Title : The impact of complex rehabilitation on the level of forming self-care skills at children with a cerebral palsy
Aims. The problem of medical rehabilitation and social adaptation of children with organic diseases of a nervous system, first, with the cerebral palsy (CP), remains relevant. The considerable prevalence, complexity and versatility of clinical manifestations, severity and high percent of an invalidism create difficulties in rehabilitation of children with CP. The purpose of this research was to study impact of complex rehabilitation on the level of forming self-care skills at children with a spastic diplegia.
Methods. The research included 162 patients with a spastic diplegia. Patients were divided into 2 comparable groups by the characteristics. In the main group (n=82) as a part of complex rehabilitation the robotic kinesiotherapy on the Lokomat complex, an intramuscular injection of botulinum toxin of A type were carried out. In the control group (n=80) rehabilitation treatment was carried out by traditional methods. The level of self-care violation was assessed using the self-care scale according to the following criteria: complete dependence, moderate dependence, light dependence. According to the classification system of big motor functions (GMFCS), children of both groups are divided into 2 subgroups: II level and III level. Statistical analysis of the study results was carried out using the software package IBM SPSS Statistics Professional 21.0. Expected statistically significant level was p≤0.05.
Results. Average age of the studied children in the main group was 4.84±0.56 years, in control group – 4.78±0.61 years. In the main group at 12 patients (14.6%) improvement of self-care with transition to lighter group (p=0.038) was observed. In control group improvement was noted at 4 patients (5.0%). At the end of the rehabilitation course, 69.51% of the patients of the main group experienced moderate dependence, 20.73% - mild dependence, full dependence remained in 9.76% of patients. In the control group, 55.00% of patients experienced moderate dependence, 21.25% complete dependence. At the same time, the number of patients with easy addiction in self-care after a rehabilitation course was 23.75%.
The comparative analysis of average indicators also revealed statistically significant differences in the degree of self-care skills formation. The most significant changes were observed at children testing moderate and complete dependence according to the basic data (p<0.0001).
Conclusion. As a result of the study, it was shown that the use of robotic technology together with botulinum therapy promotes to better social and household adaptation of children with spastic diplegia.
Audience Take Away:
• The results of our research showed a significant improvement in self-service skills, which is the main goal of rehabilitation of children with disabilities. The lack of data on efficacy evaluation of using robotic walking against the background of reduced spasticity does not allow us to compare our results with other researches. However, we are of the opinion that obtained data allow us to recommend this method as one of the promising methods of rehabilitation treatment in children with spastic forms of cerebral palsy.