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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
61

Desenvolvimento apendicular de lactentes nascidos a termo pequenos para a idade gestacional no primeiro semestre de vida / Fine motor development of full-term small for gestacional age infantis in the first semester of life

Arias, Amabile Vessoni 08 February 2006 (has links)
Orientador: Vanda Maria Gimenes Gonçalves / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-07T04:57:40Z (GMT). No. of bitstreams: 1 Arias_AmabileVessoni_M.pdf: 1671138 bytes, checksum: 357c2be1e2fe1e36f5c703c54e4dc57b (MD5) Previous issue date: 2006 / Resumo: O objetivo deste estudo foi avaliar e comparar o desenvolvimento apendicular no 1º, 2º, 3º e 6º meses de lactentes nascidos a termo, pequenos (PIG) ou adequados (AIG) para idade gestacional. O desenho foi de um estudo de corte seccional e de coorte longitudinal. Entre maio de 2000 a julho de 2003, foram selecionados 95 recém-nascidos no Serviço de Neonatologia Centro de Atenção Integral à Saúde da Mulher (Caism/Unicamp). Para cada neonato PIG, os dois neonatos AIG seguintes foram selecionados. O projeto foi aprovado pelo Comitê de Ética em Pesquisa. Foram critérios inclusão: residentes na região de Campinas; idade gestacional entre 37-41 semanas; peso de nascimento menor que percentil 10 para o grupo PIG ou entre percentis 10 e 90 para o grupo AIG. Foram excluídas as síndromes genéticas, malformações, infecções congênitas confirmadas e internados em UTIN. Utilizaram-se as Escalas Mental e Motora das ¿Bayley Scales of Infant Development-II¿. No estudo seccional, foram avaliados no 1º mês, 63 lactentes (18 PIG, 45 AIG); no 2º mês, 68 lactentes (25 PIG, 43 AIG); no 3º mês, 68 lactentes (22 PIG, 46 AIG) e no 6º mês, 67 lactentes (25 PIG, 42 AIG). No estudo longitudinal foram avaliados 28 lactentes (10 PIG, 18 AIG). No estudo seccional o peso ao nascimento foi significativamente menor no grupo PIG (p<0,001). Houve diferença entre os grupos quanto às mães com outra ocupação, 0,18 vezes mais associadas e grau de escolaridade materna menor que 8 anos, 3,71 vezes mais associada ao grupo PIG. O ¿Index Score¿ (IS) motor foi significativamente menor no grupo PIG no 2º mês (p=0,010). Houve diferença significativa para as provas: MO12 (tenta levar mão à boca, p=0,015) no 1º mês; ME35 (brinca com chocalho, p=0,024) e ME38 (estende mão em direção ao aro suspenso, p=0,022) no 3º mês. Houve diferença significativa para as provas avaliadas no 6º mês: ME59 (manipula sino com interesse nos detalhes, p=0,012); ME62 (puxa barbante para segurar aro, p=0,049). Houve tendência à diferença significativa para as provas MO06 (mãos cerradas maior parte do tempo, p=0,067) no 1º mês; MO31 (usa oponência parcial do polegar para apanhar cubo, p=0,077) e ME54 (transfere objetos de uma mão para outra, p=0,081) no 6º mês. No estudo longitudinal, a ¿performance¿ motora foi semelhante entre os grupos, contudo houve diferença significativa entre os meses (p=0,006) com maior freqüência de classificação inadequada no 3º mês. O IS motor foi significativamente menor no grupo PIG (p=0,039), com o menor IS no 3º mês (p=<0,000). Houve diferença significativa entre o 3º e 6º meses na prova MO29 (apanha bastão