Visão geral dos instrumentos utilizados para detecção precoce em lactentes com risco de paralisia cerebral: uma revisão de literatura

Abstract

Cerebral palsy (CP) is a group of permanent disorders of movement, development and posture that occur due to non-progressive damage to the brain. Early diagnosis of CP is crucial to facilitate access to targeted interventions. Thus, standardized, valid and viable tools should be used during the assessment of the neuropsychomotor development of children at high risk of CP. Objective: To investigate whether studies are using the tools recommended by the current guideline for early detection of CP in infants at high risk of CP. Methodology: A literature review was carried out in the MEDLINE, Embase, LILACS, SciELO and CINAHL databases, using descriptors related to “cerebral palsy”, “motor impairment”, “follow-up” and “infant”. Manual searches were also performed to identify potential studies. Studies published in the last five years (2017-2022), without language restriction, that used at least two recommendations of some of the instruments for early diagnosis (RMN, HINE, GMA, TIMP, DAYC, AIMS, NSMDA or MAI) were included. in infants younger than 2 years of age at risk for CP. Two independent reviewers selected studies and extracted data. Any discrepancies were resolved by a third reviewer. Results: Eight studies were identified in this review and presented different combinations of tools during the evaluation process. Only two studies reported the combined use of NMR, GMA and HINE. Separately, NMR represented the most used instrument for the diagnosis of CP (87.5%; n=7); followed by HINE (75.0%, n=6) and GMA (62.5%, n=5). Conclusion: Changes in MRI, as well as absence of absent movements in GMA and lower HINE scores were associated with the diagnosis of CP before 2 years of age. However, there was a scarcity in the literature of studies that follow the proposed guidelines to identify CP, especially studies in low- and middle-income countries. Therefore, further studies are still needed.