Multimedia educativa Equinoterapia como medio de consulta para el tratamiento de pacientes con parálisis cerebral / Teaching multimedia Echinotherapy as means of reference for the treatment of patients with cerebral paralysis

Introducción: Desde 1997 se utiliza en Cuba como una variante del tratamiento físico-motor de pacientes con parálisis cerebral la Equinoterapia. Varios han sido los recursos que se han empleado desde los inicios para alcanzar la vía en el desarrollo lógico de este proceso. El presente trabajo versa sobre un medio digital que proporciona las herramientas necesarias para la adecuación de la labor de los profesionales dedicados a esta actividad y que específicamente intervienen en el tratamiento de pacientes en edad infantil. Objetivo: Evaluar el impacto de la multimedia educativa Equinoterapia como medio de consulta para el tratamiento de pacientes con parálisis cerebral. Método: Se realizó un estudio cualitativo de 53 profesionales, pertenecientes a los ministerios de Educación, Salud Pública e INDER de La Habana, desde enero del 2018 hasta marzo del 2019. La propuesta fue aplicada y evaluada en 3 etapas fundamentales, para lo cual se emplearon el cuestionario y la guía de observación. Resultados: Se destacaron los aspectos pedagógicos y funcionales. Entre los primeros sobresalieron indicadores, tales como adaptación al contexto educativo, fomento de la iniciativa y el autoaprendizaje (con 5 puntos cada uno), mantenimiento de la atención a los usuarios (4,8 puntos), así como diversidad de contenidos y actividades (4,7 puntos); entre los segundos, prevaleció el indicador eficiente para su propósito con 4,8 puntos. Además, se reconocieron las posibilidades de aplicación e incidencia en la adquisición de los contenidos desarrollados. Conclusión: Los resultados obtenidos ofrecen confiabilidad y seguridad en el producto, así como muestran una incidencia positiva en la educación de posgrado, lo cual beneficiará a los profesionales y pacientes, quienes recibirán este servicio.

Introduction: Echinotherapy is used in Cuba as a variant of the physical-motor treatment of patients with cerebral paralysis since 1997. There have been several resources that have been used since the beginnings to reach the way in the logical development of this process. The present work is about a digital means that provides the necessary tools for the adaptation of the professionals work dedicated to this activity and that specifically intervene in the treatment of patients in children age. Objective: To evaluate the impact of the teaching multimedia Echinotherapy as means of reference for the treatment of patients with cerebral paralysis. Method: A qualitative study of 53 professionals, belonging to the ministries of Education, Public Health and INDER of Havana, was carried out from January, 2018 to March, 2019. The proposal was applied and evaluated in 3 fundamental phases, for which the questionnaire and observation guide were used. Results: Pedagogic and functional aspects were remarkable. Among the first ones some indicators were notable, such as adaptation to the teaching context, promotion of initiative and self-learning (with 5 points each one), preservation of the users service (4.8 points), as well as diversity of contents and activities (4.7 points); among the seconds, the efficient indicator prevailed for its purpose with 4.8 points. Also, the possibilities of application and incidence in the acquisition of developed contents were recognized. Conclusion: The obtained results offer reliability and security in the product, as well as they show a positive incidence in the postdegree education, which will benefit professionals and patients who will receive this service.

Mezcla lipidica para mejorar el desarrollo psicomotriz en niños menores de 5 años con paralisis cerebral infantil / Lipid mixture to improve psicomotriz development in under 5 years old children with child's cerebral paralysis

Introducción: La Parálisis Cerebral Infantil constituye un grupo de patologías neurológicas invalidantes que requieren un manejo multidisciplinario. La neurofuncionalidad y neuroplasticidad son elementos esenciales para comprender procesos de aprendizaje y rehabilitación de funciones tras una alteración neurológica, como la recuperación del retardo en el desarrollo psicomotor. Objetivo: Valorar el efecto de una mezcla lipídica en niños con parálisis cerebral infantil y determinar cambios en su desarrollo psicomotor. Métodos: Se realizó un estudio de tipo experimental, aleatorizado, controlado. Población: 30 niños menores de 5 años con parálisis cerebral infantil del Hospital del Niño "Manuel Ascencio Villarroel" de enero 2015 a noviembre 2016. Muestra: 14 niños, los cuales fueron divididos en grupo 1 y 2. Se administró al grupo 1 "copos lipidicos": C:Aceite de coco (35%), O:Aceite de oliva (35%), P:Aceite de pescado de mar (15%), y OS:Aceite de soya (15%)", incrementándose hasta 10ml por día por 6 meses, se valoró antropometría, test de discapacidad, perfil lipídico, y desarrollo psicomotor. Al grupo 2 se realizó las mismas valoraciones pero no recibieron "copos lipidicos". Resultados: El grupo 1 obtuvo una mejor puntuación en la recuperación psicomotriz y en las demás valoraciones realizadas como el incremento de HDL y triglicéridos con un notable desarrollo psicomotriz. Conclusión: La administración de "copos lipidicos" ofrece resultados esperanzadores en el tratamiento y rehabilitación de esta enfermedad, con mejoría en el desarrollo psicomotor.

