Rehabilitation Of Young Children Research Articles

Therapeutic nutrition is the most important factor in the treatment and rehabilitation of young children with infectious diseases

The article presents current data on the role of therapeutic nutrition in the treatment and rehabilitation of children with acute viral diseases. The main violations in the nutritional status of children with viral diseases of the upper respiratory tract, as well as those caused by coronavirus infection, are described. The paper describes in detail the properties, indications for the use of new health food products in the complex therapy and rehabilitation of young children and older with various viral diseases. The developed therapeutic food products contain plant components with antiviral, immunotropic, antioxidant, anti-inflammatory activities. The clinical and biochemical effects of a specialized product of general strengthening action for children from 12 months of age, containing vitamins and a biologically active phytocomplex, which provides a decrease in ASL-O titers, an increase in the concentration of serum IgA, and indicators of phagocytic activity, are described in detail. A clinical study of a new domestic medical food product used for colds showed its effects in improving the general condition and accelerating the recovery time, reducing inflammation in the ENT organs and coughing. The authors of the article recommend that in the course of viral diseases (influenza, COVID-19, etc.) with symptoms of dysfunction of the gastrointestinal tract, as a therapeutic food for children from 1 year old, therapeutic jelly for disorders in the gastrointestinal tract, which helps to reduce inflammation of the gastrointestinal mucosa and normalizes microbiota. For older children (from 12 years of age) the following have been developed and clinically studied: a healing drink for viral diseases with vitamin D and a detoxification drink with immunotropic and detoxification activities, respectively. All studied domestic health food products are clinically safe. The article provides detailed recommendations on the use of new therapeutic food products for viral pathology in children.

Rehabilitation of young children with movement disorders and epilepsy: rational approach and efficacy

Introduction. Epilepsy is one of the most common chronic nervous system disorders. Epilepsy in a child requiring physical, psychological and speech therapy significantly reduces its scope and decreases the likelihood of recovery.
 The aim of the study was to assess the efficacy and safety of a rehabilitation programme for young children with movement disorders and concomitant epilepsy.
 Materials and methods. Simple randomization was used to divide 123 children aged 924 months into four groups: three main groups and one comparison group. Patients in group 1 received traditional massage, excluding the cervical region, as their rehabilitation. Patients in group 2 received kinesiotherapy (Vojta therapy) in addition to traditional massage. Children in group 3 participated in a comprehensive programme, including traditional massage and kinesiotherapy (Vojta therapy). Children in the control group did not receive rehabilitation.
 Results. A statistically significant improvement in the psychomotor development parameters was observed after a course of medical rehabilitation. It was more significant when the epileptic focus was localized in the right hemisphere or the patient had generalized epilepsy. The outcome was less favourable in multifocal epilepsy and when the epileptic focus was present on the convex surface of the left hemisphere. The third group noted a statistically significant improvement in the GMFCS scores by the end of the comprehensive rehabilitation course. There were no epileptic seizures seen on repeat EEG recordings during the medical rehabilitation and one month after its completion.
 Conclusion. A comprehensive approach to planning a course of rehabilitation ensures its efficacy. The location of the epileptic focus and the distribution of epileptic activity along the convex surface of the brain determines the outcome of medical rehabilitation. An increased epileptiform activity index on EEG without signs of clinical deterioration requires more careful patient monitoring but, nevertheless, is not a reason to completely cancel rehabilitation measures.

Functional status of the cardiovascular system in young children who had correction for congenital heart defect by the age of 1 year

