Equilíbrio e palmilhas posturais em crianças com paralisia cerebral: estudo clínico aleatorizado controlado

Abstract

INTRODUCTION: The main change present in children with palsy cerebral is the motor impairment. For this, several therapeutic interventions seek to promote the selective motor control, among them the orthoses. Different types of orthotics are used for this purpose, highlighting the use of fixed and articulated orthoses. Whereas the postural insoles aims to reorganize and rearrange mechanical postural muscle tone, that may play a role similar to the conventional orthoses. OBJECTIVE: The aim of the present study was to determine the effect of the combination of postural insoles and ankle-foot orthoses on static and functional balance in children with CP. METHODS: a systematic review of the literature considering the following inclusion criteria was done: (1) design controlled clinical trial; 2) intervention: insole; 3) outcome: change in static postural balance; and 4) year of publication: 2005 to 2012. Next, we conducted a randomized controlled double blind in which after meeting the legal aspects and the eligibility criteria, 10 children between 4 and 12 years old were randomly divided into a control group (12) and experimental group (12). Children in the control group used the placebo insole and children in the experimental group used postural insoles. These insoles were made in ethylene vinyl acetate, which in the case of postural insoles, received thermoforming to fasten the foot problems related to postural correction and in the case of placebos insoles did not receive the correct parts. In relation to evaluation, this was composed of gross motor function, static balance and functional mobility and functional performance. The evaluation will be carried out of balance with the force platform used, brand model Kistler 9286BA. Data analysis considered the adherence to the bell curve, by Kolmogorov-Smirnov and how they were presented parametric, were expressed as mean (standard deviation or confidence interval of 95%). For intergroup analysis it was used the independent t test and intragroup analysis was used repeated measures ANOVA. RESULTS: In the systematic review the results described demonstrate that currently many types of Palminhas are studied and developed in order to strengthen the somatosensory information. Already Articles provided clinical evidence that postural insoles provides evidence that such insoles promote an improvement in balance. The findings contribute to a better understanding of therapeutic resources employed in pediatric neurology.