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P300 Rehabilitation of children with spastic cerebral palsy after botulinum toxin therapy
  1. Rychkova Lyubov,
  2. Mikhnovich Vanda,
  3. Belogorova Tatyana,
  4. Vlasenko Anastasiya,
  5. Dutova Natalya,
  6. Taskaeva Tatyana
  1. Scientific Centre for Family Health and Human Reproduction Problems

Abstract

Cerebral Palsy means a leading to activity limitation group of motor and body position disorders which are caused by nonprogressive brain damage in a child. The determining clinical syndrome is a motor disorder syndrome. Botulinum A toxin is regarded as the main part of the complex treatment of spastic cerebral palsy (European consensus 2009). Botulinum A toxin decreases spasticity which enables rehabilitation with relatively normal muscle tone.

Aim study of capability of more effective motor disorders correction in children with cerebral palsy with the help of combined application of selective electric stimulation and physical activity on biofeedback equipment in the course of neurometabolic therapy and therapeutic exercising after application of botulinum A toxin.

Methods We included 30 patients with cerebral palsy aged 2–14 years in our research. Then we divided children into two groups with 15 people in each who were comparable by sex, age, intensity of motor disorders. Patients of both groups were treated with botulinum A toxin in a necessary dose, B vitamins, physical activity. Moreover the patients of the first group underwent segmental electrostimulation course by means of specific selective current (LymphaVision®, Germany) and daily physical activity on device with biofeedback (MOTOmed gracile, Germany) starting from 5 min following three procedures with a gradual exposition increase up to 15 min; 10 procedures per a course. Patients of the control group were electrophoresed with sodium bromide by the Vermeil’s method.

Estimation of motor disorders was done according to the classification of Gross Motor Function Classification System (GMFCS). Muscle strength was measured by strength rating scale, muscle tone by Ashworth Scale, the number of improved and new motor abilities by questioning parents.

Results Decrease in muscle tone by 1 point to the 10th day was achieved in 90% of children of the first group and in 85% of children of the control group; improvement of abilities (walking, standing, manual skills) were noticed in 35% of children in the main and 12% control groups; new motor skills were noted only in 5% of the main group.

Conclusions application of selective electrostimulation with Lymphavision device and physical activity using the device with biofeedback MOTOmed Gracile in children with spastic cerebral palsy after botulinum toxin therapy furthers the decrease in muscle tone, ability to produce and improves new motor actions, prevents development of secondary affection, increases rehabilitation effectiveness and patients’ quality of life, considerably enlarges children’s integration in social invironment.

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