ABSTRACT Background The Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT), developed with innovative measurement methodologies, evaluates functioning of children and youth, from 0 to 21 years, with different health conditions. It is a revision of an earlier instrument (PEDI) that has been used in national and international clinical practice and research. It was felt to be necessary to make this new version (PEDI-CAT) available in Brazil. Objectives Translate and culturally adapt the PEDI-CAT to the Brazilian-Portuguese language and test its psychometric properties. Method This methodological study was developed through the following stages: (1) translation, (2) synthesis, (3) back-translation, (4) revision by an expert committee, (5) testing of the pre-final version, and (6) evaluation of the psychometric properties. The 276 translated PEDI-CAT items were divided into three age groups (0-7, 8-14, and 15-21 years). Results The PEDI-CAT translation followed all six stages. The adaptations incorporated cultural and socioeconomic class specificities. The PEDI-CAT/Brazil showed good indices of inter-examiner (intraclass correlation coefficient-ICC=0.83-0.89) and test-retest (ICC=0.96-0.97) reliability, good internal consistency (0.99) and small standard error of measurement in all three age groups (0.12-0.17). Factor analyses grouped the items from the three functional skills domains into one factor, and items from the responsibility scale into three factors, supporting the adequacy of these factor solutions to the conceptual structure of the instrument and the developmental model. Conclusion The PEDI-CAT/Brazil is a theoretically consistent, culturally appropriate, and reliable instrument. Its availability in Brazil will contribute to the evaluation and measurement of functional outcomes from clinical interventions, longitudinal follow-up, and rehabilitation research.

ABSTRACT Objective: To empirically test the relationships proposed by the International Classification of Functioning, Disability and Health (ICF) among its domains. Method: The cross-sectional study was completed with 226 adult patients with different health conditions who attended a Brazilian rehabilitation unit. The ICF components were measured with the following instruments: World Health Organization Disability Assessment Instrument II, Functional Independence Measure, Participation Scale, Craig Hospital Inventory of Environmental Factors, and a protocol designed to gather information on body structure and function and personal factors. Results: Structural equation modeling showed good model adjustment, GFI=0.863; AGFI=0.795; RMSEA=0.028 (90% CI=0.014-0.043). Significant relationships were found between activity and both body structure and function (standard coefficient=0.32; p<0.0001) and participation components (standard coefficient=–0.70; p<0.0001). Environmental and personal factors had a significant effect on the three functioning components (standard coefficient =0.39; p<0.0001; standard coefficient =-0.35; p<0.001, respectively). In contrast, body structure and function had no significant effect on participation (standard coefficient=–0.10; p=0.111) and health conditions had no significant effect on any of the functioning components, i.e., body structure and function, activity, and participation (standard coefficient=–0.12; p=0.128). Conclusion: Some of the ICF’s proposed relationships across domains were confirmed, while others were not found to be significant. Our results reinforce the contextual dependency of the functioning and disability processes, in addition to putting into perspective the impact of health conditions.

RESUMO Este estudo avaliou transversalmente a correlação entre sintomas de transtorno de déficit de atenção e hiperatividade (TDAH) e de oposição com desempenho de crianças e adolescentes nas tarefas domésticas e assistência disponibilizada pelos cuidadores. Pais de crianças e adolescentes com TDAH (n = 67), de 6 a 14 anos, foram entrevistados com o children helping out: responsibilities, expectations and supports (CHORES). Foram encontradas correlações significativas entre sintomas de oposição e assistência em cuidado próprio (r = -0,31; p = 0,01) e de hiperatividade com assistência em cuidado próprio (r = -0,30, p = 0,01) e em cuidado familiar (r = -0,25, p = 0,04). Idade está diretamente correlacionada ao número de tarefas desempenhadas pela criança e inversamente associada à assistência disponibilizada pelos cuidadores. Maior número de sintomas de oposição resultou em maior assistência disponibilizada. Características dos sintomas de oposição, como a desobediência e hostilidade frente às autoridades, são limitantes para que essas crianças acessem as tarefas por iniciativa própria, demandando maior assistência dos cuidadores.

