Systematization of methods of physical rehabilitation of children with inherited nervo-muscle diseases

Abstract

Summary. Children with hereditary neuromuscular diseases constitute one of the main groups of patients in public and private rehabilitation institutions. Therefore, there is a need to develop a rational choice of physical rehabilitation means, their systematization depending on the level of functional capabilities, which is relevant when developing an individual rehabilitation program in the centres. Purpose. Formation of an integrated approach in the rational choice of methods of physical rehabilitation and orthopedic supply for patients with hereditary neuromuscular diseases. Tasks. Development of stages for the provision of rehabilitation services, determination of the composition of an individual rehabilitation program, development of an algorithm for choosing methods of physical rehabilitation and technical means, depending on the degree of limitation of the child's motor functions. Results. The study involved 46 children aged 2 to 15 years. Assessment of the functional status of children, in accordance with the recommendations of the International Committee for the Standards of Treatment of patients with SMA, was performed on the Hammersmith scale, the assessment of muscle strength - on the Lovett test. The rehabilitation course according to the developed algorithm consisted of 4 stages: the stage of diagnosis, the stage of drawing up an individual rehabilitation program in accordance with the patient's functional capabilities, the stage of the course of physical rehabilitation and the stage of assessing its effectiveness. The main principles of rehabilitation were: stretching of contracted tissues, positioning of segments of the limbs and spine, physical activity in a submaximal mode, verticalization with the use of aids, compensation of lost functions and orthopedic correction using orthoses of various designs. The course carried out helped to stabilize muscle strength and motor activity, increase the volume of passive movements in large joints, and fine motor dexterity. Technical means of rehabilitation made it possible to correct the deformity of the segments of the limbs and the spine, to increase the dexterity of movements when performing tasks for fine motor skills. Conclusions. Adequate rehabilitation measures aimed at maintaining the motor activity of patients, maintaining muscle tone (including the respiratory muscles), timely correction of pathological attitudes of the limbs and spine in children with progressive neuromuscular diseases, inhibit the development of deformities, prolong motor activity.