Resumo:Introdução: A intervenção cognitivo-motora é benéfica para o desenvolvimento tanto motor como cognitivo do bebê. Essas intervenções, no hospital, têm sido amplamente estudadas dentro de unidades de terapia intensiva neonatal, porém poucos estudos investigam a intervenção avaliando o desenvolvimento infantil dentro de unidades de internação pediátrica. Objetivo: Avaliar o impacto da intervenção cognitivo-motora no desenvolvimento motor e cognitivo de bebês de 1 a 18 meses, hospitalizados por doenças respiratórias. Método: Pesquisa quase experimental, na qual participaram 22 bebês internados na unidade pediátrica por doença respiratória, divididos em dois grupos (10 no grupo controle e 12 no grupo intervenção), sem diferenças significativas nos dados biológicos The motor intervention as delays prevention factor in motor and cognitive development of infants during the hospital stayAbstract: Introduction: Cognitive-motor tasks intervention is beneficial for the infant's motor and cognitive development. These interventions in the hospital setting, have been widely studied in neonatal intensive care units, however, few studies evaluate child development within pediatric units. Objective: To evaluate the impact of cognitive-motor intervention in motor and cognitive development of infants hospitalized with respiratory diseases.Method: The research was characterized as quasi-experimental, 22 babies hospitalized in the pediatric unit for respiratory disease were divided into 2 groups (10 in the control group and 12 in the intervention group) without significant differences in biological and socioeconomic data. The mean age was 5.50 months (SD ± 4.51), ranging between 1 and 16 months. Questionnaire was conducted with the infant's parent/guardian for sample characterization.The Alberta Infant Motor Scale (AIMS) and the Bayley Scales of Infant Development (BSID-III) was used to evaluate motor e cognitive development. Data analysis was performed using descriptive statistics, Student's t test, General Linear Model and One Way ANOVA. Results: The results show a significant interaction between group A intervenção motora como fator de prevenção de atrasos no desenvolvimento motor e cognitivo de bebês durante o período de internação hospitalar

Aim: This study examined the neurodevelopment trajectories, the prevalence of delays, and the risks and protective factors (adverse outcomes, environment, and maternal factors) associated with cognitive, motor, and language development for preterm infants from 4– to 24-months.Method: We assessed 186 preterm infants (24.7% extremely preterm; 54.8% very preterm; 20.4% moderate/late preterm) from 4– to 24-months using the Bayley Scales of Infant Development – III. Maternal practices and knowledge were assessed using the Daily Activities of Infant Scale and the Knowledge of Infant Development Inventory. Birth risks and adverse outcomes were obtained from infant medical profiles.Results: A high prevalence of delays was found; red flags for delays at 24-months were detected at 4– and 8-months of age. The neurodevelopmental trajectories showed steady scores across time for cognitive composite scores for extremely- and very-preterm infants and for language composite scores for the extremely- and moderate/late-preterm; a similar trend was observed for the motor trajectories of moderate/late preterm. Changes over time were restricted to motor composite scores for extremely- and very-preterm infants and for cognitive composite scores for moderate/late preterm; declines, stabilization, and improvements were observed longitudinally. Positive, strong, and significant correlations were for the neurodevelopment scores at the first year of life and later neurodevelopment at 18 and 24 months. The cognitive, language, and motor composite scores of extremely and very preterm groups were associated with more risk factors (adverse outcomes, environment, and maternal factors). However, for moderate/late preterm infants, only APGAR and maternal practices significantly explained the variance in neurodevelopment.Discussion: Although adverse outcomes were strongly associated with infant neurodevelopment, the environment and the parents’ engagement in play and breastfeeding were protective factors for most preterm infants. Intervention strategies for preterm infants should start at 4– to 8-months of age to prevent unwanted outcomes later in life.

Background: This study extended previous research by investigating the combined effects of neonatal birth risks, neonatal adverse outcomes, and socioeconomic status on preterm neurodevelopment. Method: A total of 184 preterm infants were assessed using the Bayley Scales of Infant Development III in a follow-up clinic in southern Brazil. Structural equation modeling was conducted with 3 latent variables (neonatal birth risks, neonatal adverse outcomes, and socioeconomic status) and 3 outcomes (cognitive, language, and motor development). Results: The analyses showed that neonatal adverse outcomes were associated with infants’ cognitive (b = –0.45, P < .001), language (b = –0.23, P = .001), and motor (b = –0.51, P < .001) development. Socioeconomic status also explained the variances (cognitive: b = 0.20, P = .006; language: b = 0.28, P = .001; and motor: b = 0.21, P = .004), whereas neonatal birth risks remained significant only in the motor development (b = 0.15, P = .040). Conclusion: This study suggests that the most evident contributors to poor neurodevelopment were adverse outcomes and socioeconomic risk factors.

Several studies have investigated supervised physical activity in the treatment of anorexia nervosa, but there are disagreements in relation to the potential benefits/harms of this practice. The objective of this paper was to systematically review the effects of supervised physical exercise on body mass index (BMI) in adolescents receiving treatment for anorexia nervosa. The following databases were searched: PubMed, EMBASE, Cochrane Library, and SCOPUS. The search terms used were exercise, anorexia, and adolescent; articles were selected based on BMI outcomes. A total of 591 articles were retrieved. Of these, three were selected, which examined the effects of supervised physical exercise on BMI in adolescents receiving treatment for anorexia nervosa. There were no negative effects in relation to the patients' weight, but the benefits were not very evident based on clinical or biological markers. There is a lack of studies assessing the validity of physical activity during treatment for anorexia in adolescents.

