RU2350359C2 - Method of treatment of children with consequences of perinatal lesion of central nervous system by means of lymphavizhine apparatus - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: treatment is well tolerated by the patients, does not cause an exacerbation and negative reactions. Perform segmentary electrostimulating influence. Thus influence is performed by specific selective currents by means of Lymphavizhine apparatus. The electrodes are placed both on cervical and on lumbar department of a backbone of the child, and impose the first electrode paravertebrally on the area of the cervical plexus, the second electrode - on the area of a lumbar plexus, the third electrode - on cervical plexus area on an opposite side from the first and the fourth electrode - on area of a lumbar plexus on an opposite side from the second electrode. Perform treatment daily, with an exposition of 10-15 minutes within 10 days.

EFFECT: increase of treatment efficiency of children with consequences of perinatal lesion of the central nervous system, simplicity in performance and realisation possibility in any conditions.

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Description

The invention relates to medicine, in particular to pediatrics, neurology, physiotherapy and balneology, and in particular to a method for treating children with consequences of perinatal damage to the central nervous system (CNS).

Known methods for treating the effects of perinatal CNS damage with medications, for example, metabolic and antioxidant therapy (piracetam, mexidol, cytoflavin, actovegin, etc.), vascular (cavinton), vitamin therapy (mainly B vitamins) [1, 2].

The disadvantages of drug therapy are the presence of contraindications and limitations. For example, piracetam is not recommended for use up to 1 year (the most important age to prevent irreversible changes). Vitamin therapy can cause allergic reactions.

There are also known methods of treating children with the consequences of perinatal damage to the central nervous system, which are threatened by motor impairments, physical factors: the muscle relaxation method (warm fresh baths), trophostimulation method (therapeutic massage), tonic method (shower), psychostimulating methods (prolonged aerotherapy, non-selective chromotherapy ), sedative method (iodine-bromine baths), fibromodulating method (paraffin treatment) [3].

The disadvantages of these methods is the limitation of their use in children of the early neonatal period (shower, paraffin treatment), technical difficulties during the procedure.

The closest technical solution, selected as a prototype, is a method of treating children with the consequences of perinatal lesions of the central nervous system, which consists in the use of segmental electrical stimulating effects on the Amplipuls-5 apparatus. The electrodes are located paravertebrally at the level of D10-L1, type III of operation (PP current), frequency 30 Hz, duration of packages 3-3, modulation depth 100%, current strength until light vibration is felt, duration 5-6 min, daily, 6- 7 procedures, a break of 6 days, after which the treatment cycle is repeated [4].

The disadvantages of this method are: limitation of the area of exposure, since the electrodes are located only on the lumbar spine, and the cervical region remains unused; negative reactions are possible during the procedure due to the impossibility of an objective assessment of the sensations of children up to a year to select the current strength.

The objective of the invention is to increase the effectiveness of treatment of children with the consequences of perinatal damage to the central nervous system using the apparatus "Lymphavigin", through the use of a physical factor that affects the pathogenesis of the disease.

