RU2040922C1 - Method for executing medical exercises with children possessing injured locomotor apparatus - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves executing medical exercises developed with taking into consideration the ontogenesis of coordination and motor skills. The complex has physical training exercises executable first in the supine position by carrying out transverse movements crossing the central axis of the patient with arms moving in turn and together, with legs moving in turn and with both arms and legs moving together. Change of patient position for the prone one follows and a "frog" posture is assumed and head rotations are executed upon stretching legs. Then the exercises are carried out with lifting torso, bending and extending legs and arms. The patient is set to assume sequentially positions with support on arms and hands and later the exercises are continued in semiprone position moving arms and legs separately and together. EFFECT: improved movement coordination; normalized myogenic tonus. 1 tbl

Description

 The invention relates to medicine, in particular to kinesiotherapeutic methods of treating diseases with damage to the musculoskeletal system.

 The treatment of patients suffering from severe motor disorders (cerebral palsy, congenital hip dislocation, Perthes disease, myopathy, etc.) remains an urgent and urgent task of modern medicine.

 Currently known methods of treating diseases with damage to the musculoskeletal system, based on the fact that the dose of physical activity is determined by the degree of its individual tolerance and is associated with a general training effect on the body, and methods for correcting a specific pathological disorder do not affect the main pathogenetic links and are reduced to purely symptomatic therapy, allowing only a purely external reproduction of impaired functions, without restoring primary neuro-physiologically relationships.

 This approach, requiring significant costs for treatment, leads only to a temporary improvement in the patient's condition, inevitably leading to a relapse of the disease.

 A known method of treating diseases, which includes, for the purpose of correcting motor impairment, putting a child in ontogenetically early positions (postures) with the action of fingers on trigger zones, causing the physiological sequence of muscle contraction by Professor Voight's method. This method is adopted as a prototype. However, the known method in comparison with the developed technique has a number of significant disadvantages. In particular, the laws of ontogenesis of the function of movement of only 1 year of life have been studied and used, the effect on coordination of movements is mediated through normalization of muscle tone, which requires a significant duration of treatment (up to lifelong): as a rule, muscle movement becomes coordinated for at least than 10-12 months after starting treatment.

 The aim of the invention is to reduce the time of treatment of diseases with damage to the musculoskeletal system due to the use of physiological methods developed taking into account the ontogenesis of coordinating and motor skills and thereby allowing a direct impact on coordination of movements.

 This goal is achieved in that the patient after water procedures that regulate the influence of the gravitational factor, form muscle synergism according to the mechanism of the chain muscle reaction using reflex gymnastics and fix the formed neuromotor stereotypes with therapeutic and gymnastic exercises.

 The novelty of the proposed method lies in the fact that when it was created, they proceeded from the postnatal ontogenetic sequence of the formation of the functional motion system based on motor reflexes in a strict staged order, starting with unconditioned reflex activity and ending with complex behavioral reactions of the most complex level. Given the above, the formation of any movement in the body should occur according to the structure of the functional system of movement. An attempt to restore a motor act of a higher order without going through the underlying ontogenetic links will not only not restore, but will aggravate the violation of the structure of the functional movement system.

 Thus, the basis of the proposed method is the principle of the formation and consolidation of ontogenetically consistent functional relationships necessary for the physiological formation of the motor system. At the same time, it is clear that it is impossible to return an older child to a lower level of the motor reflex (especially to the level of the unconditioned motor reflex of the starting zone of formation of movement skills), but, suggesting the patient to remember the movement that was the connecting link in the formation of the next level of functional systems and maximally preserving the strict ontogenetic sequence of these stages, it is possible to significantly restore and strengthen the structural basis of the functional motion system.

 PRI me R. Patient K., two years old (medical history N 6751), was admitted to the hospital with a diagnosis of cerebral palsy, spastic tetraparesis. From the anamnesis it is known that she is sick from birth, complaints about the restriction of motor activity. A clinical examination (including with the participation of a kinesitherapist) revealed the presence of sharply increased muscle tone in all limbs, stiffness in the knee and elbow joints, sharply increased tendon reflexes, spontaneous Babinsky reflex on both sides, lag in mental development, convergent strabismus. According to computed tomography of the brain from 04.24.93, an expansion of the subarachnoid, sylvian and interhemispheric fissures was noted; according to electroencephalography, cerebral signs of bioelectrical activity of the brain are expressed by the organic type, pathological activity was not detected; according to electromyography, signs of suprasegmental dysregulation of muscle tone were noted.

 According to the proposed method, the patient was given a course of treatment.

 After free swimming for 30 minutes, muscle movements should be performed with the maximum possible use of the active component, in all cases the movement is performed along the full described trajectory by the instructor.