com toda a mão, p=<0,000), executada com maior freqüência no 6º mês por ambos os grupos. Houve tendência à diferença significativa entre o 2º e 3º meses na prova ME35 (brinca com chocalho, p=0,083) / Abstract: The objective of this study was to assess and to compare the fine motor development of infants in the 1st 2nd, 3rd and 6th months of full-term appropriate (AGA) or small-for-gestational age (SGA) infants. The research design was a prospective cross-sectional cohort study and a follow-up study. From May 2000 to July 2003, 95 full-term neonates were selected at Neonatology Service at the Center of Integral attention to Woman¿s Health (Caism/Unicamp). When a SGA neonate was chosen, the following two AGA neonates were selected. Ethical permission was obtained from the Research Ethics Committee of the Medical School at Unicamp. Inclusion criteria were: subjects living in Campinas; gestational age categorized as full-term (37-41 weeks); birth weight less than the 10th percentile for the SGA group and between the 10th and the 90th percentile for the AGA group. Genetic syndromes, multiple congenital malformations, verified congenital infections, the ones admitted at NICU. The Motor and Mental Scales of the Bayley Scales of Infant Development-II was used. The cross-sectional study evaluated in the 1st month, 63 infants (18 SGA, 45 AGA); in the 2nd month, 68 infants (25 SGA, 43 AGA); in the 3rd month, 68 infants (22 SGA, 46 AGA); in the 6th month, 67 (25 SGA, 42 AIG) infants. The longitudinal study evaluated 28 infants (10 SGA e 18 AGA). In the cross-sectional study the birth weight was significantly lower in the SGA group. There was significant difference between the mothers with another occupation, 0.18 times more associated and level of maternal education lower that 8 years, 3.71 times more associated with the SGA group. The motor index score (IS) was significantly lower in the SGA group in the 2nd month (p=0.010). There was significant difference in the items: MO12 (attempts to bring hands to mouth, p=0.015) in the 1st month; ME35 (plays with rattle, p=0.024) and ME38 (reaches for suspended ring, p=0.022) in the 3rd month. There was significant difference in the items in the 6th month: ME59 (manipulates bell, p=0.012); ME62 (pulls string adaptively to secure ring, p=0.049). There was a trend to significant difference in the items: MO06- (hands are fisted, p=0.067) in the 1st month; MO31 (uses partial thumb opposition to grasp cube, p=0.077) and ME54 (transfers object from hand, p=0.081) in the 6th month. In the longitudinal study the motor performance was similar between the groups, however there was significant difference among the months (p=0.006), with higher frequency of inadequate classification in the SGA group in the 3rd month. The motor IS was significantly lower in the SGA group (p=0.039), with the lowest motor IS in the 3rd month (p=<0.000). There was significant difference among the 3rd and 6th months in the item MO29 (uses whole hand to grasp rod, p=<0.000), with higher frequency in both groups, in the 6th month. There was a trend to significant difference among the 2nd and 3rd months in the item ME35 (plays with rattle, p=0.083) / Mestrado / Neurologia / Mestre em Ciências Médicas
62

