Treino funcional de alcance e controle de tronco em lactentes pré-termo moderados a tardios: ensaio clínico randomizado e controlado
Autor(a) principal: | |
---|---|
Data de Publicação: | 2021 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFSCAR |
Texto Completo: | https://repositorio.ufscar.br/handle/ufscar/15058 |
Resumo: | Introduction: Moderate to late preterm infants may present delays on the onset and development of those abilities due to possible complications of prematurity. Studies on specific abilities such as reaching and positioning experiences have shown a positive effect to optimize the reaching performance, head control and motor development in full-term and preterm infants. However, due to the relationship between manual abilities and trunk control, it is relevant to develop an intervention that emphasizes on the positioning experiences and reaching to enhance the motor development of infants at biological risk. Objective: to verify the feasibility and effect of early intervention programs on gross motor performance, trunk control and reaching performance in moderate to late preterm infants in reaching emergence. Methods: Preterm infants at the onset of reaching ability (Mean=4.36, SD=0.54 months) were randomized assigned into two groups: Functional Reaching and Trunk Control Training (experimental group-EG) and Positioning social training (control group-GC). Infants were assessed into 4 visits: 1) pre-test; 2) post-intervention 1; 3) post-intervention 2, and 4) follow-up. All assessments were performed by a blinded evaluator. The Functional Reaching and Trunk Control Training, consisting of functional activities was performed by a pediatric physical therapy and parents at home. The Positioning social training, consisting of only static positioning experiences, was performed only by parents. Parents used a daily log for both trainings (dose, frequency, duration and infant’s behavior), and responded to a parent feedback questionnaire. For the feasibility variables of early intervention programs, t-test for independent samples and the Chi-Square test were performed. For gross motor performance, the Mann-Whitney test was applied. For the segmental trunk control, the Chi-Square test was applied, and for trunk and reaching kinematics variables, the mixed linear model was used. Results: there were no differences of feasibility outcome measures for both intervention programs. Parents provide a positive feedback about both programs. At the follow-up, the EG presented higher total gross motor score than CG. Both groups improved on motor performance across time. There were no significant differences between groups in the segmental trunk control, trunk and reaching performance, but there were substantively important effects (clinically relevant). After training and at follow-up, EG infants presented higher trunk movement and smoother and faster reaching than CG. Conclusion: Both early intervention programs were considered feasible and both groups showed improvement on gross motor performance, trunk control and reaching performance across time. Substantively important effects were found, favoring Functional Reaching and Trunk Control Training, which can be an efficient early intervention strategy for clinicians. |
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Sato, Natália Tiemi da SilvaTudella, Eloisahttp://lattes.cnpq.br/3207258034860219Cunha, Andrea Baraldihttp://lattes.cnpq.br/8413239950848240http://lattes.cnpq.br/84373598101993263b9b9965-0f7d-4135-a2ba-3f39dc49f4df2021-10-28T10:28:05Z2021-10-28T10:28:05Z2021-07-27SATO, Natália Tiemi da Silva. Treino funcional de alcance e controle de tronco em lactentes pré-termo moderados a tardios: ensaio clínico randomizado e controlado. 