Motor Rehabilitation Of Children Research Articles

Evaluation of the Usability of a Serious Game in Virtual Reality with a Focus on the Perception and Experience of Health Professionals for Motor Rehabilitation in Children with Cerebral Palsy.

Introduction: Cerebral palsy (CP) is a nonprogressive neuropathological condition that requires lifelong neurocognitive-motor rehabilitation. Evidences indicate that the use of new technologies to assist in rehabilitation processes, such as serious games in virtual reality (VR), have served as adjuncts to therapy and capable of promoting engagement, motivation, and motor activation for these patients. Objective: To investigate the usability of a serious game in VR to help with the stability and balance of the head and trunk of children with CP, focusing on the perception and experience of health professionals. Methods: The collection was carried out with health professionals, and the results were comprehensively evaluated through viability by means of the total score, number of correct answers, number of errors, and level of difficulty during the execution of the game, which were collected from the performance report generated by the application. System satisfaction was also verified by the System Usability Scale (SUS). Results: The mean obtained from the total score of the SUS was 82.10 ± 12.66 points, being considered of high usability for the suggested purpose. The professionals' opinion about the usability of the system did not change due to the performance during the game. Conclusion: The study demonstrated that the developed rehabilitation program has successfully delivered the experience to exercise the head control and trunk balance of subjects with CP.

Digital technologies for motor rehabilitation in children: protocol for a cross-sectional European survey

IntroductionDigital technologies can be used as part of paediatric motor rehabilitation to remediate impairment, promote recovery and improve function. However, the uptake of digital technologies in this clinical field may...

First Use of Non-Invasive Spinal Cord Stimulation in Motor Rehabilitation of Children with Spinal Muscular Atrophy

Spinal muscular atrophy (SMA) is characterized by the degeneration of spinal alpha motorneurons. Nusinersen demonstrated good efficacy in the early disease phases. The feasibility of transcutaneous spinal cord stimulation (tSCS) in motor rehabilitation of patients with spinal cord injury has been demonstrated. We hypothesize that tSCS may activate intact and restored by nusinersen motorneurons and slow down the decline in motor activity, and may contribute to the development of motor skills in children with SMA. A case series is presented. Five children (6-13 years old) with SMA type II or III participated in the study. They were treated with nusinersen for ~2 years. Application of tSCS was carried out during physical therapy for 30-40 min per day in the course of 10-14 days. Outcome measures were goniometry of joints with contracture, forced vital capacity (FVC), RULM and HFMSE scales. The participants tolerated the stimulation well. The reduction of the contracture was ≥5 deg. RULM and HFMSE increased by ~1-2 points. Predicted FVC increased by 1-7% in three participants. Each participant expanded their range of active movements and/or learned new motor skills. Spinal cord stimulation may be an effective rehabilitation method in patients treated with nusinersen. More research is needed.

ПРИНЦИПИ КОРЕКЦІЇ ПОРУШЕНЬ ПОСТАВИ В ДІТЕЙ РАННЬОГО ВІКУ ІЗ ЗАТРИМКОЮ ПСИХОМОТОРНОГО РОЗВИТКУ

In the current development of society, the number of children with disabilities is steadily growing, where disorders of the nervous system and musculoskeletal system of young and preschool children occupy a leading position. Given this, the correction of the motor sphere of this category of children is a priority, which contributes to the prospects of their further socialization. Numerous specialists (P. Lesgaft, K. Ushinsky, E. Pokrovsky, I. Sechenov, M. Bernstein, O. Zaporozhets, E. Stepanenkova, O. Dubogai, T. Krutsevich; T. Osadchenko, A. Semenov, V. Tkachenko L. Shapkova, O. Shterengerts, N. Gross, O. Yurechko, S. Bubnovsky, V. Epifanov, V. Yevminov, S. Yevseyev, M. Yefimenko, O. Kaptelin, V. Kachesov) drew attention to the development of the basis theories and techniques on which the effectiveness of the process of physical development, prevention and correction of motor disorders of the child depends. Despite a fairly strong scientific foundation of the methodology of correction of physical development and motor rehabilitation of children and adults, we have not found systematic developments in this area for young children with posture disorders. It is clear that the basis for improving their motor area must be based on universal principles already known to the general public, but very specific principles of motor correction of spinal curvatures in children of the first three years of life need additional development. This determines the relevance of our study. The aim of the study was to identify universal and special principles for the correction of posture disorders in young children with psychomotor developmental delay. Summarizing the existing data in the literature, as well as focusing on personal experience gained over many years of practical activity, we have previously formed two blocks of principles of posture correction in children – universal (the principle of interaction of two systems: the subsystem "Child" and the megasystem "Universe", the principle of medical pedagogy, the principle of complexity and integrativity, the principle of comorbidity – polymorbidity, principle of early adequate care, principle of differentiation and individualization, principle of improvement of life skills (social adaptation), principle of habilitation and correctional-compensatory orientation of training and education, principle of theatricalization of correctional process) and special (principle of unity of musculoskeletal system, phylogenetic principle of motor sphere development) child, the principle of hypercorrection, the principle of a spring pendulum, the principle of "spiral", the principle of tensegrity). Keywords: principles, young children, posture, correction, delayed psychomotor development.

