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Constrangimentos da tarefa e estabilidade da postura de sentado em bebé hipotónico: estudo de caso
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Abstract(s)
Introdução: A realização da posição de sentar independente parece acontecer sem esforço e
ser apenas uma parte normal do processo de maturação mas esta requer estabilização dinâmica de todos os segmentos ligados ao corpo, e é um processo complexo de
aprendizagem e adaptação a várias forças do ambiente. Da interação entre constrangimentos
intrínsecos de extrínsecos emerge o padrão de coordenação motora. Em Fisioterapia, a
intervenção pode beneficiar com uma abordagem baseada nesta proposição. Objetivo: O
objetivo deste estudo de caso foi o de verificar se um constrangimento da tarefa funcional,
interagir com brinquedos, propiciaria alteração do padrão de estabilidade postural de sentado
num bebé hipotónico sem controlo postural eficaz. Amostra: A amostra é constituída por um
bebé hipotónico sem controlo postural eficaz sentado e outro de controlo, com
desenvolvimento normal, ambos com nove meses. Materiais e Métodos: Foi feita uma análise
cinemática dos movimentos realizados pelo tronco (C7, D7 e L5) nas condições com e sem
estimulação, através do software Kinovea 0.8.15, com recurso a rotinas em MATLAB, para
análise dos gráficos de série temporal e de recorrências. Resultados: Na condição com
estimulação, o bebé hipotónico revelou-se a nível da C7 menos deterministico (razão
%REC/%DET), mais complexo (ENT), e com oscilações posturais mais consistentes (RELENT,
MAXLINE, MEDLINE); e, o inverso ao nível das D7 e L5. Conclusão: Uma estimulação baseada
na funcionalidade das ações motoras propiciou reorganização do padrão de controlo postural
no bebé hipotónico, aproximando-se do padrão exibido pelo bebé controlo.
Introduction: Performing independent sitting position seems to happen and be effortlessly only a part of the normal maturation process but this requires dynamic stabilization of all segments connected to the body, and is a complex process of learning and adaptation to various environmental forces. From the interaction between intrinsic and extrinsic constraints emerge the pattern of motor coordination. In Physical Therapy, intervention can benefit from an approach based on this proposition. Objective: The objective of this work is to verify the presence of a constraint of the task (reaching to grab a toy) provides improved stability change of posture from sitting the child of a hypotonic infant without sitting postural control effective. Sample: The sample comprised a hypotonic baby without effective sitting posture control and another, control, with normal development, both with nine months. Materials and Methods: It was made a kinematic analysis of movements at the trunk (C7, D7 and L5) in conditions with and without stimulation, through Kinovea 0.8.15 software, using routines in MATLAB, for analysis of time series graphs and of recurrence. Results: With stimulation, at level of C7, the hypotonic infant showed less determinism (ratio %REC/%DET), more complexity (ENT), and with more consistent postural oscillations (RELENT, MAXLINE, MEDLINE), and the reverse at the level of L5 and D7. Conclusion: A stimulation based on the functionality of the motor actions led to reorganization of the pattern postural control in the hypotonic baby, approaching to the pattern displayed by a control infant.
Introduction: Performing independent sitting position seems to happen and be effortlessly only a part of the normal maturation process but this requires dynamic stabilization of all segments connected to the body, and is a complex process of learning and adaptation to various environmental forces. From the interaction between intrinsic and extrinsic constraints emerge the pattern of motor coordination. In Physical Therapy, intervention can benefit from an approach based on this proposition. Objective: The objective of this work is to verify the presence of a constraint of the task (reaching to grab a toy) provides improved stability change of posture from sitting the child of a hypotonic infant without sitting postural control effective. Sample: The sample comprised a hypotonic baby without effective sitting posture control and another, control, with normal development, both with nine months. Materials and Methods: It was made a kinematic analysis of movements at the trunk (C7, D7 and L5) in conditions with and without stimulation, through Kinovea 0.8.15 software, using routines in MATLAB, for analysis of time series graphs and of recurrence. Results: With stimulation, at level of C7, the hypotonic infant showed less determinism (ratio %REC/%DET), more complexity (ENT), and with more consistent postural oscillations (RELENT, MAXLINE, MEDLINE), and the reverse at the level of L5 and D7. Conclusion: A stimulation based on the functionality of the motor actions led to reorganization of the pattern postural control in the hypotonic baby, approaching to the pattern displayed by a control infant.
Description
Dissertação apresentada para a obtenção do grau de Mestre em Atividade Física em Populações Especiais
Keywords
hipotonia infante sentado controlo postural constrangimento da tarefa análise de recorrência hypotonia infants sitting postural control task constrain recurrence analysis