Investigação dos hábitos intestinais de crianças, jovens e adultos com Síndrome de Down e proposta de intervenção por meio de um protocolo fisioterapêutico em crianças até os três anos

• Autor(a) principal: Lando, Aline Abreu
• Data de Publicação: 2019
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações do Mackenzie
• Texto Completo: http://dspace.mackenzie.br/handle/10899/22765
• topic: constipação intestinal; Síndrome de Down; fisioterapia; massoterapia; gastroenterologia; CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL

The intestinal function is so widely-evaluated parameter, and associated with good health maintenance and individuals’ well-being. People with intellectual disabilities have an increase in risk factor concerning intestinal constipation development, however, few studies present alternatives due to enhance such a condition. Objective: to investigate intestinal habits of children, as well as adolescents and adults with Down Syndrome (DS) in order to identify the prevalence of intestinal constipation, and evaluate the effect of applying a physiotherapeutic protocol based on “Busquet Method” in constipated children in most prevalent age group, mainly, those up to three incomplete years of age. Method: A group of 130 people with DS, from both sexes participated, varying from seven months to fifty years of age, all of whom attended at an Institution which support people with special needs in São Paulo. A questionnaire on intestinal habits, created from the Rome IV criteria, was applied along with the recommendations provided by the World Gastroenterology Organization (WGO), North American and European Associations of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN and NASPGHAN), as well as the Bristol Scale. The Strengths and Difficulties Questionnaire – (SDQ) was used to analyze participants’ behavior. In the second stage of the study, the intervention consisted of 13 constipated children aged between seven months and three incomplete years, divided into Intervention Group (GI) with six participants and Control Group (CG) with seven participants. In the third phase of the study both groups were reassessed by the same instrument of the initial phase. Results: Data were analyzed according to age groups: G1 (0 to 35 months), G2 (3 to 5 years and 11 months), G3 (6 to 11 years and 11 months), G4 (12 to 19 years and 11 months) and G5 (above 20 years). Amongst the 130 evaluated, a total of 43 constipated participants (33.1%) were found, distributed respectively in 47.2%, 40%, 22.2%, 28.6%, 17.4% according to the groups, obtaining higher prevalence of constipation among participants with lower ages, without significant difference according to sex. After the intervention, the number of diagnostic criteria for constipation was significantly lower in the GI than in the CG (p = 0.051), thus five of the six GI participants were reevaluated as non-constipated. The analysis of behavioral problems showed that participants with DS who presented constipation reached a greater number of problems of conduct (p = 0.044), hyperactivity (p = 0.048) and total problems (p = 0.016) than no constipates. Discussion: Despite the creation of guidelines regarding care for those born with DS, a lack of focus and emphasis on the evaluation of bowel habits are observed. Earl intestinal constipation treatment is essential to prevent complications such as fecal incontinence described in some cases, recurrent abdominal pain and urinary tract infection. Conclusion: The implementation of an abdominal massage protocol based on the Busquet Method was efficient for the treatment of constipation in the studied population; however, this feature has not been part of the therapeutic indications, even though it is a non-invasive technique, low cost and easy application by caregivers.