Low birth weight and motor development outcomes: the current reality

OBJECTIVE: To review the literature about factors that may influence the occurrence of motor development deficits in low birth weight infants. DATA SOURCES: Studies with low birth weight infants published from 1984 to 2008, using the databases Medline and SciELO. Keywords were low birth weight and motor development; search was made on the English language. DATA SYNTHESIS: Although variations in the development of children born preterm and full term are common, their understanding is still a challenge for professionals in the pediatric health area. Researchers use different assessments and scores, which makes the deficits more difficult to be diagnosed, understood and predicted. Different results are found depending on the type of evaluation, age and the population studied. It is well known that low birth weight infants are at a higher risk for cognitive, motor and behavioral problems. On this basis, a variety of studies that explore early intervention were expected; however, this is not the case. CONCLUSIONS: Due to the relationship between motor and other domains of development, its use is important for diagnostic purposes. There is a need to standardize results for a better understanding of the deficits that low birth weight children are likely to developOBJETIVO: Realizar uma revisão da literatura sobre fatores que influenciam o déficit de desenvolvimento motor em crianças com baixo peso ao nascer. FONTES DE DADOS: Estudos com crianças com baixo peso ao nascer, publicados no período de 1984 a 2008 nas bases de dados Medline e SciELO, usando as palavras chaves baixo peso ao nascer edesenvolvimento motor, na língua inglesa. SÍNTESE DE DADOS: Embora diferenças no desenvolvimento entre crianças nascidas a termo e pré-termo sejam observadas com certa frequência, o seu entendimento ainda é um grande desafio para profissionais da saúde. O uso de diferentes testes e escores dificulta o diagnóstico, o manejo e a previsão dos déficits de desenvolvimento. Resultados heterogêneos são relatados dependendo do método de avaliação, idade e população estudada. Como é esperado que crianças com baixo peso ao nascer tenham risco para problemas cognitivos, motores e comportamentais, estudos abordando práticas de intervenção precoce seriam esperados; entretanto, isso não é observado. CONCLUSÕES: Devido à relação entre desenvolvimento motor e os outros domínios de desenvolvimento, é importante que o achado da alteração motora seja usado como uma variável diagnóstica e que os resultados encontrados sejam padronizados para melhor entendimento dos déficits que crianças com baixo peso ao nascer possam desenvolver707

Perceived Confidence of DPT Students with Telehealth to Examine Neurologic Patients during COVID 19 Pandemic

Purpose/Hypothesis: Within the neuromuscular courses (NM1, NM2) in the DPT program at the University of St. Augustine for Health Sciences (USAHS), some form of patient integration is offered to prepare students for different aspects of patientcare, including examination and treatment. The utilization of telehealth provided an opportunity to continue patient integration experiences while maintaining a safe and socially distant environment. Patients with neurological conditions were integrated into both courses as a form of patient integration. The purpose was to investigate student perceived confidence in using telehealth to examine and treat neurological patients. For this study, the data was based on the primary questions: (1) is there a difference in confidence in the examination, assessment and treatment of patients with a neurological condition as a result of using telehealth? and (2) if so, what specific components differentiate confidence as a result of the telehealth experience? Number of Subjects: Ninety students were included in the final analysis (48.7% male). Materials and Methods: This cross-sectional IRB approved study enrolled DPT students from the Miami Campus in theNM1and NM2course. Students answered the Physiotherapy Self-Efficacy (PSE) survey and a focused questionnaire at baseline and after the second experience to assess their confidence in utilizing telehealth as a form of patient integration. Analysis included descriptive statistics, averages, and trends. Paired T-test and Cohen’s d estimated effect size was used to compare student perceived confidence. Results: Two telehealth sessions were completed (one in each course). The mean total score of the PSE increased 59% (28.2 + 10.6 to 44.9 + 9.0). Significantly higher total means cores in the PSE at the end of telehealth experience were noted. Conclusions: The results suggest that student’s level of confidence was significantly lower before the first-time participation in telehealth. However, they showed significantly greater perceived confidence in their ability to complete a neurological examination and treatment using telehealth as a result of the two experiences. Clinical Relevance: The use of telehealth is novel within DPT programs and may provide educators with additional opportunities to facilitate patient integration. In addition, telehealth may increase students’ self-confidence in completing a neurological examination and treatment which is linked to a positive effect on student’s success

The New Frontier: Can Faculty be Consistent When Rating Clinical Skills Virtually?

