The purpose of this design and development research was to investigate whether the ADDIE model can be used to design online modules that teach psychomotor skills. The overarching research question was: How can the ADDIE Model of Instructional Design be used to create an online module that teaches safe and effective movement for psychomotor skills? To examine the research question, an online strength program focusing on correct technique was designed and developed. The design phase involved creating storyboards and scripts for the development phase. The development phase involved creating videos, still, audio, and slides that were put together to form instructional sequences for each movement. A website was designed to accommodate the requirements of the course and all the instructional materials were uploaded to the website. This program was implemented using college students with no health problems. Each participant was assigned to either single joint movements or multiple joint movements. They recorded themselves pre and post instruction. Strength and conditioning interns overseen by a subject matter expert and a strength and conditioning enthusiast scored these videos. The results of the implementation revealed that both beginners and advanced learners made improvements to their movements. It was concluded from the results that it was possible to teach correct movement online and that designers need to be aware of the interaction between type of learner and the specific movements rather than the type of movement. Major themes that emerged were they were unsure if they were completing the movement correctly and preferred having a coach present to provide feedback, and several participants had trouble transferring the theory into practice. Problems the reviewers had were that the videos were difficult to score due to camera angles and some issues with the rubrics. An analysis of the review process revealed there were problems with the consistency and reliability of the scoring. An overall answer to the overarching research question was that it is possible to use the ADDIE model to create successful online instruction for strength movements. It was necessary to created guidelines for designers to follow when developing online psychomotor skills courses. / Ph. D.

The purpose of this study was to investigate the effects of web-based instruction (WBI) on cognitive and psychomotor learning. The subjects of the study received two types of instructional methods, WBI (experimental group) and traditional classroom instruction (control group). Each group received 30 minutes of instruction on "Soldering a Circuit Board." The researcher chose this content subject because it involved both cognitive and psychomotor objectives, which suited the purpose of this study. It was hypothesized that there would be no significant difference between the two methods of instruction, and also that there would be no significant interaction effects between methods of instruction and gender. Forty-six subjects from a population of students enrolled in summer classes offered by the Applied Technology, Training and Development (ATTD) program at the University of North Texas voluntarily participated in this study. Random assignment of subjects was applied in this study. A subject matter expert delivered the content for both the experimental and control groups. To measure cognitive variable, a 10 item, multiple-choice test was administered immediately after instruction. To measure the psychomotor variable, a 15-item checklist was utilized by trained judges to evaluate learners’ performances while soldering. The 2 x 2 factorial model with interaction was used in this study. The analysis was run for each of the dependent variables, cognitive and psychomotor learning. Although there was not a statistically significant difference in the main effects of method of instruction or interaction effects between method and gender, the results imply that students in the traditional-classroom instruction group performed better than those in the WBI group in psychomotor learning. Perhaps, this trend would be statistically significant if the sample size were larger. This study provides empirical evidence for the effectiveness of WBI in delivering cognitive and psychomotor objectives. The outcome of this study supports the need for more research on the effects of WBI on learning domains.

This master thesis introduces the issue of individual concepts that affect the psychological and motor processes, occurring at people with physical disabilities. It addresses the definition of the basic concepts within both historical and present context. The thesis considers what kind of connection and relationships exist behind the failures of the body scheme and the human psyche, and in greater detail deals with methods that work to improve the quality of life for a person with a physical disability. The research part establishes the situation of comprehensive rehabilitation in the Czech Republic. It is developed according to the preliminary areas: lifelong learning, the status of the comprehensive rehabilitation and procedures used in caring for a person with a physical disability. KEYWORDS: physical disability, therapeutic methods, psychomotor, neuromotor, lifelong learning, comprehensive rehabilitation.

