Motor Sphere Research Articles

Особенности восстановления движений в паретичной нижней конечности у пациентов с инсультом

Aim. To identify the features of movement recovery performed on a horizontal plane by the foot of the affected lower limb and associated changes in maintaining body balance in patients with mild to moderate central paresis, and to identify factors for their improvement. Design. Clinical prospective randomized interventional longitudinal pilot study. Materials and methods. The study included 115 patients with ischemic stroke in the carotid basin, who received medical assistance according to standards and clinical guidelines. The patients were divided into two groups: the main group (I), in which stabilometric training was included in the rehabilitation measures, and the comparison group (II), in which it was not performed. Additionally, both groups were divided into subgroups with mild and moderate paresis depending on the degree of strength loss in the foot. At the beginning and end of the course, all patients underwent testing of available movements on a horizontal plane along the proposed rectilinear trajectory to the limitations corresponding to the image on the monitor screen reflecting the game situation. Foot movements were performed sequentially in the frontal plane by abduction and adduction in the hip and flexed knee joints of the paretic lower limb and in the sagittal plane by extension in the knee with simultaneous flexion in the ankle joint in combination with adduction, abduction and rotation of the foot. Then the direction was changed, and the patients flexed the knee and extended the ankle joint of the paretic lower limb. Only patients from Group I practiced these movements during repeated training. Functional testing of the motor sphere, stabilometric tests were conducted, emotional-volitional and cognitive disorders that could affect the effectiveness of the training were identified. Results. Targeted work on repeated performance of given rectilinear single-plane movements over a short course (10 sessions of 10 minutes 4 times a week) was accompanied by an improvement in balance, primarily in individuals with a moderate degree of muscle strength reduction in the foot. Improvement of stabilometric indicators in Group I reflected the effectiveness of the training. Sensitive indicators were the speed of movement of the center of pressure, area and energy intensity of the statokinesiogram. When analyzing the factors influencing the correction of movements, it was found that the greatest effect was produced by high motivation, preservation of cognitive functions, absence of anxiety and depression with active inclusion of visual control in the implementation of the motor act throughout the rehabilitation course. Conclusion. Motor rehabilitation with targeted correction of foot movements in patients with central paresis of the lower limb after stroke led to an improvement in balance in a short time, especially in patients with a moderate degree of muscle strength loss in the foot. Patients with mild foot paresis in stroke should be recommended a training course in practicing foot movements, consisting of at least 6 sessions of 10 repetitions each, and with moderate paresis — of 8 sessions of 10 repetitions. Correction of rectilinear single-plane movements in the frontal plane is formed later by one training session than in the sagittal plane. Keywords: movement, paresis, stroke, lower limb.

MODERN METHODS FOR ASSESSING MOTOR AND SENSORY INTER-HEMISPHERIC ASYMMETRY OF THE BRAIN IN CHILDREN OF PRIMARY AND SECONDARY SCHOOL AGE (8-11 YEARS OLD)

Background: The neuropsychological study of some features of interhemispheric relationships in the motorsphere in children with various types of mental disorders is of undoubted interest. It can show a number of new aspects of the problem of the formation of inter-hemispheric asymmetry and inter-hemispheric interaction in ontogenesis. Methodology: Nowadays, two approaches are used in physiology to assess brain inter-hemispheric differences: the method of determining the "handiness" by means of a survey (Edinburgh test) and the method of actively detecting motor and sensory asymmetry by N.N. Bragina and T.A. Dobrokhotova methodology. Results: The neuropsychological study of some features of interhemispheric relationships in the motor sphere in children with various types of mental disorders is of undoubted interest. It can show a number of new aspects of the problem of the formation of inter-hemispheric asymmetry and inter-hemispheric interaction in ontogenesis. Both techniques are widely represented in modern scientific literature, but we have not found research that describes the relationship between the results of testing assessment of functional brain asymmetry using the Edinburgh test and tests for determining motor and sensory asymmetry. Normally, the formation of brain inter-hemispheric asymmetry and inter-hemispheric interaction is, of course, heterochronical in nature. Conclusion: Therefore, the examined schoolchildren may encounter an almost fully formed primary level of interhemispheric connections, while the second and third levels are still in their formation. At the same time, a comparison between the results of healthy children of 8–11 years of age shows that the functional organization of inter-hemispheric asymmetry and inter-hemispheric interaction in this age range is in a state of constant ongoing development.