Habilidade motora fundamental : analise comparativa entre situação laboratorial e "natural"

Isayama, Hélder Ferreira 07 April 1997 (has links)
Orientador: Jorge Sergio Perez Gallardo / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Educação Fisica / Made available in DSpace on 2018-07-22T02:25:33Z (GMT). No. of bitstreams: 1 Isayama_HelderFerreira_M.pdf: 3180019 bytes, checksum: 83310962b6c7af8b8646d17dd9e9c3e7 (MD5) Previous issue date: 1997 / Resumo: O objetivo deste estudo foi verificar se existe variação na execução dos padrões de movimento arremessar e receber em duas situações ambientais diferentes: situação laboratorial (onde ocorreu um maior controle das variáveis) e situação "natural" (próxima da situação que ocorre em aula de Educação Física). Os participantes deste estudo foram 28 crianças de ambos os sexos e com 4 anos de idade. As crianças em movimento foram filmadas realizando as duas habilidades motoras fundamentais - arremessar e receber - nas situações laboratorial e "natural". A análise dos dados foi auxiliada por uma TV e um vídeo cassete, que foram analisados de acordo com uma descrição adaptada do movimento apresentada por GALLAHUE (1989). Neste sentido, o arremessar foi dividido em três componentes: membros superiores; tronco e pernas/pés, o receber também foi dividido em três componentes: braços/antebraços; mãos e tronco/pernas/pés. A análise estatística (teste não paramétrico de Friedman) revelou diferenças significativas para dois componentes (tronco e pernas/pés) no arremessar e tronco/pernas para o receber. Em todos os casos em que foi verificada uma diferença significativa a performance na situação "natural" foi superior à situação laboratorial. Além dos resultados suportarem a influência da noção das restrições na realização do movimento, também indicam que precauções devem ocorrer quando resultados laboratoriais são aplicados às situações práticas de ensino da Educação Física / Abstract: The purpose of this study was to identify variations in the performance motor pattern of throwing and catching in two different enviromental conditions: laboratorial situation (where bigger control of variable was available) and natural situation (a situation near to that of a physical education class). The participants of this study were twenty eight children of both sex and with four years of age. The children were video taped while performing the two fundamental motor skills throwing and catching, in the laboratorial and natural situations. The data was analyzed through a TV and video cassette, following an adapted desscription of the skill proposed by GALLAHUE (1989). The throwing and the catching were divided in three components: superior limb, trunk and legs/feet and arm/forearm, hand and trunkllegs/feet, respectively. The statistical analysis (Friedman's non-parametric test) showed statisticaliy significant differences for two throwing components (trunk and legs/feet) and trunkllegs/feet for catching. In all the cases in that a significant difference was identify, performance in the "natural" condition was superior than laboratorial condition. Further the results supported the influence of the constraints notion in the skills execution and they showed that precautions must happen when laboratorial results are applied to the practical situations of physical education teaching / Mestrado / Educação Motora / Mestre em Educação Física
63

Implications fonctionnelles de la tVTA dans le contrôle des systèmes dopaminergiques mésencéphaliques / Functional implications of the tVTA in the control of mesencephalic dopamine systems

Bourdy, Romain 28 May 2015 (has links)
La queue de l'aire tegmentale ventrale (tVTA) est une région cérébrale GABAergique localisée en arrière de la VTA. Elle projette de façon massive aux neurones dopaminergiques des groupes A9 et A10 du mésencéphale à l'origine des systèmes nigrostrié et mésolimbique. Ces systèmes sont impliqués dans de nombreuses fonctions comme la motricité et les comportements associés aux drogues. L'objectif de ma thèse est d'étudier le rôle de la tVTA via ses projections sur ces systèmes. Pour cela, nous avons utilisé des approches variées comprenant l'immunohistochimie, la pharmacologie in vivo,l'électrophysiologie in vivo et l'étude du comportement moteur. Parmi un ensemble de drogues appartenant à différentes classes, l'activation moléculaire de la tVTA sous forme de l'induction de FosB/ΔFosB est spécifique des psychostimulants et dépend de la dopamine. D'un point de vue physiologique, la tVTA exerce un tonus inhibiteur sur les neurones dopaminergiques de la VTA et joue un rôle crucial dans leur désinhibition par la morphine. Enfin, des lésions de la tVTA influencent des comportements dépendant du système nigrostrié comme le comportement de rotation provoqué par l'amphétamine, les performances motrices et l'apprentissage moteur. / The tail of the ventral tegmenta area (tVTA) is a GABAergic brain region located behind the VTA. It projects massively to dopaminergic neurons in mesencephalic A9 and A10 groups leading to nigrostriatal and mesolimbic systems that play a role in fonctions like motricity and drug-related behaviours. The objective of my thesis is to study the tVTA role through its projections to these systems. For that, we used various approaches including immunohistochemistry, in vivo pharmacology, in vivo electrophysiology, and motor behaviour. Between various drugs belonging to different classes, molecular activation of the tVTA by FosB/ΔFosB induction is only observed following psychostimulant treatment and is mediated by dopamine. From a physiological point of view, the tVTA exerts an inhibitory tone onto VTA dopamine neurons and plays a crucial role in morphine-induced desinhibition. Finally, tVTA lesions modulate nigrostriatal system mediated behaviour like amphetamine-induced rotational behaviour, motor coordination and motor skill learning.
64

