Introduction: Expiratory flow increase is a maneuver of respiratory physical therapy that promotes flow direction to the upper airways however, when applied in newborns, it may result in changes of thoracoabdominal mobility. Objective: To evaluate the thoracoabdominal mobility by photogrammetry in newborns after expiratory flow increase technique. Methods: Experimental blind study performed with newborns in supine position on a support table with upper limbs flexed, abducted and externally rotated and hip flexed at 110°. Adhesive markers were allocated for geometric delimitation of the thoracoabdominal compartment and expiratory flow increase technique was performed for 5 minutes with the therapist's hands on the thorax and abdomen. Newborns were filmed before and after the maneuver and the frames were analyzed in AutoCAD ® software by a blinded investigator at the time of the procedure. The largest and the smallest thoracoabdominal area were expressed in cm 2 and the mean values were compared between two moments (pre and post maneuver) by paired t test. Results: Twenty newborns with a mean age of 39 weeks were included. Before the maneuver, thoracoabdominal area was 56.1 cm 2 during expiration and 59.7 cm 2 during inspiration, and after the maneuver the value was 56.2 cm 2 during expiration and 59.8 cm 2 during inspiration,

Introduction: Previous studies have shown music therapy as a way to improve the clinical status of premature infants, improving vital signs and decreasing crying episodes. Objective: Compare the effects of music on vital signs of premature infants undergoing respiratory physiotherapy. Methods: We performed a randomized clinical trial consisting of 26 premature infants, divided into control group (N=12) and study group (N=14), carried out in a Neonatal Intensive Care Unit. All newborn infants undergone standard practice physiotherapy for 15 minutes: vibration and aspiration. On the study group they were exposed to classical music three minutes before the standard physiotherapy, and finished three minutes after the end of these procedures. A recorder was placed inside the incubator with an intensity of 25 decibels. Measurements of heart and respiratory rate and oxygen saturation were measured before, during and after each sessions of respiratory physiotherapy for two groups. Results: When comparing control and study groups regarding heart rate frequency and oxygen saturation, there was no statistically significant difference, but the inclusion of music determined clinically the variability of these data and 30% of the variation in respiratory rate was due to the inclusion of music during and after the physiotherapy, and the neonatal noninvasive ventilation showed less variation in their respiratory rate when compared to the neonatal on oxygen therapy. Conclusion: The results have showed a beneficial effect of music, showing lower respiratory rate in newborn infants during and after respiratory physiotherapy procedure.

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Objective: To evaluate thermal and cardiorespiratory adaptation during hot tub bath and shower in healthy newborns in the first hours of life. Study design: This is a randomized blind controlled trial, registered in ReBEC (No. RBR-4z26f3) with 184 newborns divided into hot tub group (n=84) and shower (n=100). Newborns from intervention group were immersed in a hot tub with warm water up to the neck, without exposure to air flow, and control group received traditional shower. Heart rate, respiratory rate and temperature were measured before and immediately after bath by an investigator blinded to the type of bath.Results: Groups were similar in gender, gestational age, birth weight, Apgar score at 5 th minute and hours of life, p => 0.05. To analyze thermal and cardiorespiratory adjustments, difference between postbath variables and pre-bath was calculated. In this analysis, it was found statistically significant difference between two types of bath regarding heart rate, respiratory rate and temperature. Hot tub bath decreases heart and respiratory rates and increases temperature, whereas shower provides the opposite effect (0.0001). Conclusion:This study demonstrates that hot tub baths and shower, in healthy newborns, promote thermal and cardiorespiratory adaptations, reflecting thermal, cardiac and respiratory positive reactions after hot tub bath.

-Objective: To verify if sleep disorders and differents starting time to school have impaire d motor skills in 5-year-old children. Method: Cross-sectional design consisting of 132 children with sleep disorders and 136 normal controls of the public school in the city of São Paulo. The group with sleep diso rders was identified based on a questionnaire, and motor tests for global motor coordination, fine motor coordination, perceptual-motor coordination, and static and dynamic balance were applied in all childre n . Results: In the static balance test, more specifically in the sharpened Romberg (Tandem) test, 34% of boys from the study group, who studied in the morning, failed the test (p < 0.05). In the single leg stance test, 62% of boys from the study group who studied in the morning failed (p< 0.05). Conclusion: This study suggests that sleep disorders may interact with the school period and alter motor performance, especially in boys studying in the morning.KEY WORDS: sleep disorders, preschool children, motor performance, balance, cronobiology.Distúrbios do sono, período escolar e equilíbrio em crianças com 5 anos de idade RESUMO -Objetivo: Verificar se distúrbios do sono e diferentes períodos escolares comprometem as habilidades motoras de crianças de 5 anos. Método: Realizou-se estudo transversal com 132 crianças com distúrbio do sono e 136 controles normais de escolas públicas da cidade de São Paulo. Foram utilizados questionários para distúrbios do sono e testes para coordenação motora global, motora fina, percepto-motora, equilíbrio estático e dinâmico. Resultados: No teste de equilíbrio estático, mais especificamente na p rova pé ante pé, 34% dos meninos do grupo estudo, que estudavam no período da manhã, falharam no teste (p < 0,05). Na prova de apoio monopodal, 62% dos meninos do grupo estudo, que estudavam no período da manhã, falharam no teste (p < 0,05). Conclusão: Este estudo sugere que os distúrbios do sono podem interagir com o período escolar e alterar a performance motora, principalmente de meninos que estudam no período da manhã.PA L AV R A S -C H AVE: distúrbios do sono, crianças pré-escolares, perf o rmance motora, equilíbrio, cro n ob i o l o g i a .