This task is achieved by the fact that the method of treating children with the consequences of perinatal CNS lesions using the apparatus “Lymphavigin”, including segmental electrical stimulating effect, is carried out by specific selective currents using the apparatus “Lymphavizhin”, in which the electrodes are located on the cervical and lumbar spine child, and paravertebrally, the first electrode is superimposed on the cervical plexus region, the second electrode - on the lumbar plexus region, the third electrode - on the region cervical plexus on the opposite side from the first and fourth electrodes - on the lumbar plexus on the opposite side from the second electrode daily with an exposure of 10-15 minutes for 10 days. The child’s body is affected by specific electro-stimulating currents, similar in physical parameters to biological ones, similar to the smooth muscles sent by the autonomic nervous system, which activates the peristalsis of the latter. Thus, the action of the muscle pump is triggered. It is known that in the pathogenesis of the consequences of perinatal damage to the central nervous system, the leading role is played by circulatory disorders and venous outflow, the proposed method of treatment is aimed at eliminating them. The impact is carried out on the apparatus "Limfavizhin", two pairs of flexible rubber electrodes with viscose gaskets are used. The first electrode is superimposed paravertebrally on the cervical plexus region, the second electrode is paravertebral on the lumbar plexus region, the third electrode is paravertebral on the cervical plexus region on the opposite side of the first and the fourth electrode on the lumbar plexus region on the opposite side of the second electrode. Thus, the most favorable conditions are created for improving blood circulation and venous outflow throughout the spinal cord with an emphasis on the cervical and lumbar plexus, which play a leading role in the occurrence of motor disorders in the upper and lower extremities, respectively. Procedures are carried out daily, for a course of 10 procedures, lasting 10-15 minutes. The effectiveness of the method of treating children with the consequences of perinatal damage to the central nervous system, threatened by motor impairment, is shown in the following examples.

Example 1. Child N., 6 months., Girl. Diagnosis: Almost healthy. For prophylactic purposes, a course of electro-stimulating effects was prescribed on the Limfavizhin apparatus in the physiotherapeutic department of the Clinic of the Scientific Center of the Scientific Center for Medical and Applied Problems of the Siberian Branch of the Russian Academy of Medical Sciences from 4 December 2006 to 12 December 2006 for the cervical and lumbar spine longitudinally, for a course of 10 daily procedures. During the treatment, the girl improved her sleep and appetite, increased physical activity - she sat down on her own.

Example 2. Child S., 8 months., Boy.

Diagnosis: The consequence of perinatal lesions of the central nervous system of hypoxic-ischemic genesis. Syndrome of bilateral pyramidal insufficiency (more pronounced in the lower extremities).

Complaints: for a slight delay in motor skills, the boy does not rise, does not stand on his own.

Objectively: muscular dystonia, an increase in tendon reflexes, more in the lower extremities are detected in the motor sphere. Step reflex - tightens fingers.

Treatment: regimen events, general massage with an emphasis on the lower extremities (before that took place at the age of 3 months), as a physiotherapeutic correction a course of electro-stimulating effects on the apparatus “Limfavizhin” was assigned in the amount of 10 daily procedures on the basis of the Clinic of the State Medical Center Scientific Center for Surgery, Siberian Branch of the Russian Academy of Medical Sciences from 10.10.06-13.10.06 g.

After the course of treatment, an increase in motor skills was noted: the child independently gets up in the crib, holding on to the support.

Example 3

Child M., 3 years old, girl.

Diagnosis: The consequence of perinatal lesions of the central nervous system of hypoxic-traumatic genesis. Cerebral Palsy Syndrome. Right hemiparesis.

Complaints: stiffness in the right upper and lower extremities, restriction of movement in the right hand, pulls the right leg.

Objectively: in the motor sphere, a restriction of movements in the right upper limb is revealed in the form of a forced position, the arm is half bent in the elbow joint and brought to the body. Hypertonicity of the flexor muscles, an increase in tendon reflexes on the right, are noted. The lower limb is unbent in the knee joint, does not bend when walking, "describes the movements of the compasses." The characteristic pose of Wernicke-Mans. An increase in tendon reflexes on the right is also noted.

The girl is constantly undergoing rehabilitation in the department of neurology and institutions of the spa type, with a frequency of 1 time in 3 months. Treatment: a course of drug therapy was prescribed, massage of the right half of the body, a course of electrostimulating effects on the apparatus “Limfavizhin” was appointed as a physiotherapeutic correction in the amount of 10 daily procedures on the basis of the neurological department of the Clinic of the State Scientific Center of the Scientific and Technical Center of the Scientific and Technical Center of the Russian Academy of Medical Sciences from 7.08.06-18.08.06 .

