Resumo:
Background: Autism Spectrum Disorder (ASD) is characterized by neurodevelopmental
disorders, presenting motor symptoms that may predispose to falls and gait disorders.
Exergaming has shown promising results in children with ASD, but few studies evaluated the
effects of exergaming on gait and the risk of falls. Objective: To assess the effects of
exergaming compared with telemonitoring on motor performance during gait and the risk of
falls in children with ASD. Methods: Randomized controlled clinical trial. 22 participants,
diagnosed with ASD, level I or II; age: 5 to 9 years; without continuous use of medications that
interfere with balance and falls; without physical therapy for 2 months. Randomized into
Exergaming Group (EG, n=11) and Telemonitoring Group (TG, n=11). The EG followed the
exergaming protocol: 2 weekly sessions of 30-35 min each (10 min initial, 20-25 min
exergaming, 5 min cooldown) for 3 months, while the TG received a booklet of activities to be
done at home, with the guardians, and were telemonitored biweekly. A blind evaluation wawas
done through validated questionnaires, a fall diary, and a gait assessment in the gait laboratory.
Parametric tests were used to compare independent and paired variables. For categorical
variables, Fisher's exact test or Chi-square test was used for comparisons between groups, and
McNemar's test for intragroup comparisons. A significant level of 5% (p <0.05) was considered.
Results: The results were presented in three articles format. The first article described the
protocol of the clinical trial. The second article presented the central adaptations made during
the exergaming treatment and the main criteria for children with ASD to benefit with this
therapy. The central adaptations were single mat, sound, adequacy of sensory stimuli, and
acoustic and spatial isolation. The main criteria for the use of exergaming in children with ASD
are imitation ability, triangulation of attention, and obeying simple commands. The third article
presented the results of the intervention carricarried out in the clinical trial. There was a change
in the pelvic symmetry indices, with a moderate effect size in pelvic obliquity for the EG
(d=0.660) and in inclination and rotation in the TG (d=0.605; d=0.823, respectively). There
were no significant changes in the other kinematic gait parameters. There was a reduction in
the number of falls for all children, with a moderate effect size (d=0.747) only in those in the
EG and a statistically significant improvement in the balance scale score for the TG (p=0.011).
However, the groups had no significant differences for any of the parameters evaluated.
Conclusion: There was no difference between the groups regarding motor performance during
gait and the risk of falls in children with ASD. However, the results in the intragroup
demonstrated a reduction in the number of falls in EG and an improvement in the balance in
TG. Both groups demonstrated to be viable resources to be used in the motor rehabilitation of
children with ASD, as long as both are adapted, as additional therapeutic tools for gait control,
balance, and fall prevention. Registered: Clinical Trial, ID number NCT05908357. CAAE:
66594723.2.0000.5543.
