Intervenções fisioterapêuticas em crianças com Síndrome de Down e a relação com os aspectos da CIF: uma revisão integrativa
Data
2023-12-29
Autores
Mendonça, Isabelly dos Santos 
Orientadores
Sá, Cristina dos Santos Cardoso de
Tipo
Trabalho de conclusão de curso
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A Síndrome de Down (SD) possui características como a frouxidão
ligamentar e a hipermobilidade articular, fraqueza muscular, hipotonia e pé plano, as
quais acarretam alterações no controle postural, coordenação motora e equilíbrio,
causando atraso na aquisição dos marcos do desenvolvimento motor. A Fisioterapia
possibilita o cuidado abrangente a partir do modelo biopsicossocial da Classificação
Internacional de Funcionalidade, Incapacidade e Saúde (CIF), a qual aborda os
aspectos de Função e Estrutura do corpo, Atividade e Participação, e Fatores
Ambientais e Pessoais. Ao estabelecer objetivos e condutas da terapia, é necessário
compreender o indivíduo como um todo e quais demandas repercutem no cotidiano,
visando os aspectos de Atividade e Participação. Trabalhar o desenvolvimento das
habilidades motoras da criança com SD permite maior envolvimento na vida diária,
acarretando maior independência à criança. Objetivo: Identificar as possibilidades de
intervenções fisioterapêuticas e seus efeitos em crianças com SD e como relacionam se com o desenvolvimento das habilidades motoras e os aspectos de Atividade e
Participação da CIF. Metodologia: Revisão integrativa com busca de estudos
publicados do ano de 2013 a agosto de 2023, nas bases de dados Cochrane, Scielo,
Portal CAPES, PEDro, PubMed e Biblioteca Virtual de Saúde (BVS), a qual indexa
artigos da MEDLINE e LILACS Foram incluídos textos disponíveis na íntegra e
gratuitamente, em inglês, português e espanhol, podendo apresentar metodologia de
estudo de caso/série de casos, ensaios clínicos randomizados ou não-randomizados,
estudos observacionais e revisões sistemáticas. A temática dos textos apresentava
crianças com SD, de ambos os sexos, intervenções fisioterapêuticas,
desenvolvimento neuropsicomotor e os aspectos da CIF de funcionalidade, atividade
e participação. Resultados: Foram selecionados 8 estudos, os quais apresentaram
que as crianças com SD apresentam déficits no desenvolvimento das habilidades de
função social, mobilidade e autocuidado e necessitam de mais assistência do
cuidador em comparação a crianças sem SD. A função motora fina, a força de
preensão, a destreza manual e o controle postural também apresentam resultados
diminuídos e estão relacionadas ao desempenho em atividades e na participação. Os
fisioterapeutas concentram a maior parte de suas condutas em Função e Estrutura
do corpo, e muitas não são baseadas em evidências. Apenas dois estudos abordam
intervenções em crianças com SD, as quais demonstram ser benéficas à Atividade e
Participação. O treinamento isocinético mostrou-se eficaz para a força muscular e
equilíbrio postural, os quais são relacionados ao desenvolvimento de habilidades
motoras. A utilização do IPO como avaliação e elaboração de proposta de
intervenção, enfatizando condutas que treinem atividades de autocuidado também foi
vantajosa, apresentando melhora na realização dessas tarefas. Conclusão: Os
resultados demonstram a importância da fisioterapia para os aspectos de Atividade e
Participação da CIF. Em comparação a crianças típicas, as crianças com SD
apresentam déficits no desenvolvimento de habilidades motoras e nos aspectos de
atividade e participação. A prática fisioterapêutica com crianças com SD possui
diversas ferramentas de avaliação e intervenções, porém muitas não são baseadas
em evidências. São necessários mais estudos que abordem a temática desta revisão
com melhor qualidade metodológica e maior amostra.