Introduction: Infantile Cerebral Paralysis constitutes a group of invalidating neurological pathologies that require a multidisciplinary management. The Neurofunctionality and Neuroplasticity are essential to understand the learning processes and rehabilitation of functions after a neurological alteration, such as the recovery of the delay in the psychomotor development. Objective: To evaluate the effect of a lipid mixture in children with Cerebral Infantile Paralysis and to determine changes in their psychomotor development. Methods: An experimental, randomized, controlled study was carried out. Population: 30 children under 5 years of age with Cerebral Infantile Paralysis of the "Manuel Ascencio Villarroel" Children's Hospital from January 2015 to November 2016. Sample: 14 children, which were divided into group 1 and group 2.They were administered to group 1 "lipidie copos": C: Coconut oil (35%), OR: Olive oil (35%), P: Sea fish oil (15%), and OS: Soybean oil (15%)", increasing up to 10cc per day for 6 months, anthropometry, disability test, lipid profile, and psychomotor development were assessed. The same assessments were made to group 2 but they did not receive "lipidie copos". Results: Group 1 obtained a better score in psychomotor recovery and in the other evaluations performed. Conclusion: The administration of "lipidie copos" offers hopeful results in the treatment and rehabilitation of this disease, with improvement in psychomotor development.

Clinical Study on Needle Knife plus Rehabilitation Training for Treatment of Cerebral Paralysis with Strephexopodia / 上海针灸杂志

Objective To investigate the clinical efficacy of needle knife plus rehabilitation training in treating cerebral paralysis (CP) with strephexopodia.Methods One hundred and one CP patients with single or double strephexopodia were randomized to a treatment group (51 cases) and a control group (50 cases).The control group received rehabilitation training based on hospital-community-home network rehabilitation mode.The treatment group received needle knife therapy in addition.Both groups were treated for six months.The clinical therapeutic effects were evaluated in the two groups by comparing pre-/post-treatment footprint ratios and weight-bearing lateral X-ray results.Results There were statistically significant post-treatment differences in the footprint ratio and xy/yz ratio between the two groups (P＜0.05).There were statistically significant pre-/post-treatment differences in the space between navicular tubercles and ground and the space between the cuboid bone and ground in the treatment group (P＜0.05).As compared with the control group,the space between navicular tubercles and ground and the space between the cuboid bone and ground had statistically significant post-treatment differences in the treatment group (P＜0.05).Conclusion Needle knife plus rehabilitation training can effectively relieve strephexopodia in CP patients.

Effect of Occupational Therapy on Upper Limb Function in Children with Hemiplegic Cerebral Paralysis / 中国康复理论与实践

@#ObjectiveTo explore the clinical effect of occupational therapy on upper limb function in children with hemiplegic cerebral paralysis. Methods38 cases with hemiplegic cerebral spastic paralysis who were 6～36 months old accepted upper limb occupational therapy. The clinical effects on affected limb were evaluated. ResultsThe function of affected limb, including their hands improved after treatment (P<0.01). The incidence of cure was the most in group aged <12 month, the least in 24～36 month group, and it was different among various age groups (P<0.05). ConclusionOccupational therapy can improve the upper limb function of children with hemiplegic cerebral paralysis, especially in those earlier than 1 year age.

Parálisis cerebral infantil: características clínicas y factores relacionados con su atención / Infantile cerebral palsy: clinical characteristics and factors related to its attention

Se realizó un estudio descriptivo trasversal de 244 pacientes portadores de parálisis cerebral infantil que fueron atendidos en la consulta de rehabilitación del Policlínico de Especialidades Pediátricas de Camagüey. Se demostró un predominio de la forma clínica cuadriparética (58.60 %), el retraso mental estuvo presente en el 75 % de los pacientes estudiados y los factores perinatales considerados en el 45.08 % como el posible factor causal, el 50.40 % de los que fueron evaluados no realizaban tratamiento de forma sistemática. Es importante continuar investigando sobre los factores que caracterizan el comportamiento de este problema de salud, para poder reducir su incidencia y optimizar la calidad de la atención que se le brinda a los afectados.