The diploma thesis is focused on the concept of the psychomotor development in context of remaining primary reflexes in children. The author draws on the knowledge of developmental psychology and neurophysiology that some of developmentally earlier stages must under optimal circumstances and maturation of a child disappear and be replaced by ontogenetically newer forms. Research confirms continuity of persistent primary reflexes, psychomotor development and learning and behavioral problems. The thesis aims to investigate whether inhibition of primary reflexes using Neuro-developmental therapy improves the condition of children with delayed psychomotor development, including their school grades. The author in the introductory chapters focusses on normal psychomotor development of children, in particular gross motor skills, fine motor skills, sensory skills, including proprioception and kinesthesia and their importance for learning ability in school age. The next part of the thesis is focused on particular primary reflexes and their impact on psychomotor development. The author pays special attention to the climbing stage in infancy which she considers as an important milestone in the optimal psychomotor development. Case studies shows, that skipping any developmental stage can be considered as a...

Le rétinoblastome est une tumeur rare qui touche la rétine du jeune enfant. L’inactivation bi-allélique du gène RB1 est à l’origine du développement tumoral. RB1 est le premier gène suppresseur de tumeur qui ait été identifié et la prédisposition au rétinoblastome constitue un véritable paradigme de la prédisposition aux cancers. Dans les formes non prédisposées génétiquement, les deux mutations apparaissent dans une cellule rétinienne unique ; le rétinoblastome est alors unilatéral. Dans les formes à prédisposition génétique, la première mutation est constitutionnelle et la deuxième est somatique. La mutation constitutionnelle est une néo-mutation pré- ou post- zygotique dans les formes sporadiques, alors qu’elle est héritée dans les formes familiales. Dans les formes avec prédisposition génétique, le diagnostic est plus précoce que dans les formes sans prédisposition et la bilatérisation du rétinoblastome est généralement la règle. Néanmoins, de rares familles présentent une pénétrance réduite et une variabilité phénotypique se traduisant par la coexistence de patients atteints de rétinoblastome bilatéral ou unilatéral, d’apparentés porteurs sains et d’apparentés présentant des rétinomes. Les mécanismes responsables de la variabilité phénotypique intrafamiliale sont inconnus et l’existence de facteurs génétiques modulant le phénotype tumoral est probable.L’origine de la variabilité de l’expression phénotypique du rétinoblastome peut être la résultante (i) de l’existence de mutations en mosaïque, (ii) de mutations de RB1 et (iii) de facteurs modificateurs génétiques indépendants du locus de RB1. Trois axes distincts et originaux basés sur ces origines possibles de variabilité phénotypique ont été développés pour caractériser les relations génotype/phénotype dans le rétinoblastome. Premièrement, les conséquences d’une mosaïque somatique ont été illustrées grâce à l’étude d’une famille ayant bénéficié de cinq diagnostics prénatals. Dans ces familles, certains fœtus porteurs de l’allèle à risque identifié par une approche indirecte basée sur l’étude de microsatellites au locus de RB1, n’étaient pas porteurs de la mutation du parent atteint, lui-même atteint d’un rétinoblastome bilatéral. Ainsi, nous avons démontré la présence d’une mosaïque somatique et gonadique chez ce parent lourdement atteint. La conséquence de l’existence de patients présentant une mosaïque dans le cadre du conseil génétique a été discutée. La suite de nos travaux a pris en compte ces résultats afin de limiter les biais que pourrait induire la présence de mutations en mosaïque dans des études de corrélation génotype/phénotype dans le rétinoblastome. Deuxièmement, l’association de grandes délétions emportant RB1 avec des retards psychomoteurs chez des patients atteints de rétinoblastome a été étudiée. Une approche de CGH hautement résolutive, ciblée sur le locus de RB1, a été mise en place afin de caractériser le rôle des gènes contigus de RB1 dans ce syndrome. Ainsi, cette approche a permis de définir une zone à risque de retard psychomoteur que nous proposons comme seuil d’alerte pour