2021. Tese (Doutorado em Fisioterapia) – Universidade Federal de São Carlos, São Carlos, 2021. Disponível em: https://repositorio.ufscar.br/handle/ufscar/15058.https://repositorio.ufscar.br/handle/ufscar/15058Introduction: Moderate to late preterm infants may present delays on the onset and development of those abilities due to possible complications of prematurity. Studies on specific abilities such as reaching and positioning experiences have shown a positive effect to optimize the reaching performance, head control and motor development in full-term and preterm infants. However, due to the relationship between manual abilities and trunk control, it is relevant to develop an intervention that emphasizes on the positioning experiences and reaching to enhance the motor development of infants at biological risk. Objective: to verify the feasibility and effect of early intervention programs on gross motor performance, trunk control and reaching performance in moderate to late preterm infants in reaching emergence. Methods: Preterm infants at the onset of reaching ability (Mean=4.36, SD=0.54 months) were randomized assigned into two groups: Functional Reaching and Trunk Control Training (experimental group-EG) and Positioning social training (control group-GC). Infants were assessed into 4 visits: 1) pre-test; 2) post-intervention 1; 3) post-intervention 2, and 4) follow-up. All assessments were performed by a blinded evaluator. The Functional Reaching and Trunk Control Training, consisting of functional activities was performed by a pediatric physical therapy and parents at home. The Positioning social training, consisting of only static positioning experiences, was performed only by parents. Parents used a daily log for both trainings (dose, frequency, duration and infant’s behavior), and responded to a parent feedback questionnaire. For the feasibility variables of early intervention programs, t-test for independent samples and the Chi-Square test were performed. For gross motor performance, the Mann-Whitney test was applied. For the segmental trunk control, the Chi-Square test was applied, and for trunk and reaching kinematics variables, the mixed linear model was used. Results: there were no differences of feasibility outcome measures for both intervention programs. Parents provide a positive feedback about both programs. At the follow-up, the EG presented higher total gross motor score than CG. Both groups improved on motor performance across time. There were no significant differences between groups in the segmental trunk control, trunk and reaching performance, but there were substantively important effects (clinically relevant). After training and at follow-up, EG infants presented higher trunk movement and smoother and faster reaching than CG. Conclusion: Both early intervention programs were considered feasible and both groups showed improvement on gross motor performance, trunk control and reaching performance across time. Substantively important effects were found, favoring Functional Reaching and Trunk Control Training, which can be an efficient early intervention strategy for clinicians.Introdução: Lactentes pré-termo podem apresentar atraso na emergência e no aprimoramento de habilidades devido às possíveis intercorrências da prematuridade. Estudos de intervenções específicas como o alcance e de experiências posturais têm mostrado efeitos positivos no desempenho do alcance, controle de cabeça e desenvolvimento motor de lactentes a termo e pré-termo. No entanto, devido à relação entre o desempenho de habilidades manuais e o controle de tronco é relevante desenvolver uma intervenção que enfatize atividades de tronco associadas ao alcance para potencializar o desenvolvimento motor de lactentes de risco biológico. Objetivos: Verificar a viabilidade e o efeito dos programas de intervenção precoce sobre o desempenho motor grosso, controle de tronco e desempenho do alcance em lactentes pré-termo moderados a tardios na emergência do alcance. Métodos: 39 lactentes pré-termo na idade de emergência do alcance (Média=4.36, DP=0.54 meses de idade) foram randomizados em dois grupos: treino funcional de alcance e controle de tronco (grupo experimental–GE) e treino de posturas e social (grupo controle–GC). Os lactentes foram avaliados pela Segmental Assessment of trunk control (SATCo), Alberta Infant Motor Scale (AIMS) e avaliação cinemática do desempenho do tronco e alcance em 4 visitas: 1) pré-treino; 2) pós- treino 1; 3) pós- treino 2 e 4) retenção. As avaliações foram realizadas por um avaliador cego. O treino funcional de alcance e controle de tronco, composto por atividades funcionais foi realizado