Physical Therapy, Sports Therapy and Rehabilitation, Multidisciplinary
17
Scopus Publications
Scopus Publications
Perceptions of the Body in Cerebral Palsy: Voices of Family Caregivers Mariana Cristina Palermo Ferreira, Érica Cesário Defilipo, Lélia Cápua Nunes, Pedro Henrique Berbert de Carvalho Healthcare Switzerland, 2026 Background/Objectives: Cerebral palsy (CP) is the most prevalent physical disability in the pediatric population, resulting in functional limitations and restrictions in participation, with higher prevalence rates in low- and middle-income countries. Caregivers of children and adolescents with CP face both physical and emotional challenges, and their perceptions of the body may act as contextual and cultural indicators shaping children’s participation, care practices, and well-being within the family environment. This study aimed to understand the perceptions, values, and cultural beliefs of family caregivers about the bodies of children and adolescents with CP. Methods: A qualitative study was conducted using six focus groups with 22 mothers and grandmothers of children and adolescents with CP. Participants were recruited from rehabilitation services. Discussions were audio-recorded, transcribed verbatim, and analyzed using content analysis. The analytical process involved systematic coding, categorization, and thematic interpretation to identify recurring meanings and patterns across narratives. Results: Three thematic categories emerged: (1) perceptions of the body within social interactions; (2) viewing the body as capable of performing activities independently when stimulated/taught; and (3) viewing the body as dependent, requiring constant supervision and support. Conclusions: The findings highlight the need to expand family caregivers’ knowledge about CP to promote children’s participation and mitigate beliefs related to limitations, dependence, fragility, and vulnerability.
Diet quality and functional nutritional assessment in children and adolescents with cancer Priscilla Faria Goretti, Raiane Marques Barbosa, Anke Bergmann, Leonardo Barbosa Almeida, Érica Cesário Defilipo, Paula Silva de Carvalho Chagas Nutrition and Health, 2026 Introduction Malnutrition and changes in body composition are common in pediatric cancer patients and are often underestimated during outpatient care. Simple anthropometric tools and functional assessments may enhance nutritional screening and clinical monitoring in this population. This study aims to investigate the relationship between anthropometric indicators, handgrip strength (HGS), and dietary intake in children and adolescents undergoing cancer treatment, compared to healthy peers. Methods A cross-sectional study was conducted with 45 participants (15 cancer patients and 30 age- and sex-matched controls). Assessments included arm and calf circumferences, tricipital skinfold, arm muscle circumference, HGS via dynamometry, and a 3-day dietary record classified using the NOVA system. Results The cancer group reported significantly lower consumption of ultra-processed foods compared to controls ( p = 0.039). Anthropometric indicators and HGS were significantly lower in the cancer group ( p < 0.05). A strong positive correlation was found between HGS and calf circumference (r > 0.80). In the total sample, 42.2% were eutrophic, while 51.1% were classified as overweight or obese. Conclusion HGS and basic anthropometric measurements may serve as supportive tools for early identification of nutritional risk. Integrating these indicators into routine outpatient care may support targeted interventions and promote dietary quality in children with chronic illnesses.
Reliability and Acceptability to Caregivers of Telehealth Administration of the Pediatric Evaluation of Disability Inventory – Computer Adaptive Test (PEDI-CAT) for Brazilian Youth with Down Syndrome Julia de Souza Castilho, Raiane Marques Furtado Barbosa, Kênnea Martins Almeida Ayupe, Érica Cesário Defilipo, Paula Silva de Carvalho Chagas Physiotherapy Canada, 2024 Purpose: To estimate test-retest reliability of the two versions of the PEDI-CAT administered via telehealth to caregivers of Brazilian young people with DS, to compare scores on the two versions, and to determine caregiver acceptance of telehealth administration of the assessment. Method: A methodological study approved by the research ethics committee. Data collection was performed online, with a mean duration of 45.0 minutes for the content-balanced version of the PEDI-CAT and 17.5 minutes for the speedy version. Results: In total, 28 caregivers of individuals with DS up to age 21 years participated (mean = 5.9 years; SD = 4.9 years). Intra-class correlation coefficients for the four domains of the PEDI-CAT content-balanced version and four domains of the PEDI-CAT speedy version ranged from 0.77 to 0.97. There was a statistical difference between the versions in the scores of the social-cognitive domain (p < 0.05). A mean of 105 items (SD = 21) was administered in the content-balanced version and a mean of 51 items (SD = 8) in the speedy version. All the caregivers found the method of administration of the PEDI-CAT acceptable. Conclusions: This study demonstrated that either version of the Brazilian version of the PEDI-CAT can be used by telehealth in clinical practice to assess children, adolescents, and young adults with DS.
