Avaliação de um programa de aplicação de toxina botulínica tipo A em crianças do Vale do Jequitinhonha com paralisia cerebral

Abstract

O objetivo do estudo foi avaliar os efeitos de um programa público de aplicação de toxina botulínica tipo A (TBA) na espasticidade muscular, amplitude de movimento, qualidade da marcha, independência funcional e qualidade de vida de crianças e adolescentes com paralisia cerebral (PC). Foi realizado um estudo quase experimental que avaliou os efeitos do emprego da TBA, aplicada três vezes, com intervalos de três meses, em 14 crianças com PC. Estas foram avaliadas através da Escala Modificada de Ashworth, Goniometria Manual, Physician Rating Scale, Inventário de Avaliação Pediátrica de Incapacidade (PEDI) e Questionário do Cuidador da Criança (QCC). Foi observada redução da espasticidade, aumento da amplitude de movimento, melhora das habilidades funcionais de autocuidado e mobilidade do PEDI e das áreas de cuidado pessoal, conforto e interação/comunicação do QCC. O programa de aplicação de TBA em crianças e adolescentes com PC, realizado em um núcleo de reabilitação público do Vale do Jequitinhonha, foi efetivo para a população beneficiada.

Domains of quality of life of children suffering from cerebral palsy: a cross-sectional study

“…A melhoria no estado de saúde da criança, com diminuição de sequelas motoras e até mesmo da espasti-Tabela 1 -Correlações entre os valores médios dos domínios da escala CP Qol-Child, Fortaleza, 2013. (11) , resulta em maior habilidade no uso dos equipamentos que permitem locomoção e consequente socialização.…”

The Pediatric Evaluation of Disability Inventory and Its Contributions to Brazilian Studies / O Inventário de Avaliação Pediátrica de Incapacidade e Suas Contribuições para Estudos Brasileiros

“…The results showed through PEDI that there was an improvement in ROM, influencing self-care and functional skills, but no decrease in caregiver assistance was observed. 24 The evaluation of the effects of Transcranial Direct-Current Stimulation (TDCS) applied on the primary motor cortex in children with CP showed that there was no significant improvement in the areas assessed by PEDI (self-care, mobility and social function) after the experiment. 25 Another study assessed, from the analysis of the PEDI results, changes in the functional use of the upper extremity in children undergoing the adapted Constraint-Induced Movement Therapy (CIMT) protocol, which consists of restricting the movement of the unaffected upper limb and providing intensive training in the affected limb.…”

The state of the art in therapeutic administration of botulinum toxin in children with cerebral palsy: an integrative review

“…Ideally, the administration should be performed by medical specialists in physical medicine and rehabilitation (physiatry) and/or neurologists 106 affiliated with a multi-professional rehabilitation program. 50 …”

“…Ideally, the administration should be performed by medical specialists in physical medicine and rehabilitation (physiatry) and/or neurologists 106 affiliated with a multi-professional rehabilitation program. 50 The fact that 50.5% of articles lack information on adverse effects is extremely relevant, as such data is crucial for the clinical administration of BTX in terms of safety and effectiveness. There were reports of systemic adverse effects in 12.4% of clinical trials; however, no deaths were directly related to the administration of BTX.…”

“…involving 14 patients aged 2-18 years. 50 The study conducted by Bussmann et al, which evaluated the cost-effectiveness of BTX in 60 children with walking capacity, found that BTX was efficacious when administered by specialist doctors in physical medicine and rehabilitation and/or trained neurologists. 4 Systematic outpatient treatment with BTX injections, combined with physiotherapy, occupational therapy, plaster, and/ or orthoses associated with rehabilitation team treatment, has been recommended in several studies to achieve the set objectives successfully.…”