Introduction: Down Syndrome (DS) has characteristics such as ligament laxity and joint hypermobility, muscle weakness, hypotonia and flat foot, which lead to alterations in postural control, motor coordination and balance, causing delay in the acquisition of developmental milestones motor. Physiotherapy enables comprehensive care based on the biopsychosocial model of the International Classification of Functioning, Disability and Health (ICF), which addresses aspects of Body Function and Structure, Activity and Participation, and Environmental and Personal Factors. When establishing therapy objectives and conducts, it is necessary to understand the individual as a whole and what demands impact their daily life, targeting the Activity and Participation aspects. Working on the development of motor skills in children with DS allows for greater involvement in daily life, resulting in greater independence for the child. Objective: To identify the possibilities of physiotherapeutic interventions and their effects on children with DS and how they relate to the development of motor skills and the Activity and Participation aspects of the ICF. Methodology: Integrative review with a search for studies published from 2013 to August 2023, in the databases Cochrane, Scielo, Portal CAPES, PEDro, PubMed and Biblioteca Virtual em Saúde (BVS), which indexes articles from MEDLINE and LILACS. Free and full-text articles available in English, Portuguese and Spanish, which could have a study methodology of case study/case series, randomized or non-randomized clinical trials, observational studies and systematic reviews. The theme of the articles included children with DS, of both sexes, physiotherapeutic interventions, neuropsychomotor development and the ICF aspects of functionality, activity and participation. Results: 8 studies were selected, which showed that children with DS have deficits in the development of social function, mobility and self-care skills and require more assistance from the caregiver compared to children without DS. Fine motor function, grip strength, manual dexterity and postural control also show reduced results and are related to performance in activities and participation. Physiotherapists focus most of their practice on Body Function and Structure, and many are not evidence-based. Only two studies address interventions in children with DS, which demonstrate benefits to Activity and Participation. Isokinetic training proved to be effective for muscle strength and postural balance, which are related to the development of motor skills. The use of the IPO as an evaluation and preparation of an intervention proposal, emphasizing behaviors that train self-care activities was also advantageous, showing an improvement in the performance of these tasks. Conclusion: The results demonstrate the importance of physiotherapy for the activity and participation aspects of the ICF. In comparison to typical children, children with DS exhibit deficits in the development of motor skills and in aspects of activity and participation. Physiotherapy practice with children with DS has several assessment tools and interventions, but many are not evidence-based. More studies are needed that address the theme of this review with better methodological quality and a larger sample.
Introduction: Down Syndrome (DS) has characteristics such as ligament laxity and joint hypermobility, muscle weakness, hypotonia and flat foot, which lead to alterations in postural control, motor coordination and balance, causing delay in the acquisition of developmental milestones motor. Physiotherapy enables comprehensive care based on the biopsychosocial model of the International Classification of Functioning, Disability and Health (ICF), which addresses aspects of Body Function and Structure, Activity and Participation, and Environmental and Personal Factors. When establishing therapy objectives and conducts, it is necessary to understand the individual as a whole and what demands impact their daily life, targeting the Activity and Participation aspects. Working on the development of motor skills in children with DS allows for greater involvement in daily life, resulting in greater independence for the child. Objective: To identify the possibilities of physiotherapeutic interventions and their effects on children with DS and how they relate to the development of motor skills and the Activity and Participation aspects of the ICF. Methodology: Integrative review with a search for studies published from 2013 to August 2023, in the databases Cochrane, Scielo, Portal CAPES, PEDro, PubMed and Biblioteca Virtual em Saúde (BVS), which indexes articles from MEDLINE and LILACS. Free and full-text articles available in English, Portuguese and Spanish, which could have a study methodology of case study/case series, randomized or non-randomized clinical trials, observational studies and systematic reviews. The theme of the articles included children with DS, of both sexes, physiotherapeutic interventions, neuropsychomotor development and the ICF aspects of functionality, activity and participation. Results: 8 studies were selected, which showed that children with DS have deficits in the development of social function, mobility and self-care skills and require more assistance from the caregiver compared to children without DS. Fine motor function, grip strength, manual dexterity and postural control also show reduced results and are related to performance in activities and participation. Physiotherapists focus most of their practice on Body Function and Structure, and many are not evidence-based. Only two studies address interventions in children with DS, which demonstrate benefits to Activity and Participation. Isokinetic training proved to be effective for muscle strength and postural balance, which are related to the development of motor skills. The use of the IPO as an evaluation and preparation of an intervention proposal, emphasizing behaviors that train self-care activities was also advantageous, showing an improvement in the performance of these tasks. Conclusion: The results demonstrate the importance of physiotherapy for the activity and participation aspects of the ICF. In comparison to typical children, children with DS exhibit deficits in the development of motor skills and in aspects of activity and participation. Physiotherapy practice with children with DS has several assessment tools and interventions, but many are not evidence-based. More studies are needed that address the theme of this review with better methodological quality and a larger sample.
Descrição
Citação
MENDONÇA, Isabelly dos Santos. Intervenções fisioterapêuticas em crianças com Síndrome de Down e a relação com os aspectos da CIF: uma revisão integrativa. 2023. 72 f. Trabalho de conclusão de curso (Graduação em Fisioterapia) - Universidade Federal de São Paulo, Instituto de Saúde e Sociedade, Santos, 2023.