por uma fisioterapeuta e pelos pais no domicílio. O treino de posturas e social, composto por experiências posturais estáticas, foi realizado somente pelos pais. Em ambos os grupos, os pais receberam orientações e uma cartilha. Os pais registraram diariamente a dose, frequência, duração e comportamento do lactente durante o treino e responderam um questionário de satisfação. Para as variáveis de viabilidade dos programas de intervenção aplicou-se o teste t para amostras independentes e o Qui-Quadrado, e para o desempenho motor grosso, o teste de Mann-Whitney. Para o controle de tronco aplicou-se o teste de Qui-Quadrado, e para as variáveis cinemáticas do tronco e alcance utilizou-se o modelo linear misto. Resultados: Não houve diferenças nos resultados de viabilidade dos programas de intervenção precoce. Os pais forneceram um feedback positivo sobre os programas. Na retenção, o GE apresentou maior pontuação total do que o GC. Ambos os grupos melhoraram ao longo do tempo no desempenho motor grosso. Não houve diferenças significativas entre os grupos em todas as avaliações para o controle de tronco e desempenho do alcance, mas houve efeitos substancialmente importantes (tamanho de efeito). Após o treino, os lactentes do GE apresentaram maior movimentação de tronco e alcances mais suaves e rápidos em comparação ao GC. Conclusão: Ambos os programas de intervenção foram considerados viáveis e ambos os grupos demonstraram melhora no desempenho motor grosso ao longo do tempo. Entretanto, GE apresentou melhor desempenho motor grosso após a intervenção. Efeitos substancialmente importantes foram encontrados para o controle de tronco e desempenho de alcance, favorecendo o treino funcional de alcance e controle de tronco, podendo ser uma estratégia de intervenção precoce eficiente para os clínicos.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)CAPES: Código de Financiamento 001porUniversidade Federal de São CarlosCâmpus São CarlosPrograma de Pós-Graduação em Fisioterapia - PPGFtUFSCarAttribution-NonCommercial-NoDerivs 3.0 Brazilhttp://creativecommons.org/licenses/by-nc-nd/3.0/br/info:eu-repo/semantics/openAccessPrematuroIntervenção precoceDesenvolvimento motorControle de troncoAlcance manualPrematureEarly interventionMotor developmentTrunk controlReachingCIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONALTreino funcional de alcance e controle de tronco em lactentes pré-termo moderados a tardios: ensaio clínico randomizado e controladoFunctional reaching and trunk control training in moderate to late preterm infants: a randomized controlled clinical trialinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesis600600073bc4cc-c212-4c0c-93ca-17746572cbe7reponame:Repositório Institucional da UFSCARinstname:Universidade Federal de São Carlos (UFSCAR)instacron:UFSCARORIGINALTESE NATALIA TIEMI DA SILVA SATO.pdfTESE NATALIA TIEMI DA SILVA SATO.pdfTeseapplication/pdf2732317https://repositorio.ufscar.br/bitstream/ufscar/15058/1/TESE%20NATALIA%20TIEMI%20DA%20SILVA%20SATO.pdfc4f7795b74f4fe93c0e1e2cf07fbf79fMD51Carta-comprovante-da-versão-final-de-teses-e-dissertações.pdfCarta-comprovante-da-versão-final-de-teses-e-dissertações.pdfCarta Comprovanteapplication/pdf88799https://repositorio.ufscar.br/bitstream/ufscar/15058/4/Carta-comprovante-da-vers%c3%a3o-final-de-teses-e-disserta%c3%a7%c3%b5es.pdfc12c5612de2308377f57930c16dbeae2MD54CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8811https://repositorio.ufscar.br/bitstream/ufscar/15058/5/license_rdfe39d27027a6cc9cb039ad269a5db8e34MD55TEXTTESE NATALIA TIEMI DA SILVA SATO.pdf.txtTESE NATALIA TIEMI DA SILVA SATO.pdf.txtExtracted texttext/plain223311https://repositorio.ufscar.br/bitstream/ufscar/15058/6/TESE%20NATALIA%20TIEMI%20DA%20SILVA%20SATO.pdf.txt0e56a34dd6cd4697238103cd7d6f2b1bMD56Carta-comprovante-da-versão-final-de-teses-e-dissertações.pdf.txtCarta-comprovante-da-versão-final-de-teses-e-dissertações.pdf.txtExtracted texttext/plain1403https://repositorio.ufscar.br/bitstream/ufscar/15058/8/Carta-comprovante-da-vers%c3%a3o-final-de-teses-e-disserta%c3%a7%c3%b5es.pdf.txt0bbc6f2e59260f671b4afd32ca24d548MD58THUMBNAILTESE NATALIA TIEMI DA SILVA SATO.pdf.jpgTESE NATALIA TIEMI DA SILVA SATO.pdf.jpgIM