Análise do equilíbrio estático e de deformidades nos pés de crianças com paralisia cerebral

Abstract

Aprovação do Comitê de Ética em Pesquisa (CEP) da FFC UNESP com parecer favorável número 3762/2008. RESUMO: O presente estudo analisou, por meio de um sistema de baropodometria, os tipos de pé, a influência da visão no equilíbrio estático na postura ortostática e a distribuição da pressão plantar em 16 crianças, de 6 a 15 anos, com diagnóstico de paralisia cerebral. Os resultados indicaram que o pé valgo foi o mais comum dentre os tipos de paralisia cerebral estudadas, diparesia espástica, hemiparesia espástica direita, hemiparesia espástica esquerda e ataxia; o equilíbrio estático na postura ortostática de olhos vendados apresentou maior instabilidade do que quando com os olhos abertos; a distribuição de pressão plantar não apresentou significância estatística e não houve correlação significativa entre a idade e as variáveis de equilíbrio e de distribuição da pressão plantar. Desse modo, conclui-se que a visão é um fator importante no controle postural de crianças com paralisia cerebral. DEScRitORES: criança; paralisia cerebral; postura; deformidades do pé.AbStRAct: The present study analyzed through baropodometry system, the feet's types, the vision's influence during static balance on orthostatic posture and the plantar pressure distribution in 16 children, aged from 6 to 15 years-old with diagnostic of cerebral palsy. We noted that the valgus foot was more common on the sample studied, diparetic spastic, hemiparetic spastic right, and hemiparetic spastic left and ataxic; the static balance on orthostatic posture with closed eyes was more instable compared to the orthostatic posture with opened eyes. In relation to the distribution of plantar pressure, we did not observe statistical significance and there was no correlation between age and the balance's variables and the plantar pressure's distribution. Therefore, we concluded that the vision is an important factor on postural control in children with cerebral palsy.

Distribution of plantar pressure and body posture in spastic cerebral palsy

“…(25) agreeing with our findings, Costa et al, (10) using the baropodometry system, found that the flat foot was the most common in the evaluated 16 CPs aged 6 to 15 years. It is important to remember that the age variation in our study was shorter (three to eight years) and that up to three years of age, the child's foot has a greater degree of mobility than the adult foot, as a consequence of a greater peculiar ligament elasticity in the early life.…”

“…This time was established because they are children with difficulty to remain in static posture for a long time. (10) Each record was repeated three times, for greater reliability, (11) with an interval of 10 seconds and it was considered the average of the three collections for analysis.…”

Distribuição da pressão plantar e morfologia do pé de crianças com paralisia cerebral e crianças com desenvolvimento típico

“…There was a prevalence of the flat foot among children with CP, in concordance with the results by Galli et al 10 and Costa et al 1 , in which all the studied CP topographies registered the predominance of flat foot. Such a finding can be justified by the increase of anterior weight-bearing presented by the children evaluated in this study.…”

“…Cerebral Palsy (CP) is characterized as movement and posture disorders, consequential of non-progressive afflictions in the developing encephalon, which causes performance limitations in activities easily performed by children with typical development (TD) 1,2 . Abnormalities in muscle tone and, consequently, in posture, are common in children with CP, spasticity being the most 2 predominant.…”

“…Each child conducted the test three times, with eyes open and staring at a point marked one meter away, at the height of the children glabellar point, for 10 seconds. This time was established because children with CP have difficulties to remain in static posture for a long time 1 . The mean results were used for the analysis.…”