Postural Abnormalities in Children with Congenital Zika Syndrome-Related Neurological and Visual Impairment

Deformities, body asymmetries, and muscle contractures are common consequences of atypical postural patterns in children with c ongenital Zika syndrome (CZS). This study aimed to evaluate the posture of children with CZS, considering their neurological and visual impairments. Ophthalmological assessment included binocular best-corrected visual acuity (BCVA) using Teller Acuity Cards II (TAC II) and an ocular motility evaluation. Postural alignment was measured using the PhysioCode Posture (PCP) app. Twenty-four children with CZS (12 [50.0%] female) were included, with a mean age of 6.8 ± 0.7 years (range, 4.0-7.0 years). The majority (79.2% [19/24]) had microcephaly at birth. Visual impairment was detected in 95.2% (20/21) of the children, with 85.0% (17/20) classified as moderate, severe, or blind. Shoulder asymmetry was observed in 95.8% (23/24) of participants, and 75.0% (18/24) presented abnormal postural alignment of the head and hips. Additionally, spinal deviations were found in 41.7% (10/24) of the children. All children with CZS exhibited asymmetries and improper postural patterns, which may result from a combination of neurological and visual impairments as well as environmental factors.