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Resumo: Introdução: O desenvolvimento neuropsicomotor (DNPM) é dinâmico e complexo, explicado pelo modelo contextual, que pode ser discutido com visão ampliada de saúde por meio da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). Objetivo: Caracterizar o DNPM de crianças com até três anos participantes do Programa Leite das Crianças (PLC) a partir da abordagem contextual por meio da CIF, no contexto do Núcleo de Apoio à Saúde da Família (NASF), e relacionar com aspectos individuais, familiares, socioeconômicos e estimulação da criança nos diferentes ambientes. Método: Participaram deste estudo 19 crianças, 10 (52,63%) meninos e 9 meninas (47,37%), com idade entre 7 e 35 meses (19,42 ± 9,11), devidamente autorizadas pelo responsável, avaliadas por meio de entrevista semiestruturada, questionário socioeconômico da ABEP, teste de triagem de Denver II e questionário de oportunidades no ambiente domiciliar para o desenvolvimento motor. Os instrumentos foram relacionados com os componentes da CIF para crianças e jovens (CIF-CJ). O estudo foi realizado no NASF de uma cidade da região metropolitana de Curitiba/PR, Brasil. Para análise estatística utilizou-se rô de Spearman (rs) para correlação não-paramétrica, Mann-Whitney na comparação quantitativa e o Exato de Fisher em dados categóricos para probabilidade de ocorrência. Resultados: Com relação à triagem, 9 (47,37%) crianças apresentaram o DNPM questionável, sendo a área da linguagem a mais comprometida (88,88%), 7 famílias (36,84%) foram classificadas em C1 pela ABEP. Para a estimulação recebida no ambiente domiciliar, 6 crianças (54,5%) com até 18 meses tiveram estimulação adequada e todas (n=8) as crianças maiores de 19 meses apresentaram estimulação razoável. O modelo proposto neste estudo respondeu à abordagem contextual da CIF. Conclusão: É necessária a utilização de instrumentos adequados para planejar ações na atenção básica, para que crianças que apresentem risco ao DNPM possam ser incluídas em programas de intervenções precoces, para viabilizar o NASF enquanto espaço de acompanhamento e promoção do DNPM. A CIF mostrou-se um instrumento de classificação adequado e válido para este contexto.

Introduction: The first years of life are crucial to neuropsychomotor development (NPMD), during this period children are susceptible to organic, environmental or activity-related influences that may represent protective or risk factors towards full development, with potential lifelong repercussions.Objective: This study aimed to investigate and verify the risk factors in the neuropsychomotor development (NPMD) of children aged from zero to three years, attending public early childhood education centers.Methods: Cross-sectional study, contextual approach – based on ICF (International Classification of Functioning, Disability and Health) –, Denver II developmental screening test and additional assessments about nutritional status. For the analysis, a logistic regression was performed. The International Classification of Functioning, Disability and Health (ICF) concerning body functions and structure (evaluation questionnaire), activity and participation (evaluation of NPMD in school), personal factors (family characteristics), and environmental factors (characteristics of the ECECs) were considered for the evaluation phase. The instruments consisted of a questionnaire containing items to elicit information about the child, including current, neonatal and family traits.  For the evaluation DPMD, the Denver II test was used.  Inter- and intra-rater reliability was established using Cohen's kappa, and data subsequently submitted to stepwise (backward) regression analysis using a Logit model, using binary responses. The construction of an ROC (Receiver Operating Characteristic) to define the explanatory profile of the model built also was included, in addition to the calculation of the Odds Ratio (OR), the odds of chance occurrence the association of a given variable with DPMD.Results: NPMD was within the normal parameters, in 68.8% (n = 53) and risk of delays was in 31.2% (n = 24). The area with the best performance was the fine motor-adaptive (3.75%) and the most questionable one was the language (57.5%). It was verified that 48% (n=37) of the children had normal weight while 52% (n = 40) presented some nutritional risk. Low birth weight (OR = 181), monthly family income (OR = 9) and paternal absence (OR = 34) were statistically significant factors on the risk of NPMD delays.Conclusion: low birth weight, family income and paternal absence are factors associated with risks of NPMD delays. These findings reinforce the systemic and multifactorial nature of NPMD and emphasize the need for monitoring and formulating public policies -- especially the ones dedicated to children with low income conditions --, which could contribute to the full development of children, since public early childhood education centers should be transforming agents in the quality of child development.