Speech Production in Healthy Older Adults With or Without Amateur Singing Experience.

Amateur singing is a universal, accessible, and enjoyable musical activity that may have positive impacts on human communication. However, evidence of an impact of singing on speech articulation is still scarce, yet understanding the effects of vocal training on speech production could provide a model for treating people with speech deficits. The aim of this study was to examine speech production in younger and older adults with or without amateur singing experience. Thirty-eight amateur singers (aged 20-87 years, 23 women and 15 men) and 40 nonmusician active controls (aged 23-88 years, 19 women and 21 men) were recruited. A set of tasks were used to evaluate the oral motor sphere: two voice production tasks, a passage reading task, and a modified diadochokinetic (DDK) rates task performed at a natural rhythm and as quickly as possible. Our results show that older age was associated with lower reading rate, lower articulation rate, and articulation rate variability in the DDK task, as well as reduced accuracy for the phonologically complex stimuli. Most importantly, our results show an advantage for singers over cognitively active nonsingers in terms of articulatory accuracy in the most challenging situations. This result suggests extended maximal performance capacities in amateur singers perhaps resulting from the articulatory efforts required during singing. https://doi.org/10.23641/asha.24274813.

Vincristine‑induced peripheral neuropathy in children with acute lymphoblastic leukemia: Clinical and instrumental characteristics, search for new solutions

Objective. To evaluate clinical and electroneuromyographic characteristics of vincristine polyneuropathy in children with acute lymphoblastic leukemia.Materials and methods. A single-centre prospective cohort study involved 106 children with acute lymphoblastic leukemia, aged 3 to 17 years, with vincristine polyneuropathy; clinical and electroneuromyographic data were analyzed.Results. In the majority of cases, 84.9 % (n = 90) of patients, vincristine polyneuropathy debuted during the induction phase of chemotherapy. The clinical picture was dominated by combined neurological disorders in 67.9 % (n = 72) cases, with sensory and motor disorders dominating. Sensory dysfunction was manifested predominantly by pain in the lower extremities, changes in the motor sphere were characterized by the development of distal paresis of the lower extremities. In 66.0 % (n = 70) of patients, neurological disorders corresponded to the 2nd degree of severity according to the toxicity scale (NCI-STAE). According to the ENMG study, all children had motor axonal neuropathy of the peroneal nerves.Conclusions. The results of the study showed that the clinical picture of vincristine polyneuropathy is accompanied by sensory and motor symptoms. Currently, a complex of clinical and instrumental methods is used to verify the neurotoxic complication. The main objective method of diagnosis is an electroneuromyographic study. However, its capabilities are limited for determining the clinical manifestations associated with sensory disorders.

Logopedic Technologies in Work with Children with Special Educational Needs

The scientific substantiation of motor sphere examination as one of the important components of complex pedagogical examination of children with speech disorders is considered. The article considers the problem of application of speech therapy technologies for preschool children with special educational needs. On the basis of theoretical analysis of sources of the problem, as well as practical experience of work with such children the necessity of multidisciplinary approach to the organization of their speech therapy support. Algorithms of variant technologies of speech therapy support of preschool children with delayed speech development and developmental disorders are given. The importance of involving parents of preschool children with special educational needs in joint activities with a speech therapist is given. Particular attention is paid to the need for diagnostics of the child's speech development. The problem of organization of joint work of a speech therapist and parents bringing up a child with special educational needs is revealed. The ways of solving problems arising in such families are shown. The necessity of timely and systematic correctional and speech therapy work is pointed out.

