RU2125832C1 - Method of estimation of man's motor development by scale of levels of antigravitational motion development - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method includes estimation of 12 antigravitational motion chains divided into 70 fragments which allow man to take standing position from four horizontal positions: on back, on stomach, on right and left sides. Method also includes estimation of 30 antigravitational motions formed in process of taking the vertical position by part of body or by entire body. Method is realized by use of scale for measuring the level of development of man's antigravitational motions. This scale is used to constitute individual "profile" of antigravitational system development, to perform calculations in conventional units of measurement, and to determine antigravitational system development level. EFFECT: high-accuracy prompt estimation of state of functional antigravitational motive system. 1 cl, 6 dwg, 1 tbl, 4 ex

Description

 The invention relates to medicine, to the physiology of higher nervous activity, and can be used, firstly, to assess the motor development of a child, starting from the neonatal period; secondly, for the diagnosis of disorders of antigravity motor functions in diseases and injuries of the musculoskeletal system in both children and adults; thirdly, in order to stimulate motor development during its delay and to restore individual links of antigravity movements in case of their violation; fourthly, in physical education and sports to improve motor skills in children and adults.

 The current methods of studying complex motor functions are presented in more detail in the scales of a comprehensive assessment of the psychomotor development of children and the social and household activity of adults. They allow you to evaluate general body movements, such as walking, the ability to maintain balance in a sitting position, standing, that is, movements performed in an upright position. But none of the domestic and foreign methods available today provides a detailed assessment of the transition from horizontal to the corresponding vertical position, which underlies all general body movements, in the process of which a person's balance is formed. In some diseases of the musculoskeletal system, for example, spastic diplegia - one of the forms of cerebral palsy (cerebral palsy), post-traumatic and post-stroke disturbances in the act of rising, the antigravity mechanism itself is initially affected, and the resulting disturbances in the upright position are ultimately only its consequence. As a result, diagnosis is carried out mainly in the final link of impaired motor function.

 The prototype for the invention was the method used in pediatric practice to assess motor development in children of the first year of life, given in conjunction with an assessment of the development of the psyche.

 The motility assessment is based on the study of chain symmetrical installation reflexes. The development of chain installation reflexes enables the child to develop stereotypes of movement in the first two years of life, allowing him to further move to an upright position. Therefore, the study of such stereotypes of movements is legitimate in both children and adults. In the prototype, the most complete assessment of one chain of independent anti-gravity movements developing from a horizontal position on the stomach. The second chain of motor reactions, which is formed from a position on the back, is represented mainly not by independent movements, but performed using outside help (traction by the arms, supports). This significantly reduces the reliability presented about the formation of this stereotype of movement. In addition, there is no description of the chains of motor reactions that are formed as a result of the development of asymmetric chain reflexes and which subsequently allow both a child and an adult to transition to a vertical position from a horizontal position on the right and left side.

 Thus, the current diagnostic methods allow the assessment of complex motor functions extremely superficially. This reduces the quality of treatment and does not allow timely and fully correct developmental abnormalities that occur in young children.

In order to improve the methods for assessing complex motor functions, a method was developed for measuring the level of development of antigravity movements, which is as follows. The last link is determined, at which, by the time of the examination, the development of each of the 12 main motion chains, consisting of 70 fragments of movement, which allows a person to independently transition to a vertical position from 4 horizontal ones on his stomach (front pushing away from the horizontal support - Po), is stopped, on the back (rear repulsion - ZoI and ZoII), right and left side (right and left lateral repulsion - Bo p, Bol), directly to a standing position and through intermediate positions standing on your knees, squatting. Moreover, 10 anti-gravity vertical movements (AVD-1) are evaluated, which appear when a person reaches one of the first 5 levels of development of the anti-gravity functional system. This is the retention of the corresponding part of the body in an upright position (equilibrium reaction P1 - P5) and the resulting 360 ^° turns (P1 - P5). Next, 20 anti-gravity vertical movements (AVD-2) are determined, aimed at overcoming gravity in the most vertical position, that is, at gradually reducing the foot support area, which refers to the last 6th level of development of the anti-gravity mechanism under ordinary conditions (without special training) . The data obtained are compared with the standard - "ruler" to measure the level of development of anti-gravity movements by superimposing them. To do this, with the help of a stamp, an imprint of the “ruler” is made on paper and segments of those motion fragments that the patient can perform at the time of the examination are outlined. Then the calculation is made in units of measurement - percent. Moreover, the entire system is taken as 100%, corresponding to 100 fragments of movement (70 + 10 + 20), and 1%, respectively, will be equal to the 1st fragment of movement. Part of the motion fragment will be evaluated by the corresponding share of 1%. Dynamics is determined by the number of new motion fragments mastered in the process of training, which is reflected in the graph by the number of additionally marked segments.

