Uma nova proposta para terapia psicomotora e método de avaliação de crianças e adolescentes com síndrome de Down e com transtorno do espectro autista utilizando robô socialmente assistivo

• Ano de defesa: 2024
• Autor(a) principal: Schreider, Sheila da Luz
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal do Espírito Santo; BR; Doutorado em Biotecnologia; Centro de Ciências da Saúde; UFES; Programa de Pós-Graduação em Biotecnologia
• Palavras-chave em Português: Robótica assistiva; Jogos sérios; Equilíbrio postural; Biotecnologia
• Link de acesso: http://repositorio.ufes.br/handle/10/18176

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by atypical neuropsychomotor development, communication and social interaction impairments, repetitive behaviors, stereotypies, and a preference for a restricted range of interests and activities. Children with ASD may present with muscle hypotonia and balance deficits in early childhood, leading to neuropsychomotor delay. Down Syndrome (DS) is the most common genetic alteration in humans, characterized by an imbalance in chromosomal constitution related to chromosome 21. Hypotonia is a typical feature in individuals with DS, influencing postural control and proprioception. This study aims to evaluate the effects of three therapeutic protocols of game therapy, using serious games applied through the socially assistive robot MARIA T-21, which stands for "Mobile Autonomous Robot for Interaction with Autistics and Trisomy 21 (Down Syndrome)," to assess proprioception and postural balance in children and adolescents with ASD and DS. Additionally, the study evaluated the functional performance and therapeutic progress of these children and adolescents through body image analysis, captured by a multi-camera system placed in the four corners of the experimental room. The serious games used in the research were designed by the MARIA T-21 robot. The sample consisted of 20 children and adolescents, with 11 having ASD and 9 with DS, aged between 5 and 18 years, divided into three data collection groups. These children and adolescents were recruited from institutions such as the Associação dos Amigos dos Autistas do Espírito Santo (AMAES Vitória), Vitória Down, and Associação de Pais e Amigos dos Excepcionais (APAE) in Vitória and Vila Velha. Before starting the serious game protocols, parents/guardians were informed about the study objectives, and the participants underwent a psychomotor assessment based on Victor da Fonseca’s Psychomotor Battery. Parents/guardians of children and adolescents in the third data collection phase answered the PEDI-CAT questionnaire, a functional assessment tool, before and after the application of the serious game protocol. This protocol consisted of 10 sessions of 45 minutes at AMAES Vitória and APAE Vitória and 4 sessions of 45 minutes at APAE Vila Velha, held twice a week, focusing on proprioception, balance, and both gross and fine praxia. The games used included Sound Sequence, Arara Game, Hopscotch, Healthy Food, Cross Kids, Bricks, and Star Wars, along with Warm-Up and Drawing activities (called Draw with Me). At the end of the protocol, participants underwent a psychomotor assessment identical to the initial one. The results showed that the use of the MARIA T-21 robot and serious games was an effective therapeutic strategy, providing a playful approach and increasing children's adherence to therapy. There was a significant improvement in psychomotor profile, with gains in posture maintenance, such as unipedal support and tiptoe standing, as well as an increase in average levels achieved in the Arara Game. Body image analysis of two adolescents with DS revealed fluctuations in postural control, with improved motor efficiency over the sessions. The image analysis tool used, BalancePro, proved highly valuable for tracking the progress of these two evaluated adolescents, providing numerical data on movement during the analyzed task. In conclusion, the use of the MARIA T-21 robot and serious games in this study proved to be a promising alternative for motor rehabilitation in children and adolescents with ASD and DS, contributing to improved motor skills and overall development, facilitating their integration into school and social settings, and promoting greater autonomy. It is believed that, for families, these advances may lead to improved quality of life and family interactions, as well as facilitate the social and school inclusion of children and adolescents.