Medyczna i Socjalna Rehabilitacja Dzieci z organicznym niepelnosprawnosciami ukladu nerwowego na Ukrainie. Ukraińskie Centrum Medycznej Rehabilitacji z zaburzeniami układu nerwowego Ministerstwa Zdrowia na Ukrainie

Abstract

ORGANIZATION OF MEDICAL AND SOCIAL CARE FOR CHILDREN WITH ORGANIC DISORDERS OF NERVOUS SYSTEM IN UKRAINE AUTHORS: Martyniuk Vladymyr, Oksana Nazar, Oksana Maistruk. AFFILIATION: Ukrainian Rehabilitation Centre for Children with Organic Disorders of Nervous System of Ministry of Health of Ukraine, Kiev, Ukraine, e-mail: ukrmedcentr@gmail.com Introduction: Ukrainian Medical Rehabilitation Center for Children was opened in 1996. The center works on the model of rehabilitation "tandem - partnership", "child-family-specialist" based on the active involvement of parents in the rehabilitation process. There were 12157 children from all regions of Ukraine in 201 rehabilitation courses which were carried out in the center during 1996 – 2015. The childrens were with the different diseases of nervous system, the most with cerebral palsy (65,9%). The aim of this research was to verify effectiveness of rehabilitation course. Material and methods: The study was carried out at 128 children with CP aged 3,6 ± 0,2 years, that had treatment in the Ukrainian medical rehabilitation center. The rehabilitation course was individual for each child and lasted 4 weeks. It included a combination of the different types of the rehabilitation. The rehabilitation included: Bobath therapy, Vojta therapy, sensory integration, acupuncture, dynamic proprioceptive correction using reflex-load device “Gravistat” and orthopedic correction, hypoxic training, psychological and pedagogical correction, speech therapy. In researches we used anonymous survey of patient’s parents, the Ashworth scale, GMFM, GMFCS and PedsQL. Results: According to the results of an anonymous survey of the parents, positive dynamic was observed at 94,1% of respondents. The total score of GMFM was increasing on 7,0±0,4 point (p<0,05). Using the intermittent hypoxic training in complex rehabilitation improve the adaptive capacity of children with CP, which contributed to the increasing of theirs rehabilitation potential and QL indicies. DPC method allows to reduce the impact of pathological tonic reflexes for children with CP. Conclusions: Rehabilitation care for children with movement disorders must be closely directed to the patient to provide uninterrupted rehabilitation process with active involving of parents. A multidiscipline approach involving specialists of different spheres should be used while performing an individual program of rehabilitation. The preference is given to non-medicated physical methods of rehabilitation. The level of adaptive abilities of a child should be taken into account and corrected on time if possible. Key words: children, rehabilitation, cerebral palsy, reflex-load device “Gravistat”