Measuring muscle activation using electromyography during neurodevelopmental treatment in individuals with severe cerebral palsy.

BACKGROUND: In the motor rehabilitation of individuals with neurological disorders, including cerebral palsy (CP), Neurodevelopmental treatment (NDT) one of the most used approaches worldwide. OBJECTIVE: To verify muscle activation in NDT handling in individuals with severe CP using electromyography. METHODS: This was a controlled, cross-sectional, quantitative clinical trial. The individuals were evaluated using electromyography to analyze the muscular activation of the spinal erector, gluteus medius, rectus abdominis and multifidus during different NDT handling. We evaluated 59 individuals: 39 with spastic quadriparesis CP (Gross Motor Function Classification System, level IV-V) and 20 typically-developing individuals (control group). These groups were homogeneous with respect to age and gender. RESULTS: There was a significant difference in muscle activation of the spinal erector, gluteus medius, rectus abdominis and multifidus in the six NDT handling used in this study: side-sitting for kneeling; supine for lateral decubitus, prone position for lateral decubitus, "sitting on horseback", sitting on the roll, and proprioceptive stimulation sitting on the ball. CONCLUSION: The results show that all NDT handling analyzed in this study were effective for muscle activation of the spinal erector, gluteus medius, rectus abdominis and multifidus in individuals with severe spastic quadriparetic CP.

Analysis of muscle activation in children and adolescents with severe cerebral palsy / Análise da ativação muscular em crianças e adolescentes com paralisia cerebral grave

Abstract Introduction: Children and adolescents with spastic quadriparesis have a worse selective motor control, and studies with this population are still very scarce. The same is true with scientific evidence of one of the methods most used as a physiotherapeutic treatment in this population, the Bobath Concept. Objective: To evaluate spine erector muscles activation, gluteus medius and gluteus maximus, through the handling of the Bobath Concept and the sustained kneeling posture in subjects with a diagnosis of severe cerebral palsy; and to compare muscle activation with a reference group, in order to increase the reliability of this study. Methods: A cross-sectional study was carried out with 38 children and adolescents with cerebral palsy, classified by GMFCS at levels IV and V, and 20 healthy participants, aged between 3 and 18 years. They were submitted to the handling of the Bobath Concept and to the sustained kneeling posture, with muscle activation obtained by electromyography. Results: We observed significant muscle activation during handling in side-sitting, with weight transfer and without the help of another therapist, and in the sustained kneeling posture, for the erector of the spine and gluteus medius. Conclusion: The evidence from this study suggests that both the handling in side-sitting and the sustained kneeling posture cause significant muscle activation in the erector of the spine and gluteus medius for severe quadriparesis subjects, GMFCS IV and V, which can contribute to the improvement of postural control and decision-making in physical therapy practice.

Resumo Introdução: Crianças e adolescentes com quadriparesia espástica apresentam pior controle motor seletivo e estudos com essa população ainda são muito escassos. O mesmo ocorre com as evidências científicas de um dos métodos mais utilizados como tratamento fisioterapêutico nessa população, o Conceito Bobath. Objetivo: Avaliar a ativação dos músculos eretores da coluna, glúteo médio e glúteo máximo por meio do manuseio do Conceito Bobath e da postura ajoelhada sustentada, em indivíduos com diagnóstico de paralisia cerebral grave; e comparar a ativação muscular com um grupo de referência, a fim de aumentar a confiabilidade deste estudo. Métodos: Realizou-se um estudo transversal com 38 crianças e adolescentes com paralisia cerebral, classificados pelo GMFCS nos níveis IV e V, e 20 participantes saudáveis com idade entre 3 e 18 anos. Eles foram submetidos ao manuseio do Conceito Bobath e à postura ajoelhada sustentada, com ativação muscular obtida por eletromiografia. Resultados: Observou-se ativação muscular significativa durante o manuseio na posição sentada de lado, com transferência de peso e sem auxílio de outro terapeuta, e na postura ajoelhada sustentada para o eretor da coluna e glúteo médio. Conclusão: As evidências deste estudo sugerem que tanto o manuseio na posição sentada de lado quanto a sustentação da postura ajoelhada causam significativa ativação muscular no eretor da coluna e glúteo médio para indivíduos com quadriparesia grave, GMFCS IV e V, o que pode contribuir para a melhora do controle postural e tomada de decisão na prática fisioterapêutica.

Predictors for Screen Time Exposure among Children between 3 and 5 Years Old in Southern Brazil.

BACKGROUND: The use of technology is an increasingly common practice among preschoolers. Little is known about the relationship between screen time exposure (STE) and aspects related to family and the environment. AIM: The aim is to characterize STE in Brazilian children aged between 3 and 5 years. Furthermore, the objective of this study is to associate the STE of children and of their parents with sociodemographic variables. METHODS: Children aged between 3 and 5 years from southern Brazil and their parents participated in this study. To investigate STE, the researchers developed a specific questionnaire. To compare STE between age groups, the Kruskal-Wallis test was performed, followed by Dunn's post hoc test. Spearman's correlation and linear regression were used to correlate the variables. RESULTS: Children (n = 237) spend an average of 3.7 ± 0.8 h/day in front of screens. The STE of children had a moderately positive correlation with the STE of their parents (r = 0.4; p-value < 0.001). Only the variables of the children's and parents' STE had a significant and positive association. The model is significant (F = 6164, p-value < 0.001) and the residuals of the model met the necessary assumptions, with normal distribution, constant variance and without the presence of outliers. CONCLUSION: Children in southern Brazil remain in front of screens four times longer than the recommended amount of time. It was also found that the STE of parents directly influences that of their children.

