Audiovisual stimulation in children with severely limited motor function: does it improve their quality of life?
*Correspondencia: Dra. Salesa Barja. División de Pediatría. Facultad de Medicina. Pontificia Universidad Católica de Chile. Lira 85, 5.º piso. Santiago, Chile.
E-mail: sbarja@uc.cl
INTRODUCTION Children with neurological diseases that impose severe limitations on their mobility have a deficient quality of life (QL). AIMS. To study whether the QL of such patients improves with the application of a programme of audiovisual stimulation.
PATIENTS AND METHODS A prospective study was conducted on nine children, six of whom were males (mean age: 42.6 ± 28.6 months), with severely limited mobility and who had been hospitalised for long periods. Two audiovisual stimulation programmes were produced and applied, together with videos, by means of a specially designed structure. The stimulus was applied twice a day for 10 minutes over 20 days. The first ten days the stimulus was carried out in a passive manner and the second block of ten days it was performed with the guidance of the observer. Biological, behavioural and cognitive variables were recorded and an adapted QL survey was applied.
RESULTS Three cases of spinal muscular atrophy, two of congenital muscular dystrophy, two of myopathy and two with other conditions were diagnosed. Eight patients completed the follow-up. From the baseline point of view, they presented a regular QL (7.2 ± 1.7 points; median: 7.0; range: 6-10), which improved to good on finishing the therapy (9.4 ± 1.2 points; median: 9.0; range: 8-11), with an intra-individual difference of 2.1 ± 1.6 (median: 2.5; range: –1 to 4; CI 95% = 0.83-3.42; p = 0.006). Improved cognition and a favourable perception in the caregivers were detected. No changes took place in the biological or behavioural variables.
CONCLUSIONS Audiovisual stimulation can be used to enhance the quality of life of children with severely limited mobility.
Objetivo Estudiar si la CV de dichos pacientes mejora con la aplicación de un programa de estimulación audiovisual.
Pacientes y métodos Estudio prospectivo en nueve niños, seis de ellos varones (edad media: 42,6 ± 28,6 meses), con limitación grave de la movilidad, hospitalizados de manera prolongada. Se elaboraron dos programas de estímulo audiovisual que, junto con vídeos, se aplicaron mediante una estructura especialmente diseñada. La frecuencia fue de dos veces al día, por 10 minutos, durante 20 días. Los primeros diez días se llevó a cabo de manera pasiva y los segundos diez con guía del observador. Se registraron variables biológicas, conductuales, cognitivas y se aplicó una encuesta de CV adaptada.
Resultados Se diagnosticaron tres casos de atrofia muscular espinal, dos de distrofia muscular congénita, dos de miopatía y dos con otros diagnósticos. Ocho pacientes completaron el seguimiento. Desde el punto de vista basal, presentaron CV regular (7,2 ± 1,7 puntos; mediana: 7,0; rango: 6-10), que mejoraba a buena al finalizar (9,4 ± 1,2 puntos; mediana: 9,0; rango: 8-11), con diferencia intraindividual de 2,1 ± 1,6 (mediana: 2,5; rango: –1 a 4; IC 95% = 0,83-3,42; p = 0,006). Se detectó mejoría en cognición y percepción favorable de los cuidadores. No hubo cambio en las variables biológicas ni conductuales.
Conclusión Mediante la estimulación audiovisual es posible mejorar la calidad de vida de niños con limitación grave de la movilidad.
