianças com risco de apresentar paralisia cerebral, entre 3 e 24 meses de idade, por pediatras e fisioterapeutas infantis.

Characterization of environmental factors in children and adolescents with cerebral palsy in Minas Gerais: Participa Minas / Caracterização de fatores ambientais de crianças e adolescentes com paralisia cerebral de Minas Gerais: Participa Minas

ABSTRACT Objective: To characterize the environmental factors of children and adolescents with Cerebral Palsy (CP) in the state of Minas Gerais (MG), Brazil. Methods: This is a cross-sectional study involving 164 caregivers of children/adolescents with CP, aged 1-14 years. The Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS) were used to classify the participants' functioning, and environmental factors were evaluated by an on-line questionnaire that examined products and technologies, physical environment, services, and systems. A descriptive analysis was performed using percentage and frequency. Results: Most participants had bilateral CP (66.9%) and 45% of them were spastic. Levels II and V of the GMFCS and MACS were the most frequent. About half (49.4%) used anticonvulsants, 27.4% underwent botulinum toxin application, and 29% went through orthopedic surgery in the lower limbs. Among the participants, 71.3% used orthoses in the lower limbs, and 51.8% used the public health care system. Most had access to physiotherapy (91.5%), but found difficulties to access interventions with other professionals, such as psychologists (28%) and nutritionists (37.8%). The school was the most frequently adapted environment (78%), and had the highest level of structural adaptation (42.7%). Conclusions: The results of this study suggest that the barriers to access health services and barriers to the physical environment may impact participation and social inclusion.

RESUMO Objetivo: Caracterizar os fatores ambientais de crianças e adolescentes com paralisia cerebral (PC) no estado de Minas Gerais (MG), Brasil. Métodos: Trata-se de um estudo transversal envolvendo 164 cuidadores de crianças/adolescentes com PC, na faixa etária de um a 14 anos. O Sistema de Classificação da Função Motora Grossa (GMFCS) e o Sistema de Classificação da Habilidade Manual (MACS) foram utilizados para classificar a funcionalidade dos participantes e os fatores ambientais foram avaliados por um questionário on-line que abordou produtos e tecnologias, ambiente físico, serviços e sistemas. Análises descritivas foram realizadas por meio de porcentagem e frequência. Resultados: A maioria dos participantes tinha PC bilateral (66,9%) e 45% deles eram espásticos. Os níveis II e V do GMFCS e MACS foram os mais frequentes. Cerca de metade (49,4%) fazia uso de anticonvulsivantes, 27,4% realizaram aplicação de toxina botulínica e 29% cirurgia ortopédica em membros inferiores. Utilizavam órteses em membros inferiores 71,3% e eram usuários do sistema público de saúde 51,8%. A maioria tinha acesso à fisioterapia (91,5%), mas dificuldade de acesso a intervenções com outros profissionais, como psicólogos (28%) e nutricionistas (37,8%). A escola foi o ambiente mais frequentado (78%) e também mais adaptado estruturalmente (42,7%). Conclusões: Os resultados deste estudo sugerem que barreiras de acesso aos serviços de saúde e barreiras no ambiente físico podem impactar a participação e inclusão social.

Percepções dos pais sobre uma intervenção de esportes modificados para crianças com paralisia cerebral.

OBJETIVO: Explorar as percepções dos pais de crianças com paralisia cerebral (PC) sobre uma intervenção de esportes modificados, intitulada Sports Stars Brasil. MÉTODOS: Pais de crianças (n = 15, com idades de 6 a 12 anos) com PC, classificadas nos níveis I e II do GMFCS, que participaram do Sports Stars Brasil, foram recrutados para este estudo qualitativo descritivo. As crianças receberam uma intervenção de esportes modificados de oito semanas (1 hora por semana). Após a intervenção, os pais participaram de um grupo focal. A interpretação das "minhas palavras favoritas" (saúde, família, diversão, funcionalidade, amigos e futuro) da Classificação Internacional de Funcionalidade, Incapacidade e Saúde foi usada para orientar a os grupos focais. As transcrições foram codificadas usando a metodologia de análise de conteúdo. RESULTADOS: Os pais relataram experiências positivas com o Sports Stars Brasil, incluindo a redução do sedentarismo ("Saúde"), melhora das habilidades motoras ("Funcionalidade"), maior conexão entre a criança e a família ("Família"), melhor socialização ("Amigos"), aumento na participação em atividades prazerosas ("Diversão") e conscientização sobre a importância da atividade física ("Futuro"). Todas as experiências positivas estavam interconectadas. INTERPRETAÇÃO: A capacidade do Sports Stars de integrar todos os aspectos do funcionalidade apoia seu papel como uma opção de intervenção promissora para crianças com PC deambulantes.

