Motor deficits are debilitating in that they affect everyday function in human beings (Zillmer & Spiers, 2001). Cerebral Palsy (CP) is one particular disorder that is primary characterised by motor deficits, more specifically gross motor function deficits. As a result, people with CP are restricted in their everyday function and lack independence and self-sufficiency. With other factors such as stigmatisation and prejudice, social participation becomes limited which leads to isolation and loneliness, which may further lead to psychological disorders such as depression, anxiety, low self esteem and poor quality of life. These assumptions are based on the application of the mental health model, and one could assume the poorer the level of functioning the more likely a person’s psychological well-being will suffer. Thus, the study attempted to investigate these assumptions by exploring the relationship between levels of gross motor function and psychological well-being. A sample of 43 participants based in a care centre in Johannesburg completed a demographic questionnaire, the Major Depression Inventory (MDI), The Becks Anxiety Inventory (BAI), The Rosenburg Self Esteem Scale (RSE) and the Comprehensive Quality of Life Scale (COMQOL – A5). In addition, through observation, the level of gross motor function was determined by utilising the Gross Motor Function Classification System (GMFCS). The data that was gathered and was statistically manipulated to explore three main questions. Before the relationship between gross motor function and psychological well-being could be explored it was necessary to examine the suitability of the use of psychological measure on an adult with CP sample. Results indicated that the MDI (r = 0.78), BAI (r = 0.76). RSE (0.77), and COMQOL (r = 0.99) had high internal constancy reliability. The relationship between demographical variables, namely, age, gender, years of residency, experience of motor deterioration and presence of epilepsy, were tested against the level of gross motor function. No significant results were found apart from motor PDF created with pdfFactory trial version www.softwarelabs.com 4 deterioration. More participants with a higher level of gross motor function experienced motor deterioration (77%) than those with a lower level of gross motor function (44%). Lastly, the relationship between psychological variables and gross motor function was investigated as well as difference between the levels. Correlations revealed very weak positive relationships, with the exception of depression having a very weak negative relationship. All relationship were non significant. Although slight differences were seen between levels, they were non significant. 7% of participants were diagnosed with depressive disorders, and 47% with anxiety disorders. Problems with certain questions pertaining to the BAI raised concerns over the suitability of its use in CP adult samples. The study concluded that psychological measures, excluding the BAI, were suitable for use on a sample of adults with CP. It also highlighted that the level of motor functioning is not related to or determines psychological well-being in adults with CP. PDF created with pdfFactory trial version www.softwarelabs.com

O Gross Motor Function System Expanded and Revised (GMFCS E & R) e o Manual Ability Classification System (MACS) têm sido amplamente utilizados na pesquisa e na prática clínica como complemento ao diagnóstico da paralisia cerebral (PC). Ambos consistem em cinco níveis, sendo que o nível V indica maior limitação funcional. O objetivo deste estudo foi realizar o processo de tradução e adaptação transcultural do GMFCS E & R e MACS, avaliar a confiabilidade inter-avaliadores (entre terapeutas e entre terapeutas e pais) e intra-avaliadores (terapeutas) acerca dos sistemas de classificação (GMFCS E & R e MACS) e verificar a influência de fatores relacionados à criança (tipo de PC) e aos pais (escolaridade, renda, ocupação e idade) na confiabilidade entre terapeutas e pais. Participaram 100 crianças com PC, que eram acompanhadas pelo serviço de neurologia ou de reabilitação de um hospital terciário no interior paulista na faixa etária entre 4 a 18 anos, e seus pais. Para a aplicação dos sistemas de classificação realização da tradução e adaptação transcultural do GMFCS E & R, seguiram-se seis estágios: tradução, síntese das traduções, retrotradução para língua de origem, comitê de análise, submissão aos autores e pré-teste. A coleta de dados foi feita por dois terapeutas com diferentes níveis de experiência na área de neuropediatria. Os terapeutas classificaram a função motora grossa da criança (GMFCS E & R) através da observação direta (controle de cabeça, tronco, transferências, mobilidade) e os pais responderam ao GMFCS Family Report Questionnaire, onde deveriam