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BACKGROUND: Perinatal lesions of the central nervous system (CNS) prevail among other diseases of the nervous system in children, and are an economic burden on society and public health systems. The challenge in these cases is improving the quality of life of children with perinatal hypoxic pathology, which requires long-term nursing, treatment, and rehabilitation. The level of childhood disability remains consistently high, so improving the assistance to children with disabilities is an important state task. OBJECTIVE: The analysis of the results of rehabilitation treatment. MATERIALS AND METHODS: The study utilized 150 case histories of children with perinatal lesions of the CNS, all of whom underwent commercial rehabilitation. The study of the cards was carried out post rehabilitation, which typically spanned 30 days. The study included 85 (57.0%) boys and 65 (43.0%) girls. Congenital pathologies, perinatal encephalopathy, organic lesions of the CNS, and cerebral palsy were diagnosed in 19 (13.0%), 25 (17.0%), 36 (24.0%), and 69 (46.0%) cases, respectively. The rehabilitation process included hydrokinesitherapy, Vojta therapy, exercise therapy, and massage. The assessment on the effectiveness of rehabilitation was based discharge summaries, considering the results of an objective assessment and data from additional examination methods. At the end of treatment, a survey was conducted on 95 parents of the children to assess their satisfaction level in regards to the quality and effectiveness of the rehabilitation. The survey was conducted anonymously and on a voluntary basis. RESULTS: Positive dynamics was observed in 115 (77.0%) cases. In 27 (18.0%) cases, there was no dynamics, and in 8 (5.0%) cases, it was negative. The survey results showed that the average satisfaction score from visiting the rehabilitation center was 9.6 (the maximum possible level was 10). The estimates and results obtained differed in families with different social statuses. CONCLUSION: The study proved the importance and effectiveness of comprehensive rehabilitation for children with perinatal lesions of the CNS. It also emphasized the necessity of considering the medical and social characteristics of families raising such children.
BACKGROUND: Perinatal lesions of the central nervous system (CNS) prevail among other diseases of the nervous system in children, and are an economic burden on society and public health systems. The challenge in these cases is improving the quality of life of children with perinatal hypoxic pathology, which requires long-term nursing, treatment, and rehabilitation. The level of childhood disability remains consistently high, so improving the assistance to children with disabilities is an important state task. OBJECTIVE: The analysis of the results of rehabilitation treatment. MATERIALS AND METHODS: The study utilized 150 case histories of children with perinatal lesions of the CNS, all of whom underwent commercial rehabilitation. The study of the cards was carried out post rehabilitation, which typically spanned 30 days. The study included 85 (57.0%) boys and 65 (43.0%) girls. Congenital pathologies, perinatal encephalopathy, organic lesions of the CNS, and cerebral palsy were diagnosed in 19 (13.0%), 25 (17.0%), 36 (24.0%), and 69 (46.0%) cases, respectively. The rehabilitation process included hydrokinesitherapy, Vojta therapy, exercise therapy, and massage. The assessment on the effectiveness of rehabilitation was based discharge summaries, considering the results of an objective assessment and data from additional examination methods. At the end of treatment, a survey was conducted on 95 parents of the children to assess their satisfaction level in regards to the quality and effectiveness of the rehabilitation. The survey was conducted anonymously and on a voluntary basis. RESULTS: Positive dynamics was observed in 115 (77.0%) cases. In 27 (18.0%) cases, there was no dynamics, and in 8 (5.0%) cases, it was negative. The survey results showed that the average satisfaction score from visiting the rehabilitation center was 9.6 (the maximum possible level was 10). The estimates and results obtained differed in families with different social statuses. CONCLUSION: The study proved the importance and effectiveness of comprehensive rehabilitation for children with perinatal lesions of the CNS. It also emphasized the necessity of considering the medical and social characteristics of families raising such children.
Введение. У пациентов с инсультом в реабилитационном периоде обнаруживаются ключевые проблемы, ограничивающие функционирование. Характер ключевых проблем определяет потребность определенных специалистов в составе мультидисциплинарной бригады (МДБ). Цель исследования-описать ключевые проблемы, ограничивающие функционирование пациентов с инсультом, и определить, какие специалисты должны входить в состав МДБ. Материал и методы. Исследование наблюдательное. Размер выборки-81 человек. В выборку включены пациенты в острейшем периоде ишемического или геморрагического инсульта, с оценкой по модифицированной шкале Рэнкина 2 и более баллов при поступлении в стационар, возрастом старше 18 лет. В выборку намерено не включали пациентов с изолированной транзиторной ишемической атакой, изолированным субарахноидальным кровоизлиянием, с уровнем сознания при поступлении «кома 2-й степени» и более. Пациентам-участникам исследования оказана медицинская помощь в соответствии с имеющимися рекомендациями, проведена мультидисциплинарная реабилитация. В ходе реабилитации у каждого пациента выделены первая и вторая ключевая проблемы, ограничивающие функционирование. Результаты. Ключевые проблемы носили немедицинский характер в 24 % случаев, снижение толерантности к физической нагрузке-27 % случаев, проблемы со средой-6 % случаев, нарушения глотания и речи-17 % случаев, проблемы сестринского характера-4 % случаев. Для решения ключевых проблем требовалось участие психолога в 38 % случаев, физического терапевта-в 69 % случаев, эрготерапевта-в 28 % случаев, невролога-в 27 % случаев, врача-реабилитолога-в 27 % случаев. Выводы. В состав мультидисциплинарной бригады должны входить специалисты медицинского (врач-реабилитолог, профильный специалист, медицинская сестра) и немедицинского профиля (эрготерапевт, физический терапевт, психолог, логопед, и др.).
In 2023, September 8 marks World Physical Therapy Day. Modern domestic trends in the development of a comprehensive rehabilitation system are bringing regional specialists not only to a new level of recognition and demand, but also to the need to create innovative approaches to the modern system of professional training. The narrative of combining a variety of restorative measures that have an effect on the patient, the emergence of statutory enactments regulating various areas of rehabilitation, as well as the approval of a new medical specialty “Physical and Rehabilitation Medicine” with the corresponding professional specialist standard prove the increasing relevance of comprehensive rehabilitation. The study presents a particularly significant function of medical personnel in the rehabilitation system and identifies regional features in the process of specialist training using the example of the Orenburg Region.
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