ORTHOSIS MANAGEMENT OF CHILDREN WITH SPASTIC FORMS OF CEREBRAL PALSY: COMPARATIVE ANALYSIS OF THE INITIAL FILLING OF THE INDIVIDUAL REHABILITATION AND HABILITATION PROGRAM AND RECOMMENDATIONS OF THE MEDICAL AND TECHNICAL COMMISSION

Abstract

Introduction. Cerebral palsy (CP) is one of the most common neurological causes of childhood disability. In patients with cerebral palsy, the underlying disease is often complicated by secondary orthopedic disorders, for the prevention of which orthopedic methods of treatment, including orthoses and other technical means of rehabilitation (TMR) are widely used. Funding for orthosis is carried out from the Federal budget on the basis of an individual program of rehabilitation and habilitation (IPRH) of a disabled child. IPRH, in turn, is filled in taking into account the appointments of the attending physician of the orthopedist. Purpose. To analyze the compliance of recommendations on orthosis, initially introduced in the IPRH, and clinical recommendations of the medical and technical commission (MTC) of the rehabilitation Center for disabled children with spastic forms of cerebral palsy. Materials and methods. Conducted a prospective analysis of IPRH and MTK findings was made in a group of 63 disabled children aged 2 to 17 years, formed by random sampling. All patients were divided into 5 groups depending on the level of motor activity in accordance with the classification of GMFCS. Results. There were statistically significant differences (p < 0.05) between the number of orthoses initially introduced into the IPRH and the recommended MTK with a fluctuation of the visibility index depending on the group (GMFCS) from 38.9% to 56.0%. Summary. All groups noted the need for orthopedic equipment recommended by the MTC and not included primarily in the IPRH, which suggests the need for a multidisciplinary approach to the selection of TMR, including orthoses for children with spastic forms of cerebral palsy. The level of motor activity is an important expert factor in the formation of IPRH recommendations: with a decrease in the level of motor activity, the number and range of orthoses required for the patient increases. The maximum number of orthoses is recommended for additional introduction in IPRH, noted in patients in groups 3 and 5 of GMFCS.