MULTIPLE SCLEROSIS IN A CHILD. CLINICAL CASE

Introduction. Pediatric-onset multiple sclerosis (POMS) is defined as MS with onset before 18 years of age, using the 2017 McDonald Criteria. 3-5% of all MS cases have pediatric onset. Mean age of onset in POMS is 11 years, however, most patients are older than 15. There is a known female predilection for MS, although not in the younger than 11 years age group. Materials and methods. Our article presents a clinical case of MS in children. We think that this information will be interesting for neurologists and pediatricians. Results. Our patient is a boy 13 years, born from the 3 pregnancy, 3 birth. His development was appropriate for his age. There is no patient with multiple sclerosis in the offspring. Symptoms started with blurred vision in one eye when he was 11 years old. He was under the supervision of a neurologist and received treatment. His condition has stabilized. Symptoms repeated after 6 months. In addition to the weakness of vision, there is also a difficulty in performing precise movements. In neurological status: Pupils reaction to light was preserved. Left-sided oculomotor deficiency is noted. Swallowing and hearing N. In the motor sphere: peripheral muscle tone D=S, hypotonia, reflexes D=S, hyperreflexia, muscle strength D=S, normal. Reflexogenic zones in the lower limbs have expanded. Sensory system without any changes. He is unstable in the Romberg state. In finger- nose test intentional tremor is seen. Brain MRI: active demyelinating lesions (largest 14x8) in supratentorial and infratentorial region. Spine MRI: contrast enhancing demyelinating lesions in C1 and C5. 3 months later, an increase of demyelinating lesions was noted in the MRI examination of the brain and spinal cord. Ophthalmologist's examination: retrobulbar neuritis. LP: Oligoclonal band was positive. General and biochemical analysis of blood was normal. Conclusion. There is quite a lot of information about multiple sclerosis in adults in the literature. However, it has not been adequately studied in children. Thus, we believe that studying the characteristics of the course of multiple sclerosis in the pediatric population is important and of social importance.

EFFECTIVENESS OF INFLUENCE OF BOCCE ON IMPROVING THE MOBILE SKILLS OF CHILDREN WITH SPECIAL EDUCATIONAL NEEDS

According to the results of the analysis of scientific-methodical and special literature, it was established that with various types of nosologies, the motor sphere almost always suffers first of all, which has a negative impact, first of all, on the physical and then on the general psychophysical development of a child with special educational needs.
 The developed Bocce training program for children with inclusion included theoretical, general physical, special, technical and tactical training, and competitions. During the event, safety techniques were observed, the integrity of the equipment was checked, and the technical condition of children's strollers was checked. During the preparation of the program, the emotional state of children, their moral and willpower qualities in the competitive and training process were taken into account.
 As a result of conducting adaptive motor recreation, a conclusion can be drawn regarding the effectiveness of using the game of bocce to increase the motor abilities of children with inclusion. During the performance of regular physical exercises, the muscles of the shoulder girdle were significantly strengthened, physical strength, amplitude of movements and endurance, resistance to loads increased.

Дополнительная общеразвивающая программа социально-гуманитарной направленности «Я развиваюсь» для детей 4–5 лет

<p>The article is devoted to the description of the program “I am developing” for preschool children 4–5 years old. The implementation of the program is based on an interdisciplinary psychological and pedagogical approach and is aimed at revealing the internal resources of pupils (including those with disabilities), cognitive development, the development of regulatory functions, as well as the emotional, personal and communicative development of children. Classes are built in the stream of the neuropsychological approach and suggest an early start of corrective action in the created developmental environment. The basis of this developing psychological and pedagogical program is the theoretical provisions of L.S. Vygotsky, A.R. Luria about the patterns of development and the hierarchical structure of the brain organization of higher mental functions in ontogenesis (the theory of three functional blocks of the brain), as well as theoretical and applied research by A.V. Semenovich about neuropsychological correction according to the principle of “replacing ontogenesis method”. As a result of approbation of the program, results were obtained confirming an increase in the basic properties of voluntary attention, the development of basic cognitive functions (thinking, memory), the emotional-volitional sphere, communication skills, as well as the motor sphere (perseverance, impulsivity reduction, elimination of hyperkinetic and hypokinetic syndromes).</p>

Особенности планирования занятий физической культурой в дошкольных учреждениях для ретардированных детей, имеющих нарушения речи

