[Effects of locomotor training and functional electrical stimulation on postural function in children with severe cerebral palsy].

Cerebral palsy (CP) considerably impairs the ability to maintain upright stance. In the present study the effects of locomotor training and functional electrical stimulation (FES) on postural control have been determined in children (n = 27) aged 6­12 years with severe CP. The severity level of the CP clinical manifestations was determined as 3 according to the Gross Motor Function Classification System (GMFCS) classification. All patients participated in 15 half-hour sessions of mechanic therapy using robot-assisted passive stepping. In 12 out of 27 children, the locomotion therapy was accompanied with FES. Stabilometry and plantography tests were performed before and after the course of interventions. In addition, similar posturographics tests were performed in 23 healthy children same age. Postural control in children with CP was characterized by a forward shift of the center of pressure (COP) projection; higher values of the COP trajectory area and length, as weel as by mean amplitude of the COP oscillations, and the absence of COP response to the eyes closed condition. After treatment, the posturographic characteristics had a tendency to normalization in relation to the values obtained in neurologically intact children. The improvement was observed in 43% of children without FES and in 75% of children which used FES. Analysis of plantograms revealed normalization of footprints in children received FES. Thus, it was demonstrated that FES combined with locomotor training resulted in the improvement in vertical posture control in children with severe CP.

[Neurorehabilitation of Patients with Cerebral Palsy].

Cerebral palsy is one of the common diseases that cause significant motor impairments. This review deals with new methods of motor rehabilitation of children with cerebral palsy in terms of modern physiology, as well as with summarized and analyzed results of experimental studies on the effectiveness of these methods.

[Treatment of contractures of the lower extremity joints in patients with infantile cerebral palsy against the background of prolonged epidural blockade].

The authors describe specific effects of prolonged epidural blockade in treatment of contractures of the lower extremity joints in children with cerebral palsy. The method was used in 5 patients aged from 11 to 16 years. The prolonged epidural blockade during 4-5 weeks allowed adequate motor rehabilitation and conditions for learning to walk.