Influência dos diferentes assentos no alinhamento postural: rede adaptada para paralisia cerebral

Abstract

RESUMO A rede de tecido é uma opção para o sentar na região norte do Brasil. No entanto, sua estrutura flexível pode causar instabilidade postural nos indivíduos com paralisia cerebral (PC), limitando sua independência. Assim, criou-se a rede adaptada, com inserção de sistema assento/encosto, buscando posicionamento sentado com alinhamento postural adequado. O objetivo deste estudo foi verificar o alinhamento de tronco e membros inferiores (MMII) de indivíduos com PC nas condições: rede adaptada, rede sem adaptação e banco, comparando-os com indivíduos-controle, sem alterações neurológicas. Seis indivíduos com PC (GPC) e seis típicos (GC), de 8 a 14 anos, foram avaliados na postura sentada nas condições: rede adaptada, banco e rede sem suporte de assento/encosto. Por meio da análise cinemática foram avaliados ângulos de tronco, pelve e membros inferiores na postura estática por 5 segundos. Houve aplicação de parte do questionário Quebec B-Quest com os responsáveis. Resultados: houve semelhança dos ângulos de MMII, pelve e tronco nas três condições. Quebec B-Quest: maior satisfação quanto às dimensões do produto e menor quanto ao conforto e à segurança. A rede adaptada pode ser considerada opção de sentar por curtos períodos de tempo, pois promoveu adequado alinhamento postural em indivíduos com PC.

Effect of Adaptive Seating Systems on Postural Control and Activity Performance: A Systematic Review

“…Of the remaining 59 studies, a fulltext review resulted in 21 studies that met the inclusion criteria (Figure). 14,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] Six cohort, 5 experimental, 10 crosssectional, and among these 11 were longitudinal studies with no RCT studies identified. Seating posture was investigated in 15 studies, postural control in 13 studies, and activity performance in 10 studies with some studies investigating more than 1 outcome (Table 2).…”

“…Four of the 21 studies had comparative data; however, these studies did not have the same outcome measure for comparing intervention groups. 14,[24][25][26]…”

“…Meta-analysis and effect measures were not computed because of the limited quantitative data in each study using common objective outcome measures. Four of the 21 studies had comparative data; however, these studies did not have the same outcome measure for comparing intervention groups 14,24–26…”

“…24,27,40 Involuntary movements as seen in chorea and muscle tone were also documented as improved in anterior seated positions. 24,26,27,40 Where better hand-eye coordination or a decrease in muscle tone is required, the anterior tilted seating position is recommended for children with CP. 24 This was in contrast to posterior tilted seating which although helping to maintain lumbar lordosis showed less benefits, and until further research is conducted the use of anterior tilted seating position is preferential over posterior tilting.…”

“…14,37 Children with GMFCS level IV benefited from seating support systems; however, a hammock seat may also promote short-term postural correction. 26,27 Children with bilateral CP benefited from postural orientation in a powered wheelchair. 25 The regular use of paper-made chairs promoted child motor skills, interaction with family and friends, and involvement in daily activities.…”