Predictive validity of the Denver developmental screening test (Denver-II) to detect risk of developmental coordination disorder in preterm children.

INTRODUCTION: The Denver-II is widely used as a screening tool, however, no studies were found about its validity to predict the risk of Developmental Coordination Disorder (DCD) in preterm children. OBJECTIVE: To verify the predictive validity and accuracy of the Denver-II to identify the risk of DCD in preterm children. METHODS: Methodological study with 121 preterm children, evaluated with the Denver-II at ages 1, 2, 3, 4 and/or 5 years and with the Movement Assessment Battery for Children (MABC-2) at 7 years. Univariate binary logistic regression analyses were performed and ROC curves were derived. RESULTS: Children classified as suspect by Denver-II at 2, 3, and 4 years were, respectively, 3.45, 7.40 and 6.06 times more likely to have a risk of DCD on the MABC-2 (p < 0.05). The area under the ROC curve was considered fair for ages 2 (0.60, 95 % CI 0.50-0.70), 3 (0.61, 95 % CI 0.51-0.71) and 4 (0.64, 95 % CI 0.54-0.74) years. The greater the number of suspects in Denver-II over time, the greater the probability of risk of DCD in the MABC-2 (p < 0.001). CONCLUSIONS: Global developmental assessment with the Denver-II at ages 2 to 4 years is considered to have fair accuracy to discriminate risk of DCD at school age in children born preterm.

Translation, reliability, and validity of the Brazilian-Portuguese version of the Early Activity Scale for Endurance (EASE).

PURPOSE: Translate, investigate reliability, and construct validity of the Brazilian Early Activity Scale for Endurance (EASE). MATERIALS AND METHODS: Translation followed the international guidelines. Test-retest reliability was tested by 100 parents of children with cerebral palsy (CP): 18 months-5 years and 6-11 years. To determine construct validity, 94 parents of typically children completed the EASE. Statistical analysis included Bland-Altman, Intraclass Correlation Coefficient (ICC), Internal Consistency, and Floor and Ceiling Effect. RESULTS: The majority of the sample consisted of children with CP in GMFCS (IV-V). EASE showed good test-retest reliability for younger (ICC = 0.8) and excellent test-retest reliability for older children with CP (ICC = 0.9), and good internal consistency of 0.7 and 0.8 for the young and older group, respectively. Bland-Altman showed the bias close to zero, with no ceiling or floor effect. Regarding construct validity, younger children showed lower scores when compared to the older children. Endurance differed significantly between children with CP who were walking and those who were not walking and also for age groups. Children with CP showed lower endurance compared to typically participants in the same age group. CONCLUSIONS: Brazilian EASE is reliable and valid to estimate endurance in children with CP. Results provide evidence of construct validity.

Endurance to physical activity is an important construct to be evaluated and that directly interferes with the health and quality of life of children with Cerebral Palsy (CP).The Brazilian-Portuguese version of the 4-item Early Activity Scale for Endurance (EASE) is a valid and reliable scale to assess endurance to physical activity in children with CP.

Practitioner-led, peer-group sports intervention combined with a context-focused intervention for children with cerebral palsy: a protocol of a feasibility randomised clinical trial.