le généticien. Cette zone définit un gène, PCDH8 d’expression cérébrale exclusive, comme un excellent candidat au retard psychomoteur. Enfin, troisièmement, une approche « gène candidat » reposant sur l’étude du SNP309 du promoteur de MDM2, a été mise en œuvre. / Retinoblastoma is the most common intraocular childhood cancer and occurs when both alleles of the RB1 gene are inactivated in the retina. In patients without genetic predisposition, the two mutations occurred in a single unique retinal cell. In subjects with a genetic predisposition to retinoblastoma, the first RB1 mutation is found in the germline and the second appears as a somatic mutation. Germline carriers usually develop bilateral or multifocal tumors and the diagnosis is earlier. However, some rare families exhibit low penetrance and variable expressivity of the disease because bilaterally affected, unilaterally affected, and unaffected mutation carriers are known to coexist. The existence of genetic modifiers in retinoblastoma therefore appears highly probable and must be considered. The lack of penetrance and the variable expressivity could be the sum of three independent causes. The presence of a mosaic can affect the phenotype, the nature of the mutation can drive low penetrance and particular phenotype like psychomotor delay in case of large genomic deletions and genetic modifier factors could modulate the phenotype. These three major keys have been studied in order to highlight the relations between the phenotype and the genotype. Firstly, the consequences of mosaicism have been illustrated by a prenatal diagnosis concerning a couple with a bilateral retinoblastoma-affected male patient who requested five successive prenatal diagnoses and in whom RB1 mutation mosaicism had important implications. Implications of mosaicism in genetic counseling have been discussed and taken into consideration in order to limit bias in the two following genotype/phenotype studies. Secondly, the association between whole germline monoallelic deletions of the RB1 gene and psychomotor delay was studied by a high-resolution CGH array focusing on RB1 and its flanking region. Comparative analysis detected a four megabase critical interval including a candidate gene, protocadherin 8 (PCDH8). PCDH8 is thought to function in signaling pathways and cell adhesion in a central nervous system-specific manner, making loss of PCDH8 one of the probable causes of psychomotor delay in RB1-deleted patients. Thirdly, a candidate gene approach based on partners that are necessary for the development of the tumor attempted to find possible genetic modifiers. MDM2, which increases p53 and pRB catabolism, was therefore a prominent candidate. The minor allele of MDM2 that includes a 309T>G transversion (SNP rs2279744) in the MDM2 promoter is known to enhance MDM2 expression. In family-based association analyses performed in 70 retinoblastoma families, the MDM2 309G allele was found to be statistically significantly associated with incidence of bilateral or unilateral retinoblastoma among members of retinoblastoma families under a recessive model (Z = 3.305, two-sided exact P = .001). The strong association of this genotype with retinoblastoma development designates MDM2 as the first modifier gene to be identified among retinoblastoma patients

O corpo caloso é a maior comissura cerebral, responsável pela conexão entre os hemisférios cerebrais. Anatomicamente está localizado na profundidade da fissura inter-hemisférica e é dividido em quatro regiões: esplênio, corpo, joelho e rostro, que se continua inferiormente na lamina rostralis. A malformação do corpo caloso (MCC) representa uma desorganização na arquitetura cerebral, resultante da impossibilidade parcial ou completa das fibras da comissura calosa atravessarem a linha média. Pode estar associada a outras malformações, tanto do sistema nervoso central quanto de outros órgãos. As causas de malformações do corpo caloso são múltiplas, podendo ser ambientais, vasculares ou genéticas. As malformações do corpo caloso são comuns, principalmente entre as crianças com distúrbio do desenvolvimento neuropsicomotor ou retardo mental, mas podem também ser observada em indivíduos normais. Existem mais de 50 síndromes clínicas, autossômicas ou ligadas ao X, dominantes ou recessivas, associadas a MCC. A investigação de pacientes com malformação de corpo caloso por meio do cariótipo