Purpose/Hypothesis: Accreditation criteria mandate the evaluation of student technical skills. The emerging need for DPT programs to deliver course content remotely and subsequently assess student clinical skills highlights the lack of research surrounding faculty rating consistency when evaluations occur virtually. This study aimed to investigate rating consistency among faculty testers when assessing clinical skills virtually. The primary questions were: (1) is there faculty rating consistency for virtual practical assessments, (2) are there any trends that impact faculty rating of virtual practical performance? Number of Subjects: 623 Materials and Methods: Faculty utilized check list rubrics based on Miller’s Pyramid of Assessment to evaluate students’ virtual practical performances. During the case-based virtual practical performance students were required to simulate a face to face patient encounter, or verbally describe how to perform skills during a patient encounter appropriately. A convenience sample of 623 individual student scores across the DPT curriculum were collected and utilized. Post hoc analysis and One-Way ANOVA was employed to determine differences between faculty raters. Results: There were 4 to 7 faculty raters per course, with faculty testing 7 to 13 students on average. Students were expected to complete the virtual practical performance within; 11-20 minutes (47.5%), 21-30 minutes (25.5%), and 41-60 minutes (15%). Individual course analysis revealed some differences in faculty rating of the students’ virtual practical skills for 6 of the 13 courses. One course in the first year and five courses in the second year of the curriculum had significant differences in faculty rating of student virtual skills performances (p=0.018, p=0.001, p=0.045, p=0.013, p=0.004, p=0.001). Overall, the students’ scores earned from the faculty raters were consistent when compared to traditional face to face practical scores. Conclusions: Faculty rating of students’ virtual skills performance were more consistent in the first year of the DPT curriculum, with more variability in rating for the program’s second year courses. There is the possibility that more faculty rating errors during the second year of the curriculum may have impacted how the students were rated. Even with the differences in faculty rating, virtual skills practicals may be an acceptable option for DPT programs. Clinical Relevance: The recent Coronavirus 2019 (COVID-19) pandemic has increased the need for innovative virtual methods for testing technical skills taught in physical therapy programs. Assessing if consistency between faculty raters can be maintained in the virtual environment is essential in determining the effectiveness of this form of examination. The results of this study indicate that consistency appears to be better maintained earlier in the curriculum, the reason for this trend is unknown. Some difference in how faculty rated students could be attributed to the difference in the courses. This study will be significant in helping to show that effective faculty rating of students’ performance of virtual technical skills is possible

Childhood And Adolescent Obesity: How Many Extra Calories Are Responsible For Excess Of Weight?

To review the main articles on energy imbalance and obesity in order to quantify the daily energy surplus associated with weight gain in children and adolescents. Articles published in the last ten years, indexed in electronic databases Medline (Pubmed) and SciELO-Br. In the Medline database, the descriptor energy gap was used and describes the energy values ​​associated with changes in body weight in individuals or populations. In SciELO-Br database, the descriptors obesity, energy metabolism, energy balance, and energy imbalance were used, once it was not possible to find national articles discussing the energy gap. In the pediatric population, four studies were performed and indicate that children and adolescents are gradually gaining weight due to a small, but persistent, daily positive energy balance of 70 to 160kcal above the total energy suitable for growth. The results suggest that small changes in daily eating behavior as well as physical activity would be enough to prevent future weight gain in this population. gradual weight gain can be explained by small daily average of positive energy balance, from 70 to 160kcal above the total energy suitable for growth. The incentive to small changes in eating behavior and physical activities that promotes daily reduction of 160kcal can be an accessible practice in order to block weight gain in this population.31252-

Childhood and adolescent obesity: how many extra calories are responsible for excess of weight?