Effectiveness evaluation of translingual neurostimulation in motor rehabilitation in children with spastic diplegia

Introduction. Cerebral palsy is one of the most common non-progressive neurological disorders caused by fetal or infant brain injury. Current rehabilitation for children with cerebral palsy involves a series of measures, including physical training, special massage techniques, physiotherapy, treatment by certain positions and postures, use of supporting orthoses and fixation devices for walking, and special orthopedic suits facilitating verticalization and motor activity of a child. Over the last few decades, computerized stimulators and robotics with virtual reality systems have been actively used in neurorehabilitation. However, most of these systems did not show significant efficiency in rehabilitation of children with cerebral palsy. In the last few years, different non-invasive electrostimulation techniques have been considered innovative and can be applied independently or in combination with existing procedures. One of such techniques is translingual neurostimulation.
 Aim. This study aimed to evaluate the effectiveness of a combination of translingual neurostimulation and physical rehabilitation for children with cerebral palsy.
 Materials and methods. In this study, we observed 134 children (63 girls and 71 boys) with spastic diplegia aged 2–17 years (mean age is 7.8 years old ± 0.3). Depending on the type of rehabilitation therapy, the patients were divided into two groups: active (main) and control. Active group consisted of 94 children who received standard restorative treatment in combination with translingual neurostimulation, whereas the control group consisted of 40 children who received only standard rehabilitation treatment without translingual neurostimulation.
 Results. Both groups of patients showed positive dynamics; however, patients in the active group showed greater improvements as evidenced by all grading scales. Improvements were observed in children of all ages, and the results were mostly stable for 12 months.
 Conclusion. Translingual neurostimulation is a novel approach to neurorehabilitation that shows promising results, in addition to its proven effectiveness and safety. As a result of neurostimulation, the patient’s brain becomes more susceptible to the applied therapeutic procedures aimed at restoring motor control and formation of new motor skills, thereby markedly increasing the effectiveness of neurorehabilitation. This study broadens the perspectives in the use and further development of translingual neurostimulation in rehabilitation of children with cerebral palsy.

Application of non-invasive electric stimulation of the spinal cord in motor rehabilitation of children with consequences of vertebral and cerebrospinal injury (preliminary report)

Introduction. Vertebral and cerebrospinal injury and its consequences constitute an important problem in modern medicine. In recent years, studies have shown that percutaneous electric stimulation in patients with these injuries can influence the neuronal networks of different parts of the spinal cord to activate afferent and efferent reflex connections with complete or partial disorders of supraspinal influences of various geneses.
 Aim. To investigate the effect of percutaneous electric stimulation of the spinal cord on the dynamics of recovery of neurological functions in children with vertebral and cerebrospinal injury.
 Materials and methods. Seven patients aged 4 to 18 years with lesions of the spinal cord from C5-C6 to Th12-L1 and who mainly had a marked neurological deficit were examined from 1 month to 9 years after surgical treatment. All patients underwent neurophysiological studies, including electroneuromyography, electromyography, and somatosensory-evoked potentials. The patients and their parents kept a diary of urination.
 Results. This clinical study showed that percutaneous electric stimulation of the spinal cord contributed to the rapid and complete restoration of the neurological functions in patients with vertebral and medullar conflict and depended directly on the early terms of surgical intervention.
 Conclusion. The positive results obtained in the complex rehabilitation of children with vertebral and cerebrospinal injuries by using non-invasive percutaneous electric stimulation of the spinal cord support the use of this method in the early stages after surgical intervention.

Clinical, neurological, and neurophysiological evaluation of the efficiency of motor rehabilitation in children with cerebral palsy using robotic mechanotherapy and transcutaneous electrical stimulation of the spinal cord

