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A presença de deformidades cranianas em idades precoces tem sido frequente nos últimos anos, contudo a literatura não explana qual a relação destas e o controlo postural. Posto isto, o presente estudo tem como principal objetivo compreender relação entre a presença de deformidades cranianas e o comportamento do controlo postural em bebés de 4 e 6 meses. Foi ainda objetivo, estudar a relação entre as deformidades cranianas e o desenvolvimento sensoriomotor, avaliado através da Escala Motora Infantil de Alberta. Estudo analítico observacional transversal, no qual se recorreu à análise do comportamento do centro de pressão em 22 bebés (7 com deformidades cranianas e 15 sem deformidades cranianas), entre os 4 e os 6 meses de idade, durante a realização do gesto de alcance em decúbito dorsal. Os dados foram recolhidos com recurso a uma plataforma de forças e ao sistema de aquisição de imagem Qualisys. Foram analisadas variáveis do comportamento do centro de pressão (CoP), especificamente valores máximos pico a pico, valores médios pico a pico, desvio padrão, root mean square, área total, distância média do deslocamento e velocidade média, nas direções cefalocaudal e mediolateral. Utilizou-se, ainda, dois instrumentos de avaliação: Escala de Severidade da Plagiocefalia de Atlanta e Escala Motora Infantil de Alberta (EMIA). Todas as variáveis foram estatisticamente tratadas pelo software Statistical Package For The Social Sciences versão 29, assumindo-se um intervalo de confiança de 95% e um nível de significância de α=0,05. Todas as variáveis apresentaram valores superiores no grupo de crianças com deformidades cranianas comparativamente com o grupo sem deformidades cranianas : observaram-se diferenças significativas entre os grupos, nas variáveis Root Mean Square na direção mediolateral e Desvio-Padrão na direção mediolateral (p=0,039 e p=0,039, respetivamente). O grupo de bebés sem deformidade evidenciou um score da EMIA significativamente superior ao grupo com deformidade (p< 0,001). Este estudo permitiu concluir que parece existir uma relação entre a presença de deformidades cranianas em bebés de 4 e 6 meses e o comportamento do CoP, expresso por mecanismos menos eficientes, bem como em relação ao desenvolvimento sensóriomotor.
The presence of cranial deformities at an early age has been frequent in recent years, however, the literature does not explain the relationship between these deformities and postural control. That said, the main objective of this study is to understand the relationship between the presence of cranial deformities and postural control behavior in 4- and 6-month-old infants. Another objective was to study the relationship between cranial deformities and sensorimotor development, assessed using the Alberta Infant Motor Scale. A cross-sectional observational analytical study was conducted, analyzing the behavior of the center of pressure in 22 infants (7 with cranial deformities and 15 without cranial deformities), aged between 4 and 6 months, while performing a reaching movement in the supine position. Data were collected using a force platform and the Qualisys image acquisition system. Variables of center of pressure (CoP) behavior were analyzed, specifically peak-to-peak maximum values, peak-to-peak mean values, standard deviation, root mean square, total area, mean displacement distance, and mean velocity in the cephalocaudal and mediolateral directions. Two assessment instruments were also used: the Atlanta Plagiocephaly Severity Scale and the Alberta Infant Motor Assessment Scale (AIMAS). All variables were statistically processed using Statistical Package For The Social Sciences version 29 software, assuming a 95% confidence interval and a significance level of α=0.05. All variables showed higher values in the group of children with cranial deformities compared to the group without cranial deformities: significant differences were observed between the groups in the Root Mean Square variables in the mediolateral direction and Standard Deviation in the mediolateral direction (p=0.039 and p=0.039, respectively). The group of infants without deformities had a significantly higher EMIA score than the group with deformities (p<0.001). This study concluded that there appears to be a relationship between the presence of cranial deformities in 4- and 6-month-old infants and CoP behavior, expressed by less efficient mechanisms, as well as in relation to sensorimotor development.
The presence of cranial deformities at an early age has been frequent in recent years, however, the literature does not explain the relationship between these deformities and postural control. That said, the main objective of this study is to understand the relationship between the presence of cranial deformities and postural control behavior in 4- and 6-month-old infants. Another objective was to study the relationship between cranial deformities and sensorimotor development, assessed using the Alberta Infant Motor Scale. A cross-sectional observational analytical study was conducted, analyzing the behavior of the center of pressure in 22 infants (7 with cranial deformities and 15 without cranial deformities), aged between 4 and 6 months, while performing a reaching movement in the supine position. Data were collected using a force platform and the Qualisys image acquisition system. Variables of center of pressure (CoP) behavior were analyzed, specifically peak-to-peak maximum values, peak-to-peak mean values, standard deviation, root mean square, total area, mean displacement distance, and mean velocity in the cephalocaudal and mediolateral directions. Two assessment instruments were also used: the Atlanta Plagiocephaly Severity Scale and the Alberta Infant Motor Assessment Scale (AIMAS). All variables were statistically processed using Statistical Package For The Social Sciences version 29 software, assuming a 95% confidence interval and a significance level of α=0.05. All variables showed higher values in the group of children with cranial deformities compared to the group without cranial deformities: significant differences were observed between the groups in the Root Mean Square variables in the mediolateral direction and Standard Deviation in the mediolateral direction (p=0.039 and p=0.039, respectively). The group of infants without deformities had a significantly higher EMIA score than the group with deformities (p<0.001). This study concluded that there appears to be a relationship between the presence of cranial deformities in 4- and 6-month-old infants and CoP behavior, expressed by less efficient mechanisms, as well as in relation to sensorimotor development.
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Deformidades cranianas Plagiocefalia Centro de pressão Desenvolvimento motor Escala Motora Infantil de Alberta