A descriptive study of 244 patient's carriers of infintile cerebral palsy that were attended in the rehabilitation consultation at the Pediatric Specialties Hospital of Camagüey was conducted. A predominance of the quadriparetic clinical form (58.60%) was shown, mental retardation was present in the 75% of the patients studied and the perinatal factors were considered at the 45.08% as the possible causal factor, the 50.40% of the ones that were evaluated did not carry out treatment of systematic form. It is important to continue investigating on the factors that characterize the behavior of this health problem, to be able to reduce its incident and to optimize the quality of the attention that is offered to the affected patients.

Analysis of Kinetic Function of Articulating Organs in Children with Cerebral Palsy / 中国康复理论与实践

@#Objective To survey the kinetic function of articulating organs in children with cerebral paralysis.Methods The kinetic characteristics of articulating organs in 115 cerebral paralysis children aged 2～6 were observed,including frequency of respiration,stability of respiration,if there was reverse respiration,whether the respiration of mouth and nose was separated,the longest articulating and expiration time,original reflections of mouth and so on.Results and Conclusion The kinetic function of children's articulating organs was limited just like that of their limb.So their kinetic characteristics of articulative organs differed from adults's and normal children's.

Avaliação da amplitude articular do tornozelo em crianças com paralisia cerebral após a aplicação de toxina botulínica seguida de fisioterapia / Evaluation of the widthto articulate of the ankle in children with cerebral paralysis after the application of botulinum toxin procceded by physioterapy

Objetivo: avaliar o grau de amplitude de movimento da articulação do tornozelo em crianças com paralisia cerebral, do tipo diparesia e tetraparesia espástica, após a aplicação de toxina botulínica tipo A em músculos gastrocnêmios, seguida por fisioterapia. Método: estudo observacional e transversal, avaliando 10 crianças de ambos os sexos, faixa etária de 2 a 7 anos, sendo 5 diparéticas e 5 tetraparéticas do tipo espástica, com presença de equinismo bilateral. Realizadas 3 avaliações em intervalos pré e pós bloqueio, sendo que o grau de mobilidade do tornozelo, obtido através da goniometria articular. Resultados: constatou-se que a injeção intramuscular de toxina botulínica do tipo A aumentou o grau de movimento da articulação do tornozelo e ainda, aumentou a pontuação na escala de atividades dinâmicas. Conclusão: a toxina botulínica tipo A combinada ao tratamento fisioterapêutico é um método eficaz no processo de reabilitação de pacientes que apresentam espasticidade por seqüela de PC.

Objective: to evaluate the degree of width of movement of the articulation of the ankle in children with cerebral paralysis, of the type diparetic and tetraparetic spastic, after the application of Botulinum Toxyn type A in gastrocnemius muscles proceeded by physiotherapy. Method: were accomplished a study prospective, traverse and observacional, they were appraised 10 children, of both sexes, presenting an age group from 2 to 7 years, being 5 diparetic and 5 tetraparetic of the type spastic, with presence of bilateral bilateral equinus . Were accomplished 3 evaluations in intervals before and powders blockade, and the degree of mobility of the ankle obtained through the goniometry to articulate. Results: it was verified that the injection intramuscular of Botulinum Toxyn type A increased the degree of movement of the articulation of the ankle and still, it increased the punctuation in the scale of activities dynamics. Conclusion: the Botulinum Toxyn type A combined with physiotherapy is an effective method in the process of patient rehabilitation that they present spasticity for sequel of Cerebral Paralysis.

Some observation on the incidence of cerebral paralysis in HaTayprovince

The incidence of cerabral paralysis in Ha Tay Province is counted by 2 ways: the incidence on lower 5 years old children an “the incidence on newborn”. The incidence on children who were borned from 1/1/1994 to 31/12/1997 live to 5 years old is 3.01/1000 in which the highest years (1996) is 4.69/1000 and the lowest years (1994) is 1.97/1000. Rate of getting cerebral paralysis take 1/3 new cases at the same age group. Rate of death at ≤ 5 age take 1% nearly (112/1620). The rate include death in newborn. Number of ≤ 5 children death due to cerabral paralysis take 11% death cases total. New suffer cerabral paralysis rate from 1994-1997 is 4,18/1000 alive children