Positioning Effects for Procedural Pain Relief in NICU: Systematic Review.

OBJECTIVES: To systematically review the literature regarding the effectiveness of different positioning methods for procedural pain relief in neonates admitted to the Neonatal Intensive Care Unit (NICU). DESIGN: A systemized search of the literature was carried out by means of two independent evaluators through the systematic search of electronic index databases. DATA SOURCES: A search for relevant studies was performed in four databases (Medline, Web of Science, Scopus, and BVS-BIREME). REVIEW/ANALYSIS METHODS: Manual searches were conducted on suitable references from the included articles, and 1,941 publications were eligible for the analysis. The flowchart for the articles' selection was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, and in relation to bias risks according to the Physiotherapy Evidence Database (PEDro) scale. RESULTS: Based on the inclusion criteria, only 20 publications remained. According to the PEDro scale, 75% of the studies presented good methodological quality, with scores between 6 and 8, and 5% scored ≤4 points. None of them were blinded in relation to the therapies, but all of them performed intergroup statistical comparisons. According to the results of this review, we recommend facilitated tucking by parents (FTP) in NICU of at least 30 minutes duration, starting 15 minutes before, during the painful procedure, and 15 minutes after to relieve pain and to stabilize the physiological, hormonal, and behavioral responses of the newborns. CONCLUSIONS: Positioning should be used as a nonpharmacological strategy for procedural pain relief in newborns. This review showed that facilitated tucking by parents for 30 minutes was the best position for pain relief in premature newborns during procedures in the NICU. Positioning is recommended as a nonpharmacological method for pain relief; FTP of at least 30 minutes duration should be the first positioning choice during procedures in the NICU.

Insatisfação com a imagem corporal em adolescentes na cidade de Farroupilha, RS / Body image dissatisfaction in adolescents in Farroupilha, RS

Introdução: O objetivo deste estudo foi verificar a prevalência da insatisfação com a imagem corporal em adolescentes na cidade de Farroupilha, RS. Métodos: Foram avaliados neste estudo 886 adolescentes com idade entre 11 e 14 anos. Foi utilizada para avaliação a escala de nove silhuetas. Também foi verificada a prevalência em relação ao sexo, idade, exercícios fora do horário escolar e estado nutricional pela circunferência da cintura. Resultados: O estudo apresentou prevalência de insatisfação de 73,6% entre os adolescentes. Os meninos apresentaram menor prevalência em relação às meninas. Conclusão: A prevalência de insatisfação com a imagem corporal estudada é elevada e deve ser motivo de preocupação pela sociedade em questão. Sugerem-se programas que visem à prevenção e promoção da saúde dos adolescentes em idade escolar nos temas avaliados (AU)

Introduction and aim: This study was designed to find the prevalence of dissatisfaction with body image in adolescents in the city of Farroupilha, RS. Methods: This study evaluated 886 adolescents aged 11 to 14 years. The scale of nine silhouettes was used for evaluation. We also checked the prevalence in relation to gender, age, exercise out of school hours, and nutritional status by waist circumference. Results: The prevalence of body image dissatisfaction among adolescents was 73.6%. The boys had a lower prevalence than the girls. Conclusion: The prevalence of body image dissatisfaction found here is high and should be cause for concern. Programs should be suggested to prevent and promote the health of school-aged adolescents in the evaluated topics (AU)

Prevalência de sintomas para transtornos alimentares em escolares de 11 a 15 anos da rede municipal de ensino da cidade de Nova Petrópolis, RS / Prevalence of symptoms for eating disorders in schoolchildren aged 11 to 15 years of the municipal school system of the city of Nova Petrópolis

Objetivo: Verificar a prevalência de sintomas para Transtornos Alimentares (TA) em escolares de 11 a 15 anos da rede municipal de ensino da cidade de Nova Petrópolis, RS. Métodos: Foi realizado um estudo transversal com 323 escolares (população na faixa etária). Para avaliação dos sintomas para TA, utilizou-se o teste de atitudes alimentares (EAT 26). Resultados: A prevalência de sintomas para TA foi de 21,7%. A insatisfação com a imagem corporal foi de 79,3%. Os escolares insatisfeitos apresentaram quase o triplo de chances de estarem com os sintomas em relação aos satisfeitos. Conclusões: As prevalências de sintomas para TA e a insatisfação com a imagem corporal da população estudada encontram-se elevadas e devem ser motivo de preocupação dos profissionais de saúde (AU)

Aim: To determine the prevalence of symptoms for Eating Disorders (ED) in schoolchildren aged 11 to 15 years of the municipal school system of the city of Nova Petrópolis, RS. Methods: A cross-sectional study was conducted with 323 schoolchildren (population in the age group). To evaluate for ED symptoms, the Eating Attitudes Test (EAT 26) was used. Results: The prevalence of symptoms for ED was 21.7%. Dissatisfaction with body image was 79.3%. The dissatisfied schoolchildren were nearly three times more likely to have symptoms than satisfied ones. Conclusions: The prevalence of symptoms for BP and the dissatisfaction with body image in the studied population are high and should be a matter of concern to health professionals (AU)