Background: Self-reported clinical worsening by people with Parkinson's disease (PD) during social distancing may be aggravated in Brazil, where the e/tele-health system is precarious.Objectives: This study aims to investigate self-reported changes in motor and non-motor aspects during social distancing in people with PD living in Brazil and to investigate the factors that might explain these changes.Methods: In this multicenter cross-sectional trial, 478 people with a diagnosis of idiopathic PD (mean age = 67, SD = 9.5; 167 female) were recruited from 14 centers distributed throughout the five geographical regions of Brazil. The evaluators from each center applied a questionnaire by telephone, which included questions (previous and current period of social distancing) about the motor and non-motor experiences of daily living, quality of life, daily routine, and physical activity volume.Results: Self-reported clinical worsening in non-motor and motor aspects of daily life experiences (Movement Disorder Society-Unified PD Rating Scale—parts IB and II—emotional and mental health, and fear of falling) and in the quality of life was observed. Only 31% of the participants reported a guided home-based physical activity with distance supervision. Perceived changes in the quality of life, freezing of gait, decreased physical activity volume, daily routine, and fear of falling explained the self-reported clinical worsening (P < 0.05).Conclusions: Self-reported clinical worsening in people with PD living in Brazil during social distancing can also be aggravated by the precarious e/tele-health system, as perception of decreased physical activity volume and impoverishment in daily routine were some of the explanatory factors. Considering the multifaceted worsening, the implementation of a remote multi-professional support for these people is urgent.

RESUMO O objetivo deste trabalho foi identificar instrumentos de avaliação do desenvolvimento neuropsicomotor (DNPM) de crianças de 0 a 2 anos, de baixo custo, que possam ser usados no contexto de creche e/ou ambiente clínico em programas de intervenção precoce, sistematizando esses instrumentos conforme o modelo biopsicossocial da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). Foram selecionados instrumentos de avaliação do DNPM com tradução ou adaptação para o Brasil. Para isso os domínios da CIF foram escolhidos triangulando o checklist da própria CIF-CJ, core set de estimulação precoce e a última versão da CIF, para busca na literatura de instrumentos de avaliação. A sistematização das categorias selecionadas da CIF foi realizada por dois fisioterapeutas, e um terceiro para itens discordantes. As escalas que responderam aos critérios foram: Alberta Infant Motor Scale (AIMS), Teste de Triagem de Denver II, Inventário Pediátrico sobre Qualidade de Vida (PedSQl®), Affordance in the Home Environment for Motor Development-Infant Scale (AHEMD-IS) e vínculo mãe-bebê. Mesmo com essas escalas, verificou-se a necessidade de um questionário de anamnese complementar para o responsável, dados da Caderneta de Saúde da Criança e de um questionário socioeconômico da Associação Brasileira de Empresas de Pesquisa para o Brasil (ABEP). Essa sistematização está disponível no apêndice, e procura facilitar o olhar ampliado do fisioterapeuta ou profissional da educação com abrangência biopsicossocial dos bebês, além de possibilitar a identificação de riscos de forma precoce e subsidiar ações de promoção e intervenção em diferentes contextos.

Parkinson's disease (PD) is a chronic degenerative disease of the central nervous system that evolves slowly and progressively and is characterized by bradykinesia, muscle rigidity and resting tremor among other motor signs and symptoms 1,2 . Quality of life is significantly impaired not only by motor symptoms, but also by non-motor symptoms such as depression, anxiety, pain, constipation, hyposmia and sleep disturbances 3,4 . There are few studies on the incidence and prevalence of PD in Brazil; however, the most recent study shows that the disease affects 3.3% of Brazilians over the age of 60 years 4 . One of the concerns when treating PD patients is to improve their quality of life. This includes their physical, functional and emotional well-being, their degree of independence and their family relationships, as well as social, economic and political aspects of their lives 5,6 . A decline in quality of life in individuals with PD has been associated with worsening motor symptoms and the combination of neurodegenerative phenomena, psychological suffering and stigma associated with the disease