selecionar uma opção, dentre cinco, correspondente ao nível motor da criança. Quanto à habilidade manual (MACS), os terapeutas observaram a criança manipulando objetos (brinquedos, alimentação, vestuário) e obtiveram informações dos pais. Os pais realizaram a classificação da habilidade manual da criança com base na leitura do folheto explicativo do MACS. Foram realizadas filmagens das observações das crianças para avaliação da confiabilidade intra-avaliadores (terapeutas), após um mês da avaliação inicial. Utilizou-se o coeficiente Kappa (k) para avaliação da confiabilidade inter-avaliadores (entre terapeutas e entre terapeutas e pais) e intra-avaliadores (terapeutas) acerca do GMFCS E & R e MACS e o teste do qui-quadrado (x2) para verificar a associação entre os fatores relacionados à criança e aos pais. Após realizados os seis estágios referentes à tradução e adaptação transcultural do GMFCS E & R e MACS, as versões em português foram aprovadas pelos autores. Em relação à confiabilidade inter-avaliadores (AV1 e AV2), obteve-se concordância quase perfeita para o GMFCS E & R e MACS (K = 0,902 e 0,90 respectivamente), assim como intra-avaliadores, obtendo-se concordância quase perfeita para ambos avaliadores acerca do GMFCS E & R (k=1,00) e MACS (K= 0,958 para AV1 e K= 0,833 para AV2). Em relação à confiabilidade entre terapeutas e pais, esta foi substancial para GMFCS E & R (K = 0,716) e considerável para MACS (K =0, 368). Em relação ao GMFCS E & R, verificou-se que o porcentual de discordâncias no grupo de pais que não trabalha fora é significativamente superior ao porcentual de discordância de quem trabalha fora (x 2 =4,79; p= 0,03), quando comparada à classificação do terapeuta. Maior freqüência de pais classificaram as crianças como severamente limitada, comparada à classificação do terapeuta (x 2 =4,26; p= 0,04). Em relação ao MACS, verificou-se que as discordâncias entre terapeutas e pais foram significativamente superiores nas crianças de 4 a 6 e 6 a 12 anos do que em relação às crianças de 12 a 18 anos (p=0,05), assim como pais na faixa etária de 20 a 30 anos discordaram significativamente mais do terapeuta (p=0,04). É importante considerar a influência de fatores ambientais no desempenho típico da criança com PC em relação à função motora grossa e habilidade manual. Portanto, embora terapeutas e pais apresentem diferentes perspectivas em relação a tais aspectos, por julgarem diferentes contextos como referência (pais consideram o desempenho em casa, escola, ambientes externos; o terapeuta, o ambiente clínico), os dois pontos de vista necessitam ser apreciados conjuntamente. Conclui-se que as versões traduzidas para o português Brasil do GMFCS E & R, GMFCS Family Report Questionnaire são confiáveis para classificar crianças com PC por pais e terapeutas. / The Gross Motor Function System Expanded and Revised (GMFCS E & R) and Manual Ability Classification System (MACS) has been widely used in research and clinical practice to complement the diagnosis of cerebral palsy (CP). Both consist of five levels where the level V indicates greater functional limitation. The aim of this study was to carry out the process of translation and cultural adaptation of the GMFCS E & R and MACS, evaluate the inter-rater reliability (between therapists and between therapists and parents) and intra-rater (therapists) about rating systems and verify the influence of factors related to the child (type PC) and parents (education, income, occupation and age) in reliability between therapists and parents. Participants 100 children with CP who were accompanied by the department of neurology and rehabilitation of a tertiary hospital in São Paulo aged 4-18 years and their parents. To perform the translation and cultural adaptation of the GMFCS E & MACS, followed by six stages: translation, synthesis of translations, back translation for source language, analysis committee, submission to the authors and pretest. Data collection was done by two therapists with different levels of experience in neuropediatric.Therapists rated the child\'s gross motor function (GMFCS & E) through direct observation (head control, trunk, transfers, mobility) and parents responded to GMFCS Family Report Questionnaire, which should select an option Among five, corresponding to the child\'s motor. As for manual ability (MACS), therapists observed the child handling objects (toys, food and clothing) and obtained information from parents. Parents held the classification of manual ability of the child based on reading the brochure MACS. Were filmed observations of children to assess intra-rater reliability (therapists), one month after the initial evaluations. To assess the reliability used the kappa coefficient (k) and the chi-square (x2) to determine the association between factors related to the child and parents, the