Background. The topic relevance is determined by the increasing number of children with congenital heart defect (CHD) who require surgical correction at an early age. For further follow-up it is necessary to determine a functional status of the cardiovascular system (CVS), its adaptation to new conditions of hemodynamics, that is especially important in childhood during the period of morphological and functional changes in the growing organism. Aim. To assess the functional status of the CVS in children with CHD using a test with dosed exercise load (EL) to determine the need for an individual approach to physical rehabilitation.Materials and methods. The study included 80 children, who have been surgically treated for CHD by the age of 1 year. The study population included 32 (40.0%) boys and 48 (60.0%) girls; an average age of patients was 33.5 ± 4.28 months. The control group included 50 conditionally healthy children, with an average age of 35.0 ± 4.1 months; of which 23 (46%) were boys and 27 (54%) were girls. To assess the functional status of the CVS, a test with dosed EL was performed (10 squats in 20 s). Blood pressure and heart rate were measured at rest and after exercise, the double product and the quality of response index were calculated. Results. In children with CHD 2 years after surgery, resting blood pressure was lower compared with healthy children, no significant differences in heart rate between groups were found. The double product in children of the main group was close to above average value. Analysis of hemodynamic changes due to EL showed a more pronounced increase in heart rate and less pronounced increase in pulse pressure and stroke volume in children with CHD after correction, which indicates the adaptation of CVS to EL due to an increase in the rate rather than the strength of heart contractions. The quality of response index in the group of children with CHD corresponded to an irrational reaction to EL. Analysis of CVS responses to the load showed that the most prevalent type was asymptaticotonic one (when there is an increase in heart rate and almost no changes in blood pressure). In the hypertensive type (revealed in a small number of children), there is a significant increase in both heart rate and systolic and diastolic blood pressure. The time of hemodynamics backing up to the baseline parameters did not exceed 5 minutes in both groups, no child complained during the test. Conclusions. In young children who had surgical correction for septal CHD in infancy, blood pressure is characterized by low parameters, that is associated with a possible alteration in the regulation of vascular tone. The predominant type of the CVS response to EL in young children with septal CHD which was corrected in infancy is the asympathicotonic one with a normal period of restoration of hemodynamics to the baseline parameters. The test with EL allows us to individualize the program of physical rehabilitation of young children who had surgery for septal CHD in infancy, taking into account the status of CVS and the initial fitness

IMOVE: Intensive Mobility training with Variability and Error compared to conventional rehabilitation for young children with cerebral palsy: the protocol for a single blind randomized controlled trial

BackgroundCerebral palsy (CP) is the most common cause of physical disability in children. The best opportunity to maximize lifelong independence is early in motor development when there is the most potential for neuroplastic change, but how best to optimize motor ability during this narrow window remains unknown. We have systematically developed and pilot-tested a novel intervention that incorporates overlapping principles of neurorehabilitation and infant motor learning in a context that promotes upright mobility skill and postural control development. The treatment, called iMOVE therapy, was designed to allow young children with CP to self-initiate motor learning experiences similar to their typically developing peers. This manuscript describes the protocol for a subsequent clinical trial to test the efficacy of iMOVE therapy compared to conventional therapy on gross motor development and other secondary outcomes in young children with CP.MethodsThe study is a single-blind randomized controlled trial. Forty-two participants with CP or suspected CP between the ages of 1–3 years will be randomized to receive either the iMOVE or conventional therapy group. Distinguishing characteristics of each group are detailed. Repeated measures of gross motor function will be collected throughout the 12–24 week intervention phase and at three follow-up points over one year post therapy. Secondary outcomes include measures of postural control, physical activity, participation and caregiver satisfaction.DiscussionThis clinical trial will add to a small, but growing, body of literature on early interventions to optimize the development of motor control in young children with CP. The information learned will inform clinical practice of early treatment strategies and may contribute to improving the trajectory of motor development and reducing lifelong physical disability in individuals with CP.Trial registrationClinicalTrials.gov identifier NCT02340026. Registered January 16, 2015.

Rehabilitation of adolescents after surgical treatment of dysplastic coxarthrosis

Background. The prevalence and severity of stage II and III dysplastic coxarthrosis determine the medical and social importance of its prevention and treatment. For a practicing orthopedic surgeon, there are two established stages of orthopedic treatment: the surgical stage and the restorative stage. The domestic and foreign literature from the previous 25 years comprises few publications regarding the rehabilitation of young children after reconstructive hip joint surgeries. Thus, the issues regarding the rehabilitation of teenagers following extra-articular operations on the hip joint remain unexplored.
 Aim. To evaluate the effectiveness of the developed program of rehabilitation for children after the surgical treatment of dysplastic coxarthrosis stages I and II.
 Material and methods. We analyzed the results of the surgical and rehabilitative treatment of 40 children (100%) with dysplastic coxarthrosis stage I and II; the study population included 27 girls (67.5%) and 13 boys (32.5 per cent) aged 13–18 years (total 54 joints). The rehabilitation period was divided into the following 4 stages: I preoperative, II postoperative day 1–2, III postoperative day 3–21, IV outpatient treatment (after hospital discharge to 1 year postoperatively).
 Results. By the time of discharge, the range of motion in the hip joint was as follows: bending 950° ± 40°, withdrawal 150° ± 50°, and extension 100° ± 30°. According to the results of the electromyography performed 3 months postoperatively, there was an increase in the amplitude of biopotentials for the gluteal muscle. The long-term result was evaluated after 1 year. The average modified Harris Hip Score and a scale developed in the The Turner Scientific and Research Institute for Children’s Orthopedics, significantly (p < 0.05) differed from preoperative ones.
 Conclusion. Early rehabilitation allows an increase in the strength and tone of muscles and restores the amplitude of movements in conditions of altered anatomical and biomechanical relationships in the hip. The verticalization of patients with the learning of proper load distribution on the parts of the foot enables effective recovery of the correct gait pattern. Comprehensive treatment of adolescents with dysplastic coxarthrosis according to the proposed method not only improves the condition of the affected hip joint and lower limb as a whole, but also improves the child’s quality of life.

