Gerenciamento postural para crianças e adolescente com paralisia cerebral classificadas no níveis III, IV e V do Sistema de Classificação da Função Motora Grossa: uma revisão de literatura

Abstract

Postural management refers to a planned multidisciplinary approach program that encompasses all activities and interventions that impact posture and function. Considering that deformity patterns must be predicted and minimized in children and adolescents with CP, it is necessary to systematize scientific evidence on possible physiotherapeutic interventions related to postural management. Objective: To systematically review the literature on physiotherapeutic interventions related to postural management for children and adolescents with CP classified at levels III, IV and V of the GMFCS. Methods: Literature review of the EMBASE, Medline, PEDro and Pubmed databases, in studies indexed from 2000 to 2023, in which the search strategy consisted of using the terms: Cerebral Palsy, Postural Management, Self-Help Devices, Adapted equipment, Orthopedic Devices and Joint Deformities. The articles identified by the initial search strategy were evaluated according to pre-established inclusion criteria. The data were tabulated and presented through a descriptive analysis. Results: New studies were included, which described the following disciplines: the use of the Chailey Adjustable Postural Support System (CAPS) lying, sitting and standing; Customized Seat Orthosis (siège moulé) associated with Neurodevelopment Treatment; Plaster structure (stard) with hip abduction; Standing Vertical Frame and a Non-Frame Thoracic-Lumbar-Sacral Orthosis (TLSO-SIDO). According to the GRADE System Classification, all studies have very low methodological quality. Conclusion: The present findings demonstrate that there is a scarcity of studies that encompass physiotherapeutic interventions related to postural management for children and adolescents with CP (GMFCS III, IV and V), promoting unreliable applicability. Therefore, there is a need to carry out new studies, with high methodological quality to assist health professionals in clinical decision-making and improving clinical practice.