[Individual profile of functional asymmetries in children with cerebral palsy in application of medical-training suit].
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Biomedical subjects
Publications and source records attributed to A N Sinel'nikova.
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Maintenance of vertical posture is a complex coordination act dependent on a multi-level system of regulation. Functional state of the visual system may contribute significantly to the implementation of the mechanisms of vertical posture maintenance. Stabilographic examination of healthy teenagers and patients afflicted with the main CCP forms with the method of dynamic proprioceptive correction revealed dependence of posture stability and involvement of the visual analyzer on sex.
The paper presents the study concerning influence of somatosensory stimulation (single wearing of either space loading costume "PENGUIN" or its modification--"ADELY" costume) on the individual profile of interhemispheral cerebral assymmetry (IPIHCA) in patients with spastic form of infantile cerebral paralysis (ICP). The computer stabilograph analyzed motor arms' asymmetry, sensory asymmetry of visual hemiareas, asymmetry of the position of centre of gravity. It is shown that peculiarities of the realization of the standing position either with visual control or without it both in healthy individuals and in patients depended on initial IPIHCA. Initial stability was higher in healthy individuals than in patients, besides in healthy persons it was higher in right-handers while in patients--in left-handers. There was possibility of changes of both IPIHCA and stability during keeping up vertical position even during single somatosensory stimulation. For elaboration of new criteria of the estimation of the efficiency of treatment in patients with CNS damages, including ICP, it is necessary to take into consideration different influence of somatosensory stimulation on IPIHC in right-handers and left-handers.
Presented are results of the investigations of individual profiles of the brain interhemispheric asymmetry (IPIHA) in healthy grown-ups and children prior to, during, and immediately after somatosensory stimulation. The somatosensory stimulation was performed by one-time wearing of space g-loading suit PENGUIN and its modification ADELIE. IPIHA was studied by the main functional asymmetries including motor hand asymmetry, sensory asymmetry of the visual hemispheres, body mass center asymmetry (BMA) using a computerized stabilimeter indirectly measuring the muscle tone of contralateral extensor. Results demonstrate differences in IPIHA of grown-ups and children, persons with right- and left-hand motor asymmetry. It was shown that peculiar features of standing posture acquisition with and without visual control are original IPIHA and age dependent. Initial stability was higher in grown-ups than children and right-handed grown-ups and left-handed children. IPIHA and stability of the vertical posture can be modified even during single somatosensory stimulation. Unequal effects of the somatosensory stimulation on IPIHA in right- and left-handed subjects of varying age dictate the necessity to allow for these differences when assessing effects of the somatosensory stimulation in grown-ups and developing criteria of effective therapy of patients with CNS pathology, specifically, infantile cerebral paralysis.
The paper presents and analyzes the results of assessment of vertical stability and walk in patients with infantile cerebral paralysis before and after dynamic proprioceptive correction, which is of great importance for differential diagnosis of different forms of this disease, for controlling the course of therapeutical measures, for working out criteria for the efficiency of treatment.
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Individual profiles of brain interhemispheric asymmetry (IPA) and stability in maintenance of the vertical posture have been studied in healthy children and adults and patients with the spastic form of the infantile cerebral palsy before and after visual stimulation. The IPA were built on the basis of motor asymmetry of hands, asymmetry of visual half-fields, and asymmetry of muscle extension tone in vertical position in Romberg test at computer stabilograph. The visual stimulation was realized by unilateral tachistoscopic administration of a verbal stimulus in the visual half-field on the side of worst detection of the master stimulus during the procedure of initial IPA construction. The IPA were different in children, adults, and patients. Even single visual stimulation changed the initial IPA (not only its visual but motor and stability-related components). A correlation was shown between the individual features of realization of the vertical position, initial IPA, age of the subjects, and presence/absence of the cerebral palsy. The visual stimulation led to a decrease in initially low stability and, on the contrary, an increase in initially high stability both in healthy subjects and patients with cerebral palsy, regardless of their handedness. Increase in stability of the vertical posture was accompanied by a decrease in the role of the visual analyzer, and, on the contrary, decrease in stability was associated with an increase in the role of the visual analyzer in stability control. It is necessary to take into account the dissimilar action of sensory stimulation on the IPA and stability of the vertical posture in assessment of the effects of sensory stimulation on healthy persons and patients with CNS lesions, in particular, with cerebral palsy, in the course of development of new ways of treatment.