CONGENITAL FOOT DEFORMITIES IN PRESCHOOL CHILDREN: CLINICAL ASPECTS AND ALGORITHMIC APPROACH IN THE WORK OF PEDIATRICIANS

Aim - analysis of the incidence of musculoskeletal system diseases and comorbid pathology in children; development of an algorithm for the rehabilitation of young children with congenital foot deformities for their parents and primary care professionals. Materials and methods. 244 cards of complex rehabilitation in rehabilitation centers of the Samara region for the period from January 2013 to August 2016 were studied. The children were divided into two groups: I group - the core group - included children of senior preschool age who were born between 22-37 weeks of gestation with birth weight of 500-2499 g; group II - control group - included children of preschool age who were born at 38-41 weeks of gestation with birth weight 2500-4500 g. Results. The study revealed the incidence of diseases of the musculoskeletal system in children in rehabilitation centers of the Samara region. The number of children with congenital deformities of the foot was 49.7% in the group of prematurely born children; flatfoot composed 42.3%, which proves the importance of the background condition (prematurity) in the development of congenital diseases of the foot. Multivariate analysis showed that the following factors are statistically significant: infantile cerebral palsy (p = 0.004), varus and valgus foot deformity (p

Two-Phase Transplantation (TPTX) Concept: A New Approach for Instant Rehabilitation of Young Children after Avulsion of Central Incisor

Background: To present a new idea for rapid management of tooth avulsion in young children and adolescents (age: 6 to 16) by this case report. Case presentation: A nine-year-old boy presented with loss of upper permanent central incisor in early mixed dentition (6 to 10 years, phase I). The not yet fully resorbed primary canine was used as tooth transplant for the lost incisor. The intentional renounce on endodontic treatment of the primary transplant permits natural exfoliation of the transplant occurring either spontaneously or due to undermining resorption through the adjacent erupting teeth. In the late mixed dentition (10 to 16 years, phase II), the primary tooth transplant is electively removed and replaced by a premolar autotransplant for long-term rehabilitation of the meanwhile adolescent patient. Results: Primary canine autoTX acts as a temporary denture with instant surgical gap closure. Ensuing premolar autoTX in phase II then acts as permanent denture with excellent 10 years survival rates. Patient satisfaction issued by a questionnaire resulted in good to very good school grades for both phases of autotransplantation. Conclusions: The “TPTX” concept is a new surgical approach that immediately restores the patient’s function and aesthetics after tooth loss in early childhood supporting the growth of local bone and soft tissue in the growing adolescent jaw.

The relationship of motor skills and adaptive behavior skills in young children with autism spectrum disorders

ObjectiveTo determine the relationship of motor skills and adaptive behavior skills in young children with autism. DesignA multiple regression analysis tested the relationship of motor skills on the adaptive behavior composite, daily living, adaptive social and adaptive communicative skills holding constant age, non-verbal problem solving, and calibrated autism severity. SettingMajority of the data collected took place in an autism clinic. ParticipantsA cohort of 233 young children with ASD (n=172), PDD-NOS (n=22) and non-ASD (developmental delay, n=39) between the ages of 14–49 months were recruited from early intervention studies and clinical referrals. Children with non-ASD (developmental delay) were included in this study to provide a range of scores indicted through calibrated autism severity. InterventionsNot applicable. Main outcome measuresThe primary outcome measures in this study were adaptive behavior skills. ResultsFine motor skills significantly predicted all adaptive behavior skills (p<0.01). Gross motor skills were predictive of daily living skills (p<0.05). Children with weaker motor skills displayed greater deficits in adaptive behavior skills. ConclusionsThe fine and gross motor skills are significantly related to adaptive behavior skills in young children with autism spectrum disorder. There is more to focus on and new avenues to explore in the realm of discovering how to implement early intervention and rehabilitation for young children with autism and motor skills need to be a part of the discussion.