Introduction. Rehabilitation of patients with cerebral palsy (CP) remains a very difficult task. Stable and growing movement restrictions in such patients cause a life-long need for treatment and rehabilitation. Neurorehabilitation of children with CP at various stages includes not only traditional physical rehabilitation methods, but also extensive use of robotic mechanotherapy techniques and new technologies in the field of neurophysiology. One of such technology is non-invasive percutaneous electrical stimulation of the spinal cord.Aim of the study: To assess the effect of transcutaneous electrical stimulation of the spinal cord to improve the motor function of children with spastic diplegia using the “Lokomat” robotic mechanotherapy system.Materials and methods. A clinical rehabilitation study of 26 patients aged 6–12 years with CP was conducted. The treatment group included 11 patients who received one course of robotic mechanotherapy using the “Lokomat” system combined with transcutaneous electrical stimulation of the spinal cord. The control group included 15 patients who received one course of robotic mechanotherapy only.Results. A comparative analysis of the two groups based on the results of clinical examinations using specific scales (GMFCS, GMFM-88, Modified Ashworth Scale of Muscle Spasticity), locomotor tests (L-FORCE, L-ROM), and evaluations of muscle activity using electromyography showed that one course of rehabilitation resulted in improvement in motor function in all patients of both groups, but positive dynamics were more significant in the treatment group that underwent percutaneous electrical stimulation of the spinal cord.Conclusion. Based on clinical data, changes in indicators of the locomotor tests L-FORCE and L-ROM, as well as assessment of changes in muscle activity, showed that motor rehabilitation of children with spastic diplegia using the “Lokomat” robotic mechanotherapy system combined with transcutaneous electrical spinal cord stimulation was more effective than robotic mechanotherapy only.

BIOMECHANICAL PRINCIPLES PHYSICAL REHABILITATION OF CHILDREN WITH CEREBRAL PALSY

Aim. We studied the basic biomechanical principles of physical rehabilitation of children with cerebral palsy. Materials and methods. Methods of Motion Tracking and electromyography investigated the biomechanical characteristics of gait in children with cerebral palsy. It is shown that the main differences between dynamic stereotype walk pediatric patients is to delay moving forward center of gravity and the disorganization of the lower limb movements (especially knee) in the vertical plane. Prevailing flexion - leading position of the lower extremities during locomotion cycle associated with limitation of motion in the hip joint, offset by an increase swinging body, weakening activity in the rear shock phase and its sharp increase in the fourth phase. Changes in the structure of the movement of the shoulder girdle and upper extremities can be considered as compensatory. Characteristically excessive involvement in the locomotion of the calf muscles and the rectus muscles of the back, with the central mechanisms gipersinhronizatsii activity of motor units are the primary mechanism for adaptation in a group of children that are capable of self-locomotion. Results. As a result of the research it shows that in motor rehabilitation of children with cerebral palsy should include the following elements: exercise to maintain the body balance when performing arm movements, exercises for coordination of hand movements, including motor brushes, exercises to increase mobility in the hip joints and in the back, exercises designed to exercise the calf muscles, the front thigh muscles and the rectus muscles of the back, massage to relieve hyper calf muscles.

Neurorehabilitation of patients with cerebral palsy

Cerebral palsy is one of the common diseases that cause significant motor impairments. This review deals with new methods of motor rehabilitation of children with cerebral palsy in terms of modern physiology, as well as with summarized and analyzed results of experimental studies on the effectiveness of these methods.

Rehabilitation and neuroplasticity in children with unilateral cerebral palsy.

Cerebral palsy is a childhood-onset, lifelong neurological disorder that primarily impairs motor function. Unilateral cerebral palsy (UCP), which impairs use of one hand and perturbs bimanual co-ordination, is the most common form of the condition. The main contemporary upper limb rehabilitation strategies for UCP are constraint-induced movement therapy and bimanual intensive therapy. In this Review, we outline the factors that are crucial to the success of motor rehabilitation in children with UCP, including the dose of training, the relevance of training to daily life, the suitability of training to the age and goals of the child, and the ability of the child to maintain close attention to the tasks. Emerging evidence suggests that the first 2 years of life are a critical period during which interventions for UCP could be more effective than in later life. Abnormal brain organization in UCP, and the effects of development on rehabilitation, must also be understood to develop new effective interventions. Therefore, we also consider neuroimaging methods that can provide insight into the neurobiology of UCP and how the condition responds to existing therapies. We discuss how these methods could shape future rehabilitative strategies based on the neurobiology of UCP and the therapy-induced changes seen in the brain.