com bandas G identificou cerca de 20 regiões cromossômicas associadas a esta malformação. Nos últimos anos, novas técnicas de investigação cromossômica com alta resolução tornam-se disponíveis, como a hibridação comparativa do genoma em microarranjos (CGH-array). O CGH-array permite uma análise rápida de todo o genoma em alta resolução, possibilitando reconhecer variações no número de cópias de regiões genômicas com de 0,1 a 1 Mb, e desta forma detectar microdeleções ou microduplicações que não são passiveis de serem reconhecidas pelo cariótipo com bandas G, que é capaz de detectar alterações com no mínimo 4 Mb. Nesta investigação foram incluídos 21 sujeitos com MCC, associada ou não a outras malformações encefálicas ou de outros órgãos, e atraso do desenvolvimento neuropsicomotor ou retardo mental, sem etiologia definida. Estes sujeitos foram investigados com o objetivo de detectar anormalidades cromossômicas, estruturais e/ou numéricas, por meio do cariótipo com bandas G, e de variações do número de cópias de regiões genômicas, por meio do estudo com CGH-array. O cariótipo evidenciou alteração em dois dos sujeitos (9.5%): um indivíduo apresentava um derivado do cromossomo 4 [46, XX, der(4)] herdado da mãe, que apresentava translocação balanceada entre os cromossomos 4 e 10 [46, XX,t(4; 10)(q35; q23)]; e outro apresentava um rearranjo de novo, derivado do cromossomo 8, [46, XX, der(8)]. O CGH-array foi feito nestes indivíduos para delimitar a extensão e a origem do material genético presente no rearranjo. Em dois indivíduos (11%), o CGH-array evidenciou alterações cromossômicas de novo: deleção em 6q25.1-25.3, com dimensão entre 5 e 6,7 Mb, e deleção 4q25-q28.1 com 14,5 Mb. E finalmente, em quatro sujeitos (21%), o CGH-array detectou variação no número de cópias genômicas, evidente também em um dos genitores, com significado clínico incerto. Desta forma, a investigação de alterações cromossômicas nesta amostra de 21 pacientes com MCC, permitiu: (1). Diagnosticar, com o auxílio do cariótipo, anormalidades estruturais cromossômicas em dois casos; (2). Diagnosticar, com o auxílio do CGH-array, microdeleções não visualizáveis ao cariótipo em dois pacientes; (3). Caracterizar, com o auxílio do CGH-array, a extensão e origem dos rearranjos diagnosticados pelo cariótipo. A existência de translocação equilibrada em genitor de um dos pacientes com cariótipo anormal aumenta o risco de recorrência, de anormalidades, em outras gestações. Nos demais três pacientes, este risco é considerado muito baixo. Duas das alterações cromossômicas encontradas em nossos pacientes, a deleção na região 6q25.1-25.3 e a duplicação invertida no cromossomo 8 na região p23.1 - p11.21, já foram previamente descritas em MCC. Porém não há descrições envolvendo a deleção 4q25-q28 ou a deleção 4q34.3-q35.2 combinada com a duplicação 10q 23.1 - q23.6. A investigação de alterações cromossômicas em indivíduos com MCC contribui para o esclarecimento de sua etiologia e auxilia no delineamento de regiões cromossômicas que contém genes envolvidos com a formação do corpo caloso / The corpus callosum is the largest cerebral commissure and is responsible for interconnection of cerebral hemispheres. It is located in the deepest part of the interhemispheral fissure and is divided in four regions: splenium, body, genum and rostrum, which is prolonged inferiorly as lamina rostralis. Corpus callosum malformation (CCM) is a cerebral architecture disorganization caused by complete or partial failure of callosum fibers to cross the midline. It may be associated to other malformations, both from central nervous system and other organs. Many factors can contribute do CCM, including environmental, vascular and genetics. CCM are particularly common among mentally retarded or developmentally delayed children but can also be observed in cognitively normal individuals. There are more than 50 clinical syndromes associated to CCM, occurring sporadically or inherited as an autosomal or X-linked, dominant or recessive trait. Karyotype with G-banding disclosed around to 20 chromosomal regions associated to CCM. In the last few years, new techniques for high resolution chromosomal investigation, as comparative genomic hybridization array (CGH-array), became available. CGH-array allows fast analysis in high resolution of the genome, allowing the determination of copy number variations (microduplications and microdeletions) of