ABSTRACT This study evaluated the associations among symptoms of attention-deficit/hyperactivity disorder (ADHD) and of oppositional defiant disorder (ODD) in children and adolescents’ performance in household tasks and assistance provided by caregivers. Parents of children from 6 to 14 years old with ADHD (n = 67) were interviewed with the Children Helping Out: Responsibilities, Expectations, and Supports (CHORES) instrument. Significant correlations were found between symptoms of ODD and assistance in self-care tasks (r = −0.31; p = 0.01); symptoms of hyperactivity correlated with assistance in self-care (r = −0.30, p = 0.01); and family-care (r = −0.25, p = 0.04) tasks. Age was directly associated with the number of tasks performed by children and inversely related to the assistance provided by caregivers. A greater number of ODD symptoms resulted in more household assistance from caregivers. Characteristics of ODD symptoms, such as disobedience and hostility in the face of authority, may limit these children in accessing household tasks by their own initiative, requiring assistance from caregivers.

Objective: This paper describes the development of the Protocol for Identification of Problems for Rehabilitation (PLPR), a tool to standardize collection of functional information based on the International Classification of Functioning, Disability and Health (ICF). Development of the protocol: The PLPR was developed for use during the initial contact with adult patients within a public network of rehabilitation services. Steps to develop the protocol included: survey of the ICF codes most used by clinical professionals; compilation of data from functional instruments; development and pilot testing of a preliminary version in the service settings; discussion with professionals and development of the final version. The final version includes: user identification; social and health information; brief functional description (BFD); summary of the BFD; and PLPR results. Further testing of the final version will be conducted. Conclusions: The protocol standardizes the first contact between the user and the rehabilitation service. Systematic use of the protocol could also help to create a functional database that would allow comparisons between rehabilitation services and countries over time.

OBJECTIVE: To test the intra- and interrater reliability of the Brazilian Portuguese version of the 66-item Gross Motor Function Measure (GMFM-66). METHOD: The sample included 48 children with cerebral palsy (CP), ranging from 2-17 years old, classified at levels I to IV of the Gross Motor Function Classification System (GMFCS) and four child rehabilitation examiners. A main examiner evaluated all children using the GMFM-66 and video-recorded the assessments. The other examiners watched the video recordings and scored them independently for the assessment of interrater reliability. For the intrarater reliability evaluation, the main examiner watched the video recordings one month after the evaluation and re-scored each child. We calculated reliability by using intraclass correlation coefficients (ICC) with their respective 95% confidence intervals. RESULTS: Excellent test reliability was documented. The intrarater reliability of the total sample was ICC=0.99 (95% CI 0.98-0.99), and the interrater reliability was ICC=0.97 (95% CI 0.95-0.98). The reliability across GMFCS levels ranged from ICC=0.92 (95% CI 0.72-0.98) to ICC=0.99 (95% CI 0.99-0.99); the lowest value was the interrater reliability for the GMFCS IV group. Reliability in the five GMFM dimensions varied from ICC=0.95 (95% CI 0.93-0.97) to ICC=0.99 (95% CI 0.99-0.99). CONCLUSION: The Brazilian Portuguese version of the GMFM-66 showed excellent intra- and interrater reliability when used in Brazilian children with CP levels GMFCS I to IV.

