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Infant. cerebral paralysis

Denas application for children with infantile cerebral paralysis

Baindurashvily A.G., Ovechkina A.V., Kenys V.M., Guseva I.A.

Orthopedic children’s research institute named by Turner G.I.  Saint-Petersburg, Russia


Different effects become apparent in the process of dynamic electrotherapy (DENAS) application; significant ones are anaesthetic, anti-edematous, anti-inflammatory, vasodilating and spasmolytic when implementing conservative and operative therapy of children with infantile cerebral paralysis (ICP). High muscle tone and motor function disorder as a result of central nervous system affection are differential clinical syndromes ofinfantile cerebral paralysis. However, existing clinical observations of positive DENAS impact on the functional state of neuromuscular device of children with ICP were not accompanied by neurophysiology methods till present time.

Purpose of the research: was analysis of dynamic electrotherapy impact on the state of neuromuscular device of children with ICP during complex orthopedic-surgical therapy.

Materials and methods of the research

A research of contractile function of dorsum and lower extremities muscles was carried out using the method of global electromyography (EMG) in 25 children with infantile cerebral paralysis in the age from 4 to 14 years old. 5 persons out of them were examined on the all stages of therapy including preoperative preparation, postoperative period and rehabilitation period. 12 children were examined only during postoperative period, and 8 children were examined only during preoperative preparation. Standard DENAS therapy course included 10 sessions. The research was carried out before the course was started as well as after it was finished.

The research was carried out with the help of “NEURO-MVP-4″ electroneuromyograph made by “Neurosoft” company (Russia) applying standard ground lead electrodes. Isometric mode with evaluation of amplitude and structural indices of electrogenesis of muscles under study in the projection of motor points was used. Longitudinal dorsal muscles on a level of thorax and lumbar region, tibial muscles (gastrocnemius muscle and anterior tibial muscle) and femoral muscles (rectus muscle of thigh, quadriceps muscle of thigh, tibial flexor muscles, adductor femoral muscle) were chosen for the research.

The results

Electrogenesis of reduced amplitude, 50-70% lower than age norm, with saturated pattern of action potential (AP) typical for the central dysfunction of motor structures activation and muscle tone increase by pyramidal type was registered at the initial stage in the muscles of lower extremities. Structural changes typical for the moderate segmental dysfunction of lumbar enlargement motoneurons with alpha- and gamma-motoneurons activation acceleration regulation also were registered in the 85% of cases.

Decay of amplitude indices in the dorsal muscles on the initial stage was expressed less and made up 30% of the age norm; the same structural changes were registered.

76% of children showed electrogenesis amplitude increase of studied muscled 18-22% in comparison with initial indices after DENAS course. Increment of amplitude indices in the femoral muscles came to 28% for 12 children. Electrogenesis amplitude increase in the dorsal muscles was less expressed, only 11-15% from initial data. Structural changes stayed the same.

Preliminary results evaluation of electroneurophysiological examination of children with ICP allows to assume that changes received could be associated with evident vasoactive action of DENAS. Blood circulation enhancement of ischemic tissues in the stimulation zone activates metabolic and trophic processes not only in the zone of impact, but also in the deep-underlying tissues, as well as in the zones that are segmentally connected with them. Also, reserve functional abilities of tissues are stimulated and regulating influence on the segmental and motorneuronic device is exerted as a result of general impact on the body.

On the ground of data received preconditions for further research of possibility of positive DENAS effect on the central nervous system regulating mechanisms when having long-term exposure to the indicated therapy are created.


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