BACKGROUND: There is a need to investigate relevant, acceptable and feasible approaches that promote participation in leisure-time physical activity for children with cerebral palsy (CP). The aim of this study is to assess the feasibility of a randomised controlled trial comparing a peer-group intervention focused on improving physical literacy (Sports Stars) with the combination of Sports Stars and a context-focused intervention (Pathways and Resources for Engagement and Participation, PREP) for ambulant children with CP in Brazil. METHODS: In this feasibility trial, 18 ambulant children (aged 6-12 years) with CP will be randomised into two groups (nine per group): (1) Sports Stars and (2) Sports Stars plus PREP. The Sports Stars group will receive 8 weekly group sessions, focusing on developing the physical, social, cognitive and psychological skills required to participate in popular Brazilian sports. The combined Sports Stars and PREP group will receive Sports Stars in addition to eight individual PREP sessions focused on overcoming environmental barriers to participation. The primary outcome will include feasibility measures: willingness to participate in an RCT, eligibility and recruitment rates, maintenance of evaluator blinding, acceptability of screening procedures and random allocation, feasibility of evaluating outcomes, contamination between the groups, intervention adherence, treatment satisfaction, understanding of the intervention and implementation resources. Additional instruments will be applied to obtain data related to leisure-time physical activity participation goals, overall participation (home, school and community), physical literacy, level of physical activity and family empowerment. Outcomes will be assessed before, after and 12 weeks after intervention. ETHICS AND DISSEMINATION: This feasibility trial has been approved by ethical Federal University of Minas Gerais' Ethics Review Committee (CAAE: 33238520.5.0000.5149). All potential subjects will provide written informed consent. The results of this study will be published in peer-reviewed journals and be presented at academic conferences. TRIAL REGISTRATION NUMBERS: RBR-4m3b4b6, U1111-1256-4998.

Motor Skills are Associated with Participation of Children with Autism Spectrum Disorder.

Children with autism spectrum disorder (ASD) generally have a delay in the development of motor skills when compared to typical children, however, to date, no study has investigated whether motor limitations can interfere in the participation of these children. The objectives of this study were: verify if the motor skills can explain the frequency, the percentage of number of activities, the involvement and the desire to change in participation at home, school and community of children with autism spectrum disorder (ASD) and; identify if contextual factors would modify the association between motor skills and participation outcomes. The participation and the motor skills were evaluated in 30 children with ASD between 5 and 10 years old. Participation outcomes were measured by the Participation and Environment Measure-Children and Youth (PEM-CY) and the motor skills were assessed by the Timed Up and Go, Timed Up and Down Stairs, Test of Gross Motor Development-2nd edition and Pediatric Balance Scale. The results of the study demonstrated that the motor skills of the locomotion, objects control, change position and balance explained participation outcomes of children with ASD classified from mild to moderate, between 5 and 10 years old. Moreover, the sex variable modified the association between the motor skills and the school participation, with girls performing less activities at this setting.

Effectiveness of Physical Therapy Interventions in Children with Brachial Plexus Birth Injury: A Systematic Review.

AIM: To systematically review the effectiveness of physical therapy interventions in infants, children and adolescents with brachial plexus birth injury (BPBI). METHODS: Systematic review of randomized controlled trials including patients under 18 years old with BPBI was conducted on Medline, Cochrane, Embase, Amed and Pedro databases. Methodological quality was assessed by the PEDro score and quality of evidence by the GRADE system. The primary outcomes measured were range of motion, muscle strength and bone mineral density. RESULTS: Seven studies were included, two in infant and 5 in children, of 932 title and abstracts screened. The interventions, characteristics of the participants and outcomes were diverse. The largest effect was found when other intervention was combined with conventional physical therapy in the primary outcomes, with low quality of evidence. CONCLUSION: Physical therapy interventions alone or in combination with other treatment modalities are effective in improving short-term disabilities in children with BPBI.

Moving together is better: a systematic review with meta-analysis of sports-focused interventions aiming to improve physical activity participation in children and adolescents with cerebral palsy.