BACKGROUND: The literature demonstrates that the social participation of children with disabilities is influenced by both their functional skills repertoire and environmental factors. However, it is not yet known whether the effect of functional limitations on social participation is minimized or enhanced by the environmental facilitators and barriers. This study aimed to test this hypothesis.OBJECTIVE: To investigate the moderating effect of environmental factors in the relationship between mobility and school participation of children and adolescents with cerebral palsy (CP).METHOD: Participants were 102 elementary school children and adolescents with CP, aged 6 to 17 years, classified as levels I, II, and III according to the Gross Motor Classification System, along with their parents or caregivers and teachers. School participation and parents' perceptions of barriers were evaluated using the School Function Assessment and the Craig Hospital Inventory of Environmental Factors (CHIEF), respectively.RESULTS: The regression model failed to reveal a moderating effect of environmental factors in the relationship between mobility and school participation. While mobility was a strong predictor of participation, environmental factors demonstrated a weak predictive effect on the latter. The CHIEF subscale school/work showed the factors which were greatest barrier to children's participation, while the subscale attitude/support had the least impact.CONCLUSION: The absence of moderation on the tested relationship suggests that, when investigated under the negative perspective of environmental barriers, the contextual factors do not modify the relationship between mobility and school participation. Factors specific to the school environment might add to the present study's results regarding the effect of school participation in this population.

Background: In children, reaching emerges around four months of age, which is followed by rapid changes in hand function and concomitant changes in gross motor function, including the acquisition of independent sitting. Although there is a close functional relationship between these domains, to date they have been investigated separately. Objective: To investigate the longitudinal profile of changes and the relationship between the development of hand function (i.e. reaching for and manipulating an object) and gross motor function in 13 normally developing children born at term who were evaluated every 15 days from 4 to 8 months of age. Method: The number of reaches and the period (i.e. time) of manipulation to an object were extracted from video synchronized with the Qualisys(r) movement analysis system. Gross motor function was measured using the Alberta Infant Motor Scale. ANOVA for repeated measures was used to test the effect of age on the number of reaches, the time of manipulation and gross motor function. Hierarchical regression models were used to test the associations of reaching and manipulation with gross motor function. Results: Results revealed a significant increase in the number of reaches (p<0.001), the time of manipulation (p<0.001) and gross motor function (p<0.001) over time, as well as associations between reaching and gross motor function (R2=0.84; p<0.001) and manipulation and gross motor function (R2=0.13; p=0.02) from 4 to 6 months of age. Associations from 6 to 8 months of age were not significant. Conclusion: The relationship between hand function and gross motor function was not constant, and the age span from 4 to 6 months was a critical period of interdependency of hand function and gross motor function development.

Revisões sistemáticas têm como objetivo sumarizar toda a evidência disponível, através de métodos rigorosos, para responder a uma pergunta de pesquisa específica com o mínimo de viés possível. Revisões sistemáticas são amplamente utilizadas na fisioterapia, porém nem todas as revisões possuem boa qualidade. Esse tutorial tem como objetivo guiar os autores do Brazilian Journal of Physical Therapy sobre como revisões sistemáticas deveriam ser conduzidas e descritas para que sejam aceitas para publicação. Espera-se que esse tutorial irá auxiliar autores de revisões sistemáticas, assim como editores e revisores de periódicos em como conduzir, descrever, fazer análise crítica e interpretar esse tipo de delineamento de pesquisa.

Systematic reviews aim to summarize all evidence using very rigorous methods in order to address a specific research question with less bias as possible. Systematic reviews are widely used in the field of physical therapy, however not all reviews have good quality. This tutorial aims to guide authors of the Brazilian Journal of Physical Therapy on how systematic reviews should be conducted and reported in order to be accepted for publication. It is expected that this tutorial will help authors of systematic reviews as well as journal editors and reviewers on how to conduct, report, critically appraise and interpret this type of study design.