genomic regions, with minimum size of 0, 1 to 1 Mb. This resolution is much larger than of the conventional karyotype, which is able to detect abnormalities of at least 4 Mb. This investigation included 21 subjects with CCM without defined etiology, associated or not to additional brain or other internal organ malformation and with developmental delay or mental retardation. These individuals were investigated for numeric or structural chromosomal abnormalities with karyotype with G-banding and for genomic copy number variations, using CGH-array. Karyotype disclosed abnormalities in two individuals (9.5%): one patient had a derived chromosome 4 [46, XX,der(4)], inherited from his mother, which has a balanced translocation between chromosomes 4 and 10 [46,XX,t(4;10)(q35;q23)]; and other had a de novo rearrangement, derived from chromosome 8 [46, XX,der(8)]. CGHarray analysis was conducted in these individuals to define the extension and origin of the genetic material present in the rearrangement. Among individuals with normal karyotype, CGH-array disclosed two patients (11%), with de novo abnormalities: 6q25.1-25.3 deletion, with size ranging from 5 to 6, 7 Mb, and a 14.5 deletion of 4q25-q28.1. Finally, in four subjects (21%), CGH-array detected genomic copy number variations that were also present in one of the parents, which make its clinical significance uncertain. To conclude, the investigation of chromosomal abnormalities in this sample of 21 patients with CCM, allow us to: 1. Detect two patients with chromosomal abnormalities detectable on conventional karyotype; 2. Recognize, with CGH-array technique, two additional patients with microdeletions, not seen on conventional karyotype; 3. Characterize the origin and extension of chromosomal rearrangement in the patients with abnormal karyotype. The detection of a balanced translocation in one of the parents increases the risk of occurrence of chromosomal abnormalities in future concepts of this individual. In the remaining three patients, recurrence risk is presumably very low. Two of the chromosomal abnormalities detected in our patients (6q25.1- 25.3 deletion and inverted duplication of chromosome 8 spanning p23.1 - p11.21) have been previously reported in patients with CCM. Nevertheless, chromosomal abnormalities involving chromosome 4 (deletion 4q25-q28.1) or the combined deletion 4q34.3 - q35.2 and duplication 10q 23.1 - q23.6 have not been previously reported. Investigation of chromosomal abnormalities in individuals with CCM contributes to etiology determination and helps delineation of chromosomal regions that contains gene(s) involved with corpus callosum formation.

Introdução: Tem se afirmado que não há a possibilidade de haver melhora da estabilidade dinâmica postural utilizando exercícios na água, isto é, onde a gravidade apresenta-se diminuída. Neste estudo randomizado e controlado avaliamos e comparamos a estabilidade dinâmica postural em indivíduos saudáveis que realizaram exercícios sensório-motor no solo ou na água. Métodos: Através do Biodex Balance System®, foram avaliados os limites de estabilidade postural, antes e após um programa de exercícios, de 60 indivíduos saudáveis do sexo masculino divididos em 3 grupos (solo, piscina e controle). Os indivíduos dos grupos solo e piscina realizaram um treinamento sensório-motor por 2 meses no solo e na água respectivamente; o grupo controle não realizou nenhum tipo de exercício. Resultados: 1) Foram encontradas diferenças significativas na estabilidade dinâmica entre o grupo solo e controle; 2) Foram encontradas diferenças significativas na estabilidade dinâmica entreo grupo piscina e controle; 3) Não foram encontradas diferenças significativas entre o grupo solo e piscina. Conclusões: realizar exercícios sensório-motor melhora a estabilidade postural em indivíduos saudáveis do sexo masculino, sem diferenças significativas entre os ambientes de treino (solo e água) comparados / Introduction: It has been stated that there is no way to improve dynamic postural stability using exercises in water, i.e. where there is reduced gravity. In this controlled, randomized study, we evaluate and compare postural dynamic stability in healthy individuals who performed sensory-motor exercises on the ground or in water. Methods: Through the Biodex Balance System®, the limits of postural stability were evaluated before and after a program of