The Effectiveness and Safety of Adaptive Climbing in the Rehabilitation of Patients with Cerebral Palsy

¹ Gennadii E. Sheiko, ¹ Anna N. Belova, ¹ Oksana V. Balandina, ¹ Natalia N. Rukina, ¹ Olga V. Vorobyova, ¹ Alexey N. Kuznetsov, ² Maxim A. Kavinov, ³ Vyacheslav A. Orinchuk

¹ Privolzhsky Research Medical University, Nizhny Novgorod, Russian Federation
² Regional Public Organization «Climbing Federation», Nizhny Novgorod, Russian Federation
³ N.I. Lobachevsky National Research State University of Nizhny Novgorod, Nizhny Novgorod, Russian Federation

Abstract:

The use of adaptive physical culture in the system of complex rehabilitation of patients with cerebral palsy (CP) is becoming morepopular. Adaptive climbing (AC) is one of these types of physical culture and sports activities. Currently, there are not many data in thedomestic and world literature devoted to the study of the AC use in the complex rehabilitation of patients with CP.Aim. Evaluation of the eff ectiveness and safety of AC in the rehabilitation of children and adolescents with spastic forms of CP in additionto conventional medical rehabilitation.Material and methods. The study included 30 patients aged from 5 to 18 years with spastic forms of CP who were allocated into oneof two groups: the 1st group, the study group (n=15) — patients who underwent standard medical rehabilitation and AC classes; the 2ndgroup, the control group (n=15) — participants who received only medical rehabilitation. A comprehensive assessment of the rehabilitationmeasures eff ectiveness and safety was performed before the start of AC classes and after 3 months using clinical neurological andinstrumental examinations, including biomechanical examination (electropodography, video analysis of walking and stabilography).Results. Group 1 patients showed a statistically signifi cant improvement in general motor functions on the GMFM-88 scale (p=0,0001),a decrease in the level of spasticity on the мodifi ed Ashworth scale (p=0,0051) and an improvement in manual abilities on the MACS scale(p=0,0431) 3 months after inclusion in the study. Positive dynamics in the form of an increase in the symmetry of step time (p=0,0063),step length (p=0,0083) and step velocity (p=0,0409) were noted according to the electropodographic study in the 1st group. A statisticallysignifi cant increase in the range of motion in the hip (p=0,0038) and knee joints (p=0,0076) was detected in the 1st group according tovideo analysis of walking. There was no signifi cant change in the indicators in the 2nd group, except for the severity of spasticity on themodifi ed Ashworth scale (p=0,0180). A positive correlation was found between the indicators “step length” and “ step velocity” (r=0,605,p=0,0168). A negative correlation was found between the “step velocity “ indicator and the GMFCS score (r= – 0.832, p=0,0372). Only2 adverse events were registered in the study group: acute respiratory viral infection and wrist injury during AC.Conclusion. AC, in addition to traditional methods of medical rehabilitation, leads to a decrease in spasticity, increased joint mobilityand control of voluntary movements, improved maintenance of the body position, walking and precise hand movements, and alsohas a favorable safety profi le. AC is an eff ective and safe motivating method of physical culture that can change the patient’s view ontraditional therapy.

Keywords: cerebral palsy, adaptive physical education, adaptive climbing, biomechanics, electropodography, video analysis of walking, stabilography, rehabilitation, physical rehabilitation

For citation: Sheiko G.E., Belova A.N., Balandina O.V., Rukina N.N., Vorobyova O.V., Kuznetsov A.N., Kavinov M.A., Orinchuk V.A. The Effectiveness and Safety of Adaptive Climbing in the Rehabilitation of Patients with Cerebral Palsy. Bulletin of Rehabilitation Medicine. 2022; 21 (1): 45-54. https://doi.org/10.38025/2078-1962-2022-21-1-45-54

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