Importance. The features of planning physical education classes in preschool institutions for mentally challenged children with speech disorders are considered. The purpose of the study is to analyze the features of planning physical education classes in preschool institutions for mentally challenged children with speech disorders. To achieve this goal, a number of tasks are solved: the features of the relationship between speech and motor disorders of preschool children asre characterized; a review of psychological and pedagogical literature on the research problem is conducted; methodological recommendations are developed for planning physical education classes in preschool institutions for mentally challenged children with speech disorders. Research methods. Analysis of theoretical and methodological literature on the research topic, analysis of the experience of practitioners working with preschool children with speech disorders, comparative analysis, as well as the method of generalizations. Result and Discussion. Speech disorders of preschool children are closely related to motor disorders, since the speech and motor spheres are inextricably linked; it is necessary to plan physical education classes for mentally challenged children with speech disorders in a preschool educational institution in such a way that during these classes the simultaneous development of the speech and motor spheres takes place. It is necessary to include elements of rhythmics, dance movements, aerobics, etc. in physical education classes.; in the process of planning a system of physical education classes, it is also advisable to integrate innovative techniques into classes, namely: 3D fitness, classes on step platforms (subject to technical capability), etc. Conclusion. Competent planning of physical education classes in preschool institutions for mentally challenged with speech disorders will make it possible not only to provide children with the necessary physical activity, but also to correct speech disorders to some extent.

Early Diagnosis of Parkinson's Disease Exploting Motor and Non-Motor Symptoms: Results from the PPMI Cohort

Parkinson's is a neurodegenerative disease, with a slow but progressive evolution, which involves some main functions such as the control of movements and balance. Symptoms vary by patient and include motor factors such as tremors and stiffness as well as non-motor symptoms such as cognitive impairment. Its diagnosis is not easy, so it is becoming increasingly necessary to assist doctors in identifying and predicting the disease. Artificial intelligence takes up this challenge and this work proposes a new approach to predict the onset of the disease and monitor patients. The experimentation involved the use of different classification algorithms. The proposed methodology was validated on a large ad hoc data set by compiling data collected by the Parkinson's Progression Markers Initiative (PPMI). Specifically, the study compares the results of the classification taking into consideration only the characteristics belonging to the motor sphere, or those of the non-motor sphere, with the aim of understanding which characteristics are more significant for the identification of the disease. In this regard, a multi-stage feature selection was conducted and SHAP was used to make the model explainable.

ABOUT THE FEATURES OF CRIMINALISTIC RESEARCH OF FACTORS AFFECTING HANDWRITING CHANGES

The article highlights the current topic of sustainability of handwriting features under the influence of physiological aging. The focus is on the fact that the study of actual age-specific changes in human mobility in old and old age presents significant difficulties, especially when studying changes in motor functions in the elderly. This is due to the fact that physiological old age is a fairly rare phenomenon and in most cases, when researching the motor sphere of people of old age have to deal with complex interweaving, such as real age changes, as well as motor abnormalities resulting from a number of diseases that accompany aging. The issue of the impact of age-related changes in motor functions of a person in the elderly and senile age was considered, taking into account the distribution into three age groups of people older than 55 years. This was analysed and presented in an article on the sustainability of common features in signatures of older persons. The necessity of developing a structured methodology for the study of signatures performed by older and older persons in accordance with the state standards for the registration of its results was determined, which would correspond to the level of modern scientific developments. Key words: handwriting, handwriting research, motor functions, elderly and senile persons, physiological aging, variability, confounding factor, age group.

The influence of training with free-fight means on motor skills, sensory functioning and quality of life of a child with autism (unique case)

The motor sphere of children with autism is characterized by the presence of stereotyped movements, difficulties in the formation of objective actions and household skills, and violations of fine and gross motor skills.
 The aim of the work was to establish the influence of adaptive training with elements of free-fight on the development of motor skills, sensory profile and quality of life of a child with autism.
 A 12-year-old boy A. with a diagnosis of childhood autism, social maladaptation (disability subgroup A) was chosen for the experiment. The child does not speak, cannot read or write, has impaired coordination of movements (walking on tiptoes, motor stereotypies, motor disinhibition), insufficient understanding of language. Somatically, the boy is healthy, loves motor activity.
 An assessment of the child's sensory functioning was carried out according to the Short Sensory Profile method, developed and recognized by The Psychological Corporation (USA), a survey of parents about the child's quality of life before the start of training and after a forced break in training, in addition, an assessment of the quality of direct blows with the hand and foot was carried out punching bags at each session.
 During the research period, the boy A. performed, under the guidance of a coach, exercises for coordination of movements ("obstacle course"), interaction with the coach (gymnastic exercises, various available games with a ball), exercises for developing the strength of various muscle groups (work with "Bulgarian bag", dumbbells) and special free-fight exercises (hits with hands and feet on punching bags and a dummy).
 A significant improvement of the child's sensory functioning was established, namely all types of sensitivity, except auditory filtering and sensitivity to taste and smell. The child's parents noted a significant increase in the quality of life of both the boy himself and the entire family. Significant progress was observed in learning the technique and the success of the boy's performance of special free-fight exercises. Adaptive training with elements of free fight served as a significant sensory stimulus for a child with autism, contributed to the learning of motor skills, and improved the quality of life of the family.