OBJECTIVE: To review the main articles on energy imbalance and obesity in order to quantify the daily energy surplus associated with weight gain in children and adolescents. DATA SOURCES: Articles published in the last ten years, indexed in electronic databases Medline (Pubmed) and SciELO-Br. In the Medline database, the descriptor energy gap was used and describes the energy values ​​associated with changes in body weight in individuals or populations. In SciELO-Br database, the descriptors obesity, energy metabolism, energy balance, and energy imbalance were used, once it was not possible to find national articles discussing the energy gap. DATA SYNTHESIS: In the pediatric population, four studies were performed and indicate that children and adolescents are gradually gaining weight due to a small, but persistent, daily positive energy balance of 70 to 160kcal above the total energy suitable for growth. The results suggest that small changes in daily eating behavior as well as physical activity would be enough to prevent future weight gain in this population. CONCLUSIONS: gradual weight gain can be explained by small daily average of positive energy balance, from 70 to 160kcal above the total energy suitable for growth. The incentive to small changes in eating behavior and physical activities that promotes daily reduction of 160kcal can be an accessible practice in order to block weight gain in this population.OBJETIVO: Revisar os principais artigos referentes ao tema desequilíbrio energético e obesidade, a fim de quantificar o excedente energético diário associado ao ganho de peso em crianças e adolescentes. FONTES DE DADOS: Artigos publicados nos últimos dez anos, indexados nas bases de dados eletrônicas Medline (Pubmed) e SciELO-Br. Na base de dados Medline, utilizou-se o descritor energy gap, termo que descreve os valores energéticos associados às modificações no peso corporal em indivíduos ou populações. Na base de dados SciELO-Br, utilizaram-se os descritores obesidade, metabolismo energético, balanço energético e desequilíbrio energético, devido ao fato de não terem sido encontrados artigos nacionais que discutissem o assunto energy gap. SÍNTESE DOS DADOS: Na população infantil, quatro estudos foram realizados e indicam que crianças e adolescentes estão gradualmente ganhando peso devido a um pequeno, mas persistente, balanço energético positivo diário, 70 a 160kcal acima do total calórico adequado para o crescimento. Os valores encontrados sugerem que pequenas modificações nos hábitos diários de alimentação e de atividade física seriam suficientes para evitar futuros ganhos de peso nessa população. CONCLUSÕES: O ganho gradual de peso pode ser explicado por pequena média diária de balanço energético positivo, de 70 a 160kcal acima do total calórico adequado para o crescimento. O incentivo às pequenas modificações nos hábitos alimentares e de atividades físicas que promovam a redução de 160kcal diárias pode ser uma prática acessível, a fim de barrar o ganho de peso nessa população.OBJETIVO: Revisar los principales artículos referentes al tema desequilibrio energético y obesidad, a fin de cuantificar el excedente energético diario asociado a la ganancia de peso en niños y adolescentes. FUENTES DE DATOS: Revisión de artículos publicados en los últimos 10 años, indexados en las bases de datos electrónicas MEDLINE (Pubmed) y SciELO-BR. En la base de datos MEDLINE se utilizó el descriptor energy gap, término que describe los valores energéticos asociados a las modificaciones en el peso corporal en individuos o en poblaciones. En la base de datos SciELO-BR se utilizaron los descriptores obesidad, metabolismo energético, balance energético y desequilibrio energético, debido a no haberse encontrado artículos nacionales que discutieran el tema energy gap. SÍNTESIS DE LOS DATOS: En la población infantil, cuatro estudios fueron realizados e indican que niños y adolescentes están gradualmente ganando peso debido a un pequeño pero persistente balance energético positivo diario, 70 a 160kcal por encima del total calórico adecuado para el crecimiento. Los valores encontrados sugieren que pequeñas modificaciones en los hábitos diarios de alimentación y de actividad física serían suficientes para evitar futuras ganancias de peso en esta población. CONCLUSIÓN: La ganancia gradual de peso puede explicarse por pequeño promedio diario de balance energético positivo, de 70 a 160kcal por encima del total calórico adecuado para el crecimiento. El incentivo a las pequeñas modificaciones en los hábitos alimentares y de actividades físicas que promuevan la reducción de 160kcal diarias puede ser una práctica accesible a fin de parar la ganancia de peso en esta población.25225

