TECHNICAL FIELD

Utility model belongs to the medicine, namely to the child psychoneurology and can be used for the rehabilitation of the patients with various forms of CP.

BACKGROUND ART

CP children treatment is one of the most difficult problems of the child neurology and medical rehabilitation. In most cases this disease is connected with the harmful influence on the child's brain of different factors either in the period of the development in mother's womb or during two first years of life. The pathology of the prenatal and perinatal periods is one of the most frequent reasons which causes organic lesion of the nervous system and appearance of disable children.

Organic lesion of structure and functions of the nervous system causes further various motor, mental and behavior disturbances which cause the child's disability reason and the isolation from the other children of the same age and also it's the reason of the social disadaptation.

On developing CPs organic lesion of the nervous system is accompanied by the secondary changes of the musculosceletar and other organism's system. High muscle tone, asymmetric body position and pathological movement patterns of these patients gradually cause trophic changes of the joints, disturbances of blood circulation and also cause shortening of spastic muscles, ligaments and tendons. These pathological changes are accompanied by movements' restriction of the limbs and spine joints and functional blockages formation at them. Functional blockages are formed in majority of CP children's joints.

Considerable economic costs on lasting treatment and social maintenance make actual and very important problem of the development of new effective CP rehabilitation methods aimed at social adaptation and improvement of life quality of the children.

Number of CP treatment approaches using manual therapy, therapeutic exercises, massage, drugs, physiotherapeutic remedy, and others are known.

Unfortunately the usage of only traditional therapy methods not in each case allows achieving desired results; most CP problem researchers have not paid enough attention to the spine though there are more than 100 joints in it where functional blockages can form.

For the normal development of the entire organism tight correlation of all structures is necessary, that is ensured first of all by the flow of sensory afferent (from the periphery to the center) and motor, efferent (from the center to the periphery) information.

For the CP one of the pathological factors breaking this correlation is the existence of the functional blockages of the vertebral-motor segments which restrict the mobility of the joints as well as the flow of proprioceptive information.

The prototype of the utinity model is the method of treatment infantile CP (Patent 7172 A, IPC A61H 23/00. Method of treatment patients with infantile CP / V. Kozyavkin - Jfe 93121819; claimed 04.06.1993; issued 30.06.1996) based on the usage of manual therapy for the influence on the functional blockages of the intervertebral joints and myofascial trigger points in paravertebral muscles in the lumbar region of the spine, that is carried out by the shoulder-girdle rotation and the pelvis region one to each other in addition to that the rotation is carried out backwards it means those vertebrae lying upper the blocked segment rotate forwards and those lying lower - backwards.

The disadvantage of this method is its monosegmental influence (the influence on one spine segment) that doesn't lead to the muscle tone optimization and complete removal of the functional blockages.

DISCLOSURE OF UTILITY MODEL

The basis of the utinity model is the perfection of the CP treatment method using the electric stimulation reflexotherapy after the polysegmental biomechanical correction of the spine adapted to the child's organism. The correction is curried out consecutively in all spine regions - lumbar, thoracic and cervical. It will eliminate the functional blockages of the vertebral-motor segments and normalize muscle tone, restore the mobility of the spine joints, improve the trophicity and blood circulation that will give the opportunity to reduce the signs of the nervous system dysregulation on the different levels of sensitive and motor systems of the child's organisms and opens new possibilities for the further motor and mental development of the child and the life quality improvement.

Such actions combination assists to restore spine functions, muscle tone normalization, restore flow of blood, lymph and liquor it also assists breathing activation, owing to that a new functional state of the patient is created.

The utility model core is the combination of electric stimulation reflexotherapy which is performed simultaneously with the isotonic or post-isometric muscle relaxation after the polysegmental biomechanical correction of the spine consecutively in all spine regions - lumbar, thoracic and cervical, which provides spine segments unblocking along the entire length and leads to the complex changes in the work of almost all organism systems of the patient.

Electric stimulation reflexotherapy performance will provide the potentiation of the achieved effect reached due to the biomechanical correction of the spine, the deactivating myofascial trigger points and the correction of the somato- vegetative disturbances and as a result the muscle tone normalization, the biomechanical model optimization, the stimulation of the organism inner motivations to new movements, the general tone optimization and the activation of new functional and psychological possibilities of the patient's organism.