ANALYSIS OF SCIENTIFIC RESEARCH ON THE SENSIMOTOR DEVELOPMENT OF CHILDREN WITH DISORDERS OF INTELLECTUAL DEVELOPMENT

The article provides a theoretical analysis of research on the problem of sensorimotor development with children with violation of intellectual development. Theoretical aspects of sensorimotor development of children with intellectual disabilities in the following areas are considered: vestibular-postural reactions and bilateral coordination. Motor mechanisms affect the general development of the child, his ability to work and master the curriculum. Studies have shown the effect of physical activity on mental activity and academic performance. Imperfections of the motor sphere of children with PIR are revealed. Children's gait is unstable, movements are chaotic, poorly coordinated, poorly regulated muscular effort, impaired visual-motor coordination, inability to imitate, underdevelopment of differentiated finger movements. The disadvantages of arbitrary movements are pronounced. Theoretical analysis of scientific research on the role of the central nervous system in the construction of movements. Spinal cord, medulla, diencephalon, cerebellum, large hemispheres perform their functions. Simple movements (reflective) provide normal performance of more complex movements performed due to the lower parts of the central nervous system (spinal, medulla, midbrain). More complex postures are regulated by the activity of the midbrain, the vestibular system, which obey the cerebellum. The cerebellum coordinates the proportionality of movement. To perform movement in space, it is necessary to combine all types of sensitive sphere (afferentation). This process occurs at the level of the diencephalon and subcortical nuclei. It is proved that part of the vestibular signals must be registered and modulated by the brain. The lack of modulation of vestibular stimuli will be noticeable in bilateral reactions, coordination of the two sides of the body. The postural response may go unnoticed because it is difficult for the child to adopt a particular posture. Sensorimotor development affects the functioning of the body of a child with violation of intellectual development.

Study of reactions of the sensorimotor system in adolescents during and after surgical correction of spinal deformity

BACKGROUND: Little attention has been paid to the study of delayed sensory and motor reactions in adolescents with spinal deformities after surgical treatment.
 AIM: To study the reactions of the sensorimotor system of adolescents after surgical correction of spinal deformity.
 MATERIALS AND METHODS: The state of the sensory and motor spheres was analyzed in the immediate postoperative period in 21 adolescents with idiopathic scoliosis and in 13 with congenital deformities of the spine. A complex of methods involving global and stimulation electroneuromyography was used. The amplitude of motor, reflex potentials and interference electromyogram was evaluated at the maximum arbitrary tension of the lower limb muscles. Using an esthesiometer, thermal pain sensitivity in Th1S2 dermatomes was explored. In the process of surgical correction, intraoperative neuromonitoring was performed with registration of motor evoked potentials of the lower limb muscles.
 RESULTS: At the beginning of surgical intervention, high-amplitude, well-reproducible motor evoked potentials were obtained in all patients. In the group of patients with idiopathic scoliosis, compared with those with congenital deformities, smooth flow of surgery prevailed (p 0.05) without significant changes in motor potentials relative to the baseline (p 0.05). The number of observations of motor potentials decreased in the both groups and did not exceed 10%; the differences were not significant (p 0.05). The study of the reactions of the sensorimotor system in the immediate postoperative period triggered an increase in the amplitude of M-responses of m. rectus femoris, m. flexor digitorum brevis, m. gastrocnemius, and a decrease in the amplitude of the total EMG of m. rectus femoris. Values of H-reflexes remained at the preoperative level. The analysis of thermal pain sensitivity demonstrated the presence of a more pronounced reaction than that of the motor component. Changes in indicators of this type of sensitivity in groups of adolescents with idiopathic and congenital scoliosis were opposite. In idiopathic scoliosis, negative dynamics of the values prevailed, while in adolescents with congenital deformities of the spine, positive dynamics prevailed. This was because the amount of correction of the main and compensatory curves of the deformity in the group with idiopathic scoliosis was 48% greater (p = 0.0004) and 51% greater (p = 0.011), respectively.
 CONCLUSIONS: After surgical correction of spinal deformities in adolescents, the reactions of the sensory system of thermal pain sensitivity were more pronounced than those of the motor sphere.

