OBJECTIVE: The purpose of this study was to compare postural control in typically developing (TD) children and children with cerebral palsy (CP) during the sit-to-stand (STS) movement and to assess the relationship between static (during static standing position) and dynamic postural control (during STS movement) in both groups. METHOD: The center of pressure (CoP) behavior of 23 TD children and 6 children with spastic hemiplegic CP (Gross Motor Function Classification System [GMFCS] I and II) was assessed during STS movement performance and during static standing conditions with the use of a force plate. The data obtained from the force plate were used to calculate CoP variables: anteroposterior (AP) and mediolateral (ML) amplitudes of CoP displacement and the area and velocity of CoP oscillation. RESULTS: According to the Mann-Whitney test, children with CP exhibited higher CoP values in all of the analyzed variables during the beginning of STS movement. Pearson's correlation verified a positive correlation between the CoP variables during both static conditions and the performance of STS movement. CONCLUSIONS: Children with spastic hemiplegic CP present major postural oscillations during the beginning of STS movement compared with typical children. Moreover, the observed relationship between postural control in static and dynamic conditions reveals the importance of body control in the static position for the performance of functional activities that put the body in motion, such as STS movement.

Contextualização: Os déficits de controle postural em crianças com PC podem comprometer suas atividades na rotina diária. Objetivo: Verificar a relação entre o controle postural em ortostatismo de crianças com PC e suas habilidades funcionais. Método: O controle postural de dez crianças PC (GMFCS I e II) foi avaliado em ortostatismo na plataforma de força por 30 segundos. Variáveis analisadas: deslocamento ântero-posterior e médio-lateral do centro de pressão (CoP), área e velocidade de oscilação do CoP. As habilidades funcionais foram avaliadas por meio do Pediatric Evaluation of Disability Inventory (PEDI), considerando-se escores de autocuidado, mobilidade e função social nos domínios habilidades funcionais e assistência do cuidador. Resultados: O teste de correlação de Spearman verificou a relação entre controle postural e funcionalidade. Constatou-se correlação negativa forte entre as variáveis amplitude ML de deslocamento do CoP, área de oscilação do CoP e entre a variável de velocidade média de oscilação do CoP e os escores do domínio de autocuidado. Observou-se também correlação negativa moderada entre área de oscilação do CoP e mobilidade. O nível de significância adotado foi de 5% (p<0,05). Conclusões: Crianças com maiores oscilações do CoP em ortostatismo apresentam maiores escores de assistência do cuidador para a realização de AVDs, indicando maiores níveis de dependência. Isso demonstra as repercussões dos componentes de estrutura e função do corpo sobre o nível de atividade em crianças com PC, uma vez que o comprometimento do controle postural pode levar a uma maior dependência das crianças em relação a seus cuidadores.

Background: Postural control deficits can impair functional performance in children with cerebral palsy (CP) in daily living activities. Objective: To verify the relationship between standing static postural control and the functional ability level in children with CP. Method: The postural control of 10 children with CP (gross motor function levels I and II) was evaluated during static standing on a force platform for 30 seconds. The analyzed variables were the anteroposterior (AP) and mediolateral (ML) displacement of the center of pressure (CoP) and the area and velocity of the CoP oscillation. The functional abilities were evaluated using the mean Pediatric Evaluation of Disability Inventory (PEDI) scores, which evaluated self-care, mobility and social function in the domains of functional abilities and caregiver assistance. Results: Spearman's correlation test found a relationship between postural control and functional abilities. The results showed a strong negative correlation between the variables of ML displacement of CoP, the area and velocity of the CoP oscillation and the PEDI scores in the self-care and caregiver assistance domains. Additionally, a moderate negative correlation was found between the area of the CoP oscillation and the mobility scores in the caregiver assistance domain. We used a significance level of 5% (p <0.05). Conclusions: We observed that children with cerebral palsy with high CoP oscillation values had lower caregiver assistance scores for activities of daily living (ADL) and consequently higher levels of caregiver dependence. These results demonstrate the repercussions of impairments to the body structure and function in terms of the activity levels of children with CP such that postural control impairments in these children lead to higher requirements for caregiver assistance.

