The habilitation in forming the skills of manual activity in children with defects of the hand

Purpose. To evaluate the efficiency of the proposed rehabilitation system for children with defects of the hand. Materials and Methods. The program of social-and-pedagogical rehabilitation and habilitation of preschoolers with congenital and acquired defects of the hand developed and implemented in order to perfect functional potential and to form social and everyday skills after surgical treatment and prosthetics using a system of didactic games. Habilitation under this program performed in 70 preschool children at the age of 3-7 years. Most children had congenital pathology of the hand - 61 (87 %) which was caused by disordering the linear and volumetric parameters of the upper limb (adactylia, hypoplasia, aplasia, split hand and partial gigantism) and nine (9) children (13.0 %) had acquired defects and deformities including amputation. 55 children (79.0 %) undergone the stage of surgical correction; 15 ones (21.0 %) - the stage of prosthetics. Most children taking part in the experiment had unilateral defects of the hand - 39 (56.0 %). The program aimed at solving specific methodological problems: the formation and perfection of all the possible types of grasp in the presence of existing defect of the hand, including the cases after surgery and prosthetics; the development of tactile sensations in the fingers; the development of fine motility; the increase of the range of motions in the joints of the defective hand; the development of attention and concentration; the formation of social and everyday skills according to the age; the development of the ability to achieve the set tasks. Results. As it was demonstrated by the analysis of the level of social-and-everyday skills in children with defects of the hand who underwent in-patient treatment, depending on the age before medical rehabilitation and habilitation, the finding of high level of social and everyday skills (31.0 %) observed in preschool children of the age group from three years comparing with children of other age groups. The rates for four- and five-aged children were slightly lower - 25.0 % and 25.9 %, respectively. The lowest values of the studied parameter registered in children at the age of six years - 20.6 %. Conclusion. The statistically significant parameters of functional potential level in terms of grasp and social-everyday skills in children with defects of the hand obtained during the study showed that the use of the system of didactic games increased the efficiency of treatment significantly regardless of the defect type. These data demonstrate the advisability of habilitation measures immediately after surgery or prosthetics because they significantly increase the overall efficiency of medical rehabilitation already at the early stages.