PURPOSE: To analyze the effectiveness of sports-focused interventions on the participation of children and adolescents with cerebral palsy (CP). METHODS: Study searches were conducted on EMBASE, PubMed, Scielo, PEDro, CINAHL, SPORTDiscuss in June 2022. We included randomized controlled trials that investigated the effectiveness of sports-focused interventions in children and adolescents with CP in comparison with control. Risk of bias was assessed with PEDro scale and evidence certainty with GRADE approach. Data were pooled in random-effects meta-analyses and results were presented as standardized mean differences. RESULTS: Ten RCTs were selected with different modalities, mostly for ambulant children and adolescents. Significant pooled effects on participation in leisure-time physical activity were seen only in group interventions (modified sports, gross motor training, and fitness training), in comparison with control [SMD(95% CI) = 0.32(0.01-0.73) p = 0.04]. No pooled effects were seen in participation in other life areas in comparison with control (p > 0.05). Current certainty of evidence of all sports-focused interventions included was moderate due to imprecision. CONCLUSION: Positive results on leisure-time participation were seen at short-term follow-up for group interventions. Sports-focused interventions did not improve participation in other life areas, reinforcing the importance of specificity when conducting participation interventions. Studies investigating sports-focused interventions including non-ambulatory individuals are still necessary. IMPLICATIONS FOR REHABILITATIONSports-focused interventions target leisure-time physical activity participation.They present moderate evidence of their effectiveness to improve physical activity participation in individuals with cerebral palsy.Group interventions are effective in improving leisure-time physical activity participation.Sports-focused interventions did not improve participation in other life areas.

Clinical factors associated with abnormal general movements of preterm newborns during hospitalization in a neonatal intensive care unit.

INTRODUCTION: There is no clarity about which clinical variables during hospitalization in the Neonatal Intensive Care Unit (NICU) are associated with abnormal General Movements (GMs). OBJECTIVE: To describe the trajectory of GMs of preterm newborns and explore the association between clinical variables and the presence of abnormal GMs during the NICU stay. METHODS: Fifty-eight preterm newborns (33 males), with a mean gestational age at birth of 31,93 week's postmenstrual age, were evaluated using the GMs assessment by Hadders-Algra method. Clinical variables recorded weekly throughout the hospitalization period. The weekly association between clinical variables and the presence of abnormal GMs was tested using the Generalized Estimating Equations (GEE) model. RESULTS: Preterm infants were recorded for up to sixteen weeks and more than half of the infants (56.9 %) had abnormal movements in at least one week during hospitalization. The absence of peri-intraventricular hemorrhage (PIVH) grades I-II and non-invasive ventilatory support and/or oxygen therapy on the day of the evaluation reduced, respectively, by 77.3 % (OR = 0.23; p > 0.0001) and 64.3 % (OR = 0.36; p > 0.0001) the chance of having an abnormal classification. In addition, each day of increased invasive mechanical ventilation increased the chance of having an abnormal classification by 1.11 times (OR = 0.025; p > 0.0001). CONCLUSION: PIVH grades I-II, longer durations of mechanical ventilation and the presence of non-invasive ventilatory support and/or oxygen therapy are associated with abnormal movements during stay in the neonatal period. The data suggest that development outcome of infants having these conditions should be closely monitored.

Comparação entre as versões rápida e conteúdo-balanceada do Inventário de Avaliação Pediátrica de Incapacidade - Testagem Computadorizada Adaptativa (PEDI-CAT) em crianças com paralisia cerebral / Comparación entre las versiones rápida y de contenido equilibrado del Pediatric Disability Assessment Inventory-Computerized Adaptive Test (PEDI-CAT) en niños con parálisis cerebral / Comparison between speedy and content-balanced versions of the Pediatric Evaluation of Disability Inventory - Computer Adaptive Test (PEDI-CAT) in children with cerebral palsy

