GO ZIKA GO: EVALUATION OF THE FEASIBILITY OF MODIFIED MOTORIZED TOY CARS FOR THE MOBILITY OF CHILDREN WITH CONGENITAL ZIKA SYNDROME (SCZ)
Children, Zika, powered mobility, intervention, ride-on cars.GO ZIKA GO: EVALUATION OF THE FEASIBILITY OF MODIFIED MOTORIZED TOY CARS FOR THE MOBILITY OF CHILDREN WITH CONGENITAL ZIKA SYNDROME (SCZ)
INTRODUCTION: The clinical characteristics of Congenital Zika Syndrome (CZS) include a series of impairments and delays, mainly in cognitive and motor aspects, with a similar picture to Cerebral Palsy (CP). The poor prognosis in the motor performance of children with CZS raises questions about the possibilities of these children's participation in everyday life. The literature points out that powered mobility is a viable and effective possibility of intervention for children with motor disabilities, with positive impacts on general development, independent mobility, bodily functions, activities and participation. The Go Zika Go project was created to provide children with CZS with an intervention model focused on participation results, using modified motorized toy cars, seeking to test the feasibility of this intervention. OBJECTIVE: To determine the feasibility of a powered mobility intervention for children diagnosed with CZS without a prognosis for ambulation, including acceptability and preliminary efficacy. MATERIALS AND METHODS: This is a feasibility study with mixed methods, carried out at the Clínica Escola de Fisioterapia of the Faculdade de Ciências da Saúde do Trairi (Facisa/UFRN) with four children diagnosed with CZS. For this study, adherence, measured by attendance at intervention sessions, satisfaction, measured by the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) and Satisfaction Perception Questionnaire tools, and mobility learning, classified as by the Assessment of Learning Powered Mobility (ALP). Secondary outcomes related to the effect of the intervention were goal achievement assessed using the Goal Attainment Scaling (GAS), mobility and social function using the Pediatric Evaluation of Disability Inventory – Computer Adaptive-test (PEDI-CAT), and participation through the Young Children's Participation and Environment Measure (YC-PEM) or Participation and Environment Measure for Children and Youth (PEM-CY). The intervention with the modified cars lasted 12 weeks of training and 4 weeks of follow-up, with a frequency of three times a week and a dosage of 40 minutes. Descriptive statistical analyzes were performed for sociodemographic data, children's motor classification, and intervention feasibility data (adherence, satisfaction and learning with ALP). To preliminarily explore the effects of the intervention, parametric statistical analyzes were performed using the t-student test and descriptive statistics considering the results of the GAS, PEDI-CAT and YC-PEM/PEM-CY comparing the baseline results with the week 12 and week 16. RESULTS: The mean age of children with CZS included in the study was 4.75 years, two females and two males, 3 classified using the Gross Motor Function Classification System (GMFCS) as level V and a level IV. The results showed adherence of 75% of the total intervention time, satisfied or very satisfied family members,and gains in learning how to use cars after the intervention, which indicates that the Go Zika Go intervention is feasible. It also proved to be effective in achieving the goals established based on the GAS. Changes in PEDICAT means and participation scores were not statistically significant. CONCLUSION: The intervention with modified toy cars proved to be feasible and effective in providing children with CZS with goal achievement, satisfaction and learning to use the modified car. The use of motorized mobility can be considered a viable alternative for children with CZS. We suggest the development of clinical trials to explore the effect of the intervention on the functional gains and participation of children with CZS.