Identification of core functioning features for assessment and intervention in Autism Spectrum Disorders

Purpose: Framed within a biopsychosocial approach, this study aimed to identify the main functionality dimensions that experts in the field of child development and child psychopathology considered as essential in the assessment-intervention process with young children with Autism Spectrum Disorders (ASD), using the International Classification of Functionality, Disability and Health for Children and Youth. Method: The Delphi method was used to obtain consensus among experts regarding the essential functionality features for the rehabilitation of young children with ASD. Therefore, web-based three-round survey was developed. Results: There are more functionality features identified as more essential for the age group 3–6 than from the group birth-2 years of age. 49.4% of activities and participation dimensions were regarded as essential by experts, while only 13.9% of body functions were selected. 39.9% of environmental factors were also marked by experts as essential. Conclusions: Pervasive Developmental Disorders (PDD) are classified in diagnostic manuals-DSM-IV-TR and ICD-10. These classifications are valuable to detect signs/symptoms of health conditions; however, they are often not sufficient to develop individualized interventions. More functional information is needed to complement diagnostic data. The identified functionality dimensions of the ICF-CY complement diagnosis by differentiating relevant functioning aspects in all life domains, according to the biopsychosocial model and should always be addressed in the process of rehabilitation of young children with ASD.Implications for RehabilitationThe biopsychosocial approach is the most complete way of conceptualizing human development and disability; combining medical, social and functional perspectives.The ICF-CY specifies strengths and areas for improvement in the functionality of each individual, according to the biopsychosocial model of disability.This paper identifies core functioning features for the rehabilitation of young children with Autism Spectrum Disorders, in all dimensions of life, according to the biopsychosocial approach to disability.

A comparison of developmental versus functional assessment in the rehabilitation of young children

The purpose of this study was to explore the differences in and potential uses of information derived from developmental vs. functional assessment during the acute rehabilitation of very young children with acquired brain injury. Both methods of assessment are typically used during hospitalization in order to assist in developing individualized goals and outcome measures. With the trend of shortened hospital stays, effective assessment for determining optimal treatment goals and outcomes becomes increasingly important. The results from a developmental and a functional assessment obtained on 23 inpatient children below 6 years of age who had experienced either an acquired brain injury or encephalitis were compared. The data was collected through a retrospective chart review spanning 4 years. Each child received a cognitive and a language test using either the Early Learning Accomplishment Profile (E-LAP) or the Learning Accomplishment Profile Diagnostic (LAP-D) for the developmental assessment measure. The Functional Independence Measure for Children (WeeFIM) was used as a functional assessment. Summary statistics and frequencies were calculated for variables including age and diagnosis. Partial Pearson correlations and 95% confidence intervals were calculated between the functional and developmental assessments, adjusting for the amount of time between administrations of the two exams. Pearson correlations were computed between length of hospital stay and performance on the developmental and functional quotients. Moderate, statistically significant Pearson partial correlations were found between the E-LAP/LAP-D cognitive quotient and the WeeFIM cognitive quotient (r = 0.42, 95% CI (0, 0.72)), the E-LAP/LAP-D language quotient and the WeeFIM cognitive quotient (r = 0.55, 95% CI (0.17, 0.79)) and the E-LAP/LAP-D cognitive quotient and the WeeFIM total quotient (r = 0.50, 95% CI (0.10, 0.76)). An inverse correlation was found between the length of stay and the E-LAP/ LAP-D cognitive quotient (r = -0.68, 95% CI (-0.86, -0.34)) as well as the E-LAP/LAP-D language quotient (r = -0.61, 95% CI (-0.83, -0.23)). The moderate but limited correlations between developmental and functional assessments may be attributed to differences in the two forms of assessment including the test items, their administration and scoring. While both forms of assessment were thought to be useful for developing individualized treatment goals and measuring outcomes, there were advantages and disadvantages to each.

A developmental approach to sensory disabilities in early childhood.

Rehabilitation for young children with hearing and visual disabilities is considered from a developmental angle. The effect of these sensory disabilities on parents; the constraints on development imposed by each disability; and medical and surgical treatment and the use of aids in young children are discussed.

Modern Concepts of Rehabilitation of Young Children with Severe Hearing Impairment

Modern Concepts of Rehabilitation of Young Children with Severe Hearing Impairment