[Current approaches to the use of robotic devices in rehabilitation complex of children with cerebral palsy]. / Sovremennye podkhody k primeneniyu robotizirovannykh ustroistv v komplekse reabilitatsii detei s tserebral'nym paralichom.

Cerebral palsy is a neurological disease that is associated with multiple motor impairments and dysfunctions in children. The effective recovery of motor activity in both the upper and lower limbs is an important condition for the patient's social independence throughout his life. Robotic systems are new devices which are becoming increasingly popular as a part of the treatment of cerebral palsy. They have become a good addition to comprehensive rehabilitation therapy, including conducted at the sanatorium-resort stage. Further research is needed to clarify and prove the extent to which these devices help in treatment of children with cerebral palsy.

[Effect of iodine-bromine baths on stress-systems indicators in children with autism spectrum disorders]. / Vliyanie iodobromnykh vann na pokazateli stress-sistem u detei s rasstroistvami autisticheskogo spektra.

The continuous increase in the prevalence of autism spectrum disorders (ASD) in the population, the debatable nature of many aspects of etiology, pathogenesis, and treatment of these disorders justify the urgent need for the development of effective medical rehabilitation methods affecting the pathogenetic mechanisms.Exposure of children with ASD to external stimuli in excessive force often leads to the stress-systems response not corresponding to the compensation abilities of the body. OBJECTIVE: To evaluate the effect of iodine-bromine baths on stress-system indicators in children with ASD. MATERIAL AND METHODS: The study involved 74 children with ASD (F84) aged 3 to 14 years (mean age 6.23±0.37 years) included in the main group (MG). The control group (CG) consisted of 25 healthy children.The examination included detailed history taking, examination by specialists, assessment of disease severity using CARS scale, evaluation of ß-endorphin, adrenocorticotropic hormone (ACTH), and cortisol levels in blood serum by ELISA. Thirty-four (45.9%) children had a moderate autism level (total score 30-37), and 40 (54.1%) children had severe autism (total score 37-60). In the MG, there were 27 (36.5%) children with mild symptoms of hyperactivity (subgroup A) and 47 (63.5%) children with severe aggression, tantrums, and increased hyperactivity (subgroup B). All MG patients were assigned into two subgroups by randomization: Subgroup 1: 30 children with ASD received health resort treatment (HRT) without iodine-bromine baths (IB); Subgroup 2: 44 children with ASD received similar HRT and IB. RESULTS: Statistically significant increase of ß-endorphin, ACTH and cortisol levels (p<0.01, p<0.05, p<0.01, respectively) in children with ASD (compared to those in CG children) was identified. In children without hyperactivity, a moderate increase of these parameters was noted; significantly higher values were observed in children with severe hyperactivity, impulsiveness, and aggression (p<0.05, p<0.001, respectively). After treatment, there was a statistically significant increase in ß-endorphin level in subgroup 1 children who received HRT without IB, while in children of subgroups A and B (p<0.05, p<0.05, p<0.01, respectively), there was a decrease in ACTH level (p<0.05, p<0.01, p<0.001 respectively) and a trend towards a cortisol level decrease. Inclusion of IB in HRT course associated with a significant decrease of ß-endorphin level in children of subgroups A and B (p<0.001), a decrease of ACTH level (p<0.001) and cortisol (p<0.001, p<0.01, p<0.001, respectively), which resulted in vicious circle breaking and normalization of relations between stress-limiting and stress-releasing parts of pathogenesis. CONCLUSION: Most children with autism spectrum disorders showed significant increases in ß-endorphin, adrenocorticotropic hormone, and cortisol levels, indicating dysfunction between the stress-limiting and stress-releasing systems, as well as between the central and peripheral parts of the stress-releasing chain. The tonic effect of resort treatment was noted, limiting its use in children with autism spectrum disorders, increased hyperactivity, and aggression. The inclusion of iodine-bromine baths in resort treatment has a calming non-medicinal effect and can be recommended for use in children with symptoms of severe hyperactivity.

[Specifics of spa-based rehabilitation of severe forms of spastic mobility loss of patients with cerebral palsy]. / Osobennosti sanatorno-kurortnoi reabilitatsii tiazhelykh form spasticheskikh dvigatel'nykh rasstroistv u bol'nykh detskim tserebral'nym paralichom.

AIM: To study the efficacy of the developed approach to the specialized Spa-rehabilitation of motor disorders in patients with cerebral palsy (spastic diplegia). MATERIAL AND METHODS: The study included 86 patients (45 (52,33%) women and 41 (47.67%) men), aged from 10 to 16-years, mean 13,02±2,13. All patients were divided into 2 groups depending on the method of treatment. RESULTS AND CONCLUSION: Administration of minimally invasive procedures during the course of rehabilitation can effectively restore the volume of movements in the limbs, stimulate motor development in children and form a new stereotype of walking. An analysis of the follow-up data one year after the treatment confirms the efficacy of the proposed approach to rehabilitation.

[S100B protein in the blood of children with autism spectrum disorders]. / Belok S100V v krovi detei s rasstroistvami autisticheskogo spektra.

