RU2341244C1 - Method of treatment of children with limited abilities - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: perform examination, pharmacotherapy and a complex including medical gymnastics and massage to children with disease of nervous system. Use passive-active and active physical exercises: respiratory, exercises on coordination, on a relaxation, on normalisation of poses and positions of a head and limbs, on correction of a posture and walking, exercise with use of balls at rate of performance of exercises, from slow to an average, the maximum amplitude of movements, a starting position - laying on a back, stomach, knee-elbow position, sitting, kneeling and standing. The pharmacotherapy includes introduction of Biovital gel, RINITOLA EDAS.

EFFECT: raises efficiency of treatment at the expense of creation of conditions for adaptation improvement.

3 ex, 8 dwg, 3 tbl

Description

The invention relates to the field of pediatrics, rehabilitation and can be used to treat children with disabilities against the background of the infectious process, including in the conditions of rehabilitation centers.

The problem of treating children with disabilities is relevant. The choice of this direction, as one of the leading ones in pediatrics, is not accidental, since the dynamism of the environment associated with scientific and technological research, the expansion of the collective education network, place great demands on the adaptive capabilities of the child’s body and require an in-depth study of the physiological mechanisms of its biological and social adaptation, growth and development . Adaptation is the process of developing the reaction rate and at the same time it is the result of the implementation of the reaction rate in specific conditions. Upon admission to the Rehabilitation Center, the child goes through a period of adaptation. Adaptation capacity in a disabled child is reduced. He has not only severe disorders in the neuropsychic and physical development, but also the immune and endocrine systems. The child constantly balances between the state of health and the disease, and often in addition to a disabling disease that limits his life, he gets ARI and SARS. In the well-known sources of information, a unified systematic approach to the treatment of such a category of patients was not found, the basis of the known approaches is symptomatic treatment. Thus, at present, there is a need to create an algorithm for research and treatment of children with disabilities, which is based on the task of significantly improving adaptation in newly arriving children, which in turn helps to increase the effectiveness of treatment in children who visit the Center daily.

A new technical task is to increase the effectiveness of treatment by creating conditions for improving adaptation.

To solve the problem in a method of treating children with disabilities, including examination, pharmacotherapy, and a complex that includes therapeutic exercises, massage for children with diseases of the nervous system G according to class ICD-10, therapeutic exercises are carried out in the form of individual or small group exercises 3 times in week, with a duration of 30 minutes, using passively active and active physical exercises: breathing, coordination exercises, relaxation, normalization of postures and set th head and limbs, for the correction of posture and walking, exercises using balls at the pace of exercise, from slow to medium, maximum range of motion, starting position - lying on your back, stomach, knee-wrist, sitting, kneeling and standing, the massage is carried out in a room with a temperature of 22 degrees Celsius, at the same hours, 30 minutes after eating, with a duration of 25 minutes, the course consists of 15 procedures, and the starting position is lying on the stomach with a roller under the ankles - back massage paravertebral x areas, the back surface of the legs, or - lying on the back with a roller under the knees, massage the front surface of the legs, abdomen, chest, arms, while using techniques: superficial and deep stroking, sawing, crossing, squeezing, shifting, continuous vibration, receptions are used in alternation, and pharmacotherapy includes the introduction of Biovital gel for children 1 teaspoon 1 time per day for 10 days, RINITOL EDAS-131 2-3 drops per mucous membrane of each nostril 2 times a day for 10 days, anaferon children 1 tablet 1 once a day for 30 days, pine nut oil about nuts, 1 teaspoon 1 time per day for 30 days, for children with diseases of the nervous system F according to class ICD-10, therapeutic exercises are carried out in the form of individual or small-group exercise therapy, 3 times a week, with a duration of 25 minutes, use active physical exercises, including general developmental exercises without objects and with objects on shells, to develop strength, flexibility, dexterity, to correct coordination abilities, to correct posture, at a pace of performing exercises from slow to fast, the amplitude of movement maximum initial position - lying on his stomach, lying on his back, knee-wrist, kneeling, sitting, standing, they also perform classical therapeutic massage of the collar zone using techniques: superficial and deep stroking, sawing, crossing, squeezing, shifting , continuous vibration, techniques are used in alternation, the duration of the procedure is 10 minutes, a course of 10 procedures, pharmacotherapy includes taking glutamevitis 1 tablet 2 times a day after meals, anaferon children 1 tablet on an empty stomach 1 time per day for 30 days, succinic acid 50 mg 2 times a day in the morning and at lunch after meals according to the scheme: 5 days of admission, 2 days off, children with diseases of the nervous system Q according to the ICD-10 class conduct therapeutic exercises in the form of individual or small-group exercise therapy 3 times a week, lasting classes 25 minutes using active physical exercises, general developmental without objects and with objects, exercises for the development and correction of coordination abilities, exercises for correcting posture, arches of the foot, for the development of fine motor skills of the fingers, speed of exercise from m slow to fast, the amplitude is maximum, the starting position is lying on your back, stomach, sitting, standing, conducting a general classical massage using techniques of superficial and deep stroking, spiral grinding, sawing, shearing, squeezing, striking, techniques are used in alternation, the duration of the procedure 15 minutes, a course of 10 procedures, pharmacotherapy includes taking picovitis 1 teaspoon 1 time per day for 20 days, anaferon children 1 tablet on an empty stomach, 1 time per day for 30 days, pine nut oil and 1 teaspoon 1 time per day for 30 days.

