[Personalized approach to working up an early motor rehabilitation program for children with vertebral column and spinal cord injury, taking into account exercise tolerance]. / Personalizirovannyi podkhod k sostavleniiu programmy rannei dvigatel'noi reabilitatsii detei s pozvonochno-spinnomozgovoi travmoi s uchetom tolerantnosti k fizicheskoi nagruzke.

BACKGROUND: The relevance of rehabilitation of children with vertebral column and spinal cord injury (VCSCI) is due to the steady growth in the number of such patients. The mandatory conditions for early motor rehabilitation are to size efforts, to exclude fatigue and overtraining, and to gradually increase loads. The priority tasks of drawing up an individual motor program are to determine the rehabilitation abilities of a child and his/her willingness to perform the proposed load. AIM: To investigate whether the motor rehabilitation program can be personalized for children with severe VCSCI on the basis of estimation of exercise tolerance. METHODS: The investigation enrolled 25 patients with VCSCI (12 people with superior paraparesis or inferior paraplegia and 13 with inferior paraparesis or inferior paraplegia); their mean age was 12.1±5.0 years. An individual active motor rehabilitation program was worked out for all the patients according to the results of exercise tolerance testing. The latter was performed using ergospirometry to determine the maximum oxygen consumption (VO2 max) and the time to reach the anaerobic threshold. RESULTS: After a rehabilitation cycle, all the patients showed an increase in VO2 max and time to reach the anaerobic threshold. The obtained results about the increase in VO2 max with active exercises and the expansion of the aerobic corridor in both patient groups suggest that the exercise tolerance was enhanced due to increases in muscle strength and total body endurance. By the end of the rehabilitation cycle, all the patients displayed an increase in the motor density of exercises to 29.2±4.3 (64.9%) of the 45 min. Passive load decreased to 15.8±4.3 (35.1%) min. CONCLUSION: Assessment of the individual capabilities of a patient allows one to personalize the motor rehabilitation program. Ergospirometry is a technique to monitor the adequacy of the proposed program.

[The experience with the early rehabilitation of the children presenting with the vertebral cerebrospinal injury]. / Opyt rannei reabilitatsii detei s pozvonochno-spinnomozgovoi travmoi.

This article was designed to report the experience with the provision of early rehabilitation care to the children suffering from a spinal-cord injury (SCI) that was gained at the Clinical and Research Institute of Urgent Pediatric Surgery and Traumatology. The authors have developed and describe the combined multidisciplinary approach making it possible to promote the recovery of the children presenting with SCI at the first stage of the rehabilitative treatment. They distinguish three basic periods in the early rehabilitation of the children with this condition, defined the main goals of rehabilitation and the role of each specialist in their achievement. The results of the work provided the basis for the development of a stepwise approach for the extension of the rehabilitation measures and the solution of the tasks facing rehabilitation of the patients with vertebral cerebrospinal injuries. The correction of nutritive losses was found to be a most important component of the early stage of the rehabilitation process preceding the full-scale rehabilitative treatment. The role of various technical devices designed for the patients' re-education in functional motor activities, development and acquisition of the sustained self-service skills, enhancement of the patient's mobility, and improvement of his/her quality of life is discussed. The importance of the early beginning of the rehabilitation measures for the children suffering from a vertebral cerebrospinal injury has been confirmed.