Results of complex abilitation of children with the diskinetic form of infantile cerebral palsy. Clinical example

Authors of this article consider results of complex abilitation of children with the diskinetic form of infantile cerebral palsy on the example of the concrete child at the age of 4 with this form of the disease with the myoclonic syndrome. The detailed investigation permitted authors to reveal in this girl both the characteristic symptoms, typical of patients with the diskinetic form of infantile cerebral palsy, and the specific peculiarities, connected with the myoclonic syndrome. From the point of view of authors, the following features belong to the first ones: presence of several stereotypes of walking, high cadence, weak control of change of cadence and step length, flexion position at the joints of the lower extremities, remarkable variability of the biomechanical and electromyographic indices, increase of angle of flexion at a knee joint (KJ) in the stance phase of the step, shift of the extreme values of the angular displacements to the right along the temporal axis, increase of electrical activity of muscles and its prolongation during the locomotor cycle. Quite other peculiarities of walking are noted during the myoclonic attack, which worsen the disorders of the biomechanical and innervative structure of walking to greater extent, namely, increase of duration of the locomotor cycle, diminution of duration of the stance phase and growth of duration of the swing phase, decrease of duration of the extension phase and growth of duration of the flexion phase at the given joints, two–stepped character of angle of flexion at a KJ and HJ in the left leg, oscillatory character of movements at the same joints in the right leg, appearance of the great and simultaneous maximums of activity of a number of muscles. Authors thoroughly considered necessity of complex abilitation with application of children’s exoskeleton in this child with the diskinetic form of infantile cerebral palsy. Authors described in details peculiarities of application of the children’s exoskeleton, organization and program of everyday trainings. Authors demonstrated, that the expressed improvement of the locomotor function is observed already after five sessions of training in the exoskeleton: only one locomotor stereotype is remained, remarkable variability of parameters of walking disappears, walking velocity and cadence are diminished, transfer from «running» as the only possible way of locomotion to walking takes place, amplitude of movements at a hip and knee joints considerably decreases, for all this duration of the separate phases grows.