Avaliação da capacidade funcional cardiorrespiratória e modulação autonômica em pacientes com paralisia cerebral

Abstract

Background: Little is known about the functional cardiorespiratory capacity of children with Cerebral Palsy (CP). Many questions also arise regarding the modulation of the autonomic nervous system for different motor severity of them. Consolidating evaluative forms of functional capacity easily accessible and simple understanding for these children that are reliable and reproducible. Objective: Study 1: To investigate whether the six-minute walk test (6MWT) and walk test 10 meter (TC10m) are performed to assess functional capacity in children and adolescents with CP. Study 2: To investigate whether there are differences in autonomic modulation in different levels of motor severity in children with CP. Study 3: To investigate the reproducibility of the 6MWT and Shuttle Walk Test Incremental (SWTI) in children with CP in different levels System Functional Classification Engine Gross (GMFCS) I to III. Material and Methods: Study 1: This is a systematic review with meta-analysis. The survey was conducted until November 2015 in 5 databases: Pubmed, Pedro, Medline, Cochrane, CINAHL under results criteria in 6MWD and TC10m. Study 2: This is a cross-sectional study. Attended by 30 children with levels of GMFCS I to III. The Heart Rate (HR) and RR interval data were collected through a HR monitor (Polar RS800CX Polar, Finland). Children were instructed to remain lying in the supine position for 10 minutes then remained standing for 10 minutes. Study 3: This is a cross-sectional study. Each child held 2 times the same test (6MWT and SWTI) with an interval of 30 minutes between them. The reproducibility of both tests was tested for children with CP, GMFCS I to III. Results: Study 1: 39 studies met the criteria consistent with the objective of the systematic review. We conducted a meta-analysis of 5 studies, including three studies reported the 6MWT, only one is in favor of the experimental group (EG); and 2 to TC10m, both close in favor of GE. Study 2: There were no statistically significant differences (p> 0.05) on the parameters LF, HF and LF / HF ratio between different classifications of GMFCS. Study 3: The distance covered on the 1st and 2nd test, for both tests was not statistically significant (p = 0.63 for 6MWT and p = 0.39 for SWTI). Conclusion: Simple and valid tools are likely to become practice of professional conduct on behalf of individuals with CP. The autonomic modulation is not correlated with the severity of motor children with CP. Field tests: 6MWT and SWT are reproducible and reliable for this population.