Uso das mãos na realização de atividades bimanuais de crianças e adolescentes com paralisia cerebral unilateral espástica

• Ano de defesa: 2021
• Autor(a) principal: Simone Aparecida Bueno
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; Brasil; EEFFTO - ESCOLA DE EDUCAÇÃO FISICA, FISIOTERAPIA E TERAPIA OCUPACIONAL; Programa de Pós-Graduação em Ciências da Reabilitação; UFMG
• Palavras-chave em Português: Paralisia cerebral; Hemiparesia; Mãos; Habilidade manual; Desempenho bimanual; Avaliação; Paralisia cerebral nas crianças; Capacidade motora
• Link de acesso: http://hdl.handle.net/1843/41695; https://orcid.org/0000-0003-0234-634X

Children and adolescents with unilateral spastic cerebral palsy (USCP) may show important limitations in hand function, compromising their performance in daily activities. It is known that daily routine activities involve actions that require the combined use of hands. Such activities can be considered challenging for these individuals, due to motor and sensory impairments, environmental and personal characteristics. The aim of this study was to investigate the factors that interfere with the use of hands in bimanual activities of children and adolescents with USCP. A cross-sectional study was conducted with 102 parents/caregivers of children and adolescents with USCP, aged 6 to 18 years. Data collection comprised the classification of the child's manual skills, according to the Manual Ability Classification System (MACS); child's age; side of the involvement; and information on the use of hands in everyday activities, through the Children's Hand-Use Experience Questionnaire (CHEQ 2.0). Cluster analysis identified groups of children and adolescents who performed CHEQ bimanual activities with and without caregiver assistance. Multiple linear regression analysis identified the contribution of factors: age, gender, classification of hand function (MACS), side of hemiparesis, and cluster of assistance, in the outcomes of efficacy, time, and discomfort in the use of hands. The MACS variables and clusters of assistance were predictors of efficacy (p<0.05; r2=0.31), time (p<0.05; r2=0.37) and discomfort (p<0.05; r2= 0.22). It was shown that children and adolescents with greater impairment of manual function (i.e., MACS level III) and who received assistance in most bimanual activities were less effective in using their hands, are slower to perform activities, and feel more uncomfortable when using the affected hand. Intervention strategies aimed at promoting and performing bimanual activities in the daily routine of children with USCP should consider the proficiency and speed of use of the affected extremity, as well as the child's feeling of discomfort during such activities. The use of adaptations and educational streategies to caregivers can promote the functional performance of these children and adolescents.