Thumbnailimage/jpeg8307https://repositorio.ufscar.br/bitstream/ufscar/15058/7/TESE%20NATALIA%20TIEMI%20DA%20SILVA%20SATO.pdf.jpg94fd904d3dc1808e0f4fea6437a872edMD57Carta-comprovante-da-versão-final-de-teses-e-dissertações.pdf.jpgCarta-comprovante-da-versão-final-de-teses-e-dissertações.pdf.jpgIM Thumbnailimage/jpeg9234https://repositorio.ufscar.br/bitstream/ufscar/15058/9/Carta-comprovante-da-vers%c3%a3o-final-de-teses-e-disserta%c3%a7%c3%b5es.pdf.jpgfe779e23ec9988163446e4c54977fd16MD59ufscar/150582023-09-18 18:32:18.356oai:repositorio.ufscar.br:ufscar/15058Repositório InstitucionalPUBhttps://repositorio.ufscar.br/oai/requestopendoar:43222023-09-18T18:32:18Repositório Institucional da UFSCAR - Universidade Federal de São Carlos (UFSCAR)false |
dc.title.por.fl_str_mv |
Treino funcional de alcance e controle de tronco em lactentes pré-termo moderados a tardios: ensaio clínico randomizado e controlado |
dc.title.alternative.eng.fl_str_mv |
Functional reaching and trunk control training in moderate to late preterm infants: a randomized controlled clinical trial |
title |
Treino funcional de alcance e controle de tronco em lactentes pré-termo moderados a tardios: ensaio clínico randomizado e controlado |
spellingShingle |
Treino funcional de alcance e controle de tronco em lactentes pré-termo moderados a tardios: ensaio clínico randomizado e controlado Sato, Natália Tiemi da Silva Prematuro Intervenção precoce Desenvolvimento motor Controle de tronco Alcance manual Premature Early intervention Motor development Trunk control Reaching CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
title_short |
Treino funcional de alcance e controle de tronco em lactentes pré-termo moderados a tardios: ensaio clínico randomizado e controlado |
title_full |
Treino funcional de alcance e controle de tronco em lactentes pré-termo moderados a tardios: ensaio clínico randomizado e controlado |
title_fullStr |
Treino funcional de alcance e controle de tronco em lactentes pré-termo moderados a tardios: ensaio clínico randomizado e controlado |
title_full_unstemmed |
Treino funcional de alcance e controle de tronco em lactentes pré-termo moderados a tardios: ensaio clínico randomizado e controlado |
title_sort |
Treino funcional de alcance e controle de tronco em lactentes pré-termo moderados a tardios: ensaio clínico randomizado e controlado |
author |
Sato, Natália Tiemi da Silva |
author_facet |
Sato, Natália Tiemi da Silva |
author_role |
author |
dc.contributor.authorlattes.por.fl_str_mv |
http://lattes.cnpq.br/8437359810199326 |
dc.contributor.author.fl_str_mv |
Sato, Natália Tiemi da Silva |
dc.contributor.advisor1.fl_str_mv |
Tudella, Eloisa |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/3207258034860219 |
dc.contributor.advisor-co1.fl_str_mv |
Cunha, Andrea Baraldi |
dc.contributor.advisor-co1Lattes.fl_str_mv |
http://lattes.cnpq.br/8413239950848240 |
dc.contributor.authorID.fl_str_mv |
3b9b9965-0f7d-4135-a2ba-3f39dc49f4df |
contributor_str_mv |
Tudella, Eloisa Cunha, Andrea Baraldi |
dc.subject.por.fl_str_mv |
Prematuro Intervenção precoce Desenvolvimento motor Controle de tronco Alcance manual |
topic |
Prematuro Intervenção precoce Desenvolvimento motor Controle de tronco Alcance manual Premature Early intervention Motor development Trunk control Reaching CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
dc.subject.eng.fl_str_mv |
Premature Early intervention Motor development Trunk control Reaching |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
description |
Introduction: Moderate to late preterm infants may present delays on the onset and development of those abilities due to possible complications of prematurity. Studies on specific abilities such as reaching and positioning experiences have shown a positive effect to optimize the reaching performance, head control and motor development in full-term and preterm infants. However, due to the relationship between manual abilities and trunk control, it is relevant to develop an intervention that emphasizes on the positioning experiences and reaching to enhance the motor development of infants at biological risk. Objective: to verify the feasibility and effect of early intervention programs on