Abstract
The main objective of this study is to analyse the effects of stimulation kinesitherapy on psychomotor and cognitive development in these children followed by Severe Acute Malnutrition, aged 6 months to 59 months in the intensive nutritional educational recovery Prospective cohort study with 2 groups: one group subjected to stimulation Kinesitherapy and the other group without stimulation Kinesitherapy in six INERU in the District of Bamako. The population is represented by the children followed for Severe Acute Malnutrition, aged 6 months to 59 months in 6 of the 8 Bamako intensive nutritional educational recovery units of the Strengthening Project intensive nutritional educational recovery units. The sampling is exhaustive, all children, aged 6 to 59 months, admitted to phase 2 of nutritional recovery between April 1, 2014 and July 15, 2017. The data collected includes socio-demographic, medical, psychomotor and anthropometric characteristics and physiotherapy sessions. Child development was measured using a child development assessment grid. An age-specific child development score was calculated. A bivariate analysis and a logistic regression were performed. The analysis covered 126 subjects in the group with kinesitherapy and 131 subjects in the group without Kinesitherapy. The psychomotor development score, weight/height ratio and developmental delay of the children after treatment were significantly improved in the group with stimulation Kinesitherapy compared to the group without stimulation Kinesitherapy (p<0.001). The children in the group without stimulation Kinesitherapy had 20.59 times more risk (OR=20.59 CI 6.05; 70.09) of having a developmental delay on Day 35 compared to the group with stimulation Kinesitherapy, after adjusting for age, developmental delay on Day 1, and the number of psychosocial stimulation sessions. Children with developmental delay on Day 1 were 4.16 times more likely (OR=4.16 CI 1.34; 12.90) to have a developmental delay on Day 35 compared to children without developmental delay on Day 1, after adjusting for age, physical stimulation therapy, and the number of psychosocial stimulation sessions. The anthropometric and psychomotor characteristics of the children after treatment were better in the Stimulation Kinesitherapy group, hence the need to reinforce stimulation and stimulation activities in the management of malnutrition in children aged 6-59 months.
Highlights
Nutrition is increasingly recognized as a basic pillar for the social and economic development of communities and a country
The developmental delay of the children was significantly lower in the group with stimulation kinesiotherapy compared to the group without stimulation kinesiotherapy. This can be explained by the stimulation kinesiotherapy treatment because we found that the children in the stimulation kinesiotherapy group had a greater developmental delay at admission than those without stimulation kinesiotherapy, but after being treated by the stimulation kinesiotherapy sessions, the situation was reversed: the developmental delay became low in the group with stimulation kinesiotherapy
The developmental score of the severe acute malnutrition severe acute malnutrition children in the group with stimulation kinesiotherapy was improved compared to the group without stimulation kinesiotherapy
Summary
Nutrition is increasingly recognized as a basic pillar for the social and economic development of communities and a country. World Nutrition Report showed that the prevalence of stunting has slowly declined globally, it affects at least 165 million children under 5 years of age in 2011 worldwide and at least 52 million of them are wasted or acutely malnourished [2] This malnutrition leads to wasting and stunting, often associated with motor, mental and behavioural developmental delays, which can consolidate over time, or lead to irreversible disabilities if left untreated, and to mental retardation and even cretinism in certain deficiencies. The 2015 World Nutrition Report showed that in developing countries, malnutrition remains a major health problem and is still the largest contributor to child mortality, accounting for 15% of the global burden of neonatal and child mortality. In 2015, the number of deaths of children under 5 years of age in the world was estimated at 5.9 million, 45% of which were attributable to malnutrition [4]
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