Contextualização: Ações colaborativas entre família e terapeuta são essenciais para o processo de reabilitação, podendo constituir mecanismo catalisador de desfechos funcionais positivos para crianças com paralisia cerebral (PC). Objetivos: Descrever prioridades funcionais identificadas por cuidadores de crianças com PC por nível de gravidade e idade e avaliar mudanças no desempenho e satisfação reportadas pelos cuidadores nas prioridades identificadas no intervalo de seis meses. Método: De 75 crianças com PC, atendidas semanalmente naAssociação Mineira de Reabilitação, nos serviços de fisioterapia e de terapia ocupacional, foram coletadas informações referentes à função motora grossa (Sistema de Classificação da Função Motora Grossa-GMFCS) e às prioridades funcionais estabelecidas pelos cuidadores (Medida Canadense de Desempenho Ocupacional-COPM). Os dados foram coletados em dois períodos, com intervalo de seis meses. Resultados: As principais demandas apontadas pelos cuidadores referiram-se às atividades de cuidados pessoais (48,2%). Pais de crianças com comprometimento motor grave (GMFCS V) apresentaram maior número de demandas relacionadas ao brincar (p=0,036), comparadas com outros níveis de comprometimento. Pais de crianças mais jovens reportaram maior número de demandas em mobilidade (p=0,025) e brincar (p=0,007) em relação aos outros grupos etários. Após seis meses, observou-se aumento significativo dos escores de desempenho (p=0,0001) e de satisfação (p=0,0001) da COPM. Conclusões: Pais de crianças com PC identificaram prioridades funcionais em áreas de desempenho semelhantes por nível de gravidade da função motora grossa e por grupo etário. Direcionar o processo de reabilitação infantil, visando a promover mudanças nas prioridades funcionais definidas como relevantes pelos pais, pode contribuir para o fortalecimento da colaboração família-terapeuta.

Background: Collaborative actions between family and therapist are essential to the rehabilitation process, and they can be a catalyst mechanism to the positive outcomes in children with cerebral palsy (CP). Objectives: To describe functional priorities established by caregivers of CP children by level of severity and age, and to assess changes on performance and satisfaction on functional priorities reported by caregivers, in 6-month interval. Method: 75 CP children, weekly assisted at Associação Mineira de Reabilitação, on physical and occupational therapy services. The following information was collected: gross motor function (Gross Motor Function Classification System-GMFCS) and functional priorities established by caregivers (Canadian Occupational Performance Measure-COPM). Data were collected in two moments, with a 6-month interval. Results: The main functional demands presented by caregivers were related to self-care activities (48.2%). Parents of children with severe motor impairment (GMFCS V) pointed higher number of demands related to play (p=0.0036), compared to the other severity levels. Parents of younger children reported higher number of demands in mobility (p=0.025) and play (p=0.007), compared to other age groups. After 6 months, there were significant increase on COPM performance (p=0.0001) and satisfaction scores (p=0.0001). Conclusions: Parents of CP children identified functional priorities in similar performance domains, by level of severity and age. Orienting the pediatric rehabilitation process to promote changes in functional priorities indentified by caregivers can contribute to the reinforcement of the parent-therapist collaboration.

Contextualização: Fatores ambientais são essenciais para a caracterização dos processos de funcionalidade e incapacidade, no entanto a escassez de instrumentação padronizada sobre tais elementos restringe a investigação científica de barreiras e facilitadores associados à participação social de pessoas com deficiência. Objetivos : Traduzir para o Português do Brasil, adaptar culturalmente e verificar a confiabilidade do questionário de avaliação ambiental denominado Craig Hospital Inventory of Environmental Factors (CHIEF). Método : O questionário foi traduzido para o Português, analisado, retrotraduzido para o Inglês e comparado com a versão original. A versão final (CHIEF-BR) foi administrada em 47 cuidadores de crianças e adolescentes com paralisa cerebral (PC), e a confiabilidade teste-reteste foi analisada pelo Kappa quadrático e índice de consistência (CCI) a partir de entrevista com 23 cuidadores dessa amostra, em dois momentos, com intervalo de dez dias. Resultados : Durante a administração, foi necessário o fornecimento de exemplos para facilitar a compreensão das questões relacionadas à subescala política. Kappa quadrático evidenciou que a confiabilidade teste-reteste de cada questão variou de 0,28 a 1,0 no escore de frequência e de 0,38 a 0,98 no escore de magnitude. Os coeficientes de correlação intraclasse dos escores totais apresentaram um alto índice de consistência (CCI≥0,92). Conclusão: O CHIEF-BR mostrou-se reprodutível e aplicável à amostra do estudo, podendo ser utilizado para documentar os efeitos de intervenções que visem a minimizar o impacto das barreiras ambientais na participação de crianças e jovens com PC.