The method is as follows.

The study of children begins with a diagnosis according to the international classification of ICD, according to which patients are assigned to one of the following groups: Class No. VI Diseases of the nervous system (G) (cerebral palsy, hydrocephalus, encephalopathy, the effects of neuroinfection); Class No. V Mental and Behavioral Disorders (F) (Mental retardation, schizophrenia, autism); Class No. XII Congenital malformations (deformities) of deformation and chromosomal abnormalities (Q) (Down Syndrome, Phenylketonuria).

The research algorithm is as follows:

1. Examination of the child by a pediatrician.

2. Analysis of medical records.

3. The study of the immune status (flow cytometry) with the ELISA method for the presence of certain pathogens (chlamydia, herpes, cytomegalovirus, toxoplasmosis, giardiasis, opisthorchiasis).

The purpose of treatment is carried out depending on the results of the comprehensive examination described above, taking into account the class of disease according to ICD-10. As a comparison group, a group of children was used that was comparable by sex, age, established diagnoses according to ICD-10, which did not receive this treatment.

Treatment of children with disabilities taking into account ICD-10: Class No. VI Diseases of the nervous system (G) (cerebral palsy, hydrocephalus, encephalopathy, consequences of neuroinfections.

1. Therapeutic gymnastics is carried out in the form of individual or small-group (2-3 people) exercise therapy 3 times a week, the duration of the lesson is 30 minutes (warm-up - 5 minutes, the main part - 20 minutes, the final part - 5 minutes). Passive-active and active physical exercises are used, including breathing, coordination exercises, relaxation exercises, normalization of postures and positions of the head and limbs, posture and walking correction, exercises using balls d = 85 cm. Exercise pace, from slow to medium, the range of motion is maximum. I.P. - lying on his back, stomach, knee-carpal, sitting, standing on his knees, standing.

2. Massage technique. Massage is carried out in a room with t = 22 degrees Celsius, at the same hours, 30 minutes after a meal. The duration of the procedure is 25 minutes, the course consists of 15 procedures.

Massage plan: in I.P. - lying on his stomach with a roller under the ankles - massage of the back, paravertebral areas, back surface of the legs. In I.P. - lying on your back with a roller under the knees - massage of the front surface of the legs, abdomen, chest, arms.

Massage techniques superficial and deep stroking, sawing, crossing, squeezing, shifting, continuous vibration. Receptions were used in alternation. Pharmacotherapy includes the following drugs:

- Biovital gel for children (Kinder Biovital) 1 teaspoon 1 time per day for 10 days.

- RINITOL EDAS-131 2-3 drops on the mucous membrane of each nostril 2 times a day for 10 days.

- Anaferon children 1 tablet on an empty stomach 1 time per day for 30 days.

- Pine nut oil 1 teaspoon 1 time per day for 30 days.

Treatment of children with disabilities with ICD-10: Class No. V Mental and behavioral disorders (F) (Mental retardation, schizophrenia, autism).

1. Therapeutic gymnastics is carried out in the form of individual or small-group (2-3 people) exercise therapy, 3 times a week, the duration of the lesson is 25 minutes (warm-up - 5 minutes, the main part - 15 minutes, the final part - 5 minutes). They use active physical exercises, including general-development without objects and with objects (basketballs with a rich color gamut), on shells (gymnastic wall, treadmill), exercises for developing strength, flexibility, dexterity, for correcting coordination abilities, for correcting posture. The pace of the exercise from slow to fast, the range of motion is maximum, the starting position (PI) is lying on the stomach, lying on the back, knee-carpal, kneeling, sitting, standing.