Vztah mezi úrovní motorických dovedností, tělesnou zdatností a tělesným složením u dětí ve věku 4 let / Relation between motor skills, physical fitness and body composition in preschoolers age 4

Jonáš, Michal January 2020 (has links)
Title: Relation between motor skills, physical fitness and body composition in preschoolers age 4. Objectives: The aim of this thesis is to determinate if there are any significant relationships between motor skills, physical fitness and body composition in preschool age. Furthermore, to determine the degree of these relationships and their stability over time using repeated measures. Methods: The research group consisted of n=17 preschool-age children. For the evaluation of body composition we used the method according to Matiegka (1921) The level of gross motor skills was assessed with a TGMD-2 (Ulrich, 2000). To determine the level of physical fitness, a combination of agility test 4x5 metre, multistage 20-metre shuttle run, standing long jump, sit-ups, sit-and-reach and throw ball with alternative hands. Basic descriptive statistics, normality tests, Pearson correlation, paired T-test and regression analysis with level of clinical significance were used to analyze obtained data. Results: The results of our study did not find any clinically significant relationships between the level of motor skills, physical fitness and body composition. The largest relationship was found between the 4x5 m agility test and the jump within TGMD- 2 (r = -0.68). We found the highest stability (reliability) in the...
65

A Study to Examine the Effects of Resistance Training on Motor Function, Cognitive Performance, Physical Strength, Body Composition, and Mood in Adults with Down Syndrome.

Phillips, Emily Marie 25 September 2020 (has links)
No description available.
66

Barns motorik och fysiska aktivitet - viktiga faktorer för att lyckas i skolan : En studie om grovmotorikens olika påverkan på elever

Josefsson, Anton January 2018 (has links)
Barn och vuxna blir allt mindre fysiskt aktiva medborgare vilket i sin tur leder till att hälsan påverkas negativt. Genom att utveckla barn och ungas grovmotoriska förmåga ökas deras fysiska aktivitet vilket i sin tur leder till en bättre hälsa. Forskare visar att idrottslärare har en viktig roll då deras didaktiska kunskaper ger ökad chans till motorisk utveckling hos eleverna och att skolan är en optimal plattform för utvecklingen då många elever endast utövar fysiska aktiviteter i just skolan. Genom mina studier i ämnet idrott och hälsa har jag valt att skriva denna litteraturstudien i just ämnet idrott och hälsa. Litteraturstudien är indelad i tre frågeställningar där den första belyser hur grovmotorik påverkar barn och ungas fysiska förmåga/aktivitet, den andra hur grov motorisk träning/förmåga påverkar elevers skolprestationer och den sista hur den fysiska aktivitetens och motoriska förmågan påverkar elevers självbild. Studien är baserad på elva vetenskapliga artiklar som alla undersökt sambandet mellan grov motorisk förmåga och fysisk aktivitet och dess påverkan på elever på olika sätt. Resultaten visar att en förbättrad grov motorisk förmåga ökar mängden fysisk aktivitet hos barn och unga och att en god grovmotorik kan påverkaelevers skolprestationer positivt. Resultaten visar även att elever med god grovmotorik blir mer socialt accepterade av sina klasskamrater vilket ger en bättre självbild. Det främsta resultatet som framkommit av litteraturstudien är att barn och unga som besitter en god motorisk förmåga kommer tenderar att bli mer fysiskt aktiva än ett barn med sämre motorisk förmåga, barnet kommer även ha en större chans att få ett mer fysiskt aktivt liv.
67

Developmental co-ordination disorder in pre-school children : Effects of motor skill intervention, parents' descriptions, and short-term follow-up of motor status