Background: Environmental factors are essential for the characterization of human functioning and disability; however, the shortage of standardized instruments to assess environmental factors has limited the design of scientific investigations directed at identifying barriers to and facilitators of social participation of people with disabilities. Objectives : To translate to Brazilian Portuguese, cross-culturally adapt, and verify the reliability of an environmental assessment questionnaire, entitled Craig Hospital Inventory of Environmental Factors (CHIEF). Method : The questionnaire was translated to Portuguese, analyzed, translated back to English, and compared with the original version. The final version (CHIEF-BR) was submitted to 47 caregivers of children and adolescents with cerebral palsy (CP). The intra-rater reliability was tested using quadratic kappa and intraclass correlation coefficients (ICC), through interviews of 23 caregivers drawn from the total sample, on two occasions 10 days apart. Results : During submission of the questionnaires, it was observed that examples were needed in order to facilitate the understanding of the questions related to the politics sub-scale. Quadratic kappa showed that test-retest reliability of each question varied from 0.28 to 1.0 for the frequency score and from 0.30 to 0.98 for the magnitude score. Intraclass correlation coefficients for total scores showed high consistency indices (ICC≥0.92) for test-retest. Conclusion : The Brazilian version of the CHIEF was reproducible and applicable to the study sample. It may serve as an instrument to characterize the environmental barriers as well as a way to document the effects of interventions aimed at minimizing the impact of such barriers on the participation of children and adolescents with CP.

CONTEXTUALIZAÇÃO : A otimização da marcha é objetivo relevante na reabilitação de crianças com prognóstico de locomoção na paralisia cerebral (PC). A análise da marcha com vídeos capturados por câmeras digitais necessita ser validada. OBJETIVO : Avaliar a validade de um método que envolve a inspeção de vídeos capturados por câmera digital para quantificação de variáveis temporais da marcha de lactentes com desenvolvimento motor normal e crianças com PC. MÉTODO : Onze lactentes com desenvolvimento motor normal e oito crianças com PC do tipo hemiplegia espástica capazes de deambular sem dispositivos de auxílio de marcha foram solicitadas a caminhar em um espaço contido no campo visual de dois instrumentos: câmera digital e sistema tridimensional de análise de movimento Qualisys Pro-Reflex. As medidas de duração das fases de apoio e balanço e o tempo total do ciclo da marcha foram calculados a partir da análise de vídeos de câmera digital e comparados às medidas obtidas pelo Qualisys Pro-Reflex, considerado sistema de alta acurácia. RESULTADOS: O Coeficiente de Correlação Intraclasse (CCI) demonstrou concordância excelente (CCI>0,90) nas medidas dos dois grupos, exceto para a fase de balanço dos lactentes (CCI=0,35). O erro padrão das medidas foi menor que 0,02 segundos para todas as mensurações. CONCLUSÕES : Resultados revelam semelhança entre os dois instrumentos, sugerindo que a câmera digital pode ser instrumento válido para quantificação de dois parâmetros temporais da marcha. Tal congruência tem relevância clínica e científica, preconizando uso da câmera digital como recurso auxiliar à avaliação e documentação de efeitos terapêuticos das intervenções direcionadas à marcha de crianças com PC.

BACKGROUND: The optimization of gait performance is an important goal in the rehabilitation of children with cerebral palsy (CP) who present a prognosis associated with locomotion. Gait analysis using videos captured by digital cameras requires validation. OBJECTIVE: To evaluate the validity of a method that involves the analysis of videos captured using a digital camera for quantifying the temporal parameters of gait in toddlers with normal motor development and children with CP. METHOD: Eleven toddlers with normal motor development and eight children with spastic hemiplegia who were able to walk without assistive devices were asked to walk through a space contained in the visual field of two instruments: a digital camera and a three-dimensional motion analysis system, Qualisys Pro-Reflex. The duration of the stance and swing phases of gait and of the entire gait cycle were calculated by analyzing videos captured by a digital camera and compared to those obtained by Qualisys Pro-Reflex, which is considered a highly accurate system. RESULTS: The Intraclass Correlation Coefficient (ICC) demonstrated excellent agreement (ICC>0.90) between the two procedures for all measurements, except for the swing phase of the normal toddlers (ICC=0.35). The standard error of measurement was less than 0.02 seconds for all measures. CONCLUSIONS: The results reveal similarities between the two instruments, suggesting that digital cameras can be valid instruments for quantifying two temporal parameters of gait. This congruence is of clinical and scientific relevance and validates the use of digital cameras as a resource for helping the assessment and documentation of the therapeutic effects of interventions targeted at the gait of children with CP.