Introdução: Em períodos de internação, as experiências vividas pelas crianças podem se mostrar desfavoráveis ao desenvolvimento. Programas interventivos compensatórios podem minimizar esses riscos. Objetivo: Analisar o impacto de uma intervenção cognitivo-motora no desenvolvimento cognitivo e motor de bebês hospitalizados com diagnóstico de fibrose cística. Material e métodos: Participaram do grupo interventivo (GI) seis bebês com diagnóstico de fibrose cística internados em unidade pediátrica de um hospital universitário. O grupo controle foi composto por bebês saudáveis pareados com o GI por idade gestacional, idade, sexo e renda familiar. Os dois grupos foram avaliados com a Alberta Infant Motor Scale (AIMS) no pré- e pós-intervenção; e, a Bayley Scales of Infant Development (BSID-III) foi utilizada para avaliar os bebês do GI. Resultados: O GI apresentou escores motores inferiores ao GC no pré-intervenção e desenvolvimento semelhante no pós-intervenção. Mudanças positivas e significantes foram observadas para o GI no desenvolvimento motor amplo (AIMS: p = 0,026; BSID-III: p = 0,042) e fino (BSID-III: p = 0,043), bem como no percentil de desenvolvimento motor (AIMS: p = 0,043). Conclusão: O impacto da intervenção no ambiente hospitalar foi positivo para o desenvolvimento motor e cognitivo dos bebês com fibrose cística, potencializando e prevenindo descontinuidade no desenvolvimento motor e cognitivo.Palavras-chave: desenvolvimento infantil, fibrose cística, destreza motora, cognição.

Aims: to systematically review the prevalence of DCD in individuals born preterm; explore this prevalence according to gestational age and different assessments cut-offs; and compare to full-term peers. Methods: The eligibility criteria was observational and experimental studies reporting the prevalence of DCD in preterm individuals. A systematic search was performed in databases from inception until March 2022. The selection was performed by two independent reviewers. Study quality assessment was performed using the checklists from Joanna Briggs Institute (JBI). Data analysis were performed on Excel and Review Manager Software 5.4. Results: Among the 1774 studies identified, 32 matched the eligibility criteria. The pooled estimates of DCD rate in preterm was 21% (95% CI 17.8–24.3). The estimate rates were higher as gestational age decreased, and preterm children are two times more likely to have DCD than their full-term peers RR 2.2 (95% IC 1.77–2.79). Interpretation: The limitation was high heterogeneity between studies: the assessment tools and cut-off points, as well as the age at assessment, were diverse. This study provided evidence that preterm children are at higher risk for DCD than full-term children, and the risks increased as gestational age decreased.

Objective: To perform a longitudinal investigation of risk factors in premature infants’ cognitive, motor, and language development. Methods: Thirty-three preterm infants were assessed at 4, 8, and 12 months of corrected age, using the Bayley-III Scales. Parents completed questionnaires regarding development opportunities at home, parenting practices and knowledge. Results: Significant associations were found (1) at 4-months between cognitive scores and family income, variety of stimuli, availability of toys, parenting practices and knowledge; language and parenting practices; and motor skills and parenting practices; (2) at 8-months between cognitive score and length of stay in the Neonatal Intensive Care Unit (NICU), gestational age, birth weight, toys, and parenting knowledge; language and toys; and motor skills and toys and parenting knowledge; (3) at 12-months between cognitive scores and length of stay in the NICU, family income, breastfeeding, toys, and parenting knowledge; language and income and toys; and motor scores and length of stay in the NICU, gestational age, income, stimuli, toys, and parenting knowledge. Regression analyses indicated that: for (1) cognitive development, stimulus variety explained 72% of the model variance at 4 months of age; time at the NICU explained 67 and 43% at 8 and 12 months of age, respectively, and breastfeeding time explained 41% of the model variance at 12 months; (2) for language development, family income explained 42% of the model variance at 12 months; and for motor development (3), time at the NICU explained 80% of the model variance at 12 months. Conclusions: The development over the first year of life is not explained by the severity of birth conditions and associated morbidities only, but also by parenting practices.

PurposeEarly identification of impairments is crucial to providing better care for preterm children, especially those from low-income families. The early motor assessment is the first step in monitoring their neurodevelopment. This study investigates if motor development in the first year of life predicts impairments in cognition and language at 3-year-old in a Brazilian preterm cohort.Materials and methodsData were collected in a follow-up clinic for high-risk infants. The Bayley Scales were used to assess children at 4, 8, 12, and 36 months of age, considering composite scores. Cognitive and language impairments were considered if scores were ≤85. Children (N = 70) were assessed at 4 and 36 months, 79 were assessed at 8 and 36 months, and 80 were assessed at 12 and 36 months. Logistic regressions were used to analyze the predictability of cognitive and language impairments, and receiver-operating characteristics (ROC) curves were used to analyze the sensibility and specificity of motor assessment and cognitive and language impairments.ResultsPoor motor scores at 8 and 12 months increased the chances of cognitive and language impairment at 3-year-old. The chance of cognitive impairment at 3-year-old increases by 6–7% for each point that the motor composite score decreases, and the chance of language impairment at 3-year-old increases by 4–5% for each point that the motor composite score decreases. No-significant results were found at 4-months. Adequate sensibility and specificity were found for language impairments considering 12 months scores and for cognitive impairments as soon as 8 months scores.ConclusionMonitoring preterm motor development in the first year of life helps to identify preterm children at risk for impairment in other developmental domains. Since preterm children from low-income families tend to demonstrate poorer neurodevelopment outcomes, these children need early assessment and referral to intervention to prevent school failures and support from public policies.