Issue 4-92, 2019

Prediction of the effectiveness of rehabilitation of children of primary school age suffering from spastic forms of cerebral palsy, based on the activity of segmental skin sympathetic reactions

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1 Polyakova A.G., 1 Belova A.N., 1 Sheiko G.E., 2 Boytsov I.V.

1 Privolzhsky Research Medical University, Nizhny Novgorod, Russia
2 LTD«Multiresonance», Minsk, Belarus


ABSTRACT

Spastic forms of cerebral palsy (cerebral palsy) are manifested not only by motor disorders, but also vegetative dysfunction,which weakens the adaptive potential of the body, complicates the medical rehabilitation and worsens its prognosis.Purpose: to study the peculiarities of vegetative support disorders at the segmental level in spastic forms of cerebral palsyand to assess the degree of correlation of qualitative vegetative indicators with clinical and functional outcomes of medicalrehabilitation.The efficiency of rehabilitation of 26 patients (mean age 7.9±0.8 years) with spastic forms of cerebral palsy was studied.The rehabilitation effect (“improvement” or “no improvement”) was determined by the dynamics of clinical and functionaldata, including the scale of General motor functions (GMFM-88), adapted eschworth spasticity scale, evaluation of handmotor skills according to the classification system of manual abilities for children with cerebral palsy (MACS). In parallel, at thestart of rehabilitation, the adaptive capacity of the body was evaluated according to the dynamic segmental diagnosis (DSDtest)on the basis of vegetative activity of paravertebral segmental skin sympathetic reactions (KSR). There was a significant(p<0.05) decrease in the sympathetic regulation of the spinal column tissues compared to the norm with the presence ofa vertical gradient (the most pronounced deviation in the lower vertebral-motor segments (PDS) of the thoracic spine:118.4 μkA relative to 124.7 μkA). The strong reliable interrelation (contingent coefficient − 0,618) of the studied vegetativeindicators with the final result of rehabilitation efforts (“positive effect” – “without effect”) is defined. This makes it possible touse the indicators of the DSD test as screening biomarkers of the supposed effectiveness of rehabilitation for the competentdistribution of children in the appropriate clinical and rehabilitation groups.


KEYWORDS: cerebral palsy, segmental vegetative disorders, skin sympathetic reactions.


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This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.