 As a reference, a “ruler” was developed for measuring the level of development of anti-gravity movements of a person, that is, a device for implementing the measurement method. The device is made in the form of a pattern (Fig.6) and a stamp (2nd option), which depicts a graphical model of the age-related standard development of the anti-gravity functional movement system (Fig.1). Attached is a table given in the form of a set of cards for decoding the legend (Table 1). The lines descending from 4 points (Po, Bo p, Bo l, Zo) down the graph reflect the 12 main chains of anti-gravity movements and form, ending at points P, Bp, Bl, ZII, 4-independent chains of motion, and ending in K - 1 and K - 2, another 4 re combined motion chains in each of 2 points (4 + 4 + 4 = 12). Since all chains intersect at points 7a, 8 - 0, 8a, 8 - 1, 8 - 2, 9 - 1, additional chains of motion appear, derivatives of the main ones, which can be estimated if necessary. Each of the 100 fragments of movement is numbered and described in detail in the accompanying table under its number in the corresponding movement chain or in the corresponding columns AVD-1 and AVD-2. On the “ruler” chart, each fragment is represented by a segment bounded by horizontal strokes at the top and bottom or when connected with points 7a, 8 - 0, 8 - 1, 8 - 2, 8a, 9 - 1. A total of 90 segments are shown. Of these, 70 reflect the process of rising and 20 the formation of movements in the most vertical position (line AVD-2). Horizontal strokes located symmetrically on two sides of the vertical line under the numbers indicate the presence of symmetrical links in the motion fragment, which is taken into account when evaluating if the links in this fragment are performed asymmetrically. The exception is the Zo line, where on two sides two different chains of motion (ZoI and ZoII) are represented, developing from one horizontal position on the back. The segments indicated by dashed lines are not taken into account in the calculation, but are taken into account as links between fragments when analyzing additional motion chains. The remaining 10 movements (AVD-1) are presented on the diagram in the form of designations P1 - P5, P1 - P5. The components of the first full turn of P1 in the calculation are estimated in corresponding fractions of 1% (p s-b - 0.25%, p s-s and p s-s at 0.5%).

 The end of each movement fragment (part of the fragment) is fixed in the form of a horizontal bar with a number above it in that age period in the diagram in which it is most often detected in healthy children. Therefore, in the diagram, the length of the segments of the movement fragments and the height of the columns of age periods depend on each other. The age scale is applicable for all fragments of movement except for chains of Zo. For them, starting from the 4th fragment for ЗОI and from the 2nd for ЗОII, their age periods are given. However, the age periods for ZoII are conditional, since this chain of motion, unlike the others, develops only during special activities with the child. When assessing movements in children over 6 years old, age periods are no longer taken into account, since the system by this age should be developed by 100%, and only the correctness of the reproduction of the movement model given in the diagram is taken into account.

 Evaluation of antigravity motor functions in a patient is carried out using a sequential analysis of 100 movement fragments represented by symbols on the “ruler” and described in detail in the table. Overlaying the obtained individual data on the “line” allows you to build an individual “profile” of the development of anti-gravity movements (RAD), with which the total percentage of the development of anti-gravity movements and the percentage of the gap with the age norm are calculated. Identified violations are eliminated by subsequent training of the child in the missing movement fragments using passive and active physical exercises. The resulting dynamics is reflected in the individual "profile" of the AHF with the subsequent determination of the percentage of effectiveness.

Example 1. Girl, 5 months. Diagnosis: Perinatal encephalopathy, motor impairment syndrome, mild. The development of anti-gravity movements at the time of inspection is as follows: RAD: On - 4; Bo p - 4; Bo l - 3; ZoI - 3, 4a (right); ZoII - I;
AVD-1: P1, P1 - p cf, where Po - front repulsion 4 - fragment number in the Po chain (4%), Bo p - right side repulsion 4 - fragment number in the Bo chain (4%), Bo l - left side repulsion, 3 - fragment number in the Bo L chain (3%), ЗОI - rear repulsion first 3 - fragment number in the ЗОI chain (3%), 4а - fragment number in the ЗОI chain (1%), ЗОII - second rear repulsion, 1 - fragment number in the ZoII chain (1%), AVD-1 - vertical anti-gravity movements 1, P1 - equilibrium reaction 1 (1%), П1 п с-ж - part of the first full rotation half-turn back - stomach ( 0.5%).