RESUMOHá um grande interesse em estudar o movimento humano dentro da água, uma vez que o meio já é utilizado para treinamento e reabilitação devido às diferentes propriedades mecânicas que oferece. No entanto, há uma carência de estudos sobre as caracterís-ticas biomecânicas do andar em ambiente aquático. O presente estudo teve como objetivo determinar as variáveis angulares do joelho e tornozelo da marcha em ambiente aquático, e compará-las com o ambiente terrestre. Fizeram parte deste estudo dezenove adultos do sexo masculino, saudáveis, com média de idade de 24 anos. Os indivíduos caminharam em ambiente terrestre e em seguida no ambiente aquático com a água ao nível do processo xifóide do esterno, com velocidade auto-selecionada e confortá-vel. Para a coleta de dados foi utilizada a cinemetria. As variáveis angulares analisadas apresentaram diferenças significativas em ambiente aquático quando comparadas com as do ambiente terrestre. Os resultados encontrados neste estudo contribuem para um melhor entendimento do andar no AA no contexto de treinamento e reabilitação. ABSTRACTComparative study of the angular parameters of human gait in water and land media in young higid adults There is a great interest to study the human movement under water, once it is a means has been utilized as an alternative way for both training and rehabilitation value owing to different mechanical proprieties it offers. However, there is some information about the biomechanical characteristics of shallow water walking. For collection of the data the cinemetry was used. The present study aims purpose the determination angular characteristics knee and ankle during walking in water and comparing it to the standard of the gait done on land. They were part of this nineteen healthy adults of the sex male with mean 24 years. The individuals walked on land and water with xiphoid process level, with self-selected comfortable walking speeds. The variables joint angles investigated was differences considerably between in shallow water on land. The results in the present study contribute to a better understanding of this activity in the context of training and rehabilitation. INTRODUÇÃOA recuperação cinético-funcional da marcha ocupa um dos principais objetivos no tratamento fisioterapêutico em patologias que afetam os membros inferiores. Por conseqüência, demanda contínuos estudos, especialmente a respeito dos procedimentos de avaliação, fator que implicará diretamente nos objetivos e intervenções fisioterapêuticas. Com o avanço das formas de avaliação está sendo possível pesquisar a marcha humana em diferentes condições e ambientes, como em gravidade reduzida e no meio aquático (1)(2)(3)(4) .A habilidade de andar ereto é uma das características determinantes do ser humano. Rítmico e aparentemente sem esforço, o ato de andar é um evento contínuo que se constitui em transferir peso de um membro inferior para o outro, com o objetivo de avançar o corpo para frente, como se fossem sucessivos desequilí-brios (5) .Apesar do controle seletivo e habitua...

Objective: To evaluate the effect of the Ai-Chi method on the functional activities, quality of life, and posture in patients with Parkinson disease. Methods: The sample was divided into 2 groups: intervention (Ai-Chi method exercises; n = 8) and control group (without exercises; n = 7). Subjects were assessed for functional activities (Unifi ed Parkinson's Disease Rating Scale), quality of life (39-item Parkinson's Disease Questionnaire), and posture (postural assessment software SAPO). Results: The subjects in the intervention group showed improvement in functional activities (Unifi ed Parkinson's Disease Rating Scale score, 38.3 vs 23.8, P = .02) and posture (21.53 vs 21.86, P = .029). Conclusion: The Ai-Chi method improves functional activities and head posture in patients with Parkinson disease.Regarding aquatic exercises, there are already scientifi c reports about the effects of these exercises on subjects with PD; however, there is still a need for controlled and systematic studies, covering in detail the criteria for inclusion and exclusion, the disease level, along with the description of the technique used because currently these are scarce. 5 Ai-Chi is a technique used in aquatic physiotherapy in a heated pool with the goal to improve mobility, meditation, relaxation, and body stretching where movements are performed slowly and continuously. 6 These movements performed in a systematic way can infl uence the daily life activities of patients with PD since the changes resulting from the disease affect posture, locomotion, and quality of life (QOL) aspects. However, there are no studies to date in the literature demonstrating the effects of this method on clinical and functional outcomes in PD.Therefore, the aim of the study was to analyze the effects of Ai-Chi on functional activities, QOL, and the posture of patients with PD.