RESUMO O objetivo deste estudo foi comparar as versões rápida e conteúdo-balanceada do Inventário de Avaliação Pediátrica de Incapacidade - Testagem Computadorizada Adaptativa (PEDI-CAT) em seus quatro domínios. Para tanto, foi realizado um estudo observacional transversal com crianças com paralisia cerebral (PC). As duas versões do PEDI-CAT foram aplicadas em cada criança com um intervalo de sete dias, no formato remoto, por meio de entrevistas com os responsáveis. Foi utilizada a correlação de Pearson para verificar a associação entre os escores contínuos das duas versões do PEDI-CAT. Participaram do estudo 11 crianças com PC, entre 2 e 12 anos de idade. Foi verificada forte associação significativa entre valores médios do escore contínuo da versão rápida e conteúdo-balanceada em todos os domínios (p<0,0001). Duas crianças (18,2%) foram classificadas de forma diferente em relação ao escore normativo no domínio social-cognitivo. As versões do PEDI-CAT mostraram resultados concordantes em relação ao escore contínuo quando aplicadas em crianças com PC. No entanto, é necessário ter cautela na interpretação do escore normativo dependendo da versão utilizada no domínio social-cognitivo.

RESUMEN El objetivo de este estudio fue comparar las versiones rápida (speedy-cat) y de contenido equilibrado (content-balanced) del Pediatric Disability Assessment Inventory-Computerized Adaptive Test (PEDI-CAT) en sus cuatro dominios. Para eso, se realizó un estudio observacional transversal con niños con parálisis cerebral (PC). Las dos versiones del PEDI-CAT se aplicaron a cada niño por medio de entrevistas con los cuidadores, con un intervalo de siete días y en formato remoto. Se utilizó la correlación de Pearson para verificar la asociación entre las puntuaciones continuas de las dos versiones del PEDI-CAT. Once niños con PC, con edades comprendidas entre 2 y 12 años, participaron en el estudio. Hubo una fuerte asociación significativa entre los valores medios de la puntuación continua de la versión rápida y el contenido equilibrado en todos los dominios (p<0,0001). Dos niños (18,2%) fueron clasificados de manera diferente con relación al puntaje normativo en el dominio sociocognitivo. Las versiones del PEDI-CAT mostraron resultados concordantes en cuanto a la puntuación continua cuando se aplica a niños con PC. Sin embargo, se necesita precaución al interpretar el puntaje normativo basado en la versión utilizada en el dominio sociocognitivo.

ABSTRACT This study aimed to compare the speedy and content-balanced versions of the Pediatric Evaluation of Disability Inventory - Computer Adaptive Test (PEDI-CAT) in its four domains. A cross-sectional observational study was conducted with children with cerebral palsy (CP). The two versions of PEDI-CAT were administered to each child with a 7-days interval, remotely, in interview format with caregivers. Pearson's correlation was used to evaluate the association among scaled scores in the two versions of PEDI-CAT. In total, 11 children with CP, aged 2 to 12 years, participated in the study. A strong significant association between mean values of the scaled score of the speedy and content-balanced versions in all domains (p<0.0001) was observed. Two children (18.2%) were classified differently regarding normative standard score in the Social/Cognitive domain. Both versions of PEDI-CAT showed concordant results in relation to the scaled score when applied to children with CP. However, one must cautiously interpret the normative standard score depending on the version used in the Social/Cognitive domain.

Association between executive functions and gross motor skills in overweight/obese and eutrophic preschoolers: cross-sectional study.

