Журнал «Здоровье ребенка» 4 (64) 2015

During the last years in connection with an ecological and economic situation in Ukraine considerably morbidity grew on pathology of supporting motive vehicle, in particular to scoliosis, for the children of preschool age [1]. One of the most effective methods of physical rehabilitation at scoliosis there is complex approach, which is able to connect kinesis- and manual therapy, which is instrumental in forming of correct carriage and muscle a corset [5,6,8], strengthening of muscles of the back, and also promotes general tone of organism and normalizes functional possibilities of cardiac-vascular and respiratory systems [1,3,11]. By facilities of kinesis therapy it is possible to influence on harmonious development of supporting motive vehicle, form skills of correct carriage, obtain permanent indemnification and therapeutic effect [2,4,7,9].

Research purpose – to learn influence and estimate efficiency of application of the offered complex program of physical rehabilitation of children of preschool age with scoliosis I degree in the conditions of policlinic.

Research design. Research was conducted on the base of child's policlinic separation of the Communal 4-th city policlinic of Lvov. In research took part 174 children of preschool age (3-6 years) with scoliosis I degree, which treat oneself for an orthopedist. A basic group was made by patients, which got busy after the offered method of physical rehabilitation (87 persons). The same amount of children which the rehabilitation of scoliosis after the generally accepted method entered in the group of comparison. Both groups were identical after the age-old and sexual criteria of patients, weight of motion of disease, social belonging of parents and domestic terms of dwelling.

Employments were conducted in preschool establishments domiciliary during a year. To put comparative group got busy on the generally accepted program of physical rehabilitation as the specialized employments after physical education, which foresees the prophylaxis of violations of carriage. The offered complex of physical rehabilitation included: round-the-clock observance of the orthopedic mode, daily engaged in a medical gymnastics (special symmetric, asymmetric and detorsitic exercises), a mass therapy is with the elements of point massage, medical swimming, physiotherapy (electro stimulation of muscles), medical choreography, correcting gymnastics, after daily sleep (implementation of playing exercises in initial position, lying with the purpose of preparation of muscles to active and effective work upended). The complexes of exercises were used without an object and with a gymnastic stick, ball, rubber bandage, dumb-bells). The physical loading and duration of employments answered the pathological and age-old features of spine of children 3-6 years. Every exercise had the name, playing character and different orientation (correcting, static, dynamic, coordinating, breathing, sporting applied), and used in different static poses, dynamic motions and combinations, with gradual growth of the physical loading with the purpose of fixing of skills of correct carriage.

Results of research and their discussion. On the basis of analysis of results of external review of patients and their sciagraphy inspection among probed in 47,7% under-fives found out dysplastic scoliosis, in 33,9% children – curvature in the pectoral department of spine, in 18,4% patients – rachiocampsiss violation of carriage with an increase or diminishing of physiology bends.

To the positive effect of the conducted course of the offered method of physical rehabilitation gains in weight of body and growth (p<0,05), and also improvements of index of PEF, testify for under-fives (p<0,05). Especially important is proceeding in the proportion of physical development, removal of hypotaxia, between growth and weighing and improvement of spirometric indexes in the basic group of children.

It is discovered in connection with the leadthrough of the offered complex of rehabilitation measures found out growth of endurance and strengthening of muscles of the back and abdominal press (p<0,05), and also improvement of indexes of dinamometrii of racemes of hands, equilibrium of feet and mobility of spine (p<0,05) which creates terms for forming of correct carriage and stabilizing of scoliosis process.

The results of analysis of indexes of stabilogram (frequencies and amplitudes of vibrations of centre-of-mass body) are led to by the improvements of function of static and dynamic equilibrium for children with scoliosis in a basic group (p<0,05) which is instrumental in forming of skills of constancy of pose.

On the basis of analysis of indexes of the cardiac-vascular and respiratory systems (index of Ruf’e, test of Genchi, test of Shtange) for children it is discovered with scoliosis, that implementation of the special complex of correcting physical exercises is instrumental in normalization of coordinating function breathings and circulation of blood (p<0,05), except for it creates positive influence on the nervous-muscular system, arthral-ligamentary vehicle, muscle-arthral and vestibular receptions (p<0,05).

Thus, due to the leadthrough of complex to the rehabilitation measures it was succeeded to normalize functional possibilities of spine in 24,1% children, to attain the improvement of carriage in 42,6% patients and to stabilize a scoliosis process in 28,7% children.

Consequently, the analysis of results of the conducted research testifies to efficiency of the offered method of physical rehabilitation of children with scoliosis. The well-proven necessity of leadthrough of rehabilitation measures is for child's preschool establishments, directed on a prophylaxis and treatment of violations of carriage, scoliosis I degree.

Conclusions.

1.    The offered method of physical rehabilitation is instrumental in proceeding in the proportion of physical development, removal of hypotaxia, between growth and weighing and to the improvement of spirometric indexes for children with scoliosis.

2.    The offered method of physical rehabilitation improves the functions of static and dynamic equilibrium, influences on forming of skills of constancy of body.

3.    Efficiency of the offered rehabilitation measures is instrumental in strengthening and endurance of muscles of the back, abdominal press which creates terms for forming of correct carriage and stabilizing of scoliosis process.

4.    Application of the special complex of correcting physical exercises is created by positive influence on the nervous-muscular system, arthral-ligamentary vehicle, muscularly-arthral and vestibular a reception.

5.    The offered program of physical rehabilitation is directed on the correction of rachiocampsis and training of the cardiac-vascular and respiratory systems.

6.    Offered program of physical rehabilitation with including of round-the-clock observance of the orthopedic mode, daily engaged in a medical gymnastics (special symmetric, asymmetric and detorsitic of exercises), mass therapy, with the elements of point massage, medical swimming, physiotherapy (electro stimulations of muscles), medical choreography, correcting gymnastics after daily sleep (implementation of playing exercises in initial position, lying with the purpose of preparation of muscles to active and effective work upended) answers medical and hygienically requirements, represents a sequence, intensity and correlation of facilities and methods of physical rehabilitation of children of preschool age with scoliosis I degree.

7.    Application of the offered program of physical rehabilitation in the specialized preschool establishments allows to prevent scoliosis deformation, fix the health of children with scoliosis, to increase their motive activity and to form hygienically skills for children.