CONTEXTUALIZAÇÃO: Considerando que fatores ambientais, tal como o ambiente escolar, podem influenciar o desenvolvimento infantil, maior atenção deve ser empregada ao desenvolvimento de crianças que frequentam creches. OBJETIVO: Verificar se há diferença no desempenho motor grosso, fino e desempenho cognitivo de crianças entre 1 e 3 anos, de mesma classificação socioeconômica, frequentadoras de creches públicas e particulares em período integral. MÉTODO: Os participantes foram divididos em dois grupos, um de creches públicas (69 crianças) e outro de creches particulares (47 crianças). Todas as crianças eram saudáveis e deveriam frequentar a creche em período integral há mais de quatro meses. Para avaliação do desempenho motor fino, grosso e desempenho cognitivo, foi utilizada a escala Bayley Scales of Infant and Toddler Development - III. Para análise de comparação entre os grupos, foi realizado o teste de Mann-Whitney com crianças entre 13 e 24 meses, entre 25 e 41 meses e entre 13 e 41 meses. RESULTADOS: Crianças de creches públicas apresentaram menores escores quanto ao desenvolvimento cognitivo desde os 13 meses de vida. Os desempenhos motor fino e grosso, por sua vez, apresentaram menores escores nas crianças de escolas públicas com idade acima de 25 meses. A escolaridade materna não foi relacionada ao desempenho das crianças nos dois grupos CONCLUSÃO: O desempenho cognitivo, motor fino e grosso de crianças de mesma classe econômica, frequentadoras de creches públicas, apresentam piores performances quando comparadas às de creches particulares.

BACKGROUND: Given that environmental factors, such as the school environment, can influence child development, more attention should be paid to the development of children attending day care centers. OBJECTIVE: Todetermine whether there are differences in the gross motor, fine motor, or cognitive performances of children between 1 and3 years-old of similar socioeconomic status attending public and private day care centers full time. METHOD: Participants were divided into 2 groups, 1 of children attending public day care centers (69 children) and another of children attending private day care centers (47 children). All children were healthy and regularly attended day care full time for over 4 months. To assess cognitive, gross and fine motor performance, the Bayley Scales of Infant and Toddler Development III was used. The Mann-Whitney test was used for comparative analyses between groups of children between 13 and 24 months, 25 and 41 months, and 13 and 41 months. RESULTS: Children in public day care centers exhibited lower scores on the cognitive development scale beginning at 13 months old. The fine and gross motor performance scores were lower in children over the age of 25 months attending public centers. Maternal education was not related to the performance of children in either group. CONCLUSION: The scores of cognitive performance as well as fine and gross motor performance of children of similar socioeconomic status who attend public day care centers are lower than children attending private daycare centers.

BACKGROUND: The isokinetic dynamometer has been considered the gold-standard measurement of muscle performance. However, the reliability for the passive mode in children has not been reported to date.OBJECTIVES: The purpose was to evaluate the reliability of the isokinetic dynamometer in passive mode in children. METHOD:Twenty-one healthy children (ten girls, eleven boys), aged 5 to 12 years (age: 8.5±2.2 years), were evaluated using an isokinetic dynamometer. Each participant was tested twice with a one-week interval and performed five consecutive cycles of knee extension and flexion. The test was performed at 60º/s in the concentric passive mode and the children performed maximal contractions. The measured variables were peak torque, average peak torque, total work, and average power, time to peak torque and angle of peak torque for dominant and non-dominant lower limbs. Reliabilities were determined using intraclass correlation coefficient (ICC3,1), standard error of measurement (SEM and SEM%), and coefficient of variation (CV).RESULTS:We found good reliability in both lower limbs for peak torque, average peak torque, total work and average power of knee flexors and extensors, with ICC3,1values greater than 0.80; SEM ranging from 6.7 to 79.2; SEM% ranging from 10.4% to 16.8%; CV lower than 15%. Bland-Altman analysis showed that the bias was low than 10% and limits of agreement (LOAs) ranging from 33.9% to 59.2%, and -28.8% and -52.8%, showing that measures tended to disagree. However, time to peak torque (ICC3,1<0.68; SEM > 0.34; SEM%>37.4%; CV>41.7%; bias >24.0%; LOA>101.0%) and angle of peak torque (ICC3,1<0.76; SEM>9.3; SEM%>27.6%; CV>15.3%; bias>11.0%; LOA>61.0%) were not reliable.CONCLUSIONS: The findings indicate that isokinetic evaluation in passive mode for knee extensors and flexors of dominant and non-dominant lower limbs of children without disabilities was reliable for peak torque, average peak torque, work, and power. However, average time to peak torque and angle of peak torque were not reliable.

