Instrumentos de avaliação, intervenções, barreiras e facilitadores ambientais para a participação na comunidade de crianças e adolescentes com paralisia cerebral: revisão de escopo

Abstract

Introduction: Cerebral palsy (CP) is a group of developmental disorders that permanently affect movement and posture, typically resulting from non-progressive lesions of the central nervous system occurring during the prenatal, perinatal, and postnatal periods. This health condition can lead to impairments in body structures and functions, activity limitations, and participation restrictions. Specifically, in the domain of participation, children with CP engage less in community activities compared to their typically developing peers, and this participation decreases with age.Objective: To identify and describe the barriers and facilitators that restrict community participation of children and adolescents with CP. Methods: A literature search was conducted between May 2023 and August 2023 in the PubMed, Scielo, and embase databases. The keywords used were "barriers," "facilitators," "participation," "social participation," "community participation," and "cerebral palsy," employing their respective English expressions, and included studies published between 2013 and 2023. Results: Five articles were included, all randomized clinical trials. The analyzed articles showed a higher prevalence of spastic CP type, unilateral involvement, and GMFCS level I. The instruments used to assess participation included PEM-CY, COPM, CP QOL, PODCI, LIFE H, and GAS. The main barriers found in the study were accessibility and mobility limitations. On the other hand, facilitators that favored participation were community support and geographical location. The studies emphasize the importance of early personalized interventions, considering not only physical limitations but also environmental and social factors, aiming at the inclusion and potential of children with CP. Conclusion: Regarding the participation of children and adolescents with CP, early and individualized interventions considering social and environmental factors are of utmost importance. Multidisciplinary and child-centered approaches are crucial for promoting inclusion and active participation. Facilitators such as family support, environmental adaptation, and access to assistive technologies are fundamental, although challenges like accessibility and the scarcity of studies on GMFCS levels IV and V persist.