Delayed childhood neurodevelopment and neurosensory alterations in the second year of life in a prospective cohort of ZIKV-exposed children.

We report neurodevelopmental outcomes in 216 infants followed since the time of PCR-confirmed maternal Zika virus (ZIKV) infection in pregnancy during the Rio de Janeiro epidemic of 2015-2016 (refs. 1,2). Neurodevelopment was assessed by Bayley Scales of Infant and Toddler Development, third edition (Bayley-III; cognitive, language and motor domains) in 146 children and through neurodevelopment questionnaires/neurological examinations in 70 remaining children. Complete eye exams (n = 137) and hearing assessments (n = 114) were also performed. Below-average neurodevelopment and/or abnormal eye or hearing assessments were noted in 31.5% of children between 7 and 32 months of age. Among children assessed by Bayley-III, 12% scored below -2 s.d. (score <70; a score of 100 ± 2 s.d. is the range) in at least one domain; and 28% scored between -1 and -2 s.d. in any domain (scores <85-70). Language function was most affected, with 35% of 146 children below average. Improved neurodevelopmental outcomes were noted in female children, term babies, children with normal eye exams and maternal infection later in pregnancy (P = 0.01). We noted resolution of microcephaly with normal neurodevelopment in two of eight children, development of secondary microcephaly in two other children and autism spectrum disorder in three previously healthy children in the second year of life.

Conventional physical therapy and physical therapy based on reflex stimulation showed similar results in children with myelomeningocele.

We aimed to investigate whether infants with myelomeningocele would improve their motor ability and functional independence after ten sessions of physical therapy and compare the outcomes of conventional physical therapy (CPT) to a physical therapy program based on reflex stimulation (RPT). Twelve children were allocated to CPT (n = 6, age 18.3 months) or RPT (n = 6, age 18.2 months). The RPT involved proprioceptive neuromuscular facilitation. Children were assessed with the Gross Motor Function Measure and the Pediatric Evaluation of Disability Inventory before and after treatment. Mann-Whitney tests compared the improvement on the two scales of CPT versus RPT and the Wilcoxon test compared CPT to RPT (before vs. after treatment). Possible correlations between the two scales were tested with Spearman correlation coefficients. Both groups showed improvement on self-care and mobility domains of both scales. There were no differences between the groups, before, or after intervention. The CPT and RPT showed similar results after ten weeks of treatment.

Conventional physical therapy and physical therapy based on reflex stimulation showed similar results in children with myelomeningocele / Fisioterapia convencional e fisioterapia com estimulação reflexa apresentaram resultados semelhantes em crianças com mielomeningocele

ABSTRACT We aimed to investigate whether infants with myelomeningocele would improve their motor ability and functional independence after ten sessions of physical therapy and compare the outcomes of conventional physical therapy (CPT) to a physical therapy program based on reflex stimulation (RPT). Twelve children were allocated to CPT (n = 6, age 18.3 months) or RPT (n = 6, age 18.2 months). The RPT involved proprioceptive neuromuscular facilitation. Children were assessed with the Gross Motor Function Measure and the Pediatric Evaluation of Disability Inventory before and after treatment. Mann-Whitney tests compared the improvement on the two scales of CPT versus RPT and the Wilcoxon test compared CPT to RPT (before vs. after treatment). Possible correlations between the two scales were tested with Spearman correlation coefficients. Both groups showed improvement on self-care and mobility domains of both scales. There were no differences between the groups, before, or after intervention. The CPT and RPT showed similar results after ten weeks of treatment.

RESUMO O estudo investigou se crianças com mielomeningocele melhorariam sua habilidade motora/funcional após dez sessões de fisioterapia e comparou o quadro motor de um grupo submetido à fisioterapia convencional (FC) com outro tratado com fisioterapia com estimulação reflexa (RF). Doze crianças foram alocadas em FC (n=6, 18,3 meses de idade) ou FR (n=6, 18,2 meses de idade). FR envolveu facilitação neuromuscular proprioceptiva. As crianças foram avaliadas com a Medida de Função Motora Grossa (GMFM) e o Inventário de Avaliação Pediátrica de Incapacidade (PEDI) antes e depois do tratamento. Testes de Mann-Whitney compararam a melhora na GMFM e PEDI (FC versus FR) e testes de Wilcoxon compararam FC e FR (antes versus depois). Possíveis correlações entre GMFM e PEDI foram testadas por coeficientes de Spearman. Ambos os grupos melhoraram na GMFM e PEDI (domínios autocuidado e mobilidade). Não houve diferença entre os grupos antes e após a intervenção. FC e FR apresentaram efeitos semelhantes depois de dez semanas de tratamento.