2. Massage technique. Conduct a classic therapeutic massage of the collar zone. Massage techniques: superficial and deep stroking, sawing, crossing, squeezing, shearing, continuous vibration. Receptions are used in alternation.

The duration of the procedure is 10 minutes, 10 treatments per course.

Pharmacotherapy includes taking:

- Glutamevit 1 tablet 2 times a day after meals.

- Anaferon children 1 tablet on an empty stomach once a day for 30 days.

- Succinic acid - 50 mg 2 times a day (morning, lunch) after meals according to the scheme: 5 days of admission, 2 days break.

Treatment of children with disabilities taking into account ICD-10: Class No. XII Congenital malformations (malformations) of deformation and chromosomal abnormalities (O) (Down Syndrome, Phenylketonuria).

1. Therapeutic gymnastics is carried out in the form of individual or small-group exercise therapy 3 times a week, the duration of the lesson is 25 minutes (warm-up - 5 minutes, the main part - 15 minutes, the final - 5 minutes). They use active physical exercises that are generally developing without objects, with objects (basketballs with a rich color gamut), exercises for developing and correctly coordinating abilities, exercises for correcting posture, arches of the foot, and developing fine motor skills of the fingers. The pace of exercise from slow to fast, the maximum amplitude. (PI) - lying on your back, stomach, sitting, standing.

2. Massage technique. Conduct a general classic massage. Massage techniques: superficial and deep stroking, spiral rubbing, sawing, shearing, squeezing, striking. Receptions are used in alternation. The duration of the procedure is 15 minutes, 10 courses per course.

Pharmacotherapy includes taking:

- Pikovit 1 teaspoon 1 time per day for 20 days,

- Anaferon children 1 tablet on an empty stomach, 1 time per day for 30 days - Pine nut oil, 1 teaspoon 1 time per day for 30 days.

Features of exercise therapy in cerebral palsy are that, given the degree of restriction of movements, a complex of passively active exercises is used, the intensity and duration of the lesson depends on the child’s age, the form of cerebral palsy and the presence of concomitant pathology, while taking into account hidden potential opportunities, observing didactic principles: , systematic, from simple to complex, from known to unknown.

Features of massage for cerebral palsy: general differential massage is applied with a predominance of relaxing techniques.

Features of exercise therapy for mental retardation: the degree of perception of the instructor's speech and visual commands is taken into account, the intensity and duration of the lesson is determined by the degree of decrease in intelligence.

Features of massage for mental retardation: to improve cerebral circulation, massage of the collar zone is used.

Features of exercise therapy at Down Syndrome: motivation is used in bright color and shape (multi-colored balls, soft designers and modules); preference is given to game elements of exercise therapy.

Features of massage with Down Syndrome: given the concomitant decrease in muscle tone - a general massage is used.

Additional use of drugs: gel bio-vital for children (kinder bio-vital), pikovit, glutamevit; homeopathic medicines: anaferon for children, Rintol, EDAS-131, succinic acid, pine nut oil “Cheese-crushed handmade, improves the performance of VC, strength indicators, helps to alleviate the number of pathological types of reaction of the cardiovascular system (CCC) to standard physical activity, increase resistance organism to hypoxia, a significant decrease in the incidence of acute respiratory infections, SARS.

A decrease in the incidence of acute respiratory infections, acute respiratory viral infections in the main group by 20%, compared with the comparison group. Improved immunological blood counts.

Example 1: ICD-10: Class No. VI Diseases of the nervous system (G). Patient A. 2.5 years old, was admitted to the Rehabilitation Center with a diagnosis of: Diagnosis: G 82.1 cerebral palsy, spastic diplegia of the lower extremities; N 90-91 - sensorineural hearing loss, articulation disorder due to hearing loss (ZPR, OHP - 1 level); G 91, 93.4 - encephalopathy, externally - internal hydrocephalus, due to iv infection (CMVI, chlamydia); myotonic syndrome; A 89 - intrauterine infection in the form of a cytomegalovirus infection with a primary lesion of the central nervous system;

The child was examined by specialist doctors (pediatrician, neurologist, infectious disease specialist, physiotherapist, optometrist, otolaryngologist, optometrist, dermatologist, psychiatrist, endocrinologist). Treatment was prescribed - taking into account paraclinical and instrumental data, the severity of the underlying and concomitant diagnosis.

