Combined use of osteopathic correction and transcranial micropolarization of the brain in the treatment of children with attention deficit hyperactivity disorder

Introduction. Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder that occurs in 5-8 % of school-age children and persists into adulthood in 60 % of cases. At the present stage of neurology development, a number of significant drawbacks have been noted in the pharmacological correction of ADHD: the need for a long course of medication, the problem of polypragmasia, side effects and allergic reactions. Thus, there is a real need to develop non-drug ways to correct ADHD. Previous studies have demonstrated a sufficiently high clinical efficacy of transcranial micropolarization of the brain in the treatment of this patients group. Some studies have shown the effectiveness of the osteopathic correction use, which can increase the effectiveness of selective and sustained attention in children with ADHD. At the same time, the question of the possibility of combining various non-drug methods of treatment is quite acute.The aim of the study is to research the feasibility of osteopathic correction using in combination with transcranial micropolarization of the brain in the complex treatment of children with ADHD.Materials and methods. A controlled randomized trial was conducted in the period from January 2018 to February 2020 in Ekaterinburg and St. Petersburg. 68 patients with the established diagnosis attention deficit hyperactivity disorder aged 6 to 10 years, including 42 boys and 26 girls, were under observation. All patients, depending on the used treatment method, were divided by simple randomization into two comparable groups: the main group — 34 people, 22 boys and 12 girls, average age 7,4±1,2 years; the control group consisted of 34 people, 20 boys and 14 girls, with an average age 7,8±1,1 years. Patients received drug therapy with hopanthenic acid in age-related dosages (30 mg/kg body weight), course duration of 2 months, and transcerebral micropolarization of the brain. Each patient received one course of micropolarization, consisting of 15 sessions, the duration of each session was 30 minutes. Patients of the main group received osteopathic correction in addition to the therapy described above. In total, 4 sessions of 60 minutes each were held. The interval between the first sessions was 10 days, between subsequent sessions — from 10 to 14 days. There were evaluated the osteopathic status, the severity of ADHD manifestations and the short-term memory indicators, and the type and properties of the nervous system were determined for all patients, regardless of the group, before the start of treatment, as well as after the completion of the course of complex therapy.Results. After the therapy, there was a statistically significant decrease (p<0,05) in scores quantity on the ADHD assessment scale (ICD-10 criteria) both in the main and in the control groups, which reflects a decrease in the severity of clinical manifestations of this syndrome and demonstrates the effectiveness of the used therapy methods. In patients of the main group who received osteopathic correction, compared with the control group, there was also a significant (p<0,05) decrease in the number of regional dominant somatic dysfunctions, an increase in short-term memory indicators and a change in the type and properties of the nervous system (from weak to stable).Conclusion. The therapy carried out both with the use of osteopathic correction and without it, equally leads to a decrease in the degree of manifestations of ADHD. This indicates the clinical effectiveness of both studied integrated approaches to the treatment of children with ADHD. At the same time, osteopathic correction in the treatment of patients with ADHD significantly increases the indicators characterizing short-term memory and changes the type of response of the nervous system. These changes can be regarded as a potential opportunity to increase the learning ability of children and improve their socialization.

FEATURES OF REHABILITATION OF MOTOR DISORDERS IN STROKE

Motor disorders are the most frequent and severe consequences of impaired cerebral circulation. Our study included 50 patients (24 women and 26 men) aged 50 to 74 years who had suffered an ischemic stroke. The main group included 25 patients with ischemic stroke who received transcranial micropolarization sessions together with standard pharmacotherapy. They showed an improvement in the motor function of the affected upper limb to a greater extent than in the comparison group

The effect of rehabilitation treatment on the electroencephalography results and the course of epilepsy in children with cerebral palsy

Introduction. Cerebral palsy is often combined with epilepsy and epileptiform electroencephalographic (EEG) activity. Currently, the question of how rehabilitation with cerebral palsy is dangerous in relation to the provocation of epileptic seizures is relevant. Objective: to study the effect of cerebral palsy rehabilitation on epilepsy in a standard rehabilitation center. Material and methods. We examined 80 children with various forms of cerebral palsy and epileptiform EEG activity. The patients were divided into two groups: children of Group 1 never had epileptic seizures, children of Group 2 had a history of epileptic seizures of more than 6 months ago. The follow-up was 12 months during which children underwent EEG before and after rehabilitation courses. Depending on the risks associated with provoking epileptic seizures, patients were prescribed rehabilitation procedures of various intensities: Vojta kinesiotherapy, massage, physiotherapeutic treatment in the form of transcranial micropolarization and paraffin therapy. Results. During the study, epileptic seizures developed in 5 patients (12.5%) from Group 1 and in 7 children (17.5%) from Group 2. In all cases, rare focal seizures were recorded (1–2 times a year). All patients with seizures during our study had a history of seizures under the age of 1 year. The onset of seizures was quickly stopped by the basic antiepileptic drugs in monotherapy. Epileptic seizures developed in children with moderate to severe cerebral palsy on GMFCS (Gross Motor Function Classification System) and a history of neonatal seizures. We attributed both of these to risk factors. In children with cerebral palsy and epilepsy in remission of 6 months or more, massage and Vojta therapy did not provoke epileptic seizures. The effect of epileptiform activity on the severity of motor status and on cognitive functions in cerebral palsy has not been established in our study. Conclusion. According to our data, rehabilitation measures do not have a significant impact on the risk of developing epilepsy.