Perfil cognitivo, déficits motores e influência dos facilitadores para reabilitação de crianças com disfunções neurológicas

[Environmental influence on physical disability: a systematic review of the literature]

People with physical disabilities may, in interaction with facilitators and barriers, modify their participation in society. The environment, in the panorama of the International Classification of Functioning, Disability and Health (ICF), plays a relevant role in health and in the expression of functioning. Thus, the aim of this study was to investigate the influence of environmental factors on physical disability, based on the theoretical framework of the ICF. A systematic review of the literature was performed based on the recommendations of the following documents: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Strengthening the Reporting of Observational Studies in Epidemiology Statement (STROBE). The studies selected confirmed the theoretical precepts of the ICF. The interference of the physical and social environment, in general, might be attributed to different clinical conditions, especially in neurology, both in quantitative and qualitative studies. Methodological limitations were observed that may be obstacles to consolidating some guidelines, which should encourage further research on the subject with judicious methods, validated instruments and carefully selected samples.

An ICF-based approach for cerebral palsy from a biopsychosocial perspective

OBJECTIVES

To integrate instruments to operationalize an ICF-based approach for cerebral palsy (CP); to assess differences in activity and participation among children with hemiplegia, diplegia and quadriplegia CP; to verify the facilitators or barriers to functioning; and to investigate the explanatory factors (cognitive and motor) for the type of school attended by children with CP (regular or special).

METHODS

Sixty children with CP were assessed using the Mini-Mental State Examination and an ICF-based instrument and their parents were interviewed. Data were analysed by Chi-Squared, Anova's and Kruskal-Wallis tests and multivariate logistic regression.

RESULTS

Significant differences between CP sub-groups were found for chewing, urinary function, cognitive function and activities and participation. Twelve environmental factors were identified as barriers. Multivariate regression identified cognitive function as a significant explanatory variable for the type of school attended, whereas motor function was not significant.

CONCLUSIONS

The ICF-based approach allows a comprehensive assessment, relevant for planning interventions.

Multidisciplinary perspective for cerebral palsy assessment after an international, classification of functioning, disability and health training

OBJECTIVE

To assess knowledge related to the ICF before and after an ICF training and to identify items to compose a monocentric rehabilitation ICF code set for cerebral palsy (CP).

METHODS

(a)

DESIGN

A cross-sectional study with a descriptive-explorative design. (b)

PARTICIPANTS

Professionals from the fields of physiotherapy, nutrition, dentistry, occupational therapy, psychology, social work, speech therapy and medicine. (c)

INSTRUMENT

A questionnaire to assess ICF's knowledge (total score = 17).

RESULTS

A high effect size of the ICF training was found (Cohen's d = 4.10). Ninety-one and 43 ICF categories were selected for a comprehensive evaluation and triage, respectively, for CP.

CONCLUSION

ICF categories were identified to compose a comprehensive evaluation and for triage through an ICF code sets for CP. Studies are needed to validate the instrument on the knowledge of the ICF and to test the impact of ICF's training for clinical rehabilitation of CP.