In paraclinical data: General blood test-eosinophilia up to 12; biochemical analysis of blood - marked changes in protein metabolism, general urine analysis - phosphate crystalluria, polymerase chain reaction - cytomegalovirus DNA was detected, ELISA is sharply positive for respiratory chlamydia.

Instrumental methods of examination: ultrasound of the abdominal organs - an excess of the gallbladder, EEG - moderate cerebral changes with dysfunction of the subcortical structures.

The adaptation period at the Center was rather complicated. The child often suffered from colds. As a result of this, courses of rehabilitation treatment were interrupted (exercise therapy, massage, physiotherapy). It required a shade of the state of the immune system. An examination was performed using a Coulter Epics flow cytometer, Beckman Coulter (USA). Conclusion at the initial examination: Lymphocytosis is absolute and relative. The increased content of CD8, CD19, CD3 + CD16 + CD56. The immunoregulatory index is sharply reduced (0.46). Revealed antibodies to toxoplasmosis, chlamydia.

The child was treated according to the proposed method according to the scheme: ICD-10: Class No. VI Diseases of the nervous system (G). The complex included exercise therapy, massage, medication

1. Biovital gel for children (Kinder Biovital) 1 teaspoon 1 time per day for 10 days.

2. EDAS-131 2-3 drops on the mucous membrane of each nostril 2 times a day for 10 days.

3. Anaferon children 1 tablet on an empty stomach 1 time per day for 30 days.

4. Pine nut oil 1 teaspoon 1 time per day for 30 days.

The condition of the child has stabilized. There was a continuity in rehabilitation measures. Faster was the effect of the treatment. When re-immunological examination, using a flow cytofluorimeter "Coulter Epics" company "Beckman Coulter" (USA) - conclusion:

Relative lymphocytosis, otherwise without features. OAM, OAK without features.

The dynamics of the incidence of acute respiratory infections, SARS: 2005 - 8 times, 2006 - 3 times.

Example 2: ICD-10 Class No. V Mental and Behavioral Disorders (F).

Patient V., 8 years old, was admitted to the Rehabilitation Center with a diagnosis of:

F 72.02 - mental retardation, moderate due to a previous injury with a mild violation of behavior; Q 35 - congenital anomaly, cleft palate; violation of articulation and other anatomical abnormalities of the oral structures involved in speech functioning, causing severe systemic underdevelopment of speech; Q 53.1 - undescended testis unilateral; H 47.2 - atrophy of the optic disc; Delayed physical development; Moderate diffuse changes in the pancreas and thyroid gland; J 35.2 - 1-2 adenoids; flat feet. Cytomegalovirus infection with a primary lesion of the central nervous system.

The child was examined by specialist doctors (pediatrician, neurologist, infectious disease specialist, physiotherapist, optometrist, otolaryngologist, optometrist, dermatologist, psychiatrist, endocrinologist). Treatment was prescribed taking into account paraclinical and instrumental data, the severity of the main and concomitant diagnosis.

In paraclinical data (OAK, OAM) without pronounced violations. PCR diagnostics - cytomegalovirus DNA detected.

Instrumental methods of examination: EEG - moderate cerebral changes. Computed tomography of the brain: - cystic changes in the right hemisphere. Ultrasound of the abdominal cavity - an excess of the gallbladder.

The boy often suffered from colds due to his high susceptibility to infections. An assessment of the state of the immune system was required. A survey was performed using a flow cytofluorimeter "Coulter Epics" company "Beekman Coulter" (USA). Conclusion at initial examination: Absolute and relative lymphocytosis, impaired immunoregulation index (CD4 / CD8).

The child was treated according to the proposed method according to the scheme: ICD-10 Class No. V Mental and behavioral disorders (F). In addition to exercise therapy and massage appointed appointment:

1. Glutamevit 1 tablet 2 times a day after meals.

2 Anaferon for children, 1 tablet on an empty stomach once a day for 30 days.

3 Succinic acid - 50 mg 2 times a day (morning, lunch) after meals according to the scheme: 5 days of admission, 2 days break.

The condition of the child has improved. Repeated analysis using a flow cytofluorimeter showed efficacy in ongoing therapy. Conclusion is the norm option.

The dynamics of the incidence of acute respiratory infections: 2005 - 6 times, 2006 - 2 times.

Example 3: ICD-10: Class No. XII Congenital malformations (malformations) of deformation and chromosomal abnormalities (Q).

