Influence of physiotherapy on the motor skills of children with congenital Zika syndrome : clinical trial
Bibliographic record
Abstract
Congenital Zika syndrome can cause a number of changes in the child, including severe brain abnormalities. Injuries to the developing central nervous system result in sensorimotor disorders with repercussions on motor performance. Physical therapy allows the acquisition of motor skills based on the child's interaction with the environment and the task. The present study aimed to analyze the role of physiotherapy in the acquisition of the motor skills of children with congenital Zika syndrome. This is a clinical trial developed at the Physiotherapy Clinic of the University Hospital of Sergipe, with a sample of 46 children with congenital Zika syndrome. Data collection was from January 2016 to December 2017, at the physiotherapeutic admission of the child and at 18 months of age. The children were stratified according to the age group in the initial evaluation. In the first moment, a form was designed to record information on the identification and clinical characteristics of mothers and children, sociodemographic characteristics of families, neurological and musculoskeletal disorders, and type of neurological lesion. The severity of the neurological lesion was classified based on the data obtained in the medical record in the transfontanel ultrasonography report, based on the Noyola Classification System. Motor skills were assessed through the Alberta Infant Motor Scale (AIMS), stratified scores by age group and subgroup of neurological injury. The children were then submitted to a physiotherapy program, with a frequency of two weekly sessions and a duration of up to 50 minutes each. The program was based on the principles of neurodevelopment therapy (Bobath), muscle stretching and passive mobilizations. When children completed 18 months of age, motor skills reassessment was performed through the AIMS. The results showed that there was an increase in the total score comparing the initial evaluation and at 18 months of age in the children who started physical therapy with age from 0 to 6 months (p <0.0001). Despite this increase, the total scores of the study sample at 18 months were significantly lower than the normative values, with a significant difference (p <0.0001). In the initial evaluation, only children older than 4 months of age presented motor impairment when compared with normative values (p <0.0001). As for most neurological lesions, the degree was moderate to severe, with a predominance of multiple calcifications, mainly cortical-subcortical, severe cortical atrophy and agenesis / hypoplasia of the corpus callosum. The severity and type of neurological lesions in children with congenital Zika syndrome suggest impairment of neuronal migration and proliferation related to motor dysfunction. However, early physiotherapy promoted a difference in the behavior of the motor skills of these children.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".