Pless, Mia January 2001 (has links)
This investigation was undertaken to examine effects of motor skill intervention in children with motor difficulties consistent with developmental co-ordination disorder (DCD) diagnosed in child health care before school entrance, to analyse the parents' descriptions of their children, and to follow up the children's motor status in a short-term perspective. Thirteen studies on the effects of motor skill intervention were submitted to a meta-analysis (Study I). Thirty-seven children who at age 5 to 6 years were diagnosed as having motor difficulties consistent with DCD were enrolled in an experimental investigation of effects of group motor skill intervention on motor skills (Study II) and on self-perceived competence (Study III). The parents' descriptions of their children were obtained at an interview (Study IV). The children's motor status was re-examined when they were 7 to 8 years old (Study V). Motor skill intervention, using the Specific Skills approach, in a group setting or in a home programme, 3 to 5 times per week, was found beneficial for children with DCD who were older than 5 years of age. The non-specific group motor skill intervention influenced the number of children with borderline motor difficulties who changed to having no motor difficulties, and seemed to enhance awareness of motor competence. Parents whose children had definite motor difficulties were more inclined to support their children in physical activity, and reported worry and uncertainty. The children had not changed their motor status at the age of 7 to 8 years. The children with definite motor difficulties, in particular, continued to have these difficulties. Children who when 5 to 6 years old have motor difficulties and who score at the 5th percentile or below at the Movement ABC motor test, seem to need active support in joyful motor learning situations to reduce unwillingness and displeasure.
68

Perfil motor de escolares com Transtorno de Déficit de Atenção com Hiperatividade

Oliveira, Cristina Camargo de 07 February 2014 (has links)
Made available in DSpace on 2016-06-02T20:44:14Z (GMT). No. of bitstreams: 1 5808.pdf: 1446230 bytes, checksum: a10d89d03f3e47cfd1287dcb554233b9 (MD5) Previous issue date: 2014-02-07 / Financiadora de Estudos e Projetos / This study aimed to identify the motor profile of students with interdisciplinary diagnosis of Attention Deficit Disorder with Hyperactivity (ADHD), and compare with students with good academic performance, and to verify the incidence of Developmental Coordination Disorder in this study population. A total of 46 students participated in the study, males and females, with ages ranging from 7 to 10 years and 11 months, attending from 1st to 5th year of elementary education at public schools in cities of São Paulo state. The students were divided into two groups: Group I (GI) included 23 students with Attention Deficit Disorder with Hyperactivity; Group II (GII) included 23 students with good academic performance, paired according to gender and age group with GI group. Groups experienced motor assessment (Movement Assessment Battery for Children - Second Edition (Movement ABC - 2). MABC Test consisted of eight items grouped into three sections (manual dexterity, target and precision, and balance), parents / guardians responded to DCDQ questionnaire - Brazil, which contains 25 questions about the motor behavior of the child, and the Economic Classification questionnaire. The results were statistically analyzed in order to characterize and compare the motor profile of the students, intra and intergroup. The results showed that some of the students in GI presented indicative of Developmental Coordination Disorder, whereas in GII, none of the students presented indicative of Developmental Coordination Disorder. However, it is possible to stand out an incidence of Developmental Coordination Disorder in the population with Attention Deficit Disorder with Hyperactivity in about 43%. These findings will hopefully contribute to the knowledge about students with ADHD, helping to guide actions to assist this population by teachers, health professionals, and family. / Este estudo teve por objetivos identificar o perfil motor de escolares com diagnóstico interdisciplinar de Transtorno do Déficit de Atenção com Hiperatividade (TDAH), comparar com os escolares com bom desempenho acadêmico e verificar a incidência de Transtorno do Desenvolvimento da Coordenação na população deste estudo. Participaram 46 escolares, de ambos os gêneros, na faixa etária de 7 a 10 anos e 11 meses de idade, que frequentam do 1º ao 5º ano do ensino fundamental de escolas públicas municipais de cidades do interior de São Paulo. Os escolares foram distribuídos em dois grupos: Grupo I (GI) - composto por 23 escolares, com diagnósticos multidisciplinares de Transtorno do Déficit de Atenção com Hiperatividade, em uso regular de medicação; Grupo II (GII): composto por 23 escolares com bom desempenho acadêmico, apresentando notas iguais ou superiores a 8,0 no boletim escolar e observações pertinentes realizadas pelas professoras em relação a cada escolar. Os escolares foram pareados segundo gênero e faixa etária. Os grupos passaram por avaliação motora (Movement Assessment Battery for Children - Second Edition (Movement ABC-2). O Teste MABC é composto por oito itens, agrupados em três seções (destreza manual, alvo e precisão e equilíbrio), os pais/responsáveis responderam ao Questionário DCDQ-Brasil, composto por 25 questões sobre o comportamento motor da criança, e ao Questionário de Classificação Econômica, para fins de pareamentos dos grupos. Os resultados foram analisados estatisticamente visando à caracterização e comparação intra e intergrupos do perfil motor dos escolares. Os resultados mostraram que no GI, que é o grupo composto por escolares com Transtorno do Déficit de Atenção com Hiperatividade, estão presentes alguns escolares com indicativo de Transtorno do Desenvolvimento da Coordenação, sendo a Habilidade do Equilíbrio a mais acometida; No GII, que são escolares com bom desempenho acadêmico, não foram encontrados escolares com indicativo de Transtorno do Desenvolvimento da Coordenação. Portanto é possível destacar uma incidência de Transtorno do Desenvolvimento da Coordenação na população com Transtorno do Déficit de Atenção com Hiperatividade, em aproximadamente 43%. Espera-se que esses resultados contribuam com o conhecimento dos escolares com TDAH, colaborando para a orientação de ações voltadas ao atendimento e diagnóstico precoce desta população pelos professores e profissionais da saúde, objetivando uma melhora na qualidade de vida dessas crianças e familiares envolvidos.
69

