2014, Volume 6, Issue 4

Rehabilitation of children with movement disorders resulting from cerebral palsy



Lyudmila V. Sharova1, Nikolay M. Belokrylov1, Jana V. Nenakhova2

1Perm State Humanitarian-Pedagogical University
2Perm State Medical Academy named after acad. E. A. Wagner


Author for correspondence: Lyudmila V. Sharova; Perm State Humanitarian-Pedagogical University; email: sharovalv@bk.ru

DOI: 10.2478/bjha-2014-0027

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Abstract

Background: The origin and prevalence of cerebral palsy can hardly be considered fully understood. The relationship between orthopedic and neuropsychiatric disorders in children with cerebral palsy in the available literature is also insufficiently presented.
Material/Methods: Authors conducted a clinical and epidemiological analysis and examined the nature of motor disorders in 267 children with cerebral palsy aged from 3 to 16 years old. The monitoring period of patients ranged from 3 to 7 years. They underwent clinical neurological examination, radiography of the spine and joints, ultrasound examination of the joints and periarticular structures, electroencephalography and electroneuromyography in dynamics, with the help of a variational cardiointervalography characterized by an autonomic dysfunction (Veyn AM, 2000), studied the biomechanical parameters of walking, using scorecards, questioning and evaluate the effectiveness of the treatment using the special system to cerebral palsy (Pinchuk D Yu, Dudin MG, 2002).
Results: In 80% of cases, brain damage occurred during fetal development. The authors distinguished primary and secondary disorders of movements. 71 persons (26.6%) had neurogenic and myogenic contractures, and in 196 people (73.4%) contractions were exacerbated by bone deformities. In the rehabilitation system 163 people (61 %) had a need for a surgical operation.
Conclusions: The efficiency ratio of the functional status after rehabilitation in different age groups has improved by 10-22% more than before the treatment. It was shown objectively that improvement in the motor capacity in patients with cerebral palsy due rehabilitation has a positive effect on the function of the cerebral cortex.


Key words: cerebral palsy, rehabilitation, physiotherapy, pediatric orthopedics, joint deformity, contracture, orthopedic devices