reliability between therapists and parents. Performed after the six stages related to translation and cultural adaptation of the GMFCS E & R and MACS, the Portuguese versions were approved by the authors. Regarding inter-rater reliability (AV1 and AV2), we obtained almost perfect agreement for the GMFCS E & R and MACS (K = 0.902 and 0.90 respectively) as well as intra-rater, yielding almost perfect agreement for both evaluators about the GMFCS E & R(k = 1.00) and MACS (K = 0.958 for AV1 and AV2 for K = 0.833). Regarding reliability between therapists and parents, this was substantial for GMFCS E & R (K = 0.716) and to considerable MACS (K = 0, 368). Regarding the GMFCS E & R, it was found that the percentage of disagreements in the group of parents who do not work out is significantly higher than the percentage of those working outside of disagreement (x 2 = 4.79, p = 0.03), compared to ratings of therapist. Parents classify children as more severely limited than therapists (x 2 = 4.26, p = 0.04). It is important to consider the influence of environmental factors on the performance of children with PC in relation to gross motor function and manual ability. Therefore, parents and therapists have different perspectives regarding such aspects, judging by different contexts as reference (parents consider performance at home, school, outdoors, therapist, the clinical setting), the two points of view need to be assessed together. We conclude that the translated versions for Portuguese - Brazil\'s GMFCS E & R, GMFCS Family Report Questionnaire are reliable to classify children with CP by parents and therapists.

O Gross Motor Function System Expanded and Revised (GMFCS E & R) e o Manual Ability Classification System (MACS) têm sido amplamente utilizados na pesquisa e na prática clínica como complemento ao diagnóstico da paralisia cerebral (PC). Ambos consistem em cinco níveis, sendo que o nível V indica maior limitação funcional. O objetivo deste estudo foi realizar o processo de tradução e adaptação transcultural do GMFCS E & R e MACS, avaliar a confiabilidade inter-avaliadores (entre terapeutas e entre terapeutas e pais) e intra-avaliadores (terapeutas) acerca dos sistemas de classificação (GMFCS E & R e MACS) e verificar a influência de fatores relacionados à criança (tipo de PC) e aos pais (escolaridade, renda, ocupação e idade) na confiabilidade entre terapeutas e pais. Participaram 100 crianças com PC, que eram acompanhadas pelo serviço de neurologia ou de reabilitação de um hospital terciário no interior paulista na faixa etária entre 4 a 18 anos, e seus pais. Para a aplicação dos sistemas de classificação realização da tradução e adaptação transcultural do GMFCS E & R, seguiram-se seis estágios: tradução, síntese das traduções, retrotradução para língua de origem, comitê de análise, submissão aos autores e pré-teste. A coleta de dados foi feita por dois terapeutas com diferentes níveis de experiência na área de neuropediatria. Os terapeutas classificaram a função motora grossa da criança (GMFCS E & R) através da observação direta (controle de cabeça, tronco, transferências, mobilidade) e os pais responderam ao GMFCS Family Report Questionnaire, onde deveriam selecionar uma opção, dentre cinco, correspondente ao nível motor da criança. Quanto à habilidade manual (MACS), os terapeutas observaram a criança manipulando objetos (brinquedos, alimentação, vestuário) e obtiveram informações dos pais. Os pais realizaram a classificação da habilidade manual da criança com base na leitura do folheto explicativo do MACS. Foram realizadas filmagens das observações das crianças para avaliação da confiabilidade intra-avaliadores (terapeutas), após um mês da avaliação inicial. Utilizou-se o coeficiente Kappa (k) para avaliação da confiabilidade inter-avaliadores (entre terapeutas e entre terapeutas e pais) e intra-avaliadores (terapeutas) acerca do GMFCS E & R e MACS e o teste do qui-quadrado (x2) para verificar a associação entre os fatores relacionados à criança e aos pais. Após realizados os seis estágios referentes à tradução e adaptação transcultural do GMFCS E & R e MACS, as versões em português foram aprovadas pelos autores. Em relação à confiabilidade inter-avaliadores (AV1 e AV2), obteve-se concordância quase perfeita para o GMFCS E & R e MACS (K = 0,902 e 0,90 respectivamente), assim como intra-avaliadores, obtendo-se concordância quase perfeita para ambos avaliadores acerca do GMFCS E & R (k=1,00) e MACS (K= 0,958 para AV1 e K= 0,833 para AV2). Em relação à confiabilidade entre terapeutas e pais, esta foi substancial para GMFCS E & R (K = 0,716) e considerável para MACS (K =0, 368). Em relação ao GMFCS E & R, verificou-se que o porcentual de discordâncias no grupo de pais que não trabalha fora é significativamente superior ao porcentual de discordância de quem trabalha