Functional state of the child is also accompanied by the general psychoemotional activation, so called phenomenon "patient's revival". The new functional state creation gives much broader opportunities for the effective influence on the organism's structures and functions.

The method is carried out like this.

The polysegmental biomechanical correction of the spine adapted to the child's organism is performed in all spine regions - lumbar, thoracic and cervical after the manual diagnostics and appropriate preparation. The blocked segments correction of the thoracic region is carried out by special impulse techniques of mobilization from top to bottom on paravertebral lines with pressure till the moment of mobilization.

On the lumbar region simultaneous rotation backward with manipulation impulse performance involving all blocked segments. The cervical region correction is carried out by the multivector movement with complex trajectory - head turning, rotation, traction in one and other directions with simoltaneous mobilization and manipulation on this region.

After the biomechanical correction electric stimulation reflexotherapy is performed. The influence is performed on the standard points of the classical meridians in compliance with the sequence during muscle relaxation and choice of the influence area from the center to the periphery, from top to bottom with the usage of a portable electric stimulator by bundles of low voltage impulses of complex configuration. The influence on the trigger points of the musculoskeletal apparatus is carried out simultaneously with isotonic or post-isometric muscle tension, with the relaxation positions and postures used.

Thus, the usage of the method appearing causes the releasing of the functional blockages of the vertebral-motor segments and foci elimination of pathological afferentation in the child's body and because of that a new functional state is created which is accompanied by muscle tone normalization, increasing of the passive and active movement range of the joints, improving trophic of the tissues, activation of mental processes that opens new possibilities for further motor and mental development of the patient, and improving of life quality.

The treatment course consists of 10-12 treatment modalities. The second treatment course if necessary may be carried out in 4-6 months.

EXAMPLE

Patient D, bom on 2001, diagnosis: CP, syndrome of spastic paraparesis, stage of unaided walking, phase of standing up by himself. Has passed the treatment course be the Kozyavkin method in the period from 18.07.10 to 29.08.10.

History: the child was born from the first pregnancy that proceeded against the background of pyelonephritis at 38 weeks term, induced delivery, in hypoxia, with a weight of 3700 g. Anhydrous period of 12 hours. Early psychomotor development delayed. Head began to hold from 3 months.

Current situation.

Emotionally adequate. Utters separate words. Alternating strabismus. Convergent strabismus on the right. Muscle tone in all four extremities increased (Ashworth-1). Head control in prone position well. Lying on his stomach possible bearing on the forearm. Rolls to prone position in the block. Crawls alternating. Maintains sitting in the long sitting position with his back rounded. Maintains unconfident sitting in the long sitting position. Sits up from supine position with hands supported. Stands alone. Can get himself up. Walks alone, the gait pattern is spastic. While walking he bends his trunk forwards, internal rotation of the left leg. Foot contact on entire sole while walking. The feet normal. He requires assistance for feeding, drinking, and dressing.

The patient was treated by Kozyavkin method.

After manual diagnostics and preparation of the patient the biomechanical correction of the spine and the electric stimulation reflexotherapy by bundles of low voltage impulses on biologically active points were carried out daily. Reflexotherapy impact was combined with isotonic and post-isometric muscle tension, applying the relaxing positions and poses. Manual and therapeutic influence is performed simultaneously on lumbar, thoracic and then on cervical regions.

10 treatment sessions were performed.

As the result of performed treatment the muscle tone in the limbs decreased. The joints active movements range increased. The boy began to squat deeply and stand up, sit longer in a squatting position, walk and go upstairs more confidently. Coordination reactions greatly improved.

INDUSTRIAL APPLICABILITY

The using of this CP treatment technique by Kozyavkin method allows significantly increase the effectiveness of the rehabilitation, release the functional blockages of the vertebral-motor segments and restore normal joint mobility of the spine, improve tissue trophic and normalize muscle tone, activate the plasticity of the nervous system and protective capacity of the organism, that promotes greatly improvement of life quality the patients with Cerebral Palsy.