CONTEXTUALIZAÇÃO: O processo de envelhecimento associado à ampliação da expectativa de vida da população pode acarretar um aumento da prevalência e incidência de doenças e de prejuízos à funcionalidade. A dependência física e o comprometimento cognitivo podem impedir o desempenho de atividades, gerando uma sobrecarga de cuidados para a família e para o sistema de saúde.OBJETIVO: Comparar as mudanças funcionais e cognitivas em idosos ocorridas num período de seis meses.MÉTODO: Trata-se de um estudo observacional longitudinal, com uma amostra de 167 idosos, selecionados a partir do banco de dados da Rede de Estudos da Fragilidade em Idosos Brasileiros do polo da Universidade Federal de Minas Gerais (UFMG). Os participantes responderam ao Miniexame do Estado Mental (MEEM), ao Índice de Katz, a Escala de Lawton e Brody e a questões relativas à Atividade Avançada de Vida Diária (AAVD). Os dados foram analisados com modelos de regressão multivariada. RESULTADOS: Observou-se diminuição da capacidade funcional nas Atividades Instrumentais de Vida Diária (AIVD), p=0,002, e, nas Atividades Básicas de Vida Diária (ABVD), p=0,038, em algumas atividades específicas. Morar sozinho (OR=2,53; IC=1,09:5,87) e condição de trabalho (OR=2,52; IC=1,18:5,41) associaram-se a mudança nas AIVD. Não houve diferença significativa no período de tempo do acompanhamento, na pontuação da AAVD, p=0,163, e do MEEM, p=0,059. Observou-se que os indivíduos com melhor cognição eram mais independentes nas AAVD e nas AIVD.CONCLUSÃO: Esses resultados revelam perfis específicos de perda e de estabilidade na funcionalidade de idosos comunitários.

BACKGROUND: The relationship between aging and increased life expectancy in the overall population likely contributes to a higher frequency rate and incidence of illnesses and functional disabilities. Physical dependence and cognitive impairment might hinder the performance of activities and result in an overload of care duties for the patient's family and the healthcare system.OBJECTIVE: The aim of this study was to compare the functional and cognitive changes exhibited by the elderly over a 6-month period.METHOD: This longitudinal and observational study was conducted in a sample of 167 elderly people, who were selected from the database of the Network of Studies on Frailty in Brazilian Elderly, Universidade Federal de Minas Gerais- UFMG. The participants submitted to the Mini Mental State Examination (MMSE), Katz Index, Lawton and Brody's scale and responded to items on Advanced Activities of Daily Living (AADLs). We analyzed the data using multivariate regression models.RESULTS: The participants' functional capacity exhibited reduced performance of specific instrumental activities of daily living (IADLs), p=0.002, and basic activities of daily living (BADLs), p=0.038. Living alone (odds ratio (OR), 2.53; 95% confidence interval (CI), 1.09-5.87) and work status (OR, 2.52; 95% CI, 1.18-5.41) were associated with changes in the IADLs. The scores in the AADL scale (p=0.163) and MMSE (p=0.059) did not exhibit any significant difference during the study period. The participants with better cognitive function were more independent in their performance of AADLs and IADLs.CONCLUSION: The results depict specific patterns of loss and stability of functional capacity in community-dwelling elderly.