fora (x 2 =4,79; p= 0,03), quando comparada à classificação do terapeuta. Maior freqüência de pais classificaram as crianças como severamente limitada, comparada à classificação do terapeuta (x 2 =4,26; p= 0,04). Em relação ao MACS, verificou-se que as discordâncias entre terapeutas e pais foram significativamente superiores nas crianças de 4 a 6 e 6 a 12 anos do que em relação às crianças de 12 a 18 anos (p=0,05), assim como pais na faixa etária de 20 a 30 anos discordaram significativamente mais do terapeuta (p=0,04). É importante considerar a influência de fatores ambientais no desempenho típico da criança com PC em relação à função motora grossa e habilidade manual. Portanto, embora terapeutas e pais apresentem diferentes perspectivas em relação a tais aspectos, por julgarem diferentes contextos como referência (pais consideram o desempenho em casa, escola, ambientes externos; o terapeuta, o ambiente clínico), os dois pontos de vista necessitam ser apreciados conjuntamente. Conclui-se que as versões traduzidas para o português Brasil do GMFCS E & R, GMFCS Family Report Questionnaire são confiáveis para classificar crianças com PC por pais e terapeutas. / The Gross Motor Function System Expanded and Revised (GMFCS E & R) and Manual Ability Classification System (MACS) has been widely used in research and clinical practice to complement the diagnosis of cerebral palsy (CP). Both consist of five levels where the level V indicates greater functional limitation. The aim of this study was to carry out the process of translation and cultural adaptation of the GMFCS E & R and MACS, evaluate the inter-rater reliability (between therapists and between therapists and parents) and intra-rater (therapists) about rating systems and verify the influence of factors related to the child (type PC) and parents (education, income, occupation and age) in reliability between therapists and parents. Participants 100 children with CP who were accompanied by the department of neurology and rehabilitation of a tertiary hospital in São Paulo aged 4-18 years and their parents. To perform the translation and cultural adaptation of the GMFCS E & MACS, followed by six stages: translation, synthesis of translations, back translation for source language, analysis committee, submission to the authors and pretest. Data collection was done by two therapists with different levels of experience in neuropediatric.Therapists rated the child\'s gross motor function (GMFCS & E) through direct observation (head control, trunk, transfers, mobility) and parents responded to GMFCS Family Report Questionnaire, which should select an option Among five, corresponding to the child\'s motor. As for manual ability (MACS), therapists observed the child handling objects (toys, food and clothing) and obtained information from parents. Parents held the classification of manual ability of the child based on reading the brochure MACS. Were filmed observations of children to assess intra-rater reliability (therapists), one month after the initial evaluations. To assess the reliability used the kappa coefficient (k) and the chi-square (x2) to determine the association between factors related to the child and parents, the reliability between therapists and parents. Performed after the six stages related to translation and cultural adaptation of the GMFCS E & R and MACS, the Portuguese versions were approved by the authors. Regarding inter-rater reliability (AV1 and AV2), we obtained almost perfect agreement for the GMFCS E & R and MACS (K = 0.902 and 0.90 respectively) as well as intra-rater, yielding almost perfect agreement for both evaluators about the GMFCS E & R(k = 1.00) and MACS (K = 0.958 for AV1 and AV2 for K = 0.833). Regarding reliability between therapists and parents, this was substantial for GMFCS E & R (K = 0.716) and to considerable MACS (K = 0, 368). Regarding the GMFCS E & R, it was found that the percentage of disagreements in the group of parents who do not work out is significantly higher than the percentage of those working outside of disagreement (x 2 = 4.79, p = 0.03), compared to ratings of therapist. Parents classify children as more severely limited than therapists (x 2 = 4.26, p = 0.04). It is important to consider the influence of environmental factors on the performance of children with PC in relation to gross motor function and manual ability. Therefore, parents and therapists have different perspectives regarding such aspects, judging by different contexts as reference (parents consider performance at home, school, outdoors, therapist, the clinical setting), the two points of view need to be assessed together. We conclude that the translated versions for Portuguese - Brazil\'s GMFCS E & R, GMFCS Family Report Questionnaire are reliable to classify children with CP by parents and therapists.

