Sleep disorders and starting time to school impair balance in 5-year-old children

Objective: To verify if sleep disorders and differents starting time to school have impaired motor skills in 5-year-old children.Method: Cross-sectional design consisting of 132 children with sleep disorders and 136 normal controls of the public school in the city of São Paulo. the group with sleep disorders was identified based on a questionnaire, and motor tests for global motor coordination, fine motor coordination, perceptual-motor coordination, and static and dynamic balance were applied in all children.Results: in the static balance test, more specifically in the sharpened Romberg (Tandem) test, 34% of boys from the study group, who studied in the morning, failed the test (p < 0.05). in the single leg stance test, 62% of boys from the study group who studied in the morning failed (p < 0.05).Conclusion: This study suggests that sleep disorders may interact with the school period and alter motor performance, especially in boys studying in the morning.Universidade Federal de São Paulo, Dept Internal Med, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Neurol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Internal Med, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Neurol, São Paulo, BrazilWeb of Scienc

Thoracoabdominal mobility evaluation by photogrammetry in newborns after expiratory flow increase technique

Introduction: Expiratory flow increase is a maneuver of respiratory physical therapy that promotes flow direction to the upper airways however, when applied in newborns, it may result in changes of thoracoabdominal mobility. Objective: To evaluate the thoracoabdominal mobility by photogrammetry in newborns after expiratory flow increase technique. Methods: Experimental blind study performed with newborns in supine position on a support table with upper limbs flexed, abducted and externally rotated and hip flexed at 110°. Adhesive markers were allocated for geometric delimitation of the thoracoabdominal compartment and expiratory flow increase technique was performed for 5 minutes with the therapist’s hands on the thorax and abdomen. Newborns were filmed before and after the maneuver and the frames were analyzed in AutoCAD® software by a blinded investigator at the time of the procedure. The largest and the smallest thoracoabdominal area were expressed in cm2 and the mean values were compared between two moments (pre and post maneuver) by paired t test. Results: Twenty newborns with a mean age of 39 weeks were included. Before the maneuver, thoracoabdominal area was 56.1 cm2 during expiration and 59.7 cm2 during inspiration, and after the maneuver the value was 56.2 cm2 during expiration and 59.8 cm2 during inspiration, with no statistical difference between before and after (p = 0.97, p = 0.92, respectively). Conclusion: Results demonstrate that expiratory flow increase technique does not seem to change thoracoabdominal mobility of healthy newborns

USE OF MUSIC DURING PHYSICAL THERAPY INTERVENTION IN A NEONATAL INTENSIVE CARE UNIT: A RANDOMIZED CONTROLLED TRIAL

Introduction: Previous studies have shown music therapy as a way to improve the clinical status of premature infants, improving vital signs and decreasing crying episodes. Objective: Compare the effects of music on vital signs of premature infants undergoing respiratory physiotherapy. Methods: We performed a randomized clinical trial consisting of 26 premature infants, divided into control group (N=12) and study group (N=14), carried out in a Neonatal Intensive Care Unit. All newborn infants undergone standard practice physiotherapy for 15 minutes: vibration and aspiration. On the study group they were exposed to classical music three minutes before the standard physiotherapy, and finished three minutes after the end of these procedures. A recorder was placed inside the incubator with an intensity of 25 decibels. Measurements of heart and respiratory rate and oxygen saturation were measured before, during and after each sessions of respiratory physiotherapy for two groups. Results: When comparing control and study groups regarding heart rate frequency and oxygen saturation, there was no statistically significant difference, but the inclusion of music determined clinically the variability of these data and 30% of the variation in respiratory rate was due to the inclusion of music during and after the physiotherapy, and the neonatal noninvasive ventilation showed less variation in their respiratory rate when compared to the neonatal on oxygen therapy. Conclusion: The results have showed a beneficial effect of music, showing lower respiratory rate in newborn infants during and after respiratory physiotherapy procedure

A IMPORTÂNCIA DO CONHECIMENTO DA COMUNIDADE SOBRE PRIMEIROS SOCORROS NA INFÂNCIA

Os acidentes que acontecem com as crianças são geralmente causados por fatores externos, sendo que a maioria poderia ser evitada pela elaboração de medidas preventivas e conhecimento de primeiros socorros. Tem-se como importantes pontos de informação a promoção e prevenção em saúde, que quando aplicados proporcionam uma melhor qualidade e aumento da expectativa de vida. Entende-se então como necessária a implementação de ações que informem a população sobre os fatores de risco na infância e sobre medidas que podem ser realizadas em situações de emergência. O objetivo é promover conhecimento a comunidade, sobre medidas de primeiros socorros na infância. Trata-se de um estudo experimental de intervenção que foi realizado na ação social do município de Araranguá-SC, em duas etapas. Primeiramente, a população era abordada e os alunos realizavam um questionário rápido de cinco perguntas sobre os conhecimentos prévios e adquiridos. Logo após, explicavam as manobras de Heimlich e de Ressuscitação Cardiopulmonar e quando utilizá-las. A análise de resultados foi dada pelas 64 pessoas que participaram e responderam o questionário, podendo ser sim, não, ou prefiro não responder. A realização de ações em conjunto com a comunidade, promove a disseminação do conhecimento, podendo diminuir o número de acidentes e morbimortalidade infantil, melhorando o desenvolvimento e a qualidade de vida das crianças