Patient J., 15 years old, was admitted to the Rehabilitation Center with a diagnosis of Q 90 - Down Syndrome; L 20.0 - atopic dermatitis; H 52.2 - astigmatism; F 72.04 - severe mental retardation with a mild violation of behavior associated with a chromosomal disorder; Hypertrophy n / m 2-3 tbsp. Development-threatening tonsillitis. Kyphoscoliotic posture: In 66 Chr. opisthorchiasis; Ptosis 1-2 tbsp: Systemic underdevelopment of severe speech.

The child was examined by specialist doctors (pediatrician, neurologist, infectious disease specialist, physiotherapist, optometrist, otolaryngologist, optometrist, dermatologist, psychiatrist, endocrinologist). Treatment was prescribed taking into account paraclinical and instrumental data, the severity of the main and concomitant diagnosis.

In the paraclinical data: OAK: severe eosinophilia, OAM without pathology, in biochemical analysis, carbohydrate disorder (fasting glucose 7 mmol / L), pigment metabolism (bilirubin - 30-10-11).

Instrumental methods: Ultrasound of the abdominal organs: diffuse change in the liver, pancreas; computed tomography: multiple calcifications of the left hemisphere, possibly congenital in nature.

According to a survey using a flow cytofluorimeter "Coulter Epics" company "Beckman Coulter" (USA). Conclusion at the initial examination: there was a sharp decrease in CD19, overproduction of CD8, the immunoregulatory index towards immunodeficiency (IRI 0.64) was violated, hypoproduction of immunoglobulin A, G, secretory immunodeficiency. IFA: antibodies to opisthorchia positive.

The child was treated according to the proposed method according to the scheme: ICD-10: Class No. XII Congenital malformations (malformations) of deformation and chromosomal abnormalities (Q). In addition to exercise therapy and massage appointed appointment:

1. Pikovit, 1 teaspoon, 1 time per day for 20 days.

2. Anaferon children 1 tablet on an empty stomach once a day for 30 days.

3. Pine nut oil 1 teaspoon 1 time per day for 30 days.

A repeat examination was performed using a Coulter Epics flow cytometer, Beckman Coulter (USA). Conclusion: eosinophilia, the main cellular markers within the physiological norm, the concentration of immunoglobulin G is moderately reduced. No dynamics was observed on opisthorchiasis. In biochemical analysis: improved carbohydrate and pigment metabolism (fasting glucose 4.6 mmol / l, bilirubin - 9-12-5).

The girl became less ill with colds. The dynamics of the incidence of acute respiratory infections: 2005 - 4 times, 2006 - 1 time. The mode of the proposed method is selected based on the analysis of observation data for groups of children with disabilities. The main indicators of the main group of children visiting the rehabilitation center are shown in diagram No. 1, control in diagram No. 2 and, further, according to ICD classification groups, respectively, in diagrams No. 1-8.

As can be seen from table 1, before the treatment in the main group, the main cellular markers (leukocytes, lymphocytes, CD 3; CD 4; CD 19, etc.) revealed abnormalities in 74.8% of children.

After the course of treatment, violations persisted in 51.42% of children. Overproduction of Ig, A, G, M - before the treatment in the main group, the main cell markers were observed in 44.74% of children, after the course of treatment, violations were recorded in 20.94% of children.

Infectious process: according to Cl. pneum high titer was detected in 51.42% of children. After complex treatment, a high titer of antibodies was observed in 40% of children. Before treatment, a high titer for HSV was detected in 40% of children, after the course in 25.71%. CMV - before treatment in 35% of children, after treatment, a high titer remained in 22.85%.

In the control group by the main cellular markers (leukocytes, lymphocytes, CD 3; CD 4; CD 19, etc.), changes were detected in 80% of disabled children.

Upon repeated examination, 57.14% revealed abnormalities in the main cellular markers.

Hypoproduction of Ig, A, G, M was noted: during the initial examination in 53.33% of children, with repeated examination in 35.23% of children. According to Cl. pneum high titer during the initial examination was observed in 57.14% of children. At re-examination in 48.57% of children. HSV at the initial examination in 48.57% of children. With a repeat of 45.71%. CMV - in 42.85% at the initial examination, with repeated at 37.14%.