Motoriska och kommunikativa utvecklingsavvikelser. : Barnhälsovårdssjuksköterskans bedömning, åtgärder och förutsättningar - en kvalitativ intervjustudie.

Johansson, Josefin, Henriksson, Emma January 2018 (has links)
Bakgrund: Det förekommer skillnader avseende hur barnhälsovårdssjuksköterskor identifierar utvecklingsavvikelser, och det har sedan länge efterfrågats evidensbaserade, standardiserade metoder för upptäckt av kommunikativa och motoriska utvecklingsavvikelser. Syfte: Att undersöka hur motoriska och eller kommunikativa utvecklingsavvikelser för barn upp till och med 18 månader uppmärksammas inom barnhälsovården, vilka förutsättningar det finns för bedömningen, samt vilka åtgärder som vidtas vid utvecklingsavvikelser. Metod: En beskrivande kvalitativ studie baserad på individuella semi-strukturerade intervjuer med 12 barnhälsovårdssjuksköterskor som arbetade på barnavårdscentraler inom Region Uppsala genomfördes. Materialet har analyserats utifrån Malteruds analysmetod systematisk textkondensering. Resultat: Barnhälsovårdsjuksköterskorna använde klinisk blick, vilken de utvecklat genom erfarenhet, när de bedömde barns utveckling. Den kliniska undersökningen beskrevs i termer av att erhålla en helhetsbild av barnet, samt att den motoriska och kommunikativa utvecklingen hör samman, och bedömdes i denna helhet. Kontinuiteten beskrevs som betydelsefull och något som underlättade bedömningen av barnets utveckling. Ett kollegialt stöd beskrevs som värdefullt, och vid utvecklingsavvikelser kunde barnhälsovårdssjuksköterskorna konsultera varandra. Vid misstanke om utvecklingsförsening följdes barnet upp, samt fick ofta uppgifter att öva på till återbesöket. I de fall utvecklingsavvikelsen kvarstod eller då det handlade om en tydlig avvikelse remitterades barnet vidare. I analysen framkom att det fanns individuella skillnader i barnhälsovårdsjuksköterskornas bedömning. Slutsats: Dagens riktlinjer med fokus på milstolpar kan försvåra barnhälsovårdssjuksköterskans utvecklingsbedömning för barn upp till och med 18 månader. En standardisering, eller ett screeninginstrument för att tydliggöra bedömningarna bidrar till en jämlik och rättvis barnhälsovård. Tidig upptäckt och tidiga insatser har stor betydelse för barnets framtida utveckling. / Background: There are differences in how Child health nurses identify developmental disorders. Furthermore, it has been requested evidence-based methods for detection of communicative- and motor disorders. Aim: Investigate how motor and communicative disorders for children up to, and including 18 months, are noted in Child health centres. Also, the basis for the assessment, what measures are taken in case of developmental disorders, and if there are any differences in the assessments. Method: Descriptive qualitative interview study, based on individual semi-structured interviews, with 12 Child health nurses working at Child health centres in Uppsala Region. The transcriptions were analysed with systematic text condensation by Malterud. Result: Child health nurses used intuition when assessing children's development, which they had procured through experience. The clinical examination was described as getting a general picture of the child. The motor and communication development was assessed in whole, due to their related. Continuity was described as meaningful and something that facilitated the assessment of the child. Collegial support was valuable, and the Child health nurses could consult each other, in case of developmental disorders. If the Child health nurses suspected development delay, the child was followed up. The family then often got exercises to practice before the re-visit. In cases where the developmental delay remained, or when the disorder was obvious, the child was referral further. The analysis found that there were individual differences in the assessment done by Child health nurses. Conclusions: Today's guidelines focusing on milestones can aggravate the Child health nurse's developmental assessment of children up to and including 18 months. A standardized method, or a screening tool, contributes to an equal and fair Child healthcare. Early detection and early intervention are of great importance to the child's future development.
70