Relation between prone, supine and sitting positioning time and motor development up to six months old

Introduction: The acquisition of motor skills depends on factors such as environment and experience. It follows that the motor development may be influenced by the positioning of infants during the first months of life. Objective: To verify the relation between prone, supine and sitting positioning time and motor development up to six months old. Method: Were evaluated 92 infants at term, of both genders, divided into three groups according to the corresponding bimester of chronological age (1st bimester, n = 30; 2nd bimester, n = 30; 3rd bimester, n = 32). To verify the time spent in each position during the awake and sleeping periods, a timeline corresponding to 24 hours was developed. Each one-hour period could be filled with a positioning option. Motor development was assessed by Alberta Infant Motor Scale. The Shapiro-Wilk test was used to verify the normality of data distribution. The Spearman correlation test was used to verify the association between the variables. Results: There was a positive association between motor development and the sleeping time and awake time in prone and sitting postures; and negative with the sleeping time and awake time in supine. Conclusion: The time spent in prone and sitting can be considered as positive for motor development. The time that the infant remains supine can negatively influence the motor development. It is suggested that intervention through guidance to parents and caregivers is important. Infants should be stimulated on different postures so that the acquisition of motor abilities occurs properly

Changes in postural balance associated with a woman's aging process

Context: Aging causes a progressive worsening in postural balance, affecting functional independence and increasing the risk of falls. Objective: The aim of the study was to evaluate the effect of aging on the static balance in women from 50-years to 89-years of age. Design: This was a cross-sectional study, with 400 irregularly active women were evaluated and grouped by age: Group 6th decade (age 50 to 59) ‒ 58 participants; Group 7th decade (age 60 to 69) ‒ 214 participants; Group 8th decade (age 70 to 79) ‒ 92 participants; Group 9th decade (age 80 to 89) ‒ 36 participants. Postural balance was evaluated using a portable force platform in a standard standing position, with Eyes Open (EO) and Eyes Closed (EC). Results: In the two measurement conditions, the elderly women in Group 9th decade presented mediolateral displacement and range, and mean velocity greater than the women's values in Groups 6th and 7th decade. In the EO e EC situation, the displacement was higher in the elderly Group 9th decade compared to younger groups. Group 8th has a mean velocity greater than Group 6th decade in the EO situation. Conclusions: Posturography showed a decline in postural balance with advancing age, suggesting that the 9th decade of life is a borderline age to this detriment due to an increase in postural instability