Thus, the application of the proposed method for the treatment of children with disabilities Class No. VI Diseases of the nervous system (G) improves the performance of the main cellular markers in the main group. Positive dynamics are observed in 8.57% of children. Normalization of Ig, A, G, M immunoglobulins was observed in 23.8%, and in the control group in 18.1% of children. Effective dynamics to reduce the high titer of antibodies to Cl. Pneum in the main group 11.42%, in the control 8.57%. A decrease in the high titer of antibodies to HSV occurred in 14.54% in the main group and by 2.86% in the control group. A decrease in the high titer of antibodies to CMV occurred in 12.15% of children in the main group and by 5.71% in the control group. As can be seen from table 2 before treatment in the main group according to the main cellular markers (leukocytes, lymphocytes, CD 3; CD 4; CD 19 and others), violations were detected in 93.33% of children. After the course of treatment, violations persist in 40% of children. Overproduction of Ig, A, G, M - before the treatment in the main group, the main cellular markers were observed in 62.22% of children, after the course of treatment, violations were recorded in 26.66% of children.

Infectious process: according to Cl. pneum high titer was detected in 100% of children. After treatment according to the proposed method, a high titer of antibodies was observed in 80% of children.

Before treatment, a high titer for HSV was detected in 33.33% of children, after the course in 20%. CMV - before treatment in 53.33% of children, after treatment, a high titer remained in 46.66%.

In the control group by the main cellular markers (leukocytes, lympholites, CD 3; CD 4; CD 19, etc.), changes were detected in 80% of disabled children.

On re-examination, 60% had abnormalities in the main cellular markers. Hypoproduction of Ig, A, G, M was noted: during the initial examination in 64.14% of children, with repeated examination in 51.11% of children. According to Cl. pneum high titer during the initial examination was observed in 66.66% of children. At re-examination in 60% of children. HSV at the initial examination in 83.33% of children. With repeated at 46.66%. CMV - in 53.33% at the initial examination, with repeated at 46.66%.

Thus, the application of the proposed method for children with disabilities Class No. V Mental disorders and behavioral disorders (F) improves the performance of the main cellular markers in the main group. Positive dynamics were observed in 53.33% of children, and in the control group - 20%. Normalization of immunoglobulins Ig, A, G, M was observed in 35.56%, and in the control group in 13.33% of children.

Effective dynamics to reduce the high titer of antibodies to Cl. Pneum 6 main group - 20.0%, in the control 6.66%. A decrease in the high titer of antibodies × HSV occurred in 13.33% in the main group and by 6.67% in the control group. A decrease in the high titer of antibodies to CMV occurred in 33.33% of children in the main group and by 20% in the control group.

As can be seen from table 3 before treatment in the main group of the main cellular markers (leukocytes, lymphocytes, CD 3; CD 4; CD 19, etc.), violations were detected in 90% of children.

After the course of treatment, violations persist in 60% of the children of the main group. Overproduction of Ig, A, G, M - before the treatment in the main group, the main cell markers were observed in 66.6% of children, after the course of treatment, violations were recorded in 50% of children. Infectious process: according to Cl. pneum high titer was detected in 80% of children. After treatment, a high titer of antibodies was observed in 50% of children. Before treatment, a high titer for HSV was detected in 50% of children, after the course in 20%. CMV - before treatment in 40% of children, after treatment, a high titer remained in 20%.

In the control group by the main cellular markers (leukocytes, lymphocytes, CD 3; CD 4; CD 19, etc.), changes were detected in 100% of disabled children.

Upon repeated examination, 80% had abnormalities in the main cellular markers. Overproduction of Ig, A, G, M was noted: during the initial examination in 60% of children, with repeated examination in 56.6% of children. According to Cl. pneum high titer at the initial examination was observed in 70% of children. At re-examination in 50% of children. HSV at the initial examination in 60% of children. With repeated 40%. CMV - in 50% at the initial examination, with repeated at 40%.

Thus, the use of the proposed method for the treatment of children with disabilities Class No. XII Congenital malformations (deformities) of deformation and chromosomal abnormalities (Q) improves the performance of the main cell markers in the main group. Positive dynamics were observed in 30% of children, and in the control group, in 20%. Normalization of immunoglobulins Ig, A, G, M was observed in 16.6%, and in the control group in 3.4% of children. Effective dynamics to reduce the high titer of antibodies to Cl. Pneum in the main group - 30.0%, in the control 20%. A decrease in the high titer of antibodies to HSV occurred in 30% in the main group and by 10% in the control group. A decrease in the high titer of antibodies to CMV occurred in 20% of children in the main group and by 10% in the control group.

