O efeito de um programa de exercício físico nos comportamentos de autoagressão, estereotipias e agressão, habilidades motoras e qualidade do sono de crianças com Transtorno do Espectro Autista (TEA) Pelotas-RS

Abstract

The objective of the study was to verify the effect of a 16-week physical exercise program (PEx) on motor skills, sleep quality, self-aggression, stereotyped behaviors and aggression in children with ASD. The present study is an experimental study and the sample was composed of children with ASD, aged between eight and 10 years old, living in the city of Pelotas, RS. Individuals were intentionally selected in institutions that attend children with ASD. All study participants were evaluated with the Childhood Autism Rating Scale (CARS) to determine the level of ASD. The parentes/guardians answered the questionnaires about: lifestyle (adapted from Marques, 2008), the Brazilian version of the inventory of behavior problems inventory / BPI-01, the Children's Sleep Habits Questionnaire - (CSHQ-PT) and about their perception of activities. All tests were applied before, middle and after the intervention. Motor skills were assessed using the test of gross motor development-2 (TGMD-2). Sleep patterns and levels of physical activity (PA) were measured objectively using an Actigraph GT3X accelerometer. The physical exercise program lasted 16 weeks, with three weekly sessions of 50 minutes. Of the 49 individuals, 39 completed all stages of the study, 84.6% (n=33) of these participants were male, 82.1% (n=32) took some type of medication. According to the report of the doctors, 53.8% (n=21) presented mild ASD, 33.3% (n=13) moderate and 12,8% (n=5) severe. Only one of the children does not go to regular school and 38,5%(n=15) do some kind of PA in their free time. Regarding the results of the intervention, a significant improvement (p <0.0001) was observed in the motor skills between the three evaluations in the intervention group, the groups (intervention and control) were similar at the beginning of the intervention; groups had different motor skills. Regarding the self-aggression behavior, both groups presented a significant decrease (p <0.001) between the evaluations. There was no difference between the groups at any time. In the results of the stereotyped behaviors, the groups were not similar at the beginning of the ntervention, but became similar in the second and third evaluation, the intervention group showed a significant decrease between the moments (p <0.001). Regarding the aggression variable, there was a decrease in aggressive behaviors in the intervention group with a significant difference between the moments (p <0.003). In the control group there was an increase in aggressive behaviors between the moments, but without significant difference. Among the groups, no statistically significant difference was found. As for the sleep quality variables, measured by the CSHQ-PT questionnaire, both groups presented a significant decrease between the moments (p <0.001). In the variables measured by the accelerometer - total sleep time and sleep efficiency - a significant difference was observed between the groups. There was no effect between the moments in both groups. In relation to the moderate and vigorous PA (MVPA) data measured by the accelerometer, the control group presented a significant decrease between the moments (p <0.001) and the intervention group maintained its levels of MVPA. The intervention and control groups present similar levels of MVPA at the pre- and middle time and became distinct at the post-moment (p = 0.05). Based on the results, it was concluded that a 16-week PEx program was able to improve motor skills and reduce aggression and stereotypy11 behaviors. However, there were no changes due to exercise, self-harm behavior, sleep quality and daily MVPA levels in children with ASD.