Brincar é estimular? Preensão, função manual e sua estimulação em pré-escolares com paralisia cerebral do tipo hemiparesia espástica.

Abstract

The prehension and hand function of children with of cerebral palsy can in be damaged in diverse levels the kind of motor impairment and also the way as they are stimulated to develop hand skills. The objective of this research was to characterize the prehension and hand function of preschool children with spastic hemiparesis and to describe how stimulation is carried through self-report of mothers of these children. Ten participants had composed the sample, distributed in two studies. In Study 1 five children with right spastic hemiparesis participated, with age varying between 56 and 86 months (average 70,8 months). Two tests, denomined as test 1 and test 2 had been applied. Test 1 was the "Domain of grasp" of the instrument "Quality of Upper Extremity Skills Test" (QUEST) in order to characterize the prehension patterns of the children. Test 2 was the "Jebsen-Taylor Hand Function Test" seeking for analyze the impact of the motor deficiency in the hand function of the child with spastic hemiparesis for six representative tasks of functional activities. As results, the data of test 1 indicated that children with spastic hemiparesis presented compatible prehension patterns with children of typical development, however in previous development. The object that presented high variety in relation to kind of prehension used for the child was the pencil and such differences had been noted in the hemiparetic side. In test 2, using average statistic analysis by mean standard desviation of the time performance, data appointed all the children were slower in their performances in relation to the accomplishment of the six functional tasks in the hemiparetic side. In Study 2, the five mothers of the children of the previous study participated. Taking their structured interview and the self-report on how they conceive and carry the stimulation was possible to reach clearly the area of playing performance of the children. The data were analyzed from the thematic analysis of the content. As results, the main findings signaled that the use of the hands was an indicator for the mothers in a way they could see child had development problems. The mothers reported as purpose of the stimulation the functionality of the hemiparetic side with children using diverse activities. How much to the types of toys that the children play, they had been identified characteristic of gender and for all the children, the analysis of the toys for performance components indicated that it has a repertoire of toys that can improve the hand skills, however few toys had presented diversity of sensorial properties. In the description of playfulness, the symbolic representations had been observed in the familiar and school occupational role. The mothers seemed directive in the stimulation of the hand function of their children, carrying through it during functional tasks, in special, the activities of the daily life and preschool activities. The activity to play as stimulation was reported in minor scale. As stimulation models, the mothers described to be based on the practical ones of stimulation of the therapists of their children, showing the influence of the professionals of rehabilitation in the parental ones of stimulation of the child with physical disabilities. Finally, to play is detached as a half essential for stimulation of the hand function in the child with spastic hemiparesis, which reaffirms that to play is also to stimulate. Recommendations for other studies and implications for interventions are argued.