Efeito do treino de curta duração no alcance manual de lactentes a termo e suas implicações clínicas

Cunha, Andréa Baraldi 28 July 2014 (has links)
Made available in DSpace on 2016-06-02T20:18:23Z (GMT). No. of bitstreams: 1 6299.pdf: 2851436 bytes, checksum: 9d659b48fa80510421dc851a948edff4 (MD5) Previous issue date: 2014-07-28 / Universidade Federal de Minas Gerais / Objectives: Part I) To verify the effect of short-term training on reaching behavior in fullterm infants at the onset of reaching. Part II) To know the behavior of reaching, the reaching training protocols in full-term and preterm infants and to adjust these training for children with cerebral palsy (CP). Methods: In Part I, it was conducted a randomized controlled trial. 30 healthy infants at 3-4 months of age (M =14.0 ±1.6 weeks of age) were randomly assigned to: 1) reaching training group; 2) social training group (control group). The infants were submitted into 3 assessments (kinematics and qualitative) at 45° reclined position (until 5 days after the onset of reaching): 1) Pre-training, before the first session of training; 2) Post-training 1, after the first session of training, at the same day; and 3) Posttraining 2, after three sessions of training, at the following day. To perform the reaching training and social training, the infants were submitted into three short-term sessions of training, one performed on the first day and the two performed on the second day. All infants were seated reclined 45° in the researcher s lap. The infants of training group received three activities of interaction with the object under serial practice (i.e.: ABC, ABC, ABC) in each session. The infants of social group received no reaching training or stimuli for their upper limbs of each session. The variables considered were: characterizing the sample, the total reaching frequency, distal adjustments (hand orientation, hand opening, and surface of the hand contact), and spatio-temporal variables (duration of movement, mean velocity, straightness index, deceleration index, and movement unit). In Part II, we performed a literature review on: the reaching behavior in infants with typical developmental, preterm infants and infants with CP from 0 to 2 years of age; the main techniques of reaching assessment; models of reaching training protocols (immediate and short-term effects) developed for full-term and preterm infants and; on a way of adjusting reaching training for children with CP in clinical practice. Results: In Part I, a training session was effective in increasing the number of reaches and the percentage of reaches with ventral hand, and decreasing the percentage of reaches with closed and dorsal hand. In addition, three training sessions resulted in changes in the spatio-temporal variables (with shorter and more fluent reachs) and increased the percentage of reaches with vertical hand. For Part II, it was highlighted the importance of determining immediate, short, medium and long term goals, planning the therapeutic procedures directed to the goals. In addition, to use and adapt existing training protocols to intervene in infants at risk and / or diagnosis of CP, and others. Conclusions: A few short training sessions under serial varied condiction were effective in improving the reaching performance, such as changes in the number of reaches, in distal adjustments and spatio-temporal reaching variables. These results reflect the flexibility of the perceptual-motor skills development and the important role of experience in the improvement of motor behavior in infants. Furthermore, to direct the interventions to the functional objectives and, to use and adapt existing training protocols, may provide to the professionals one more tool of intervention in infants