CONTEXTUALIZAÇÃO: A aquisição da marcha é suportada por mudanças no sistema neuromusculoesquelético da criança. a literatura aponta que modificações nas dimensões das estruturas corporais resultantes do crescimento da criança explicam, em parte, o aprimoramento da marcha no primeiro ano de vida. OBJETIVOS: Avaliar se mudanças na massa corporal e comprimento da perna modulam o efeito da prática da marcha independente nos seguintes parâmetros da marcha: velocidade e comprimento da passada. MÉTODO: Trinta e dois lactentes com desenvolvimento normal foram acompanhados mensalmente a partir da aquisição da marcha independente até seis meses pós-aquisição. Avaliações longitudinais incluíram mensurações da massa corporal e do comprimento da perna de cada criança. As variáveis temporoespaciais da marcha (velocidade e comprimento da passada) foram documentadas utilizando-se o sistema Qualisys Pro-Reflex(r). Os dados foram analisados por modelos de regressão multinível, com nível de significância α=0,05. RESULTADOS:Encontrou-se um efeito do tempo de prática nas medidas de velocidade (p<0,0001) e comprimento da passada (p<0,0001). a mudança no comprimento da perna teve um efeito marginal na taxa de mudança da velocidade de marcha: crianças cujo crescimento da perna foi mais acelerado apresentaram uma taxa de mudança de velocidade maior (p=0,07). Nenhum outro efeito dos parâmetros antropométricos foi observado. CONCLUSÕES:Os resultados sugerem que o tempo de prática promove o aprimoramento do padrão de marcha de lactentes no primeiro ano de vida. Por sua vez, os efeitos do comprimento da perna e da massa corporal de lactentes no tempo permanecem indefinidos.

BACKGROUND: Gait acquisition is supported by changes in the neuromusculoskeletal system of the child. Changes in the dimensions of the body structures resulting from the growth of the child partly explain gait improvement in the first year of life. OBJECTIVES: To evaluate whether changes in body mass and leg length modulate the effect of independent gait practice (experience) on gait speed and stride length. METHOD: Thirty-two infants with normal development were monitored monthly from the acquisition of independent gait until six months post-acquisition. Longitudinal evaluations included measurements of the body mass and leg length of each child. Temporospatial variables of gait (speed and stride length) were documented using the Qualisys Pro-reflex(r) system. The data were analyzed using multilevel regression models, with a significance level of α=0.05. RESULTS: An effect of the practice time on speed (p<0.0001) and stride length (p<0.0001) was observed. The change in leg length had a marginal effect on the rate of gait speed change: children whose leg growth was faster showed a higher rate of speed change (p=0.07). No other effects of anthropometric parameters were observed.CONCLUSIONS: The results suggest that the practice time promotes the improvement of the gait pattern of infants in the first year of life. However, the effects of the leg length and body weight of infants on the benefit of practice time remain undefined.

A mobilidade funcional de crianças com paralisia cerebral (PC) é influenciada por fatores pessoais e ambientais, que servem como barreiras e/ou facilitadores e têm impacto nas estratégias e nos desfechos funcionais dessas crianças. OBJETIVOS: Descrever os métodos usuais de mobilidade usados por crianças com PC em ambiente domiciliar, escolar e comunitário, e compará-los entre famílias de diferentes níveis socioeconômicos (NSE). MÉTODOS: Foi usada a Escala de Mobilidade Funcional para avaliar a mobilidade de 113 crianças com PC de NSE alto e baixo, em casa, escola e comunidade. RESULTADOS: Foram encontradas diferenças nos métodos de mobilidade nos participantes classificados nos níveis II, III e IV do Gross Motor Function Classification System entre casa e comunidade; nos níveis III e IV, adicionalmente, foram encontradas diferenças entre casa e escola. Participantes de NSE alto relataram uso frequente da cadeira de rodas no ambiente domiciliar, enquanto os de NSE baixo usavam o engatinhar. CONCLUSÕES: Contexto ambiental e NSE das famílias podem influenciar a mobilidade e a utilização de dispositivos de suporte por crianças com PC.