Relationship between thoracoabdominal mobility and hours of life in infants: A cross-sectional study

Assessing the relationship between thoracoabdominal mobility (TAM) in newborns (NBs) is relevant for a greater understanding of pulmonary kinematics. This study aimed to assess the association between TAM, hours of life and respiratory rate (RR) in term NBs. Healthy NBs were included in the sample. They were filmed for 2 min, with markers in the lateral region of the trunk, delimiting the thoracic and abdominal areas. TAM and RR were assessed using a MATLAB® routine. For kinematic analysis, an algorithm created graphs presenting thoracoabdominal mobility. A total of 26 NBs were evaluated. TAM was the only variable that exhibited a statistically significant intergroup difference, showing that the fewer the hours of life, the greater the mobility. Simple linear regression analysis showed that RR can explain 31% of the variation in abdominal mobility (p = 0.002). Thus, the fewer the hours of life, the greater the TAM of NBs, with a predominance of abdominal compartment mobility

Distúrbios do Sono e Tempo Total de Sono em Crianças com Deficiência Visual

Os distúrbios do sono são pouco conhecidos na faixa etária pediátrica e pesquisas que contemplem o comportamento do sono das crianças com deficiência visual também são raros. A atuação dos profissionais da saúde de forma global dependem de evidências cientificas que demonstrem achados clínicos em diferentes populações para atualização terapêutica e adequada tomada de decisão

Thermal and cardiorespiratory newborn adaptations during hot tub bath

Objective: To evaluate thermal and cardiorespiratory adaptation during hot tub bath and shower in healthy newborns in the first hours of life. Study design: This is a randomized blind controlled trial, registered in ReBEC (No. RBR-4z26f3) with 184 newborns divided into hot tub group (n=84) and shower (n=100). Newborns from intervention group were immersed in a hot tub with warm water up to the neck, without exposure to air flow, and control group received traditional shower. Heart rate, respiratory rate and temperature were measured before and immediately after bath by an investigator blinded to the type of bath. Results: Groups were similar in gender, gestational age, birth weight, Apgar score at 5th minute and hours of life, p =&gt; 0.05. To analyze thermal and cardiorespiratory adjustments, difference between post-bath variables and pre-bath was calculated. In this analysis, it was found statistically significant difference between two types of bath regarding heart rate, respiratory rate and temperature. Hot tub bath decreases heart and respiratory rates and increases temperature, whereas shower provides the opposite effect (0.0001). Conclusion: This study demonstrates that hot tub baths and shower, in healthy newborns, promote thermal and cardiorespiratory adaptations, reflecting thermal, cardiac and respiratory positive reactions after hot tub bath

Therapeutic options for hemarthrosis in severe hemophilic patients

the coagulation factors VIII (FVIII) or IX (FIX), respectively. The primary therapeutic approach is to replace the deficient coagulation factor, which can be achieved with factors derived from human plasma or recombinants. However, despite having a therapeutic approach, most severe cases are symptomatic and may have complications, mainly in the muscles and joints. One example of such disorder is hemarthrosis. This manifestation tends to affect mainly the knee, ankle, or elbow joints in about 80% of cases. Objective: to describe the primary forms of treatment for joint bleeding in patients with severe hemophilia. Methods: This is a qualitative research of the integrative review type meant to identify productions on topics associated with hemarthrosis and severe hemophilia. The articles were searched through the databases PubMed, Scientific Electronic Library Online (Scielo) and Virtual Health Library (BVS) with the following search descriptors: “hemarthrosis and hemophilia”; “joint diseases and Hemophilia” and corresponding terms in Portuguese. The inclusion criteria were as follows: a) scientific articles b) available in full-text c) studies available in Portuguese, English, or Spanish d) randomized clinical trials e) articles published between 2016 and 2021 f) articles containing hemarthrosis caused by severe hemophilia. As exclusion criteria, texts that had no relation to the theme, did not answer the guiding question, other types of articles that did not include randomized clinical trials and/or presented duplicates were discarded. Results: In total, 42 articles were found in the selected databases; eight were duplicated, and 25 were excluded for not being randomized clinical trials or because they did not contemplate the theme. After careful reading, nine articles that met the inclusion and exclusion criteria were identified. Of the eligible studies, one reported factor replacement, and eight reported physiotherapeutic treatment. Conclusion: Factor replacement for hemophilic patients is essential and, based on the information obtained, early replacement is beneficial for the patient to avoid joint complications. Prophylaxis is indicated in severe hemophilia and its main objective is to prevent recurrent hemarthrosis, which can cause permanent functional deformities. Some physiotherapeutic interventions are indicated to prevent joint damage in severe hemophilic patients. The findings show diversity in the physical therapy modalities employed. The complete prevention of joint damage is still a challenge. A combination of treatments and a multidisciplinary team follow-up is necessary to ensure health and quality of life of patients