Affordances in the home environment of children at risk of developmental delay Janaína Araujo Teixeira Santos, Amanda Larissa Oliveira Lima, Letícia Dias dos Santos Silva, Fernanda da Costa Braga, Marcelo Machado Alécio, Paula Silva de Carvalho Chagas, Érica Cesário Defilipo, Aline Martins de Toledo, Paulo José Barbosa Gutierres Filho, Kênnea Martins Almeida Ayupe Revista Paulista De Pediatria, 2023 Objective: The aim of this study was to verify the adequacy of affordances in the home environment of children at risk of developmental delay and to identify factors associated with their frequency. Methods: The cross-sectional study included 97 families who responded to the Affordances in the Home Environment for Motor Development — Infant Scale (AHEMD-IS) for 3–18 months (n=63), or AHEMD – Self-Report (AHEMD-SR) for 18–42 months (n=34). The Mann-Whitney U test was used to identify the differences between the frequencies of affordances between the groups. Multiple linear regression was used to verify the association between the child’s sex, mother’s marital status, education, socioeconomic level, child and mother’s ages, house residents’ number, per capita income, and AHEMD scores (α=0.05). Results: The home affordances’ frequency in the AHEMD-IS ranged from less than adequate to excellent, while in the AHEMD-SR, the highest predominance was medium. The offer of stimuli in the AHEMD-IS was significantly higher. Higher socioeconomic level and house residents’ number were associated with greater affordances. Conclusions: The higher the socioeconomic level and house residents’ number, the greater the affordances in the homes of children at risk of delay. It is necessary to provide families with some alternatives to make their home environments richer in affordances that favor child development.
Functioning of Children and Adolescents with Cancer Olívia Lopes, Jaqueline Frônio, Anke Bergmann, Rayla Lemos, Érica Defilipo, Paula Chagas International Journal of Environmental Research and Public Health, 2022 The aim of the current study was to evaluate the functioning of children and adolescents diagnosed with cancer. This was a cross-sectional, observational study, with children and adolescents diagnosed with cancer, from 2 to 18 years of age, of both sexes, invited to participate in the city of Juiz de Fora, Minas Gerais, Brazil. The Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT) questionnaire was applied to the caregivers to assess the functioning of the participants, in four domains: daily activities, mobility, social/cognitive, and responsibility. In total, 33 children and adolescents participated, of both sexes, with a mean age of 9.23 years. The results showed that in the mobility category, participants older than 8 years presented worse functioning (OR = 22.000, 95% CI = 3.415–141.733, p = 0.0001). Children older than 8 years of age and adolescents with different types of cancer showed a higher chance of presenting lower mobility than their normal peers of the same age and compared with children under 8 years of age. Understanding the impact of childhood cancer is important for the physiotherapist to determine treatment strategies for this population who live with dysfunctions left by the cancer treatment.
Proposal of a roadmap for the assessment of environmental factors in children and adolescents from the ICF perspective Lilian de Fátima Dornelas, Érica Cesário Defilipo Revista Pesquisa Em Fisioterapia, 2022 INTRODUÇÃO: A Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) aponta que os fatores ambientais constituem o ambiente físico, social e atitudinal no qual as pessoas vivem e conduzem suas vidas, podendo atuar como facilitador ou barreira. Na área da fisioterapia neurofuncional da criança e do adolescente, o ambiente tem sido destacado como um importante componente no processo de avaliação, estabelecimento de metas e na escolha de intervenções voltadas para a participação social. OBJETIVO: Propor um roteiro de perguntas que envolvam os principais fatores ambientais relacionadas às crianças e adolescentes sob a perspectiva da CIF, visando nortear o profissional no processo de avaliação. METODOLOGIA: Estudo descritivo que envolveu a identificação das categorias da CIF mais apropriadas para os principais itens correspondentes a um roteiro de perguntas para avaliação de fatores do ambiente físico, atitudinal e social na área da Fisioterapia neurofuncional da criança e do adolescente. A construção do roteiro de perguntas para avaliação se deu em 5 fases. RESULTADOS: O roteiro proposto em formato de entrevista foi composto por 12 perguntas com 30 categorias que avaliam o ambiente físico, atitudinal e social na área neurofuncional da criança e do adolescente. A opção de resposta foi de acordo com os qualificadores e transportados para uma escala visual. CONCLUSÃO: A proposta do roteiro de avaliação dos fatores ambientais pode ajudar no processo investigatório sobre facilitadores e barreiras no ambiente da criança ou do adolescente.
Factors associated with premature birth: a case-control study Érica Cesário Defilipo, Paula Silva de Carvalho Chagas, Carolyne de Miranda Drumond, Luiz Cláudio Ribeiro Revista Paulista De Pediatria, 2022 Objective: To analyze the socioeconomic, demographic, environmental, reproductive, behavioral, and health-care factors associated with preterm birth. Methods: Case-control study, with case group composed of preterm infants and the control group by full term live births. Each case was paired with two controls according to sex and date of birth. Interviews were carried out with the mothers, as well as analysis of medical records. A logistic regression model was used for data analysis following the hierarchical order of entry of the blocks. Results: 221 live births were allocated in the case group and 442 in the control group. After analysis adjusted for other factors under study, the highest chances of prematurity were associated with being the first child (OR 1.96; 95%CI 1.34–2.86; p=0.001); mothers with the highest income (OR 2.08; 95%CI 1.41–3.08; p<0.001), mothers with previous preterm births (OR 3.98; 95%CI 2.04–7.79; p<0.001), mothers that suffered violence during pregnancy (OR 2.50; 95%CI 1.31–4.78; p=0.005) and underwent cesarean section (OR 2.35; 95%CI 1.63–3.38; p<0.001). Live births to mothers who had more than six prenatal consultations had a lower risk of prematurity (OR 0.39; 95%CI 0.26–0.58; p<0.001). Conclusions: The factors associated with a higher chance of prematurity were: higher family income, previous preterm child, primiparity, violence against pregnant women and cesarean section. Having attended more than six prenatal visits was associated with a lower chance of premature birth. Violence against pregnant women showed a strong and consistent association, remaining in all final models, and should serve as an alert for the population and professionals.