CONTEXTUALIZAÇÃO: Objetos influenciam nos ajustes do alcance de lactentes, no entanto ainda não se investigou se esses ajustes se modificam em crianças com mais idade. OBJETIVOS: Verificar se o tamanho e a rigidez dos objetos influenciam os ajustes proximais e distais do alcance dos 6 aos 8 meses e aos 36 meses de idade. MÉTODOS: A nove crianças saudáveis foram apresentados: um objeto rígido grande, um rígido pequeno, um maleável grande e um maleável pequeno. Os alcances foram filmados e posteriormente analisados qualitativamente quanto aos ajustes proximais (alcance uni e bimanual) e distais (orientação da mão horizontalizada, verticalizada e oblíqua; mão aberta, semiaberta e fechada) e a preensão desses objetos (com e sem). Foram aplicados o Teste de Friedman e as comparações múltiplas de Dunn, considerando-se 0,05 como diferença significativa. RESULTADOS: Constatou-se que, aos 36 meses, houve mais alcances unimanuais do que nas idades anteriores e, em todas as idades, os alcances unimanuais foram realizados principalmente para os objetos pequenos. Aos 36 meses, as crianças orientaram a mão horizontalizada para tocar e apreender os objetos, enquanto que, aos 6 e 7 meses, a orientação foi oblíqua para tocar e verticalizada para apreendê-los, independentemente das propriedades dos objetos. No decorrer dos meses, tanto no início quanto no final do alcance, as mãos tornaram-se mais abertas, principalmente para tocar o objeto rígido grande, e as crianças realizaram cada vez mais alcances com preensão, principalmente para os objetos maleáveis ou objetos pequenos. CONCLUSÕES: De 6 a 36 meses, os alcances tornaram-se mais refinados e ajustados às propriedades mais discrepantes dos objetos apresentados, o que se observou pelas modificações nos ajustes proximais e distais.

BACKGROUND: It has been found that objects influence the adjustments to reaching of breastfeeding infants, however, it has not been investigated whether these adjustments change in older infants. OBJECTIVES: The aim of this study was to determine whether the size and rigidity of objects influence the proximal and distal adjustments to reaching of infants of 6, 7, 8 and 36 months of age. METHODS: Nine healthy infants were presented with: one large rigid, one small rigid, one large malleable and one small malleable object. The movements were videotaped and later analyzed qualitatively with regard to proximal (unimanual and bimanual reaching) and distal adjustments (horizontal, vertical and oblique hand orientation, opened, half-open and closed hand) and with regard to grasping of these objects (with and without). Friedman test and Dunn multiple comparisons were applied and 0.05 was considered as a significant difference. RESULTS: Infants of 36 months of age performed more unimanual reaching than younger infants. Additionally, at all ages, unimanual reaching was particularly performed for small objects. At 36 months of age infants guided the hand horizontally to touch and grasp the objects, while at 6 and 7 months the hand orientation was oblique to touch and vertical to grasp the objects, regardless of the object's properties. Over the months, both at the beginning and at the end of reaching, the hands became more open, especially to touch the large rigid object, and infants increasingly performed reaching with successful grasping, especially for malleable or small objects. CONCLUSIONS: From 6 to 36 months of age, the reaching became more refined and the infants adjusted to the different properties of the objects which were observed through changes in the proximal and distal adjustments.