METHODOLOGICAL PHENOMENON OF RELAXATION AND TENSION IN THE MOTOR REHABILITATION OF CHILDREN

The analysis of modern systems of children motor rehabilitation with disorders of the musculoskeletal system by means of physical education and physical therapy are shown insufficiency of the scientific and methodological validity of this approach. In different systems the authors proposed different approaches to restore muscular system enough local but fragmented. This led to the fact that in Ukraine there is still no single program for correctional physical education preschoolers with cerebral palsy and other movement disorders have. There was a need for a fundamental development of scientific and methodological framework of the system, which should be translated into the appropriate state program ordered by the Ministry of Education and Science, Youth and Sport. Purpose, tasks of the paper, material and methods Purpose of an article – consideration methodologically the most current dual pair in motor rehabilitation of children by means of physical education – a total mind-body phenomena, meditation and concentration (in relation to muscle – relaxation and stress) for more effective use in motor rehabilitation of children by means of physical education. Methods of research. Were used both the theoretical (analysis of references to the problem) and practical (the series of experiments based on the pre-school institutions in Ukraine and Russia) methods. Organization of research. The study involved 27 preschool children with cerebral motor impairment (including cerebral palsy) and 32 children of preschool age with lumbar disorders. Results The importance of relaxation (relaxation) is described in a number of domestic and foreign research. Interesting methodological vector can be seen in the main provisions of osteopathy, in particular, in the cranio-sacral techniques. In Yu.V. Chikurov works [8] is discussed about prior sense of release, ie release when working with the patient's body. This, of course, is a physical, myofascial release, ie normalization of muscle and fascial fibers. There is a natural assumption that the physical restriction, - areas with limited mobility tissue - can form the corresponding neurovascular restriction, then - mental and, at the highest and small level - informational and energy. They are called “clips”, “blocks”, “muscular armor”, “iron shutters”. Taking into account psychosomatic person’s nature the suggest idea seems to be quite correct. Such approach may be called the principle of generating a restriction when the primary, even the most insignificant, physical restriction generates a restriction of certain neuro-vascular, then - mental and, in the end, reduces the level and flow rate of the vital energy in the body (prana, chi, energy orgone, bioenergy). The assumption of such causal effect relationship between all kinds of units make it possible for reverse supposition to the positive effect of this mechanism. Pushing through certain postures and exercises physical restriction, you can automatically get rid of and from other types of restriction, going out, in the end, to increase the energy level and the rate of its power in the body of the child with disabilities.

Methodological phenomenon of relaxation and tension in the motor rehabilitation of children

Methodological phenomenon of relaxation and tension in the motor rehabilitation of children

Interactive computer play in rehabilitation of children with sensorimotor disorders: a systematic review

The aim of this review was to examine systematically the evidence for the application of interactive computer play in the rehabilitation of children with sensorimotor disorders. A literature search of 11 electronic databases was conducted to identify articles published between January 1995 and May 2008. The review was restricted to reports of intervention studies evaluating the impact of interactive computer play on motor rehabilitation in children. For each study the quality of the methods and the strength of the evidence were assessed by two independent reviewers using the guidelines of the American Academy for Cerebral Palsy and Developmental Medicine. A total of 74 articles were identified, of which 16 met the inclusion criteria. Three studies were randomized controlled trials (RCTs) and half were case series or case reports. Areas investigated were movement quality, spatial orientation and mobility, and motivational aspects. Thirteen studies presented positive findings. Two of the three RCTs investigating movement quality and one level III study examining spatial orientation showed no significant improvements. Interactive computer play is a potentially promising tool for the motor rehabilitation of children but the level of evidence is too limited to assess its value fully. Further and more convincing research is needed.

Does horseback riding therapy or therapist‐directed hippotherapy rehabilitate children with cerebral palsy?

Quantitative (not qualitative) studies were sought investigating whether horseback riding used as therapy improves gross motor function in children with cerebral palsy (CP). Eleven published studies on instructor-directed, recreational horseback riding therapy (HBRT) and licensed-therapist-directed hippotherapy were identified, reviewed, and summarized for research design, methodological quality, therapy regimen, internal/external validity, results, and authors'conclusions. Methodological quality was moderate to good for all studies; some studies were limited by small sample size or lack of non-riding controls. HBRT improved gross motor function in five of six studies (one study was inconclusive); hippotherapy improved gross motor function in all five studies. The studies found that during HBRT and hippotherapy: (1) the three-dimensional, reciprocal movement of the walking horse produced normalized pelvic movement in the rider, closely resembling pelvic movement during ambulation in individuals without disability; (2) the sensation of smooth, rhythmical movements made by the horse improved co-contraction, joint stability, and weight shift, as well as postural and equilibrium responses; and (3) that HBRT and hippotherapy improved dynamic postural stabilization, recovery from perturbations, and anticipatory and feedback postural control. The evidence suggests that HBRT and hippotherapy are individually efficacious, and are both medically indicated as therapy for gross motor rehabilitation in children with CP. Recommendations for future research are discussed.

Visual motor rehabilitation in children with cerebral palsy.

Cerebral palsied (CP) children were given intensive visuo-oculomotor training in order to improve their visuo-oculomotor control, using children's films as a visual stimulus. A comparative study was conducted on a group of normal children of the same age. Results showed that training does improve visuo-oculomotor system control as illustrated by (1) a marked increase in smooth pursuit precision and maximum velocity, (2) an improvement of saccadic movement precision and stability, and (3) a shortening of the saccadic reaction time. The highest performance was observed under conditions in which the child pointed at and followed the visuo-acoustic target with his arm extended.