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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2020.tde-05022021-124824
Document
Author
Full name
Carolina Barbosa de Souza
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2020
Supervisor
Committee
Vilibor, Renata Hydee Hasue (President)
Marques, Juliana Cristina Fernandes Bilhar
Lo, Denise Swei
Schmitt, Ana Carolina Basso
Title in Portuguese
Predição de risco para dificuldades motoras em prematuros com idade pré-escolar pelo General Movement Assessment 
Keywords in Portuguese
Desempenho psicomotor
Destreza motora
Lactente
Pré-escolar
Recém-nascido prematuro
Abstract in Portuguese
Introdução: Os avanços científicos e tecnológicos na neonatologia resultaram em aumento na sobrevivência de prematuros, e, consequentemente, no maior número de crianças com alterações do desenvolvimento. Frequentemente, dificuldades motoras como prejuízos no equilíbrio e na coordenação só são observadas na idade escolar. A detecção precoce e eficaz é fundamental para a intervenção e minimização dos danos funcionais, psicológicos e emocionais que impactam diretamente na qualidade de vida dessas crianças. Objetivos: Identificar se o repertório motor nos primeiros meses de vida de prematuros está relacionado com as dificuldades motoras observadas em idade pré-escolar e correlacionar com fatores clínicos e sociodemográficos. Método: Estudo longitudinal prospectivo com prematuros avaliados pelo General Movement Assessment (GMA) até os 4 meses de idade corrigida e reavaliados pelo Movement Assessment Battery for Children-2 (MABC-2) entre os 3 e 5 anos de idade. A One Way Anova foi usada para identificar diferença entre grupos e o teste de Fisher Exact para associação entre avaliações e fatores clínicos e sociodemográficos. Resultados: Dos 23 prematuros avaliados (65.3% masculinos, idade gestacional média de 31 semanas) 56.3% apresentaram writhing movements anormais, sendo 30.4% com dificuldades motoras pela MABC-2. Os fidgety movements estavam anormais em 26.1%, e, destes, 21.7% manifestaram dificuldades motoras. A melhor destreza manual foi associada com maior escolaridade materna (p=0.035). As crianças que fizeram fisioterapia nos dois primeiros anos de idade apresentaram mais dificuldades motoras. Conclusão: Nossos achados sugerem que a escolaridade materna parece ser um fator protetivo para a destreza manual. Além disso, as crianças prematuras devem ser acompanhadas com abordagens motoras ininterruptas até a idade escolar, a fim de prevenir prejuízos no desempenho motor
Title in English
Prediction of risk for motor difficulties in premature infants at preschool age by General Movements Assessment
Keywords in English
Child preschool
Infant
Infant premature
Motor skills
Physomotor performance
Abstract in English
Introduction: Scientific and technological advances in neonatology have resulted in increased survival of preterm infants, and, consequently, in a greater number of children with developmental disorders. Motor difficulties such as impaired balance and coordination are often only observed at school age. Early and effective detection is essential for intervention and minimization of functional, psychological and emotional impairments that directly impact the quality of life of these children. Objectives: Identify whether motor repertoire in the first months of life of preterm infants is related to the motor difficulties observed at preschool age and to correlate with clinical and sociodemographic factors. Method: Prospective longitudinal study with preterm infants born between 2013 and 2015, assessed by the General Movement Assessment (GMA) up to 4 months of corrected age and reassessed by the Movement Assessment Battery for Children-2 (MABC-2) between 3 and 5 years of age. One Way Anova was used to identify differences between groups and the Fisher Exact test for the association between assessments and clinical and sociodemographic factors. Results: Of the 23 preterm infants assessed (65.3% male, mean gestational age of 31 weeks) 56.3% had abnormal writhing movements, and 30.4% had also motor difficulties by MABC-2. Fidgety movements were abnormal in 26.1%, and 21.7% had concomitant motor difficulties. Lower motor difficulties in manual dexterity are associated with higher degree of maternal education (p = 0.035), and children who underwent physical therapy in the first two years of age had more motor difficulties. Conclusion: Our findings suggest that maternal education seems to be a protective factor for manual dexterity. In addition, premature children should be accompanied with uninterrupted motor approaches until school age, in order to minimize impairment in motor performance
 
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Publishing Date
2021-02-11
 
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