 1. I.p. Lying on your back, legs wider than shoulders, arms parallel to the legs.

1.1. Use your right brush to remove the left ear once,
* return to starting position two.

1.2. Use your left brush to reach your right ear once,
* return to starting position two.

1.3. With the hands of both hands, get the opposite ears once,
* return to starting position two.

1.4. Bend the right foot, bending the leg in all joints, behind the left leg and put it on the floor at the level of the lower third of the thigh once,
* return to the starting position two.

 1.5. Same left foot.

 1.6. Make a move 1.4. and 1.5. at the same time, crossing the legs once, * return to the starting position two.

 1.7. To connect the hands in the middle line in front of you once, * turn the upper part of the body and head to the right together with the movement of the joined hands to the right two, * repeat the same movement to the left three, * return to the initial position four.

 1.8. With the right brush, reach out the left ear and at the same time place the right foot behind the left leg and put it on the floor once, * return to the starting position two.

 1.9. Similarly to clause 1.8. On the other side.

 2. I.p. Lying on my stomach.

 2.1. Head turned to the right; hands are brought to the body, bent, hands at the level of the shoulder joints, legs bent at all joints and pulled to the stomach. * Turn the head left down to the central axis once, * move the right foot to the frog position two, * move the left foot to the frog position three, * turn the head left, put four on the floor, * turn the head right and down to the central axis five, * pull the right leg to the stomach six, * pull the left leg to the stomach seven, * turn the head to the right, put eight on the floor.

 2.2 The head is turned to the right; hands are brought to the body, bent, hands at the level of the shoulder joints, legs in the frog position. * Turn the head left-down to the central axis once, * raising the upper body, go into the support on the forearm two, * lower the upper body three, * turn the head to the left and put four on the floor. (In the next 4 counts, the head moves from left to right).

 2.3. The head along the central axis, the upper part of the body is raised, the hands rest on the forearms, the legs are in the frog position. * Raising the upper body, move to the support on the hand once, * move the right foot into the support on the lower leg two, * move the left foot into the support on the lower leg three, * fix the position on all fours, * move the right leg to the frog position five, * move the left leg to the frog position six, * lowering the upper body, move to the forearm seven, * fix the initial position eight.

3. I. p. Lying on its side, the upper arm in front of itself (the forearm lies on the floor, the lower arm is extended in front of you, the lower leg is straight, the upper leg is bent in all joints to 90 ^° and the knee lies on the floor.

(all 4 exercises are performed first on the left, then on the right side)
3.1. Take your upper arm aside once,
* return to starting position two.

3.2. Take your upper leg aside once,
* return to starting position two.

 3.3. Movement 3.1. and 3.2. execute at the same time.

 Classes were held daily, except weekends, a total of 25 classes were held.

 After completing the course of treatment, a decrease in convergent strabismus, a decrease in muscle tone, a decrease in stiffness in the knee and elbow joints, a decrease in tendon reflexes, a lack of spontaneous Babinsky reflex on both sides, as well as a pronounced positive dynamics of psychomotor development (began to crawl on the abdomen, began to pull up and go into sitting position, etc.).

 The child was examined 3 months after treatment, the objective indicators of the functioning of the musculoskeletal system did not deteriorate.

 According to the proposed method, 30 children were treated with the following diseases: cerebral palsy, myopathy, paresis, Perthes disease, condition after orthopedic correction of congenital dislocation of the hip.

 The control group consisted of 20 patients with the same diseases. All patients in the control group received treatment according to the prototype method. The treatment results of the two compared groups are presented in the table.

 Thus, the application of the proposed method allows for pathogenetically substantiated correction of various pathological conditions with impaired musculoskeletal system of various origins, physiological means to prevent the occurrence of pathological changes in various organ systems due to the presence of diseases of the musculoskeletal system, and also to form and consolidate a high level of functional state patients, which is a basic element for increasing adaptive capacity awns body.

 The average duration of treatment to obtain persistent positive dynamics in the formation of coordinated motor acts in children who received the Balance procedure was 20 days; when treated according to the Voight method, the child undergoes, on average, 2 courses of treatment for 15-20 days each.

Claims (1)

 METHOD OF CAREING GYMNASTICS IN CHILDREN WITH A DEFECTIVE MOTOR APPARATUS, including carrying out water procedures with immersion in water and subsequent complex gymnastic exercises, characterized in that the gymnastic exercises are performed initially in a supine position by performing cross movements with the intersection of the patient’s central axis alternately and jointly with arms, alternately with legs and similar exercises with arms and legs simultaneously, then gradually transfer the patient to the position lying on his stomach in the frog position and perform head turns and legs straightening, after which they perform exercises with raising the body, bending and unbending the arms and legs, then transfer the patient sequentially to the position with support on the forearms and hands, and then in the side position continue exercises with the abduction of arms and legs separately and simultaneously.

Images