BACKGROUND: Preschool age (3-5 years old) is a crucial period for children to acquire gross motor skills and develop executive functions (EFs). However, the association between the qualitative gross motor skills and EFs remains unknown in preschoolers, especially among overweight and obese children. METHODS: This was a cross-sectional, exploratory, and quantitative study carried out on 49 preschool children, divided into two subgroups according to their body mass index (overweight/obese: 24; eutrophic [normal weight]: 25). The mean age was 4.59 years. More than half of the sample were boys (55%) and most of the mothers had completed high school (67%) and were class C socioeconomic level (63%). Gross motor skills were assessed using the Test of Gross Motor Development-2, while EFs were evaluated using Semantic verbal fluency (SVF), Tower of Hanoi (TH), Day/Night Stroop, and Delayed Gratification tests. Multiple linear regression models adjusted for sex, age, maternal education, socioeconomic status, quality of the home environment, and quality of the school environment using the stepwise method were executed, considering the cognitive tasks as independent variables and gross motor skills as dependent variable. RESULTS: The overweight/obese preschoolers showed worse locomotor skills than their eutrophic peers and below average gross motor quotient (GMQ). Overweight/obese girls performed worse in OC skills than boys with excess weight. SVF (number of errors) and TH (rule breaks) explained 57.8% of the variance in object control (OC) skills and 40.5% of the variance in GMQ (p < .05) in the overweight/obese children. Surprisingly, there was no significant association between any of the EF tasks and gross motor skills in the eutrophic children. CONCLUSION: A relationship between EF tasks (number of errors in SVF and rule breaks in TH) and gross motor skills (OC and GMQ) was demonstrated in the overweight/obese preschoolers, indicating that worse cognitive flexibility, working memory, planning, and problem solving are associated with worse gross motor skills in this population when compared to eutrophic children.

Determinants of High Fat Mass Index in Preschoolers Living in Brazilian Urban Areas.

OBJECTIVE: Determine the social, environmental, and personal factors associated with high fat mass index in preschoolers. DESIGN: A quantitative, exploratory, and cross-sectional study. SETTING AND PARTICIPANTS: Fifty-one Brazilian preschoolers from public schools living in urban areas. MAIN OUTCOME MEASURE(S): The preschoolers' fat mass index was determined using dual-energy radiological absorptiometry. The quality of home and school environments were accessed using the Early Childhood Home Observation for Measurement of the Environment and Early Childhood Environment Rating Scales. The physical activity levels were recorded by accelerometers. The daily energy intake was recorded and sociodemographic data using the Brazilian Economic Classification criterion. Data on exposure time to screens and parental obesity were collected according to the parents' reports. ANALYSIS: Data analyses were performed using simple and multiple regressions models. RESULTS: Parental obesity (ß, 0.516; 95% confidence interval [CI], 2.078-5.133), high quality of environmental stimulation of home (ß, 0.429; 95% CI, 1.294-4.023), and high exposure time to screens (ß, 0.256; 95% CI, 0.215-2.554) explained 43% of preschoolers' high fat mass index. CONCLUSIONS AND IMPLICATIONS: Identification of parental obesity, high quality of environmental stimulation of home, and high exposure time to screens as the most important determinants of the high fat mass index in preschoolers from Brazilian urban areas.

Is body fat mass associated with worse gross motor skills in preschoolers? An exploratory study.

We compared the motor competence between overweight/obese and eutrophic preschoolers with similar physical activity levels, age, socioeconomic status, maternal education, quality of the home environment and quality of the school environment. We also investigated to what extent excess body fat mass explains gross motor skills in preschoolers. A cross-sectional quantitative and exploratory study was conducted with 48 preschoolers assigned into eutrophic and overweight/obese groups. Overweight/obese preschoolers had worse Locomotor subtest standard scores than the eutrophic ones (p = 0.01), but similar Object Control subtest and Gross Motor Quotient scores (p > 0.05). Excess body fat mass explained 12% of the low Locomotor subtest standard scores in preschoolers (R2 = 0.12; p = 0.007). Excess body fat mass was associated with worse locomotor skills when the model was adjusted for physical activity levels, age, socioeconomic status, maternal education, quality of the home environment and quality of the school environment. Thus, excess body fat mass partly explains lower locomotor skills in preschoolers.

Physical environmental opportunities for active play and physical activity level in preschoolers: a multicriteria analysis.