Introdução: Considerando a alta complacência da caixa torácica em recém-nascidos, as manobras de fisioterapia, quando aplicadas sobre o tórax, devem ser corretamente indicadas e avaliadas, por meio de instrumentos fidedignos e não invasivos, a fim de assegurar a sua eficácia e segurança. Objetivo: Avaliar a mobilidade toracoabdominal pela biofotogrametria (MT) em recém-nascidos após as manobras de vibrocompressão (VC) e Reequilíbrio Toracoabdominal (RTA). Métodos: A análise foi realizada em 40 recém-nascidos, com idade > 37 semanas, em posição supina, membros superiores em flexão, abdução e rotação externa e quadril flexionado. Cada recém-nascido realizou um tipo de manobra (VC ou RTA) e foi filmado por 60 segundos antes e após a terapia, por uma câmera digital perpendicular ao plano de movimento. A análise biofotogramétrica foi realizada pelo Software AutoCAD® e os resultados foram convertidos para unidades métricas (cm2). Resultados: A manobra de RTA aumentou a amplitude do movimento toracoabdominal e a VC diminuiu. A diferença média da mobilidade toracoabdominal, entre o antes e depois, para estas duas manobras, foi de +0,20 cm2 no RTA e –1,72 cm2 na VC, entretanto não apresentaram diferença estatisticamente significativa. Conclusão: As manobras de RTA e VC apresentaram resultados antônimos sobre a mobilidade toracoabdominal, entretanto esta diferença não foi estatisticamente significativa. Palavras-chave: mecânica respiratória, fotogrametria, recém-nascido, modalidades de Fisioterapia.

Objectives: To evaluate the effect of manual chest compression (MCC) in the variables of oxygenation, hemodynamic and respiratory effeteness in infants suffering from respiratory diseases with atelectasis. Methods: Controlled clinical trial, in which 38 infants were evaluated, 19 in each study group (group A: atelectasis and group B: control). Data were measured before, immediately after and 10 minutes after the end of the technique's application. Results: The average age was of 5.05 months. There was an increase of RR in group A immediately after the application of the technique and signs of respiratory distress with a decrease in the oxygen saturation. Conclusion: There was a reduction in SpO2, an increase of RR and a worsening of clinical signs of respiratory distress. Given this, one may consider that there is a controversy about the benefits, mechanism of action, physiological and therapeutic effects of MCC when applied to infants.

BackgroundDue to the increasing prevalence of obesity among children, Shuttle Run Test (SRT) has been used as primary outcome for assessment of both physical performance and responses to different physical training programs. Thus, this study aimed to compare the performance on SRT between obese and non-obese children and the reproducibility of two SRTs carried out on different days.MethodsA cross-sectional study in which 40 children, aged from 8 to 10, were recruited from a public school. This study consisted of three visits in each school. On the first visit, we carried out a medical screening for recruited children. On the second visit, we applied the first SRT (SRT1), which was repeated on the third visit (SRT2, 24 hours apart).ResultsThere was a significant difference in the distance traveled by non-obese in comparison with obese children (mean difference: 88 meters and 95% of confidence interval: 21 meters to 156 meters). Time and distance traveled of 27 children were higher in the SRT1, whereas nine children traveled a greater distance and presented higher testing time on the SRT2, with only four children showing the same distance traveled in both tests. Although both groups presented with reduction from the SRT1 to SRT2, this reduction was not significant (non-obese: 342 ± 97 meters to 319 ± 106 meters, respectively; obese: 269 ± 91 meters to 246 ± 90 meters, respectively). In obese children, the distance traveled in the best SRT had correlation with weight (r = -0.495, p = 0.043) and BMI (r = - 0.602, p = 0.011). No correlation was observed in the non-obese children.ConclusionsOverweight children had lower performance in SRT. Although reproducible, the best performance was in the first test, which leads us to suggest applying only one test.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-017-0825-9) contains supplementary material, which is available to authorized users.