gross motor performance, trunk control and reaching performance in moderate to late preterm infants in reaching emergence. Methods: Preterm infants at the onset of reaching ability (Mean=4.36, SD=0.54 months) were randomized assigned into two groups: Functional Reaching and Trunk Control Training (experimental group-EG) and Positioning social training (control group-GC). Infants were assessed into 4 visits: 1) pre-test; 2) post-intervention 1; 3) post-intervention 2, and 4) follow-up. All assessments were performed by a blinded evaluator. The Functional Reaching and Trunk Control Training, consisting of functional activities was performed by a pediatric physical therapy and parents at home. The Positioning social training, consisting of only static positioning experiences, was performed only by parents. Parents used a daily log for both trainings (dose, frequency, duration and infant’s behavior), and responded to a parent feedback questionnaire. For the feasibility variables of early intervention programs, t-test for independent samples and the Chi-Square test were performed. For gross motor performance, the Mann-Whitney test was applied. For the segmental trunk control, the Chi-Square test was applied, and for trunk and reaching kinematics variables, the mixed linear model was used. Results: there were no differences of feasibility outcome measures for both intervention programs. Parents provide a positive feedback about both programs. At the follow-up, the EG presented higher total gross motor score than CG. Both groups improved on motor performance across time. There were no significant differences between groups in the segmental trunk control, trunk and reaching performance, but there were substantively important effects (clinically relevant). After training and at follow-up, EG infants presented higher trunk movement and smoother and faster reaching than CG. Conclusion: Both early intervention programs were considered feasible and both groups showed improvement on gross motor performance, trunk control and reaching performance across time. Substantively important effects were found, favoring Functional Reaching and Trunk Control Training, which can be an efficient early intervention strategy for clinicians. |
publishDate |
2021 |
dc.date.accessioned.fl_str_mv |
2021-10-28T10:28:05Z |
dc.date.available.fl_str_mv |
2021-10-28T10:28:05Z |
dc.date.issued.fl_str_mv |
2021-07-27 |
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info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
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doctoralThesis |
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publishedVersion |
dc.identifier.citation.fl_str_mv |
SATO, Natália Tiemi da Silva. Treino funcional de alcance e controle de tronco em lactentes pré-termo moderados a tardios: ensaio clínico randomizado e controlado. 2021. Tese (Doutorado em Fisioterapia) – Universidade Federal de São Carlos, São Carlos, 2021. Disponível em: https://repositorio.ufscar.br/handle/ufscar/15058. |
dc.identifier.uri.fl_str_mv |
https://repositorio.ufscar.br/handle/ufscar/15058 |
identifier_str_mv |
SATO, Natália Tiemi da Silva. Treino funcional de alcance e controle de tronco em lactentes pré-termo moderados a tardios: ensaio clínico randomizado e controlado. 2021. Tese (Doutorado em Fisioterapia) – Universidade Federal de São Carlos, São Carlos, 2021. Disponível em: https://repositorio.ufscar.br/handle/ufscar/15058. |
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https://repositorio.ufscar.br/handle/ufscar/15058 |
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Attribution-NonCommercial-NoDerivs 3.0 Brazil http://creativecommons.org/licenses/by-nc-nd/3.0/br/ |
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openAccess |
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Universidade Federal de São Carlos Câmpus São Carlos |
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Programa de Pós-Graduação em Fisioterapia - PPGFt |
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UFSCar |
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Universidade Federal de São Carlos Câmpus São Carlos |
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