Prenatal and perinatal care in Governador Valadares, Minas Gerais state, Brazil Érica Cesário Defilipo, Paula Silva de Carvalho Chagas, Rívia Miranda da Silva, Quézia Beatriz de Souza Costa, Mariana Cristina Oliveira Guilherme, Mariana Cristina Palermo Ferreira, Luiz Cláudio Ribeiro Fisioterapia Em Movimento, 2022 Resumo Introdução: O acompanhamento pré-natal e as condutas adotadas durante o parto são essenciais para garantir o bom desenvolvimento da gestação, prevenir complicações e proporcionar um parto saudável, sem impacto na saúde da puérpera e do recém-nascido. Objetivo: Analisar a assistência pré-natal e perinatal oferecida em Governador Valadares, Minas Gerais, e verificar se há associação entre a adequação do pré-natal e os fatores socioeconômicos, demográficos, comportamentais e reprodutivos. Métodos: Estudo transversal com base de dados pré-existente. Para a análise da adequação do pré-natal foram utilizados três critérios: 1) início até 16ª semana e número mínimo de consultas de acordo com a idade gestacional; 2) práticas dos profissionais nas consultas de pré-natal; 3) orientações oferecidas às gestantes pelos profissionais. Para a análise dos dados foi utilizada regressão logística multivariada. Resultados: Participaram do estudo 437 puérperas. A assistência pré-natal foi considerada adequada para 72,5%, 93,1% e 50,1% das puérperas, considerando os critérios 1, 2 e 3, respectivamente. As gestantes que apresentaram maior chance de terem o pré-natal inadequado, com relação ao critério 1, foram as com menor escolaridade (RC = 1,68; p = 0,046), que não possuíam companheiro (RC = 2,18; p = 0,002), que não trabalharam durante a gestação (RC = 2,18; p = 0,003) e as que não planejaram a gravidez (RC = 1,76; p = 0,023). Com relação à assistência perinatal, a presença de acompanhante e contato pele a pele foram apropriados, mas a amamentação na primeira hora de vida foi inadequada. Conclusão: Observou-se a necessidade de aprimorar as orientações fornecidas pelos profissionais e incluir a amamentação na primeira hora de vida. Os resultados podem contribuir para otimizar os serviços de saúde materno-infantil em Governador Valadares.
Functioning of a child with bilateral cerebral palsy submitted to multilevel surgery: Case report Renata Martins Rosa, Elisa de Jesus Valenzuela, Erica Cesario Defilipo, Paula Silva de Carvalho Chagas Revista Pesquisa Em Fisioterapia, 2021 INTRODUCTION: Interventions in different joints may be necessary to correct crouch gait and others musculoskeletal changes that occur as time passes for Cerebral Palsy (CP) children. Multilevel surgery reduces the number of hospitalizations, contributes to the prevention of secondary disabilities, and improves ambulation ability of children with diplegia. OBJECTIVE: Document the changes in mobility outcomes of a bilateral CP child, type diplegia, child after lower limbs multilevel surgery in the Brazilian context MATERIAL AND METHODS: The participant was an eight-year-old girl, Gross Motor Function Classification System level III. The mother signed the informed consent form. The Gross Motor Function Measure–66 (GMFM-66) was performed one day before surgery and one, three, six and twelve months after surgery. To complete the child’s evolution records, additional information was obtained through the electronic system of the hospital. RESULTS: The GMFM-66 total score was: 49.6 pre-operative (CI95%: 47.3-51.9); 42.8 after one month (CI95%: 40.7-45.0); 49.9 after three months (CI95%: 47.6-52.1); 52.6 after six months (CI95%: 50.2-55.0) and 56.9 after one year (CI95%: 54.6-59.2), increasing after 6 months of surgery (*p<0.05). The participant presented satisfactory adherence to physiotherapy. CONCLUSION: This study describes the case of a Brazilian child with CP, using the public health system. The impact of multilevel surgery was predominant in mobility, with worsening of capacity soon after surgery and progressive improvement over the months. Factors that may have contributed to our results were adherence, frequency, contextual factors.
Opportunities in the home environment for motor development Érica Cesário Defilipo, Jaqueline da Silva Frônio, Maria Teresa Bustamante Teixeira, Isabel Cristina Gonçalves Leite, Ronaldo Rocha Bastos, Marcel de Toledo Vieira, Luiz Cláudio Ribeiro Revista De Saude Publica, 2012
