RU2732345C1 - Method of activating proprioceptors in infantile cerebral paralysis - Google Patents

Abstract

FIELD: medicine.SUBSTANCE: invention refers to medicine, namely to neurology, and can be used in treating patients in paediatric neurology. Method consists in forming percutaneous muscle-intramedullary canals on the lower extremity, shoulder and forearm on an upper extremity by perforation of long tubular bones under general anaesthesia. Most involved extremity is first operated.EFFECT: method makes it possible to form stable gait, to increase volume of movements in joints, to improve fine motor skills and accuracy of movements and, as a result, to improve quality of life of patients due to formation of new, stable efferent reflex links between head and bone marrow, long tubular bones and muscles of extremity.1 cl, 1 ex

Description

The invention relates to medicine, namely to neurology, and can be used in the treatment of patients in pediatric neurology.

Activation of proprioceptors in infantile cerebral palsy is aimed at the formation of a flow of afferent impulses to the motor center of the brain in order to correct pathological friendly movements (synergies) and the formation of new efferent reflex connections. Existing methods of activating proprioceptors are achieved by external action on the limbs: physiotherapeutic procedures, massage, mechanotherapy, dynamic proprioceptive correction according to K.A. Semenova (gravity suits), autoneuritotherapy according to E.A. Melnikova (physiotherapeutic effect) [1, 2, 3, 4, 5]. External influence on proprioceptors is a therapeutic medical technology and does not allow stable correction of muscle tone, gait, statics, and limb motor skills.

The problem solved by this invention is to create a method for activating proprioceptors, which allows the formation of new, stable efferent reflex connections between the brain and bone marrow, long bones, limb muscles, in infantile cerebral palsy.

This is achieved by the formation of percutaneous musculoskeletal canals along the thigh and lower leg on the lower limb, upper arm and forearm on the upper limb.

The method is carried out as follows. Under general anesthesia, skin incisions are made up to 0.5 cm long, outside the passage of the neurovascular bundle of the upper or lower limb. Musculoskeletal canals are formed and the long bones are perforated with penetration into the marrow canal. Bones are perforated with an electric drill, the sizes of the milling holes vary from 1 mm to 5 mm depending on the diameter of the tubular bone, the number of perforations is 16-20 and is determined by the long limb.

First, with paralysis, the most affected limb is operated on, receptors are activated in it. Then, after a while, another affected limb. As a rule, half of the body is affected - an arm and a leg on one side (called hemiplegia).

Example. In the clinic of the State Budgetary Healthcare Institution of the Amur Region "Amur Regional Children's Clinical Hospital", the method of activating the proprioceptors of the limbs in infantile cerebral palsy was performed in 7 patients, from 4 to 17 years old. The results are assessed after 1 year. In all patients with paralysis of the lower extremities, the equinus of the foot regressed, a stable gait close to normal was formed, the range of motion in the joints increased, and the quality of life increased.

With the defeat of the upper limbs, fine motor skills, volume and accuracy of movements improved.

The technical result of using the invention lies in the fact that during the formation of percutaneous musculoskeletal canals along the thigh and lower leg on the lower limb, shoulder and forearm on the upper limb, the proprioceptive field is activated and new, stable efferent reflex connections between the brain and bone marrow are formed , long tubular bones, limb muscles in infantile cerebral palsy, which significantly improves the quality of life of patients.

Literature

1. Badalyan L.O., Zhurba L.T., Timonina O.V. Cerebral palsy. Kiev: Healthy. 1988.328 s.

2. Baranov A.A., Namazova-Baranova L.S., Kurenkov A.L., Klochkova O.A., Karimova H.M., Mamedyarov AM, Zherdev K.V., Kuzenkova L.M., Bursagova B.I. Comprehensive assessment of motor functions in patients with infantile cerebral palsy: study guide. manual / Baranov A.A. [and etc.]; Federal state budget scientific. institution Scientific. children's health center. - M .: Pediatr, 2014 .-- 84 p.

3. Kurenkov, A.L., Batysheva, T.T., Vinogradov, A.V., Zyuzyaeva, E.K. Spasticity in infantile cerebral palsy: diagnostics and treatment strategies / A.L. Kurenkov // Journal of Neurology and Psychiatry. - 2012. - v. 7. - No. 2. - S. 24-28.

4. Semenova K.A., Mastyukova E.M., Smuglin M.Ya. Clinic and rehabilitation therapy for infantile cerebral palsy. M .: Medicine. 1972.328 s.

5. Semenova K.A. Rehabilitation treatment of children with perinatal lesions of the nervous system with infantile cerebral palsy. M .: - 2007.

Claims (1)

A method of treating patients with infantile cerebral palsy, which consists in the fact that under general anesthesia, percutaneous musculoskeletal canals are formed along the thigh and lower leg on the lower limb, shoulder and forearm on the upper limb by perforating the long tubular bones, with the most affected limb being operated first.