BACKGROUND: Active play opportunities seems to influence the level of physical activity during childhood. However, a gap remains about which environmental opportunities including the daycare physical environment could have a positive impact on the level of physical activity in preschoolers. OBJECTIVES: (1) To develop an index to measure the environmental opportunities of free active play for preschoolers of middle-income countries; (2) to check the relationship and contribution of the index to explain objectively the level of physical activity. METHODS: A quantitative, cross-sectional, exploratory study with 51 preschool children. The established criteria for the index according to the literature were: (1) Outdoor time on typical days of the week. (2) Outdoor time on a typical weekend day. (3) The presence of internal space and external environment in the child's home that allows playing. (4) Presence of patio with space for games at the school. (5) Presence of a playground with a toy at the school. We applied multi-attribute utility theory for the determination of the multicriteria index of physical environmental opportunities. Pearson's correlation analysis and simple linear regression were used to verify the association between the index and the physical activity level. RESULTS: The index showed a positive correlation with the level of physical activity, e.g., the average time of MVPA (r = 0.408, p = 0.003). The univariate linear regression demonstrated that the quality of physical environmental opportunities for physical activity explained 20% of the preschooler's classification as active and 16% of the time in moderate to vigorous physical activity (p < 0.001). CONCLUSION: Physical environmental opportunities for active play have a positive effect on physical activity in preschoolers and should be encouraged in different social segments.

Associação entre função cognitiva e desenvolvimento motor grosso de crianças com transtornos do neurodesenvolvimento / Association between cognitive function and gross motor development in children with neurodevelopmental disorders

INTRODUÇÃO: Crianças com transtornos do neurodesenvolvimento apresentam uma variedade de condições que, em geral, possuem comprometimento da função cognitiva, bem como limitações para realizar atividades motoras grossas e finas decorrentes do déficit de equilíbrio e da coordenação motora. OBJETIVO: O presente estudo teve por objetivo verificar se a função cognitiva está associada e pode predizer desfechos do desenvolvimento motor grosso em crianças com transtornos do neurodesenvolvimento entre 5 e 10 anos de idade. MATERIAIS E MÉTODOS: Foi realizado um estudo transversal exploratório com 24 crianças com transtornos do neurodesenvolvimento, entre 5-10 anos de idade, capazes de deambular independente. Para avaliar a função cognitiva e as habilidades motoras grossas das crianças foram utilizados o MiniExame do Estado Mental e o Teste de Desenvolvimento Motor Grosso ­ segunda edição, respectivamente. Análise de regressão linear simples foi realizada e o tamanho do efeito calculado. RESULTADOS: Quinze (60%) eram meninos, com idade média de 7,81 (± 1,90), sete com deficiência intelectual, oito com transtorno do espectro autista, cinco com transtorno do déficit de atenção e hiperatividade, dois com transtornos de comunicação e três com transtornos específicos de aprendizagem. A pontuação do Mini-Exame do Estado Mental foi significativamente associada e capaz de explicar a variabilidade das habilidades de locomoção (R2=0,25; p=0,006), das habilidades de controle de objetos (R2=0,29; p=0,003) e do quociente motor grosso (R2=0,40; p=0,0001). CONCLUSÃO: A função cognitiva está associada e pode explicar o desenvolvimento motor grosso de crianças com transtornos do neurodesenvolvimento entre 5 e 10 anos de idade. Esses resultados podem contribuir para um melhor entendimento da influência da função cognitiva no desenvolvimento das habilidades motoras grossas dessa população.

INTRODUCTION: Children with neurodevelopmental disorders have a variety of conditions that, in general, cause cognitive impairments, as well as, limitations to perform gross and fine motor activities resulting from deficits in balance and motor coordination. OBJECTIVE: This study verified whether the cognitive function is associated and could predict outcomes of gross motor development in children with neurodevelopmental disorders between 5 and 10 years of age. METHODS: We carried out an exploratory cross-sectional study with 25 children with neurodevelopmental disorders, between 5-10 years of age, able to walk independently. The children's version of the Mini-Mental State Examination and the Gross Motor Development Test - second edition-evaluated the cognitive function and gross motor abilities. A simple linear regression analysis was performed, and the effect size was calculated. RESULTS: Fifteen (60%) were male, with a mean age of 7.81 (± 1.90), seven with intellectual disability, eight with autism spectrum disorder, five with attention deficit hyperactivity disorder, two with communication disorders, and three with specific learning disorders. The Mini-Exam State Examination score was significantly associated and explained the variability of locomotion skills (R2=0.25; p=0.006), object control skills (R2= 0.29; p=0.003), and the gross motor quotient (R2=0.40; p=0.0001). CONCLUSION: We concluded that cognitive function is associated with gross motor skills and could explain their development in children with neurodevelopmental disorders between 5 and 10 years of age. These results might contribute to a better understanding of the influence of cognitive function on the development of gross motor skills in this population.