Evaluate fine motor skills in students of differents socioeconomic status

Orientadores: Antonio de Azevedo Barros Filho, Vanda Maria Gemenez GonçalvesDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências MédicasResumo: O Sistema Nervoso da criança é um sistema em constante transformação resultante da interação entre forças de ordem interna e externa. As habilidades motoras são o resultado final deste complexo desenvolvimento. A coordenação apendicular é uma das aquisições motoras essenciais no desenvolvimento neuropsicomotor e intelectual da criança, com ele a criança consegue realizar atividades importantes como os movimentos de ¿pinça¿ e oponência do polegar indispensáveis para a escrita. Os objetivos deste trabalho foram inicialmente avaliar e comparar a coordenação apendicular de escolares da primeira série do ensino fundamental de níveis socioeconômicos distintos. Em seguida, observar os fatores associados para o desenvolvimento inadequado desta coordenação e o comportamento da dominância lateral. Foram avaliados 238 escolares: 118 da escola pública e 120 da escola privada quanto à coordenação apendicular por meio do Exame Neurológico Evolutivo. Um questionário contendo informações sobre os pais e a criança foi respondido previamente pelo responsável. As escolas foram selecionadas intencionalmente para representar os dois níveis socioeconômicos distintos pretendidos. Na análise dos dados foram utilizados para os testes de associação o teste qui-quadrado e razão de chances (odds ratio) pelo método de regressão logística univariada seguida de análise multivariada. Para comparação entre as médias foi utilizado teste de Mann-Whitney. Na escola pública foram observadas 73,3% das crianças com coordenação apendicular inadequada enquanto na escola privada apenas 22,5% (p=0,0001). As crianças da escola pública apresentaram 5,5 vezes maior chance de terem coordenação motora inadequada para a idade quando comparadas às da escola privada. Crianças que iniciaram a vida escolar após os 4 anos de idade apresentaram risco de 2,8 vezes maior de inadequação na coordenação apendicular do que as crianças que iniciaram a vida escolar antes desta idade. Quando realizada análise com as duas escolas separadamente, para identificar os fatores associados dentro de cada grupo, na escola estadual a idade de início escolar permaneceu no modelo. Sendo que as crianças que iniciaram vida escolar após 4 anos apresentaram risco 4,21 vezes maior de coordenação inadequada. Na escola privada nenhuma variável permaneceu no modelo. Quanto à dominância lateral as crianças com coordenação apendicular inadequada apresentaram mais inconstância na preferência manual (p=0,0007). Existe diferença na coordenação apendicular de crianças da primeira série do ensino fundamental de níveis socioeconômicos distintos. Os fatores socioeconômicos e a entrada tardia na escola são os que mais influenciam na coordenação apendicularAbstract: A child¿s nervous system is a system in constant change resulting from the interaction of internal and external forces. Motor skills are the end result of this complex development. Appendicular coordination is one of the essential motor acquisitions in a child¿s neuro-psychomotor and intellectual development. With it the child is able to perform important activities such as ¿fine tweezer¿ and thumb opposition movements that are indispensable for writing. The purposes of this study were initially to evaluate and compare the appendicular coordination of elementary school first graders from differing socio-economic backgrounds. Then to observe the factors associated with the inadequate development of such coordination and the lateral dominance behavior. The evaluation involved 238 students. Out of the 238 students, 118 were from a public school and 120 came from a private school. They were evaluated as to appendicular coordination through the Evolutional Neurological Test. A questionnaire containing information on parents and child was previously responded to by the responsible parent. The schools were deliberately selected to represent the two different socioeconomic levels intended. In the data analyses for the association tests the chi-square test and the odds ratio test using the univaried logistic regression method followed by multivaried analysis were used. The Mann-Whitney test was used for comparing means. In the public school it was observed that 73.3% of the children showed inadequate appendicular coordination, while in the private school only 22.5% (p=0.0001) displayed such trait. As compared to private school children, public school children were 5.5 times more likely to have inadequate motor coordination for their age. Children who started school after 4 years of age presented a 2.8 times greater risk to have inadequate appendicular coordination than the children who started school before that age. When the children from the two schools were analyzed separately to identify the factors associated within each group, in the public school the starting school age remained within the model. The children who started school after 4 years of age presented a risk 4.21 times greater for inadequate coordination. In the private school no variable remained within the model. As to lateral dominance, children with appendicular coordination showed more inconstant manual preference (p=0.0007). There is a difference in the appendicular coordination of children in the first grade of the elementary school of different socioeconomic levels. Socioeconomic factors and a child¿s late entry in school are the factors that most influence appendicular coordinationMestradoSaude da Criança e do AdolescenteMestre em Saude da Criança e do Adolescent