Reabilitação de crianças com microcefalia associada à síndrome congênita pelo zika vírus: revisão da literatura

Abstract

Congenital syndrome associated with Zika virus infection (SCZV) is a set of signs and symptoms manifested by children of mothers infected during pregnancy. The relationship between microcephaly and the Zika virus was confirmed in November 2015. Children with SCZV present neuromotor dysfunctions that interfere in the performance of activities and participation of the child and family, with environmental factors related to the function- dysfunction process. There is no specific treatment for SCZV and, to get specialized services, children are referred according to their neurological, motor, auditory, visual, and respiratory needs. The literature on the effectiveness of rehabilitation programs for children with SCZV is still scarce, leading professionals in the field to rely on therapies focusing on the management of individuals with other types of disabilities and on accumulated clinical experience. It is important to know the types of intervention that have been proposed in the field of habilitation/rehabilitation of children with SCZV. Objective: to investigate scientific knowledge about the types and intervention programs in rehabilitation for children with congenital syndrome associated with Zika virus infection. Method: literature review using the descriptors: “zika virus”, “rehabilitation”, “physical therapy”, “occupational therapy” and terms relevant to search for articles related to the theme, not present in the MeSH database: “ zika virus "," microcephaly "," child "and" rehabilitation "in the Pubmed and BVS databases. The inclusion criteria were studies published in the last 10 years (2010-2020), experience reports, case studies, quasi-experimental studies, randomized and non-randomized clinical trials. Results: 334 articles were found, three met the inclusion criteria and selected for analysis. Discussion: An experimental pilot trial study proposed an intervention based on a protocol based on family-centered practice, intensive training of functional activities and enrichment of opportunities in the home environment. There were improvements in children's occupational performance, family satisfaction and increased environmental stimuli at home. An experience report described a specific cultural activity in a rehabilitation center, thus not presenting clinical outcome measures for the evaluation of the action. A case study described a physical therapy protocol composed of activities carried out with a child with SCZV by the professional and the family in the home environment with a focus on postural control, mobility, and social function. The intervention resulted in discrete improvements in stabilizing postural alignment, mobility, and social function, without changes in caregiver assistance. Final considerations: As a public health problem with national impact, greater incentive is needed for the development of public policies for this population. It is necessary to encourage practices for the evaluation and monitoring of rehabilitation programs implemented in specialized centers, investment in financial and human resources to research investigating the effectiveness of these programs and later disseminating the results to the community.