RU2155615C2 - Method for treating children suffering from consequences of spinal form of poliomyelitis - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves treating patients with an apparatus having two inductors: the first one of 104 mm and the second one of 59 mm diameter. The unductors are designed as solenoids enclosed into cylindrical casings. Paretic muscles and segmentally injured vertebral column regions are exposed to treatment. Exposure time is 5-10 min, intensity is 0.5-1 Tesla unit, pulse batches frequency is 45 per min with 4 pulses in a batch, interval length between the pulses is equal to 50 ms. The whole course is 10 procedures long when applied in daily mode. EFFECT: improved functional activity of injured neurons; increased muscular tonus and force of the injured muscles. 3 tbl

Description

 The invention relates to medicine, in particular to pediatric neuropathology and physiotherapy.

 Closest to the claimed is a method of treatment with an alternating magnetic field of low frequency ("Guide to physiotherapy and physioprophylaxis of childhood diseases" edited by A.N. Obrosov and TBKarachevtseva // M .: Medicine, 1987.- P. 75-76 , 306). This method involves the impact on the affected structures of the human body from the apparatus "Pole-1" using paravertebrally located inductors with an intensity of 10 mlT, duration of 10 minutes, 10 treatments per treatment course.

 Under the influence of a magnetic field, eddy currents of low frequency are induced in living tissues, metabolic processes are enhanced, and trophic function improves. But this effect is not enough to improve the functional state of nerve cells of the spinal cord, which are in a parabiotic state after an acute period of poliomyelitis.

 The essence of the invention is as follows: the effect is carried out from the apparatus of pulse induction therapy "SETA-1" using two inductors with a diameter of 104 mm first and 59 mm second (inductors are solenoids placed in cylindrical bodies). The impact was carried out on paretic muscles and segmental on the affected spine. The exposure time is 5-10 min, the intensity is 0.5-1 T, the frequency of the bursts of pulses is 45 in 1 min, the number of pulses in a packet is 4, the time interval between pulses is 50 ms, for a course of 10 procedures daily. Procedures can be released in a sitting and lying position.

 The method is illustrated by the following example.

 Patient Tamila B., 2 years 10 months. (case history No. 9), was admitted to the children's neuropsychiatric department of the Pyatigorsk clinic on 11.28.95 with a diagnosis of poliomyelitis, spinal form, paresis of the muscles of the right arm and legs, early recovery period. She became ill with acute polio in July 1995. She was treated in a hospital, after which she was sent to the Pyatigorsk clinic.

 Objectively: a child of low nutrition, somatically healthy. Pulse - 100 beats. in 1 min. In neurological status: ch.m.i. - intact, moves independently, but at a very limited distance. Muscle tone and strength of the right arm, pelvic girdle and lower limbs are reduced. The strength indicators of the muscles of the right hand were 3 points, the gluteus, adductors and abductors, as well as the muscles of the left thigh and right lower leg - 2-3 points. Passive movements in the joints in full, active - limited in the left leg, recurrence of the left knee joint. Tendon reflexes from the upper extremities S> D, knee lower, D> S, Achilles on the right is reduced, on the left is absent.

 EMG data: the amplitude of oscillations of the flexors of the hand d - 200.0 μV, s - 250 μV, the extensors of the hand d - 200.0 μV, s - 200.0 μV, the anterior tibial muscle d - 450.0 μV, s - 300.0 mkv, gastrocnemius d - 250.0 mkv, s - 150.0 mkv.

The treatment was prescribed: exercise therapy - individual development, tonic massage of the muscles of the back, abdomen, buttocks, extremities, mud applications for paret limbs and spine: mud temperature 38-39 ^o C, duration 7-10 min, treatment 8 times 2 times week and pulse induction therapy. The latter was carried out from the SETA-1 apparatus to the lumbar spine and paretic muscles, the intensity of exposure during the first procedure was 0.5 T, further increasing to 1 T, the frequency of bursts of pulses was 45 in 1 min, the number of pulses in a packet was 4, and the interval between pulses - 50 ms, duration of procedures - 5 min daily, only 10 procedures.

 The procedures were well tolerated. The emphasis in treatment was placed on a more paretic left leg.

 After the treatment, an improvement in the general condition, an increase in body weight by 1.1 kg, an increase in the volume of active movements in the left ankle joint by an average of 15, an increase in strength in the muscles of the thigh and lower leg by 1 point were noted. The gait noticeably improved, the child began to cover considerable distances on his own. The electromyogram recorded an increase in oscillation potentials in the thigh muscles by 200-250 μV, in the calf muscles by 240-350 μV compared with the initial data.

 The child was discharged with a significant improvement.

 Treatment according to the proposed method was carried out for 40 patients who had a spinal form of poliomyelitis (main group), and 13 children with the same pathology (control group) received treatment according to the prototype method. According to the main clinical characteristics, both groups of patients were approximately the same in percentage terms (Table 1).

 Analysis of the treatment results by the proposed and known methods revealed a positive trend in clinical and electrophysiological parameters in children of both groups, but it turned out to be more significant in patients treated with the proposed method (table. 2).

 As the data in table. 2, in patients of the main group, the number of children significantly increased, which appeared a qualitatively new function: 5 out of 21 began to stand independently and 6 of 23 patients walk without support. Among the children of the control group, 2 out of 8 learned to sit without support and only 1 out of 8 children began to move independently. The size of the circumference of the paretic limbs increased significantly only in children of the main group, an average of 0.8 mm. Muscle strength also significantly increased in children treated with the proposed method. Electromyography indicators confirmed an improvement in the bioelectric activity of paretic muscles. The amplitude of EMG oscillations of the gastrocnemius and anterior tibial muscle increased on average by 45.0 + 5.4 μV (P <0.01). Children in the control group also showed a tendency to increase the amplitude of the oscillations by an average of 27.5 + 4.2 μV. Assessing the dynamics of the clinical and functional indicators of children in both studied groups, we ascertained the following treatment results (Table 3).

 Thus, the treatment efficiency of the proposed method was 83.5%, known - 69.0% (P <0.05). We associated the advantage of the proposed method of treatment with the use of magnetic induction of greater intensity, in which there is a complex effect on both the segmental spinal cord and the peripheral neuromuscular apparatus, which allows, on the one hand, to stimulate neuroreflective synaptic transmission, and on the other - contribute to improving the functional state of spinal neurons. Apparently, this type of physiotherapy is more appropriate for children in the early recovery period of poliomyelitis.

Claims (1)

 A method of treating children with the consequences of the spinal form of poliomyelitis by exposure to a low frequency magnetic field, characterized in that the effect is carried out in a pulsed mode from the SETA-1 apparatus on paretic muscles and segmental on the affected spine using two inductors with an intensity of 0.5 - 1 T, the frequency of bursts of pulses is 45 per minute, the number of pulses in 1 packet is 4, the interval between pulses is 50 ms, the duration is 5-10 minutes daily, for a course of 10 procedures.

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