After the course of treatment, a decrease in spasticity on the affected limbs was noted, the girl was able to straighten her hand, take small objects, with effort she can straighten her right arm in the elbow joint. The gait became more springy, there was a flexion in the knee joint.

The dynamics of the increase in muscle strength points in the affected limbs is presented in the table.

Table.
The dynamics of the increase in muscle strength in the affected limbs during treatment. No. A patient Diagnosis Assessment of muscle strength in points (before treatment) Assessment of muscle strength in points (after treatment) one Baby P., 6 months Almost healthy 5,0 5,0 2 Baby S., 8 months Bilateral pyramidal insufficiency syndrome 4.0 5,0 3 Child M., 3 years old Cerebral Palsy Syndrome. Right hemiparesis 3.0 4.0

As can be seen from the table, in the process of treatment there was an increase in muscle strength by 1 point, which is an objective indicator of the effectiveness of the proposed method for treating children with the consequences of perinatal damage to the central nervous system using the apparatus "Lymphavizhin".

On the basis of the Clinic of the State Institution Scientific Center ME of the VSNC SB RAMS, 50 people aged 3 months to 8 years received treatment with electrostimulating effects on the Limfavizhin apparatus, of which 26 (52%) were boys and 24 (48%) were girls. The distribution by age is as follows: children under one year old - 6 (12%), from 1 to 3 years old - 20 (40%), from 3 to 6 years old - 11 (22%), from 6 to 8 years old - 23 (46%). All children had a history of perinatal damage to the central nervous system, which with age in 24 (48%) people was transformed into a persistent motor defect in the form of paresis and paralysis. All children, regardless of age, well tolerated a course of 10 daily procedures, lasting 10-20 minutes, depending on age. A positive effect in the form of an increase in motor activity and muscle strength was achieved in 72% of cases. The severity of the effect was significantly higher in the group of children under one year old and from one year to 3 years old, which is explained by the great compensatory capabilities of the nervous system at the early start of rehabilitation.

A method of treating children with the consequences of perinatal damage to the central nervous system using the Lymphavigin apparatus is a clinically highly effective, syndrome-pathogenetically substantiated method and contributes to a significant improvement in the clinical course of the disease, namely, an increase in motor activity and muscle strength, with timely treatment and reversible changes in the nervous system avoids disability, that is, it is economically viable.

The proposed method for the treatment of children with the consequences of perinatal damage to the central nervous system with the help of the "Lymphavigin" apparatus is well tolerated by patients, does not cause exacerbation and negative reactions, is simple to perform, and can be carried out in any conditions (hospital, clinic, sanatorium, dispensary).

Information sources

1. Petrushina A.D. Levitina E.V. Pathogenetic rationale for the use of Mexidol in the treatment of hypoxic-ischemic encephalopathy in newborns / Russian Pediatric Journal, No. 6, 2001 p.10.

2. Petrukhin A.S. Children's Neurology / M., Publishing House "Medicine", 2004 p.364.

3. Ponomorenko G.N. Private physiotherapy: Textbook. allowance / Ed. G.N. Ponomorenko. - M., YuAO Medicine, 2005. - P.484-488.

4. Semenova K.A. Physiotherapy and spa treatment of patients with cerebral palsy / Methodical recommendations, Central Research Institute of Balneology and Physiotherapy, USSR Ministry of Health, 1987, p.15 - prototype.

Claims (1)

A method of treating children with the consequences of perinatal CNS damage using the apparatus “Lymphavijin”, including segmental electrostimulating effect, characterized in that the effect is carried out by specific selective currents using the apparatus “Lymphavijin”, in which the electrodes are placed on the cervical and lumbar spine of the child moreover, the first electrode is applied paravertebrally to the cervical plexus region, the second electrode to the lumbar plexus region, and the third electrode to the cervical region Leathen on the opposite side from the first and fourth electrode - on the lumbar plexus region on the opposite side from the second electrode, daily exposure to 10-15 minutes for 10 days.