Avaliação da funcionalidade em crianças e adolescentes com acidente vascular cerebral e paralisia cerebral: Um estudo exploratório

Abstract

Stroke and cerebral palsy may cause impairment in body structures and body functions, activities limitations and participation restrictions. Environmental factors may influence the functionality of cerebral palsy children and stroke children. This influence may occur in a positive way (facilitators) or a negative way (barriers). Objectives: 1) to develop and start a validation process of a functioning assessment system (checklist) for cerebral palsy children and stroke children, from a biopsychosocial perspective, using the International Classification of Functioning,Disability and Health (ICF) as reference; 2) to perform an initial assessment of the checklist applicability, 3) to compare the functionality profile among children or adolescents diagnosed with cerebral palsy, stroke and controls. Methods: The process to develop an assessment checklist was done in three stages: 1) literature review on the use of ICF in cases of stroke and cerebral palsy; 2) connection of ICF core sets for stroke and the Brazilian Child and Adolescent Statute; 3) categoriesselection from the results of stages 1 and 2, done by the researchers. Then, the elaborated checklist was used to evaluate the functionality of controls and children or adolescents diagnosed with stroke and cerebral palsy. Results: 58 categories were selected for the second and third level of ICF (18 of body functions and structures, 15 of activity and participation, 25 of environmental factors). The assessment with control children (N = 34), stroke children (N = 16) and cerebral palsy children (N = 29), from 5 to 19 years old, shown the applicability of the developed checklist andidentified significant differences between the three groups, regarding impairment (mental functions, sensory functions, voice and speech functions, functions of the cardiovascular and haematological systems, neuromusculoskeletal functions and genitourinary functions) and activities limitations (learning and applying knowledge, general tasks and demands, communication, mobility, self care, domestic life, majorareas life and community, social and civic life). Considerations: The developed checklist makes feasible the biopsychosocial proposal and allows information registration about the functioning and contextual factors, related with children and adolescents diagnosed with stroke and cerebral palsy. Studies are needed to validate the developed checklist and to develop assessment tools, according to the ICF the terminology and process of functioning and disability.