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A apresentação fetal pélvica ocorre em cerca de 3 e 4% de todos os partos e está associada a uma restrição de movimento consequente de uma vivência in-utero diferente da típica. A literatura tem evidenciado algumas alterações no comportamento neuromotor dos membros inferiores em bebés pélvicos. Considerando que o gesto de alcance (GA) constitui um dos principais meios de exploração do ambiente e de construção do conhecimento nos primeiros meses de vida, torna-se pertinente estudar o possível impacto da apresentação fetal no comportamento neuromotor dos membros superiores, através da análise do GA. Objetivo: Comparar biomecânicamente o GA realizado por bebés de
apresentação fetal pélvica versus cefálica através da análise de variáveis cinemáticas. Estudo observacional analítico transversal, com uma amostra de 20 bebés, 9 pélvicos (GAP) e 11 cefálicos (GAC). Utilizou-se o sistema de aquisição de imagem Qualisys Track Manager (QTM) para a obtenção dos dados e o Statistical Package for the Social Sciences (SPSS) de modo a avaliar o GA através da análise de onze variáveis cinemáticas: tipo de GA, frequência GA, distância percorrida mão esquerda, distância percorrida mão direita, distância percorrida GA, duração GA, velocidade pico, velocidade média, aceleração média, índice de curvatura e, unidades de movimento. Resultados: Não se verificaram diferenças
estatisticamente significativas entre os grupos. No entanto, verificou-se uma possível tendência para os bebés do GAP apresentarem valores medianos superiores, como é o caso da distância percorrida pela mão esquerda, onde o GAP apresentou uma mediana de 6204,450mm (P25=3281,073; P75=7331,651), consideravelmente superior à mediana de 4821,966mm (P25=2947,922; P75=5901,582) do GAC. De forma semelhante, na variável velocidade pico, o GAP demonstrou valores medianos de 585,217mm/s (P25=516,161; P75=646,941) e o GAC apresentou uma mediana de 386,586mm/s (P25=253,949; P75=643,033). Na amostra em estudo, os bebés de apresentação pélvica não evidenciam
um comportamento cinemático do GA diferente dos bebés de apresentação cefálica, embora apresentem valores das variáveis em análise sugestivos de um comportamento menos eficiente.
Breech fetal presentation occurs in approximately 3 to 4% of all births and is associated with restricted movement due to an atypical intrauterine experience. The literature has highlighted certain alterations in the neuromotor behaviour of the lower limbs in breech infants. Considering that reaching gesture (RG) is one of the main means of exploring the environment and building knowledge in the early months of life, it becomes pertinent to study the possible impact of fetal presentation on the neuromotor behaviour of the upper limbs, through the analysis of RG. To biomechanically compare the RG performed by breech versus cephalic infants through the analysis of kinematic variables. Cross-sectional analytical observational study with a sample of 20 infants, 9 breech (PAG) and 11 cephalic (CAG). The Qualisys Track Manager (QTM) image acquisition system was used to obtain data, and the Statistical Package for the Social Sciences (SPSS) was used to analyse RG through eleven kinematic variables: type of RG, RG frequency, distance travelled by the left hand, distance travelled by the right hand, RG distance travelled, RG duration, peak velocity, mean velocity, mean acceleration, curvature index, and movement units. No statistically significant differences were found between the groups. However, a possible trend was observed for the PAG infants to present higher median values, as seen in the distance travelled by the left hand, where the PAG had a median of 6204.450 mm (P25=3281.073; P75=7331.651), considerably higher than the CAG median of 4821.966 mm (P25=2947.922; P75=5901.582). Similarly, in the peak velocity variable, PAG showed a median of 585.217 mm/s (P25=516.161; P75=646.941) compared to CAG’s median of 386.586 mm/s (P25=253.949; P75=643.033). In the studied sample, breech presentation infants do not exhibit a different RG kinematic behaviour compared to cephalic presentation infants, although the variable values analysed suggest a less efficient performance.
Breech fetal presentation occurs in approximately 3 to 4% of all births and is associated with restricted movement due to an atypical intrauterine experience. The literature has highlighted certain alterations in the neuromotor behaviour of the lower limbs in breech infants. Considering that reaching gesture (RG) is one of the main means of exploring the environment and building knowledge in the early months of life, it becomes pertinent to study the possible impact of fetal presentation on the neuromotor behaviour of the upper limbs, through the analysis of RG. To biomechanically compare the RG performed by breech versus cephalic infants through the analysis of kinematic variables. Cross-sectional analytical observational study with a sample of 20 infants, 9 breech (PAG) and 11 cephalic (CAG). The Qualisys Track Manager (QTM) image acquisition system was used to obtain data, and the Statistical Package for the Social Sciences (SPSS) was used to analyse RG through eleven kinematic variables: type of RG, RG frequency, distance travelled by the left hand, distance travelled by the right hand, RG distance travelled, RG duration, peak velocity, mean velocity, mean acceleration, curvature index, and movement units. No statistically significant differences were found between the groups. However, a possible trend was observed for the PAG infants to present higher median values, as seen in the distance travelled by the left hand, where the PAG had a median of 6204.450 mm (P25=3281.073; P75=7331.651), considerably higher than the CAG median of 4821.966 mm (P25=2947.922; P75=5901.582). Similarly, in the peak velocity variable, PAG showed a median of 585.217 mm/s (P25=516.161; P75=646.941) compared to CAG’s median of 386.586 mm/s (P25=253.949; P75=643.033). In the studied sample, breech presentation infants do not exhibit a different RG kinematic behaviour compared to cephalic presentation infants, although the variable values analysed suggest a less efficient performance.
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Ambiente intrauterino Desenvolvimento sensório-motor Membro superior Biomecânica