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Tele-care in times of social isolation: effect of a home intervention protocol directed at activity, participation and the environmental context on the functionality of infants at biological risk: randomized controlled clinical trial

Grant number: 20/02818-4
Support type:Scholarships in Brazil - Doctorate
Effective date (Start): April 01, 2021
Effective date (End): May 31, 2023
Field of knowledge:Health Sciences - Physiotherapy and Occupational Therapy
Principal researcher:Nelci Adriana Cicuto Ferreira Rocha
Grantee:Camila Resende Gâmbaro Lima
Home Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil


Contextualization: Interventions in the first year of life are recommended for infants who have some biological risk for developmental delay, due to the enhancement of neural plasticity and the consequent possibility of better results in functionality. However, with the implementation of social distance from the Covid-19 pandemic, many at-risk infants are without therapy. An alternative in this situation concerns tele-care, therapy in which evaluations and interventions are carried out online, through instructions given to the caregivers of these children. Still, it is essential that these interventions are inserted into a biopsychosocial model, assessing the influence on the components of the body's structure and function, on activity and participation and on contextual factors. Objective: to verify the effect of a remote tele-care protocol composed of intervention and home orientation directed to the task and the context, performed by the parents, comparing it with the standard care guidance, regarding the functionality of infants with biological risk for developmental delay. Methods: Randomized controlled trial. Infants at risk for developmental delay, with a corrected age of 3 to 12 months, will be included, divided into two groups: control group (general guidelines) and experimental group (specific home guidance). Infants will be assessed for body structure and function (General Movements Assessment); activity (Infant Motor Profile; Alberta Infant Motor Scale and Sensory Profile); participation (Young Children's Participation and Environment Measure); and contextual factors (Parent-Child Early Relational Assessment; Affordances in the Home Environment for Motor Development; Depression, anxiety and stress scale; Social restriction questionnaire - COVID-19 and Social Support Scale The intervention will have an 8-week period, and pre- and post-evaluations will be carried out during this period. All assessment and intervention procedures will be carried out online, with instructions to parents for home therapy. Statistical analysis will be guided according to the normal distribution of data, and a level of significance of 5% will be adopted. Expected results: It is expected that after the intervention the experimental group will show greater gains in motor skills, as well as greater participation and interaction between caregiver-baby. It is also expected that the environment in which the child is inserted become richer and more stimulating. (AU)

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