AIM: To evaluate the plasma content of S100B protein in children with autism spectrum disorders (ASD). MATERIAL AND METHODS: Forty-five children with autism (item F84 of ICD-10), aged from 6 to 15 years, were examined. The control group (KG) consisted of 25 healthy children. The study included examination by specialists, an assessment of the severity of the disease using the Children's Rating Scale of Autism scale (CARS), evaluation of S100B in blood serum. RESULTS: The content of S100B in children with autism was significantly higher in comparison with KG. The level of S100B in children with ASD with abnormal development of brain structures (MRI) was significantly higher compared with KG and a group of children without signs of disturbance of brain structures. S100B levels were higher in children with severe ASD, and differed from controls in children with moderate ASD. CONCLUSION: The majority of children with ASD show signs of stress of neuroprotective mechanisms, and children with anomalies of brain structures have signs of hypoxia of the brain and damage of the blood-brain barrier.

[The efficacy of cellex combined with sanatorium-based rehabilitation scheme in patients with cerebral palsy]. / Vliianie sanatorno-kurortnogo lecheniia s vkliucheniem preparata tselleks na éffektivnost' reabilitatsii bol'nykh detskim tserebral'nym paralichom.

AIM: To study the efficacy of the drug cellex combined with sanatorium treatment in the rehabilitation of patients with cerebral palsy. MATERIAL AND METHODS: The study included 59 patients, mean age 17.06±0.7 years, with spastic form of cerebral palsy who were administered a course of sanatorium-spa treatment in a specialized spa-resort. All patients underwent complex clinical and neurological examinations and electroencephalography. The main group (n=23) received cellex (a course of 10 injections) in addition to traditional treatment. RESULTS AND CONCLUSION: The efficacy of treatment assessed by the level of hand functioning and cognitive abilities was higher in the main group compared to the patients of control and comparison groups. Besides, the higher academic performance and positive dynamics of EEG (higher alpha rhythm amplitudes and decreased activity of pathological rhythms) were observed.

[A complex sanatorium-resort rehabilitation of patients with cerebral palsy with spastic diplegia]. / Kompleksnaia sanatorno-kurortnaia reabilitatsiia bol'nykh DTsP so spasticheskoi diplegiei.

AIM: To study an influence of combined methods of rehabilitation for recovery of motor functions in patients with cerebral palsy with spastic diplegia (CPSD). MATERIAL AND METHODS: Seventy-six patients with CPSD, aged from 14 to 19 years (mean age 18.7±4.63 years), were under observation. A comprehensive clinical and instrumental examination was conducted. Patients of the main group received a course of underwater spinal traction with the introduction of the drug cellex along with Spa treatment. Patients of the comparison group received only Spa treatment. RESULTS AND CONCLUSION: Signs of involvement of segmental structures of the nervous system in the pathological process and their role in the formation of motion pathology are established. It is shown that the inclusion of underwater traction according to the original technique and simultaneous introduction of cellex in the complex of rehabilitation measures allows to achieve a pronounced positive dynamics in the form of expansion of motor capabilities of patients with cerebral palsy. There was a significant decrease in spastic muscle tone, restoration of the volume of movements in the joints, improved walking. Positive clinical dynamics was correlated with EMG data.

[The effect of cellex on regenerative processes in cerebral parenchymal hemorrhage under experimental condition]. / Izuchenie vliianiia preparata tselleks na regeneratornye protsessy v tkani golovnogo mozga pri modelirovanii parenkhimatoznogo krovoizliianiia u zhivotnykh.

AIM: To study an effect of the protein-peptide preparation cellex on the cerebral tissue processes in case of parenchymal hemorrhage breed under experimental conditions. MATERIAL AND METHODS: The research involved the morphological examination of fragments of cerebral tissues of 57 rabbits of Chinchilla breed in artificially-provoked hemorrhagic stroke. Animals were divided into 2 groups: the first group received cellex once a day during 10 days, the second group received physiological solution in the same doses. The cerebral tissue was examined macroscopically and with histological, immunocytochemical and morphometric methods with subsequent data analysis. RESULTS AND CONCLUSION: A much more pronounced regression of the neurological deficit was observed in the group of animals which were administered cellex. There was a significant increase in volume of active movements in the limbs. No connective tissue changes were observed macroscopically in rabbits of the first group. Besides, the area of destruction decreased in size in comparison with initially diagnosed one. A decline in the rate of the formation of connective tissue was observed in damaged parts of the brain. The microscopic study of the first group showed that the degree of inflammatory and hemodynamic disturbances was much lower and necrosis foci were not detected, however small foci of neoangiogenesis were found.

[The organizational status and tasks of sanatorium-health resort treatment and health promotion for children suffering as a result of the Chernobyl catastrophe]. / Sostoianie i zadachi organizatsii sanatorno-kurortnogo lecheniia i ozdorovleniia detei, postradavshikh v rezul'tate chernobyl'skoi katastrofy.

Al the Ukrainian Research Institute of Childhood Health-Resortology and Physiotherapy, more than 1000 children who became victims of the Chernobyl disaster were studied for their health status and time-related indices of same under the influence of the chief health-resort factors with the aid of the present-day clinical-and-laboratory, immunobiochemical, neurophysiological and radioimmunoassay techniques. The efficacies of the instituted therapies (87.9%) suggest that the above children may derive benefit from treatment at the Yevpatoriya health resort, with improvement of their health being consequent upon it. At the same time, primary tasks have been outlined, the solution of which tasks will, we believe, help in improving the diagnosis and quality of the treatments administered.

[The assessment at a sanatorium of the mental status of children who were victims of the Chernobyl catastrophe]. / Otsenka psikhicheskogo statusa v sanatorii u detei, postradavshikh ot Chernobyl'skoi katastrofy.

Psychic disorders are not infrequent findings in children who survived Chernobyl accident. This fact necessitates special psychotherapeutic, psychocorrective and psychoprophylactic treatment which should be added to standard therapeutic care in sanatoria.