Prognsótico da função motora em crianças com paralisia cerebral a partir dos escores das avaliações de detecção precoce: revisão da literatura

Abstract

Introduction: Cerebral Palsy (CP) is the most common physical disability in childhood, characterized by permanent disorders of movement and posture due to non-progressive lesions that occurred in the developing brain. Identifying and understanding the impact of this condition on children's motor function is essential. Objective: To identify and describe the early detection assessment scores related to the prognosis of gross motor function in children with CP. Methodology: In this literature review, a search was conducted in the PubMed/Medline database between February and March 2024, using the terms “Cerebral palsy” and “prognosis,” combined with “assessment instrument,” “General movements,” “Hammersmith Neonatal Neurological Examination,” and “Hammersmith Infant Neurological Examination.” Studies were included if they involved a CP or high-risk for CP population up to 10 years of age, utilized standardized early detection instruments, and had outcomes related to the prognosis of gross motor function in this population. Results: After evaluating the 300 articles found based on the inclusion and exclusion criteria, 8 articles were included in this review, comprising a sample of 1,837 children, with 725 diagnosed with CP, aged between 26 weeks and 3 years and 5 months. The standardized assessment instruments used in the studies were General Movements Assessment (GMA) and Hammersmith Infant Neurological Examination (HINE). The results indicate that HINE scores below 40 at 3 months corrected age are strongly associated with quadriplegia, Gross Motor Function Classification System (GMFCS) levels III to V, and non- ambulation. In contrast, HINE scores above 60 are associated with hemiplegia, GMFCS levels I and II, and independent ambulation. Regarding detailed GMA, the lower the Motor Optmality Score (MOS) value, the higher the motor impairment and GMFCS level, and the higher the MOS value, the lower the motor impairment and GMFCS level. Conclusion: Early detection assessments, such as HINE and GMA, can help understand the prognosis of gross motor function in children with CP, allowing for early intervention referral, the establishment of realistic treatment plans, and guidance for parents or caregivers, enabling proper future planning.