Functional Capaсities of Limb Muscles in Patients with Partial Damage to the Cervical Spinal Cord

INTRODUCTION: In the long-term course of traumatic spinal cord disease (TSCD), neuroplastic adaptive and maladaptive changes occurred on different structural levels of the nervous system, which leads to a shift in the activation and strength characteristics of the limb muscles. The standard neurological assessment is approximate; therefore, objective instrumental studies of the motor sphere of patients with partial damage to the cervical spinal cord have not lost their significance.
 AIM: To study the activation and strength characteristics of the limb muscles of patients with partial injury of the cervical spinal cord in the long-term course of the disease (type B on the American Spinal Cord Injury Association (ASIA) scale).
 MATERIALS AND METHODS: The study enrolled 28 patients with fractures of the cervical spinal cord vertebrae in the late period of the TSCD of ASIA type B. The amplitude of motor responses (M-responses) of the upper and lower limbs was assessed using electroneuromyography. The strength of the upper limb muscles was evaluated using manual dynamometers.
 RESULTS: M-responses were absent in 9% and 64% in the upper and lower limbs, respectively. The amplitude of the most recorded M-responses of the upper and lower limb muscles was reduced relative to the norm. The reduction was not uniform, with significant differences in different leads. The average values of the amplitude asymmetry of M-responses did not exceed the norm. Moreover, 61% of the patients could perform hand-grip functions and hold the wrist dynamometer. Only 59% of the patients could make an effort and the results of strength measurement were obtained, whereas in 41% of cases, zero values were obtained. Statistical analyses revealed a clear relationship between the motor deficiency index of the upper limb and hand-grip strength.
 CONCLUSION: The degree of preservation of M-responses and evident asymmetry of evoked electrical activities of the upper and lower limb muscles indicate the existence of a certain level of neurotrophic interaction in the muscle fibermotor neuron system. The level of reduction of the hand-grip strength and its relationship with the motor deficiency index allows discussion about the partial preservation of the voluntary control of the motor function of the upper limbs.

GOALBALL AS A WAY TO CORRECT THE PHYSICAL DEVELOPMENT OF STUDENTS WITH VISION PROBLEMS

The purpose of the study is the impact of the training process of playing goalball on the physical development and control results of the participation of visually impaired students in sports tournaments. The effectiveness of the goalball game is shown as a means of correcting the physical development of students with problematic vision, contributing to adaptation to changing living conditions and regulation of the compensatory activity of the motor sphere.

CLINICAL CHARACTERISTICS IN CORNELIA DE LANGE SYNDROME OF THE FIRSTTYPE ON THEEXAMPLE OF A CLINICAL CASE

— Relevance: Cornelia de Lange syndrome is a rare congenital disorder associated with orphan diseases and is characterized by multiple stigmas of dysembryogenesis at birth. This syndrome occurs in newborns with a frequency of 1: 30,000 to 1: 10,000; there are no gender differences in the frequency of occurrence. Cornelia de Lange syndrome is a dominantly inherited disease, but most cases are sporadic de novo, therefore, mainly children with Cornelia de Lange syndrome are born from genetically healthy parents. Purpose: Using the example of a clinical case, to demonstrate the characteristic features of the clinical picture, namely the phenotype and deviations of the neurological status in Cornelia de Lange syndrome. Materials: Girl M., born in 2018, at the age of 1 year 11 months, together with her mother, was admitted to the Center for Pediatric Neurology and Medical Rehabilitation No. 2 in Tver, Russia. The girl had the following complaints (according to the mother): the child does not walk independently, stands with legs apart, and does not speak. She has obsessive movements ("crossed out" hand movement, waves her arms, puts his right hand behind the body, shakes objects in the mouth area), lags behind in development, does not differentiate significant adults, does not speak, there is no pointing gesture. Inpatient examination and treatment was carried out at the Center for Pediatric Neurology and Medical Rehabilitation. Results: Based on the examinations, the following diagnosis was established: Cornellia de Lange syndrome, type 1. Delayed physical, static-motor and mental development. Short stature. Congenital kidney anomaly: horseshoe kidney. Sensorineural hearing loss I-II degree The priority areas in this case are: improving the patient's quality of life, stimulating the development of the mental and motor spheres, socialization with other children. Conclusion: This clinical case demonstrates the need for early diagnosis of genetic disorders in order to build correct social and medical rehabilitation.