The effectiveness of the treatment complex was characterized by an improvement in VC, strength indicators, a decrease in the number of pathological types of CCC reactions to standard physical activity, an increase in the body's resistance to hypoxia, and a significant decrease in the incidence of acute respiratory infections and acute respiratory viral infections. A decrease in the incidence of acute respiratory viral infections in the main group by 20% compared with the comparison group. Improved immunological blood counts. The effectiveness of the proposed method was confirmed using the methods of statistical processing (the criterion of Pearson's correspondence was used). The error in the analysis of the work done is less than 5%, which indicates the reliability of the results.

Thus, the data obtained indicate the possibility of an effective rehabilitation treatment of children with disabilities. Moreover, the advantages of this treatment regimen in the conditions of the Rehabilitation Center are obvious. The proposed method creates the conditions for improving adaptation, anti-epidemic and pre-seasonal prophylaxis of acute respiratory infections, acute respiratory viral infections is achieved. An important advantage is the simplicity and accessibility of the proposed treatment regimen for parents.

Immunopathology in disabled children attending a rehabilitation center (ICD-10, Class No. VI Diseases of the nervous system (G))

70 children were examined

Table 1 The main group of 35 children Control group 35 children X ² p Before treatment After treatment Before treatment After treatment White blood cells 9 one 10 6 12.70 <0.002 Lymphocytes 23 fourteen 25 eighteen 49.40 <0.002 CD 3 (t lymph.) 9 four 10 8 9.47 <0.05 CD 4 (t helpers) 12 6 16 eleven 10/19 <0.002 CD 8 (t sup.) fifteen 5 16 eleven 02/23 <0.002 CD 4+ / CD 8+ thirty 9 32 26 30.71 <0.002 CD3 + CD16 + CD56 10 5 13 12 12/15 <0.002 CD 19 12 8 fourteen 13 18.19 <0.002 TNK 9 5 10 9 10.96 <0.01 Immune BUT fourteen 7 21 16 30.67 <0.002 Immune G 17 3 16 fifteen 27.90 <0.002 Immune M fifteen 5 fourteen 10 19.47 <0.002 Cl. trach one one 0 0 - - Cl. pneum 21 fourteen 17 fifteen 33.74 <0.002 HSV eleven 7 twenty eighteen 30.25 <0.002 CMV 10 5 12 eleven 13.16 <0.002 TOXOCAROSIS 0 0 0 0 - - TOXOPLASMOSIS 2 2 one one - - Giardiasis 3 2 5 5 - OPISTORCHOSIS one one 2 2 - -

Immunopathology in disabled children attending a rehabilitation center (ICD-10, Class No. V Mental and behavioral disorders (F))

Examined 30 children

table 2 The main group of 15 children Control group 15 children X ² p Before treatment After baking Before treatment After treatment White blood cells 8 four eleven 9 03/15 <0.002 Lymphocytes 9 7 10 8 20.81 <0.002 CD 3 (t lymph.) 10 5 5 four 12.6 <0.01 CD 4 (t helpers) 6 four 7 6 10.26 <0.01 CD 8 (t sup.) 7 5 8 6 10.92 <0.01 CD 4+ / CD 8+ fourteen 6 12 9 30.72 <0.002 CD3 + CD16 + CD 56 8 5 7 6 11.43 <0.002 CD 19 eleven 7 10 9 23.84 <0.002 TNK 7 four 7 5 8.56 <0.01 Immune A. fourteen 7 13 12 38.69 <0.002 Immune G 6 3 10 8 15.97 <0.002 Immune M 8 2 6 3 41.82 <0.002 Cl. trach 0 0 0 0 - - C1. pneum fifteen 12 10 9 38.19 <0.002 HSV 5 3 8 7 12.66 <0.01 CMV 8 3 8 5 10.86 <0.01 TOXOCAROSIS 0 0 0 0 - - TOXOPLASMOSIS one one one one - - Giardiasis one 0 3 2 - - OPISTORCHOSIS one one 2 2 - -

Immunopathology in disabled children attending a rehabilitation center (ICD-10, Class No. XII Congenital malformations (malformations) of deformation and chromosomal abnormalities (Q)