exercises, in 60 healthy males, divided into three groups (ground, swimming pool and control). The individuals in the ground and swimming pool groups carried out sensorial-motor training for two months, on the ground and in the water, respectively; the control group did not perform any kind of exercises. Results: 1) Significant differences were found in dynamic stability between the ground and control groups; 2) Significant differences were found in dynamic stability between the swimming pool and control groups; 3) No significant differences were found between the ground and swimming pool groups. Conclusions: performing sensory-motor exercises improves postural stability in healthy males, without significant differences between the training environments (ground and water) compared in this study

A proposta deste estudo foi comparar o desenvolvimento motor de crianças que praticaram Dança Educativa com o desenvolvimento motor de crianças que não praticaram e verificar a permanência dos resultados obtidos, após seis a oito meses do término da intervenção. O estudo foi realizado com 85 crianças matriculadas no 1º ano do Ensino Fundamental de duas escolas da zona sul de São Paulo, randomizadas por sorteio em dois grupos (intervenção e controle). Os dois grupos tiveram seu desenvolvimento motor avaliado em três momentos: antes da intervenção, após a intervenção e após seis a oito meses do término da intervenção. O grupo intervenção participou de um programa de aulas de Dança Educativa por sete meses. Foram excluídas da análise as crianças com deficiência intelectual e/ou física, prematuras, entre outros critérios de exclusão. Os resultados indicaram que as crianças que participaram do programa de Dança Educativa obtiveram ganhos significativos em seu desenvolvimento motor geral e nas bases: equilíbrio, praxia fina e global, em comparação às crianças que não participaram. Foram analisados através de comparação dos resultados dos grupos controle e intervenção com os testes qui-quadrado e test t. A Dança Educativa auxiliou na evolução do desenvolvimento motor de crianças e seus resultados mantiveram- se, parcialmente, meses após o término da intervenção / The purpose of this study was to compare the motor development of children who practiced Educational Dance with the motor development of children who did not practice and to verify the permanence of the results obtained after six to eight months after the intervention. The study was carried out with 85 children enrolled in the first year of Elementary School in two schools in the south of São Paulo, randomized by lottery into two groups (intervention and control). The two groups had their motor development evaluated in three moments: before the intervention, after the intervention and after six to eight months after the intervention. The intervention group participated in an Educational Dance class program for seven months. Children with intellectual and / or physical disabilities, premature, and other exclusion criteria were excluded from the analysis. The results indicated that children who participated in the Educational Dance program achieved significant gains in their general motor development and on the basis of balance, fine and overall praxis, compared to children who did not participate. They were analyzed by comparing the results of the control and intervention groups with chi-square and t-tests. The Educational Dance helped in the development of children\'s motor development and their results were maintained, partially, months after the end of the intervention

A prematuridade se caracteriza por ser qualitativamente distinta do nascimento de termo, em função das intercorrências neonatais, do impacto do período de permanência na incubadora e da influência da ação da gravidade no desenvolvimento postural, do equilíbrio e da locomoção. Este estudo teve como OBJETIVOS: 1- comparar a coordenação motora axial de lactentes pré-termo (RNPT) saudáveis, com a de lactentes de termo (RNT), por meio dos escores da Alberta Infant Motor Scale (AIMS), segundo a idade cronológica (ICr) e corrigida (ICo), a partir do termo até a utilização da marcha independente como principal meio de locomoção; 2- verificar período de aquisição, entre RNPT e RNT, segundo ICo, de 7 itens avaliados pela AIMS (transição de quatro apoios para sentado; engatinhar; segurar o(s) pé(s) em supino; sentar-se independente; transição de sentado