Baby Sign Language in the development of young hearing children: A review of selected studies

The aim of this theoretical article is to increase the cognitive value of the subject of Baby Sign Language, in particular their positive impact and significance for the development of a hearing child. Addressing this problem seems important because of constant interest in sign language for children, both among parents and scientists. Equally important is the argument of the lack of a sufficient number of Polish studies in this area. The article consists of a short introduction and four thematically and logically arranged parts. The first contains a synthetic description of the process of language acquisition and development as well as the communication of a young child. The second part presents the history of the Baby Sign Language, its basic assumptions and principles. The third part discusses the importance and benefits of using the Baby Sign Language in the development of a young child. The study ends with a short summary with final conclusions, which show, based on the presented empirical material, that the Baby Sign Language has a positive significance for the child's development in almost all its spheres, i.e. e.g. in the linguistic, cognitive, emotional and motor spheres.

Using physical education lessons to develop the autonomy of primary school children

The shift in emphasis from the motor sphere to the mental, psycho-emotional sphere leads to a decrease in the natural motor activity of the younger schoolchild, which actualizes the development of the functional and body adaptive capabilities by means of motor activity. In this regard, the formation of independence for physical education is one of the most important problems in Kazakhstani primary school. Therefore, this research has been undertaken to study: a) the state of work of the country's general education schools in the formation of independence skills in junior schoolchildren; b) the essence and features for the formation of the independence skill in younger schoolchildren through general developing exercises in physical education lessons; c) to propose measures that ensure the effectiveness of the physical education process in primary school to improve the physical fitness of schoolchildren, the formation of their motivation for independent physical education. The revealed results showed that the real experience for organizing physical education of schoolchildren in primary school is not effective enough. The present study points to the beneficial effect of general developing exercises on the physical development of children, especially on the development effectiveness of the independence of schoolchildren and their need for systematic physical exercise.
 
 Keywords: general developing exercises, formation, pedagogical conditions, primary education; primary schoolchildren.

Traumatic intracranial hipertension correction in patients with intracranial hematomas during the early postoperative period with the use of systemic angioprotector

Post-traumatic brain edema is integral pathophysiological process in patients with severe traumatic brain injury, leading to increase of intracranial pressure (ICP). Intracranial hypertension (ICH), in turn, increases the number of deaths in this group of patients. The most important task in the treatment of victims in the early postoperative period after the removal of traumatic intracranial hematomas is correction of ICH syndrome.Purpose of the study. To evaluate the effect of the systemic angioprotector use on the treatment outcomes of patients with traumatic intracranial hematomas in the early postoperative period.Materials and methods. The study included 50 patients with traumatic intracranial hematomas. Group I — the main group (with the use of systemic angioprotector, n=24), group II — the comparison group (without the use of the medication, n=26). The effectiveness of treatment was compared — according to the following criteria: survival in the postoperative period (14 days), level of consciousness (at admission and average value during the day throughout the treatment), course of neurological status: meningeal signs, cranial nerve function, motor sphere, response to pain stimuli, autonomic system disorders (at admission and every day throughout the treatment), monitoring of ICP (before removal of the hematoma and average value throughout the measurement), changes in the multispiral computed tomogram of the head (at admission, on the 3rd, 7th, 14th day).Results. The study found that the mortality rate in the main group of patients with intracranial hematomas in the early postoperative period decreased by 21.5%. The average value of ICP for the entire period of measurement in group I is 15.0±7.6, in group II 17.3±8.4 mm Hg. The average value of points of the Glasgow com scale on the 14th day in group I is 9.2±1.9, in group II 7.5±0.7 points. The duration of intraventricular monitoring of ICP was less in the first group — 4.3±1.2 days, compared to the second group — 6.2±1.5 days.Conclusion. The use of systemic angioprotector in the complex treatment can reduce intracranial pressure (ICP) in patients with traumatic intracranial hematomas in the early postoperative period and improve intermediate outcomes.