at risk and / or established diagnosis of CP. / Objetivos: Parte I) Verificar o efeito do treino de curta duração de alcance em lactentes nascidos a termo no período de aquisição da habilidade. Parte II) Conhecer o comportamento de alcance, protocolos de treino de alcance em lactentes a termo e prétermo e; ajustar esses protocolos de treino de alcance para crianças com paralisia cerebral (PC). Métodos: Na Parte I, foi realizado um estudo randomizado controlado, com 30 lactentes a termo, de 3-4 meses de idade (M= 14,0±1.6 semanas de idade), alocados em dois grupos: 1) grupo de treino de alcance, 2) grupo de treino social (grupo controle). Os lactentes foram submetidos à três avaliações (cinemática e qualitativa) na postura reclinada a 45° (até 5 dias após aquisição do alcance): 1) pré-treino, antes da primeira sessão de treino; 2) pós-treino 1, após a primeira sessão de treino, no mesmo dia e; 3) póstreino 2: após a terceira sessão de treino, no dia seguinte ao pré- e pós-treino 1. Para realizar o treino de alcance e o treino social, os lactentes foram submetidos à três sessões, uma realizada no primeiro dia, e duas realizadas no segundo dia. Todos os lactentes foram posicionados no colo do pesquisador em reclinado a aproximadamente 45°. O grupo de treino de alcance recebeu 3 atividades de interação com objeto em condição de prática variada seriada (ex: ABC, ABC, ABC) em cada sessão e o grupo treino social não recebeu estímulos em seus membros superiores em cada sessão. Foram consideradas variáveis de caracterização da amostra, frequência total de alcances, ajustes distais (orientação, abertura e superfície de contato das mãos) e variáveis espaço-temporais (duração do movimento, velocidade média, índice de retidão, índice de desaceleração e unidades de movimento). Na Parte II, realizou-se um revisão da literatura existente sobre: o comportamento do alcance em lactentes com desenvolvimento neurossensoriomotor típico, nascidos prematuros e com PC de 0 a 2 anos de idade; as principais técnicas de avaliação do alcance; os modelos de protocolos de treino de alcance, de efeitos imediatos e de curto prazo, desenvolvidos com lactentes a termo e pré-termos e; formas de como ajustar treinos de alcance para crianças com PC na prática clínica. Resultados: Para Parte I, uma sessão de treino foi eficaz em aumentar o número de alcances e a porcentagem de alcances com mão orientada ventralmente e diminuir a porcentagem de alcances com a mão fechada e dorsal. Além disso, três sessões de treino resultaram em mudanças nas variáveis espaço-temporais (alcances com menor duração e mais fluentes) e maior porcentagem de alcances com a mão orientada verticalmente. Para a Parte II, destaca-se a importância de traçar objetivos imediatos, de curto, médio e longo prazo, planejando as condutas terapêuticas de forma direcionada aos objetivos. Além de utilizar e adaptar os protocolos de treino (efeitos imediatos e de curto prazo) existentes para intervir em bebês com risco e/ou diagnóstico estabelecido de PC, entre outras alterações neurossensoriomotoras. Conclusões: Sessões de curta duração em condição de prática variada seriada foram efetivas em aprimorar o desempenho do alcance, como mudanças no número de alcances, nos ajustes distais e nas variáveis espaço-temporais do alcance. Esses resultados refletem a flexibilidade do desenvolvimento de habilidades percepto-motoras e o importante papel da experiência no aprimoramento do comportamento motor de lactentes. Além disso, direcionar as intervenções aos objetivos funcionais e; utilizar e adaptar os protocolos de treino existentes, podem fornecer à profissionais mais uma ferramenta para intervir em bebês com risco e/ou diagnóstico estabelecido de PC.

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