para quatro apoios; ficar em pé sem apoio; marcha independente); 3- determinar a influência de variáveis biológicas e sóciodemográficas para obtenção da marcha em RNPT. MÉTODOS: estudo coorte, prospectivo, observacional, mensal e comparativo entre 101 RNPT (grupo de estudo) e 52 RNT (grupo controle). Foram ajustados modelo de regressão beta e equações de estimação generalizada para curvas de ICr e ICo, a fim de comparar a média mensal dos escores entre os grupos. Para comparar as idades de aquisição dos sete itens da AIMS entre os RNT e RNPT, foram utilizadas estimativas de Turnbull da distribuição da idade e modelo de taxa de falhas proporcionais de Cox para censuras intervalares. Para análise estatística dos resultados das médias mensais entre os grupos e as idades de aquisição dos itens, recorreu-se à construção de intervalo de confiança (IC). Para análise das variáveis prognósticas no tempo da aquisição da marcha nos RNPT, análise de sobrevivência para censuras intervalares e modelo de regressão Weibull foram utilizados. O nível de significância considerado foi < 5%. RESULTADOS: Finalizaram o estudo 77 RNPT e 49 RNT. Os escores segundo ICr dos RNPT demonstraram ser estatisticamente inferiores em relação aos dos RNT. Segundo a ICo, os escores dos RNPT tornaram-se equivalentes aos dos RNT, não demonstrando diferença estatística significativa. Dos 7 itens analisados, somente em pé sem apoio e a marcha foram adquiridos mais tardiamente pelos RNPT. As variáveis biológicas com influência significante no tempo de aquisição da marcha foram: peso ao nascimento (PN), estatura ao nascimento (EN) e permanência no hospital após nascimento. CONCLUSÃO: A coordenação motora axial dos RNPT deve ser avaliada segundo ICo para não ser subestimada. A aquisição da marcha e a posição em pé sem apoio se desenvolvem mais tardiamente nos RNPT. Além disto, a aquisição da marcha em RNPT foi tão mais tardia quanto menor o PN e EN, assim como o longo período de internação após o nascimento retardaram a marcha nos RNPT. / The prematurity characterizes to be qualitatively different from term delivery, due to neonatal morbidities, impact of the long period in the incubator and the influence of gravidity in the postural development. This study has as OBJECTIVES:1- to compare the gross motor development in healthy preterm infants (PT) with term infants (T), using Alberta Infant Motor Scale (AIMS) scores, according to corrected and chronological ages, from term to walking independently; 2- To compare the age attainment of seven AIMS items, according to corrected age (four-point kneeling to sitting; reciprocal creeping; hands to feet in supine; sitting independently; sitting to four-point kneeling; stand alone; early stepping) between PT and T infants; 3- To study biologic and sociodemographic factors that affect walking attainment in PT. METHODS: cohort, prospective, observational monthly and comparative study between 101 PT and 52 T. In order to compare descriptively mean monthly scores, beta regression models and general estimated equations were used to adjust the chronological and corrected age graphics and for statistics purposes, the confidence interval of monthly mean scores were used. Turnbull estimation of age distribution and Cox´s proportional hazards model were used to compare the age in each seven items between groups. For prognostic factors of age walking attainment in PT, methods of Kaplan-Meyer and Weibull regression model were used. The level of significance was considered significant, if p < 5%. RESULTS: 77 PT and 49 T infants finished the study. Chronological age scores of PT were statistically lower in comparison with T scores. According to corrected age, PT monthly mean scores were not statistically different from T scores. Of seven analysed items, only standing alone and early stepping were attained later in PT infants. The variables that seemed to influence statistically in age of walking attainment were: birth weight and stature and duration of hospitalization. CONCLUSION: Gross motor development of PT infants should be assessed according to corrected age, in order not to be underestimated. The both milestones standing alone and early stepping developed later in PT infants. The lower the birth stature and weight were, the longer it took for the PT infants to attain walking, while the longer the PT newborns stayed hospitalized, the later they started walking.