20 children examined

Table 3 The main group of 10 children Control group 10 children X ² p Before treatment After treatment Before treatment After treatment White blood cells 2 0 5 3 9.51 <0.01 Lymphocytes 8 5 6 four 33.28 <0.002 CD 3 (t lymph.) four one 7 5 10.48 <0.01 CD 4 (t helpers) 6 3 5 four 12.83 <0.002 CD 8 (t sup.) 5 four 8 6 13.97 <0.002 CD 4+ / CD 8+ 9 6 10 8 18.57 <0.002 CD 3 + CD 16 + CD 56 7 four 5 3 9.7 <0.01 CD 19 four one 6 four 17.3 <0.002 TNK 7 6 four four 10.9 <0.01 Immune BUT 6 one 5 3 8.76 <0.01 Immune G 8 3 6 7 15.6 <0.002 Immune M 6 one 7 7 14.5 <0.002 Cl. trach 0 0 0 0 - - Cl. pneum 8 5 7 5 15.93 <0.002 HSV 5 2 6 four 10.08 <0.01 CMV four 2 5 four 8.44 <0.01 TOXOCAROSIS 0 0 0 0 - - TOXOPLASMOSIS one one one one - - Giardiasis one 0 2 2 - - OPISTORCHOSIS one one 2 2 - -

Claims (1)

A method of treating children with disabilities, including examination, pharmacotherapy, and a complex including therapeutic exercises and massage for children with diseases of the nervous system G according to class ICD-10, therapeutic exercises are carried out in the form of individual or small group exercises 3 times a week, with a duration of lesson 30 minutes, using passively active and active physical exercises: breathing, coordination exercises, relaxation, normalization of postures and positions of the head and limbs, correction posture and walking, exercises using balls at the pace of exercise, from slow to medium, maximum range of motion, starting position - lying on your back, stomach, knee-wrist, sitting, kneeling and standing, massage is carried out in a room with a temperature of 22 ° C, at the same hours, 30 minutes after eating, with a duration of 25 minutes, the course consists of 15 procedures, and the starting position is lying on your stomach with a roller under the ankles - massage of the back, paravertebral areas, back of the legs, either - lying on your back with in Alik under the knees, they massage the front surface of the legs, abdomen, chest, arms, while using techniques: superficial and deep stroking, sawing, crossing, squeezing, shifting, continuous vibration, the techniques are used in alternation, and pharmacotherapy includes the introduction of Biovital gel for children 1 teaspoon 1 time per day for 10 days, RINITOL EDAS-131 2-3 drops per mucous membrane of each nostril 2 times a day for 10 days, anaferon children 1 tablet 1 time per day for 30 days, pine nut oil 1 teaspoon 1 time a day for 30 days, children with diseases of the nervous system F according to class ICD-10, therapeutic exercises are carried out in the form of individual or small-group exercises of physical therapy, 3 times a week, with a duration of 25 minutes, they use active physical exercises, including general developmental exercises to develop strength without objects and with objects on the apparatus flexibility, dexterity, on the correction of coordination abilities, on the correction of posture, with the pace of exercises from slow to fast, the amplitude of the movements maximum, the starting position - lying on his stomach, lying on the back, knee-wrist, kneeling, sitting, standing, they also perform classical therapeutic massage of the collar zone using techniques: superficial and deep stroking, sawing, crossing, squeezing, shearing, continuous vibration, techniques are used in alternation, the duration of the procedure - 10 minutes, in a course of 10 procedures, pharmacotherapy includes taking glutamevitis 1 tablet 2 times a day after meals, anaferon children 1 tablet on an empty stomach once a day for 30 days, succinic acid 50 mg 2 times a day in the morning and lunch after meals according to the scheme: 5 days pr Ema, 2 days break, children with diseases of the nervous system Q according to the ICD-10 class undergo therapeutic exercises in the form of individual or small-group exercise therapy 3 times a week, the duration of the lesson is 25 minutes using active physical exercises of general development, without objects and with objects, exercises for the development and correction of coordination abilities, exercises for correcting posture, arches of the foot, for the development of fine motor skills of the fingers, the pace of exercises from slow to fast, the maximum amplitude, the initial burning - lying on your back, stomach, sitting, standing, they perform a general classical massage using techniques of superficial and deep stroking, spiral grinding, sawing, shearing, squeezing, stripping, the techniques are used in alternation, the duration of the procedure is 15 minutes, for a course of 10 procedures, pharmacotherapy includes taking picovitis 1 teaspoon 1 time per day for 20 days, anaferon children 1 tablet on an empty stomach 1 time per day for 30 days, pine nut oil 1 teaspoon 1 time per day for 30 days.

Images