Desenvolvimento de software para avaliação e orientação de intervenção precoce em crianças com microcefalia

Abstract

Microcephaly is a clinical finding that, like other congenital malformations, has a complex and multifactorial etiology, may occur due to infectious processes during pregnancy, such as the Zika virus, the main causal cause for the increase in the number of cases of microcephaly in 2016. This project has as main objective the development of an evaluation software with early intervention guidance for children with microcephaly. The sample was registered with children with microcephaly confirmed by the Ministry of Health, followed up at Integred Support for people with Deficiency Center Foundation - FUNAD, at Cândida Vargas Institute and at the Hospital Geral de Guarabira. A physiotherapy assessment protocol for children with microcephaly was established, based on the assessment and classification of children's development, and an early intervention proposal based on the guidelines of the Ministry of Health was associated. From these protocols, a software was developed to guide the procedure of physical therapy evaluation, from which it generates a proposal for early intervention for the children. When assessing children with the available protocols, 100% was classified as abnormal (Denver II scale), 93% abnormal and 7% suspicious (AIMS scale), in addition to 59% level V and 41% level IV, with no children classified on the best levels I, II and III (GMFCS scale). When we used our instrument, first with all the variables, we identified 88% with severe microcephaly, 12% moderate and no mild case, but these results vary a lot when applying the final instrument (AME-MICRO), analyzing by category: Reflexes and tests (58% graves, 38% moderate, 4% mild ones), Motor coordination (67% severe cases, 29% moderate cases, 4% mild), Motor patterns (69% severe, 28% moderate, 3% mild), Muscle tone (71 % severe, 26% moderate, 3% mild) and Functionality (78% severe, 21% moderate, 1% mild). AME_MICRO is more appropriate than the available instruments for a differentiated assessment of the development of each child, managing to develop early intervention guidelines based on specific needs. We consider this new protocol a solution for the difficulty of access of some children with microcephaly to qualified assistance, as well as to trained professionals, envisioning its use as a new diagnostic and therapy alternative in stimulation, acting as an enhancer of health care.