Objetivo: Determinar la frecuencia y características de luxación de cadera en personas con parálisis cerebral institucionalizadas en una casa hogar de Lima, Perú. Método: Estudio transversal en niños, jóvenes y adultos con parálisis cerebral institucionalizados en una casa albergue en la ciudad de Lima – Perú, durante el año 2018. Se incluyó a toda la población (22 personas), por lo cual no se requirió realizar un muestreo. Se utilizó una ficha de recolección de datos en la cual se consideró únicamente a los usuarios con diagnóstico médico de parálisis cerebral (PC), la información del tiempo de institucionalización y antecedentes clínicos de cada participante. Las placas radiográficas fueron analizadas por un médico traumatólogo de acuerdo a los siguientes parámetros de medición: Porcentaje de migración de Reimers y el Índice acetabular. Resultados: Se evaluaron las historias clínicas de 22 personas con PC, 16 de ellos fueron varones. La edad promedio de los participantes fue 14 ± 8 años. La PC espástica fue la más frecuente de acuerdo a la topografía mientras que de acuerdo a su tipo, 10 presentaron PC del tipo diplejía y 9 del tipo cuadriplejia. La luxación completa y la subluxación bilateral fueron las más frecuentes al analizar las placas radiográficas. Según el Sistema de Clasificación de la Función Motora Gruesa (GMFCS) los participantes se encontraban entre los niveles III, IV y V. El grado de dependencia según el GMFCS era mayor para los usuarios que presentaban cuadriplejia teniendo tendencia a desarrollar una luxación total y subluxación de cadera. Solo 10 de los usuarios recibían tratamiento fisioterapéutico. Además, 6 de ellos solo contaban con un tipo de ayuda técnica como son las ortesis. Conclusiones: En conclusión, la luxación completa y la subluxación bilateral fueron las más frecuentes, así como los niveles III, IV y V según el Sistema de Clasificación de la Función Motora Gruesa (GMFCS). Además, se encontró un grado de dependencia mayor en los pacientes con parálisis cerebral tipo cuadriplejía. Este estudio muestra que esta población vulnerable, debe recibir mayor atención de terapia física, para garantizar una mejor calidad de vida. En este sentido el abordaje debe incluir el higiene postural (cambios de posiciones), descargas de peso en actividades de AVD (actividades de vida diaria), tratamiento para la espasticidad o el entrenamiento con aditamentos ortopédicos para corregir las alteraciones posturales y así evitar futuras complicaciones generadas por su condición. / Objective: Determine the frequency and characteristics of hip dislocation in people with institutionalized cerebral palsy in a home in Lima, Perú. Method: Cross-sectional study in children, young people and adults with institutionalized cerebral palsy in a shelter in the city of Lima - Perú, during the year 2018. The entire population (22 people) was included, so it was not required to perform a sampling. A data collection sheet was used in which only users with a cerebral palsy (CP) medical diagnosis, institutionalization time information and clinical history of each participant were considered. The radiographic plates were analyzed by a traumatologist under the measurement parameters of Reimers Migration Percentage and the Acetabular Index. Results: The medical records of 22 people with CP were evaluated, 16 of them were male. The average age of the participants was 14 ± 8 years. Spastic CP was the most frequent according to the topography while according to its type, 10 presented CP of the diplegia type and 9 of the quadriplegia type. Complete dislocation and bilateral subluxation were the most frequent when analyzing radiographic plates. According to the Gross Motor Function Classification System (GMFCS), participants were between levels III, IV and V. The degree of dependence according to GMFCS was higher for users who presented quadriplegia , having a tendency to develop total dislocation and subluxation of the hip. Only 10 of the users received physiotherapeutic treatment. In addition, 6 of them only had one type of technical assistance such as orthotics. Conclusions: In conclusion, complete dislocation and bilateral subluxation were the most frequent, as well as levels III, IV and V according to the Gross Motor Function Classification System (GMFCS). In addition, a higher degree of dependence was found in patients with quadriplegia type of cerebral palsy. This study shows that this vulnerable population should receive more physical therapy treatment care to ensure a better quality of life. In this sense, the approach must include postural hygiene (changes in positions), weight discharges in daily living activities, treatment for spasticity or training with orthopedic attachments to correct postural alterations and thus avoid future complications. generated by their condition. / Tesis

