Intervenções fisioterapêuticas em crianças e adolescentes com mielomeningocele: uma revisão de literatura

Abstract

Spina bifida is a congenital malformation defined by a failed closure of the neural tube. Successively the injury, children and adolescents with myelomeningocele have neurological, motor and sensory deficits below the level of injury, affecting directly their daily living activitiesand functional performance. Thus, the aim of the present study was to review, identify and critically analyze the literature on the possible physiotherapeutic interventions available for children and adolescents with myelomeningocele. A search was carried out in the literature, without restriction of language or type of study, between the months of March and April 2022, in the electronic databases PUBMED, PEDro and COCHRANE, without limitation of period. One reviewer independently evaluated all identified potential studies. Eight studies were included in which the sample was primarily composed of children and adolescents diagnosed with myelomeningocele and aged between 0 and 18 years and motor practices that were related to the physiotherapeutic intervention. Methodological quality of each study was evaluated based on the classification of the GRADE system (Grading of Recommendations Assessment, Development and Evaluation) and it was observed that four studies were classified as very low quality, three as low quality and one as moderate quality. The selected studies addressed aerobic training associated with virtual reality, gait training on a treadmill and with the use of a long orthosis and electrical stimulation to improve muscle strength. Most studies showed good results, however, several methodological flaws. Therefore, we cannot provide concrete guidelines for clinical practice regarding motor physiotherapeutic interventions for children and adolescents with myelomeningocele, however, this study brings the more frequent physiotherapeutic approaches according to the literature in children and adolescents with myelomeningocele, thus providing intervention possibilities.