 The individual "profile" of the RAD is depicted for clarity in the diagram, partially presented only by that part where the age norm for a given child is given (Fig. 2). Missing segments of motion fragments are indicated by dashed lines. The total percentage of RAD for this age group is the minimum, is 19.5% (4 + 4 + 4 + 3 + 1 + 1 + 1 + 1 + 0.5). In this child, it is equal to 17.5%. The lag is 2%. Conclusion on this case RAD: slight asymmetry of development. I level.

 Example 2. A boy, 10 months. Diagnosis: Perinatal encephalopathy, motor impairment syndrome, delayed psychomotor development. At the time of inspection: RAD: On - 3; Bo p = Bo l = 4; ZoI - 4a; ZoII - 1; AVD-1: P1, P1 - p s-b.

 An individual "profile" (Fig. 3) is given in a partially depicted diagram taking into account the age norm. The total percentage of RAD in a child is 18.25% (3 + 4 + 4 + 1 + 1 + 3 + 1 + 1 + 0.25). The age norm is at least 37% (7 + 7 + 7 + 2 + 3 + 1 + 3 + 3 = 33 and 4% of AVD-1). Conclusion: Uniform delay in the development of all motion chains.

 The lag percentage is 18.75%. I level.

 5 lessons were held with the child on the development of anti-gravity movements. After class: RAD: Po-5; Bo p = Bo l = 7; ZoI - 4; ZoII - 1; AVD-1: P1, P1-p s-f + p f-s.

 The overall percentage of development after classes was 28% (5 + 7 + 7 + 2 + 4 + 1 = 26 and 2% of AVD-1). The lag percentage is 9% (37 - 28), the efficiency percentage is 9.75% (28 - 18.25 or 18.75 - 9). On an individual “profile” the dynamics is reflected by the continuation of the corresponding lines. For clarity, this can be done in a different color.

 Example 3. Girl, 2 years 8 months.

 Diagnosis: cerebral palsy, spastic diplegia. RAD: Po - 7, 7a, 8 - 0; Bo p = Bo l = 7, 7a, 8 - 0; ZoI - 4; ZoII - 1; K-1 (the first combined path through the position on the knees) - 8 - 0 - 8 - 1; AVD-1: P3 (partially, approximately 0.75%), P2; AVD-2: 1.

 Individual "profile" RAD (figure 4).

 The total percentage of RAD in a child is 40.75% (7 + 7 + 7 + 4 + 1 + 3 + 3 + 1 + 2 = 35, where 7 - corresponds to Po to fragment 7; 7 + 7 - Bo p and Bo l to of fragment 7; 4 - ЗОI to fragment 4; 1 - ЗОII to fragment 1; 3 - transition to 7а from Po 7, Bo p and Bol 7; 3 - transition to 8 - 0 from the same poses; 1 - К-1 from 8 - 0 to 8 - 1; 2 - two lines 4a, right and left, as well as 4.75% from AVD-1, 1% from AVD-2).

 The minimum return rate for 2 years 8 months is 87% (67 - transition to a standing position - 70 minus 3 fragments of ZoII movement, 10 - from AVD-1 and 10 - from AVD-2).

 Conclusion: A marked delay in the development of anti-gravity movements. The lag percentage is 46.75% (87 - 40.75). II level (full).

 Example 4. Girl, 5 years old. Diagnosis: Almost healthy. RAD was 95% with an age norm of 100%. Missing motion fragments are highlighted on an individual “profile” (Fig. 5): AVD-2: 19.20 and ZoII - 3.4, transition from 3 to 8 - 1. VI level.

Claims (1)

 A method for assessing human motor development on a scale of levels of development of antigravity movements, characterized in that they assess the level of development or the state of the functional system, including 100 basic antigravity movements (poses), 70 of which characterize the formation of the ability to take a vertical position from 4 horizontal positions of the body: pronator, arch support, right and left lateral, and are presented in the form of 12 chains of antigravity movements, formed under the influence of posotonic reflexes and corresponding to the development of chain rectifying symmetric and asymmetric mounting reactions, the remaining 10 and 20 antigravity movements respectively reflect the improvement of equilibrium in the upright position and the gradual decrease in the area of support on the legs, while the diagram of the age-related standard development of the antigravity functional movement system is presented in the form of a graph made using a curve and stamps, which allows you to diagnose motor disorders by building an individual "pro I "of antigravity propulsion functions, then the data is compared with the standard and level of development is determined as a percentage of the available movements to age norm, and the process of development of the system reflects the number of emerging movements.

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