Recent research has investigated the prevalence of gross motor deficits in children diagnosed with Austim Spectrum Disorder (ASD), however these studies typically utilize the Bruininks-Oserestsky Test of Motor Proficiency, the Movement Assessment Battery for Children, the Peabody Developmental Motor Scales, or the Test of Gross Motor Development for assessment. These scales are expensive, require specialized equipment, are difficult to administer, and contain numerous test items that lead to long test administration times. The current research applied the Charlop-Atwell Scale of Motor Coordination to measure gross motor function deficits in children with autism and compared the data against scores from neurotypical children to determine the degree of delay of motor development. The Charlop-Atwell scale proved to be an effective measure of motor deficits and the study had high interobservor reliability. Children with ASD scored significantly lower than neurotypical children half their age on the objective subtest and total scale score. Looking at scores on separated test items, individual motor deficits were identified and results can be referred to an occupational or physical therapist for remedial treatment program development.

Made available in DSpace on 2016-06-02T20:19:18Z (GMT). No. of bitstreams: 1 4361.pdf: 2546261 bytes, checksum: 0ea61741466b8717008009085044d937 (MD5) Previous issue date: 2012-02-29 / The objective of this longitudinal study was to verify if the treadmill gait training improves the gross motor function in children with cerebral palsy (PC). This study evaluated 18 children with CP separated in two groups according with Gross Motor Function Classification System (GMFCS). To guarantee more homogeneity in the motor conditions two studies had been carried out: study 1 (levels I/II of the GMFCS) and 2 (levels III and IV of the GMFCS). Study 1 was composed for nine children with average of age of nine years and four months (5,7-13,2 years), level I (3 children) and II (6 children) of the GMFCS and study 2 was composed also for nine children with average of age of nine years (4 - 15 years), level III (3 children) and IV (6 children). Studies 1 and 2 had been lead in three phases: baseline, intervention and retention. The intervention phase consisted of treadmill gait training held twice a week in sessions of 25 minutes for six consecutive weeks. At each stage, the participants were evaluated using the Gross Motor Function Measure (GMFM) and 10m Walk Test (WT). In the retention phase, a Satisfaction Questionnaire for parents / caregivers was applied. Study 2 also used Functional Mobility Scale (FMS) to verify the influence of the protocol in functional mobility. In the statistics analysis, the ANOVA was applied in the two studies, separately. ANOVA with repeated measures was applied (group X evaluation) to analyze the total sample of the participants of the two studies. Study 1 showed positive changes in the scores of the GMFM in six participants and the WT-10m in five participants for normal speed and six for fast speed. The ANOVA indicated that it did not have significant difference between the evaluations. The Questionnaire showed that seven parents/caretakers had observed that the children were walking more rectified and that they were changing the steps easily less tired and needed less help. Study 2 showed positive changes in the scores of the GMFM in seven participants and the WT-10m in seven participants for the normal speed and in six for the fast. The ANOVA showed that it did not have significant difference between the evaluations. The Questionnaire showed that all the parents /caretakers had told that their children had started to walk more rectified, eight had reported that they had become less tired to walk the same distance in its daily routine and five had found that they had walked with more easiness and they had needed less help. The ANOVA with repeated measures showed that group levels I/II presented higher scores of the GMFM (p=0,001) and WT-10m in normal speed (p=0,001) and fast (p=0,001). It had difference between