Functional mobility of children with cerebral palsy (CP) is influenced by personal and environmental factors, serving as barriers and/or facilitators and impacting on children's strategies and functional outcome. OBJECTIVES: To describe typical mobility methods used by children with CP at home, school and community and to compare them across family's socioeconomic levels (SES). METHODS: The Functional Mobility Scale was used to assess mobility of 113 children with CP of high and low SES at home, school, and community. RESULTS: Differences in mobility methods of participants classified as Gross Motor Function Classification System levels II, III and IV were found between home and community. For levels III and IV, differences were also found between home and school. At home, participants from higher SES used wheelchairs more frequently while those from lower SES used floor mobility (crawling). CONCLUSIONS: Environmental settings and families' socioeconomic status influence mobility and use of mobility devices by children with CP.

CONTEXTUALIZAÇÃO: A participação de crianças com deficiência nas ocupações diárias em diferentes contextos tem sido uma meta terapêutica compartilhada por pais e profissionais da área de reabilitação, gerando crescente demanda na elaboração de instrumentação. O Children Helping Out: Responsibilities, Expectations and Supports (CHORES) foi desenvolvido com o objetivo de mensurar a participação de crianças e adolescentes na rotina domiciliar. OBJETIVOS: Traduzir o questionário CHORES para a língua portuguesa - Brasil, avaliar as equivalências semântica, idiomática, experiencial e conceitual, administrá-lo em crianças e adolescentes com e sem deficiência e testar a confiabilidade teste-reteste. MÉTODO: Estudo metodológico desenvolvido nos seguintes estágios: (1) tradução do questionário por dois tradutores diferentes; (2) síntese das traduções; (3) retrotradução para o inglês; (4) análise por comitê de especialistas para desenvolver a versão pré-final; (5) confiabilidade teste-reteste; (6) administração em uma amostra de 50 pais de crianças com e sem deficiência. RESULTADOS: A tradução do CHORES foi validada em todos os estágios. As adaptações implementadas visaram a promover a compreensão do conteúdo por famílias de diferentes níveis socioeconômicos e escolaridade. O questionário apresentou forte consistência no intervalo de 7 a 14 dias (ICCs= 0,93 a 0,97; p=0,0001). Após a administração, não houve necessidade de modificação de item do questionário. CONCLUSÕES: A versão traduzida do CHORES para o português disponibiliza um instrumento inédito para os profissionais da saúde no Brasil, permitindo a documentação da participação de crianças e adolescentes na rotina doméstica e viabilizando pesquisa científica sobre o tema.

BACKGROUND: The participation of children with disabilities in daily chores in different environments has been a therapeutic goal shared by both parents and rehabilitation professionals, leading to increased demand for instrument development. The Children Helping Out: Responsibilities, Expectations and Supports (CHORES) questionnaire was created with the objective of measuring child and teenager participation in daily household tasks. OBJECTIVES: To translate the CHORES questionnaire into Brazilian Portuguese, evaluate semantic, idiomatic, experiential, and conceptual equivalences, apply the questionnaire to children and teenagers with and without disabilities, and test its test-retest reliability. METHOD: Methodological study developed through the following stages: (1) translation of the questionnaire by two different translators; (2) synthesis of translations; (3) back-translation into English; (4) analysis by an expert committee to develop the pre-final version; (5) test-retest reliability; (6) administration to a sample of 50 parents of children with and without disabilities. RESULTS: The CHORES translation was validated in all stages. The implemented adaptations aimed to improve the understanding of the instrument's content by families of different socioeconomic and educational levels. The questionnaire showed strong consistency within a 7 to 14-day interval (ICCs=0.93 a 0.97; p=0.0001). After application, there was no need to change any items in the questionnaire. CONCLUSIONS: The translation of the CHORES questionnaire into Brazilian Portuguese offers a unique instrument for health professionals in Brazil, enabling the documentation of child and teenager participation in daily household tasks and making it possible to develop scientific investigation on the topic.