Respostas cardiopulmonares durante o exercício de agachamento dinâmico com e sem vibração de corpo inteiro em adolescentes / Cardiopulmonary responses during dynamic squatting exercise with and without wholebody vibration in adolescents

INTRODUÇÃO: A vibração de corpo inteiro (VCI) tem sido amplamente utilizada como recurso terapêutico na reabilitação pediátrica. Porém, as respostas cardiopulmonares ainda são desconhecidas nesta população. OBJETIVOS: Investigar a intensidade do exercício de agachamento dinâmico com e sem VCI em adolescentes saudáveis a fim de caracterizar as respostas cardiorrespiratórias. MATERIAIS E MÉTODOS: Trata-se de um estudo quase experimental. Vinte e cinco adolescentes (14,1 ± 1,7 anos), 10 meninas e 15 meninos, foram submetidos a avaliações do consumo de oxigênio (VO2) e frequência cardíaca (FC) durante um protocolo de agachamento com e sem vibração. Os critérios de inclusão foram idade entre 12 e 18 anos, ambos os sexos, IMC normal. Os critérios de exclusão foram apresentar doenças neurológicas, ortopédicas, respiratórias, cardíacas e endócrinas crônicas ou agudas ou alguma contraindicação autorreferida para VCI (trombose venosa profunda, implantes metálicos, marca-passo, epilepsia, tumores, aneurisma ou arritmia). RESULTADOS: A VCI aumentou significativamente o VO2, FC e a percepção do esforço durante o agachamento quando comparado ao repouso e agachamento sem-VCI. VCI associada ao agachamento atingiu 24,7% do VO2máx e 56% da FCmáx prevista para a idade. Os indivíduos durante a VCI relataram esforço entre ligeiramente cansativo e cansativo em comparação com entre muito fácil e fácil no protocolo Sem-VCI. CONCLUSÃO: O agachamento associado à VCI foi considerado de intensidade leve e foi tolerado por adolescentes saudáveis. Este estudo forneceu resultados válidos desta modalidade de exercício e pode ser utilizado como uma ferramenta para definir o consumo de energia gasto durante a prática deste tipo treinamento.

BACKGROUND: Whole-body vibration (WBV) has been widely used as a therapeutic resource in pediatric rehabilitation. However, the cardiopulmonary responses are still unknown. OBJECTIVE: To investigate the intensity of dynamic squatting exercise with and without WBV in healthy adolescents to characterize cardiorespiratory responses. METHODS: This was a quasi-experimental study. Twentyfive adolescents (14.1 ± 1.7 years), 10 girls and 15 boys, underwent into oxygen consumption (VO2) and heart rate (HR) assessments during a protocol of squatting with and without vibration. Inclusion criteria were age between 12 and 18 years old of both sexes, have normal weight according to BMI. Exclusion criteria were to present chronic or acute, neurological, orthopedic, respiratory, cardiac, and endocrine disease and no self-reported contraindication for WBV (i.e. deep vein thrombosis, metal implants, pacemaker, epilepsy, tumors, arterial aneurysm, or arrhythmia). RESULTS: WBV was able to significantly increase VO2, HR, and perceived exertion during squatting exercise when compared to rest and squatting without-WBV. WBV associated with squatting reached 24.7% of the VO2max and 56% of the HRmax predicted for the age. Subjects during WBV reported a perceived exertion score between somewhat hard and hard compared to between very light and light in the Without-WBV protocol. CONCLUSION: Squatting associated with WBV was considered a light-intensity exercise that can be tolerated by healthy adolescents. This study provided valid results of this training modality and could be used as a tool to define the energy consumption spent in this training modality.