the evaluations for the total scores of the GMFM (p=0,019), being that GMFM 2 superior to GMFM 1 (p=0,06). In relation to the WT-10m, only for the fast speed had difference between the evaluations (p=0,027), being that in the after-intervention the average was greater than in the baseline (p=0,027). The protocol showed to significant changes in the motor function of the children with CP levels I/II and III/IV of GMFCS when the two groups had been analyzed jointly for the two applied quantitative measurements. In the analysis of study 1 and 2 separately, we did not find significant statistical results, however performance improvement was evidenced for the most part of the participants of the two groups, suggesting trend the improvement. The treadmill gait training leads to improvement of the gross motor function in children with CP levels I, II, III and IV. / O objetivo deste estudo longitudinal foi verificar se o treino de marcha em esteira melhora a função motora grossa em crianças com paralisia cerebral (PC). Este estudo avaliou 18 crianças com PC sendo estas separadas em dois grupos de acordo com o nível do Gross Motor Function Classification System (GMFCS). Para garantir mais homogeneidade nas condições motoras foram realizados dois estudos: estudo 1 (níveis I e II do GMFCS) e 2 (níveis III e IV do GMFCS). O estudo 1 foi composto por nove crianças com média de idade de nove anos e quatro meses (5,7-13,2 anos), classificadas nos níveis I (3 crianças) e II (6 crianças) do GMFCS; e o estudo 2 foi composto também por nove crianças com média de idade de nove anos (4 - 15 anos), classificadas nos níveis III (3 crianças) e IV (6 crianças). Os estudos 1 e 2 foram conduzidos em três fases: linha de base, intervenção e retenção. A fase de intervenção consistiu do treino de marcha em esteira realizado duas vezes por semana em sessões de 25 minutos por seis semanas consecutivas. Em todas as fases, os participantes foram avaliados usando Gross Motor Function Measure (GMFM) e Teste de caminhada de 10- m (TC). Na fase de retenção, um Questionário de Satisfação para pais/cuidadores foi aplicado. O estudo 2 também utilizou a Functional Mobility Scale (FMS), escala de avaliação usada para verificar a influência do protocolo na mobilidade funcional. Na análise estatística, foi aplicada a ANOVA nos dois estudos, separadamente. Foi aplicada ANOVA com medidas repetidas (grupo X avaliação) para analisar a amostra total dos participantes dos dois estudos. O estudo 1 mostrou mudanças positivas nos escores do GMFM em seis participantes e no TC-10m em cinco participantes para velocidade normal e em seis para velocidade rápida. A ANOVA indicou que não houve diferença significativa entre as avaliações. O Questionário mostrou que sete pais/cuidadores observaram que as crianças estavam andando mais retificadas e que estavam trocando os passos com mais facilidade, se cansavam menos e precisavam de menos ajuda. O estudo 2 mostrou mudanças positivas nos escores do GMFM em sete participantes e no TC-10m em sete participantes para a velocidade normal e em seis para a rápida. A ANOVA mostrou que não houve diferença significativa entre as avaliações. O Questionário mostrou que todos os pais /cuidadores relataram que suas crianças começaram a andar mais retificadas, oito reportaram que elas tornaram-se menos cansadas para andar a mesma distância na sua rotina diária e cinco acharam que andaram com mais facilidade e precisaram de menos ajuda. A ANOVA com medidas repetidas mostrou que o grupo níveis I/II apresentou maiores escores do GMFM (p=0,001) e TC-10m em velocidade normal (p=0,001) e rápida (p=0,001). Houve diferença entre as avaliações para o escore total do GMFM (p=0,019), sendo que o GMFM 2 superior ao GMFM 1 (p=0,006). Em relação ao TC- 10m, somente para a velocidade rápida houve diferença entre as avaliações (p=0,027), sendo que na pós-intervenção a média foi maior que na linha de base (p=0,027). O protocolo mostrou mudanças significativas na função motora das crianças com PC de GMFCS níveis I/II e III/IV quando os dois grupos foram analisados conjuntamente para as duas mensurações quantitativas aplicadas. Na análise do estudo 1 e 2 separadamente, não encontramos resultados estatisticamente significativos, porém melhora de desempenho foi constatada na maior parte dos participantes dos dois grupos, sugerindo tendência a melhora. O treino de marcha em esteira favorece a melhora da função motora grossa em crianças com PC dos níveis I, II, III e IV.