Objetivos: Avaliar o desenvolvimento neuropsicomotor de crianças com Sequência de Robin isolada (SRI), submetidas ao tratamento de obstrução das vias aéreas conforme protocolo do Hospital de Reabilitação de Anomalias Craniofaciais da Universidade de São Paulo (HRAC/USP), com intubação nasofaríngea (INF) ou tratamento postural. Verificar se o desenvolvimento neuropsicomotor do grupo INF difere do grupo postural, e avaliar a eficácia da INF em evitar sequelas de hipóxia. Materiais e Métodos: Estudo prospectivo realizado no HRAC/USP, com crianças com SRI, de 2 a 6 anos, divididas em dois grupos de acordo com o tipo de tratamento realizado: INF (Grupo 1), e postural (Grupo 2). Dados do tempo de uso da INF e sonda nasogástrica (SNG), cirurgia de miringotomia, classificação socioeconômica, grau de escolaridade dos pais, entre outros, foram coletados. Os participantes foram avaliados por meio do Teste de Screnning de desenvolvimento de Denver II (Teste de Denver II) e Exame Neurológico Evolutivo Adaptado (ENEA). Resultados: Total de 62 crianças foram avaliadas, sendo 38 do Grupo 1 e 24 do Grupo 2. Os resultados do Teste de Denver II demonstraram que 73,7% das crianças do Grupo 1 e 79,2% do Grupo 2 apresentaram desenvolvimento normal. Os resultados do ENEA apresentaram-se normais para 89,5% das crianças do Grupo 1 e 87,5% do Grupo 2. Não houve diferença significativa entre os dois grupos no Teste de Denver (p=0,854) e no ENEA (p=0,789). Realizaram a miringotomia 47,3% das crianças do Grupo 1 e 58,3% do Grupo 2. Nos resultados dos dois testes, a área do desenvolvimento mais prejudicada foi a linguagem, o que pode ser reflexo das oscilações de audição e da disfunção velofaríngea. Houve concordância moderada (k=0,563) entre os resultados dos dois testes aplicados no Grupo 1, e concordância substancial (k=0,704) no Grupo 2. O tempo médio de uso da INF foi de 60 ± 28 dias. Na análise socioeconômica do Grupo 1, 42,1% se encaixavam na classificação baixa superior, e 28,9% na média inferior; no Grupo 2, 20,8% se encaixavam na baixa inferior, e 58,3% na baixa superior, sem diferença entre os grupos (p=0,211). Não houve associação significativa entre a classificação socioeconômica e os resultados dos testes de desenvolvimento aplicados. O nível de escolaridade mais encontrado entre os pais dos participantes foram: 3º grau completo (Grupo 1) e 2º grau completo (Grupo 2), sem diferença estatística entre os grupos. Conclusões: A maioria das crianças com SRI tratadas com INF apresentaram desenvolvimento neuropsicomotor normal, semelhante aos casos menos graves do grupo postural. As crianças tratadas com INF não apresentaram sinais clínicos evidentes de sequelas neurológicas da hipóxia. / Objectives: To assess the neurological and psychomotor development of children with Isolated Robin Sequence (IRS), submitted to the treatment of airway obstruction according to the protocol of the Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo (HRAC/USP), with nasopharyngeal intubation (NPI) or postural treatment. Verify if the neurodevelopment of the NPI group differs from postural group, and evaluate the effectiveness of NPI to prevent sequels of hypoxia. Materials and Methods: Prospective study conducted at HRAC/USP, with children SRI, with 2 to 6 years old, divided into two groups according to the type of treatment performed: NPI (Group 1) and postural (Group 2). Time data of use NPI, nasogastric tube (NGT), myringotomy surgery, socioeconomic status, education level of parents, among others, were collected. Participants were assessed through the development of Screnning Denver II Test (Denver II) and Neurologic Evolutionary Examination Adapted (NEEA). Results: The total of 62 children was evaluated, being 38 in the Group 1 and 24 in the Group 2. The results of the Denver Developmental Screening Test II showed that 73.7% of Group 1 and 79.2% of Group 2 presented with normal development. The results of NEEA had presented normal for 89.5% of children in the Group 1 and 87.5% in the Group 2. There was no significantly difference between the two groups at Denver Test (p=0.854) and in the NEEA Test (p=0.789). The myringotomy was performed by 47.3% of children in the Group 1 and 58.3% of children in the Group 2. The results showed language as the most impaired area, which may reflect fluctuations of hearing and velopharyngeal dysfunction. There was moderate agreement (k=0.563) between the results of the two tests applied in the Group 1, and substantial agreement (k=0.704) in the Group 2. The average time of use of the NPI was 60 ± 28 days. In the socioeconomic analysis of Group 1, 42.1% fit the low ranking higher, and 28.9% in the average lower. In the analyses of Group 2, 20.8% were in the low ranking lower, and 58.3% were in the low ranking the top. There was no different statistic between groups (p=0.211). There was no significant association between socioeconomic status and results of development tests performed. The levels of education most found between the participants parents were: completed graduation (Group 1), and secondary school (Group 2) with no statistical difference between groups. Conclusions: Most of children with IRS treated with NPI showed normal neurological and psychomotor development, similar of minor cases of postural group. The children treated with NPI didn\'t show evident clinical signs of neurological sequels of hypoxia.