rospedРоссийский педиатрический журнал имени М.Я. СтуденикинаM.Ya. Studenikin Russian Pediatric JournalФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/1560-9561-2022-25-5-337-343kitxrorosped-207Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL INVESTIGATIONSКомплексное восстановительное лечение нарушений осанки у детей с дисплазией соединительной тканиСomprehensive restorative treatment of posture disorders in children with connective tissue dysplasiahttps://orcid.org/0000-0001-5383-0225МетальниковАнтон ИвановичMetalnikovAnton I.

Канд. мед. наук, доцент, и.о. зав. каф. хирургических болезней детского возраста ФГБОУ ВО АГМУ Минздрава России.

e-mail: ametalnickov@yandex.ru

MD, PhD, Associate Professor, Acting head Department of Surgical Diseases of Pediatrics, Altai State Medical University, Barnaul, 656038, Russian Federation.

e-mail: ametalnickov@yandex.ru

ametalnickov@yandex.ruhttps://orcid.org/0000-0003-4002-6478ТенЮрий ВасильевичTenYuri V.

Доктор мед. наук, проф. каф. хирургических болезней детского возраста ФГБОУ ВО АГМУ Минздрава России.

noemail@neicon.ruhttps://orcid.org/0000-0002-8586-1330СтрозенкоЛюдмила АнатольевнаStrozenkoLudmila A.

Проф., доктор мед. наук, директор Института педиатрии ФГБОУ ВО АГМУ Минздрава России.

noemail@neicon.ruФГБОУ ВО «Алтайский государственный медицинский университет»; КГБУЗ «Детская городская поликлиника № 9»Altai State Medical University; Children’s City Polyclinic No. 9ФГБОУ ВО «Алтайский государственный медицинский университет»; КГБУЗ «Алтайский краевой клинический центр охраны материнства и детства»Altai State Medical University; Altai Regional Clinical Center for Maternal and ChildhoodФГБОУ ВО «Алтайский государственный медицинский университет»Altai State Medical University202214092023255337343Copyright © Метальников А.И., Тен Ю.В., Строзенко Л.А., 20232023Метальников А.И., Тен Ю.В., Строзенко Л.А.Metalnikov A.I., Ten Y.V., Strozenko L.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rosped.ru/jour/article/view/207Введение

Введение. При дисплазии соединительной ткани (ДСТ) поражения характеризуются распространённостью и системностью, в патологический процесс вовлечены многие органы и системы.

Цель

Цель: разработать комплексную программу восстановительного лечения нарушений осанки у детей на фоне ДСТ.

Материалы и методы

Материалы и методы. Под наблюдением находились 90 детей в возрасте 4–17 лет. Из них 60 пациентов с ДСТ были распределены на опытную группу (30 детей) и группу сравнения (30 детей). Под диспансерным наблюдением эти дети с ДСТ находились с 2010 по 2020 г. Референтную группу составили 30 условно здоровых детей того же возраста. Все дети комплексно обследовались. Всем пациентам с ДСТ весь период диспансерного наблюдения проводили комплексное восстановительное лечение с использованием методов лечебной физкультуры, плавания и обучения пациентов в образовательной школе «Коррекция осанки» для детей.

Результаты

Результаты. У всех детей с ДСТ выявлены характерные признаки наследственных нарушений развития соединительной ткани. Установлено повышение концентраций оксипролина в сыворотке крови и увеличение экскреции с мочой оксипролина и кальция. Через 5 лет от начала проведения реабилитационных мероприятий отмечалось увеличение выносливости мышц спины, минимальное число патологических проявлений, в том числе артритов, артралгических синдромов, кокцигодиний. Через 10 лет у детей опытной группы в возрасте 14 лет формировались хорошая осанка и состоятельный мышечный корсет, отмечено минимальное число осложнений. Пациенты группы сравнения чаще предъявляли жалобы на чувство усталости, длительные некупируемые боли в грудном и поясничном отделах позвоночника, слабый мышечный корсет.

Заключение

Заключение. При выявлении признаков ДСТ у детей следует проводить длительное диспансерное наблюдение в амбулаторно-поликлинических условиях с включением комплекса восстановительного лечения в сочетании с упражнениями лечебной физкультуры и реабилитационными мероприятиями. При начальных проявлениях ДСТ со стороны позвоночника детям следует рекомендовать использование спинодержателя или полужёсткого корсета на время усиленных нагрузок, выполнения уроков, длительных тренировок.

Участие авторов

Участие авторов:Метальников А.И. — концепция и дизайн исследования, сбор и обработка материала, написание текста, статистическая обработка материала;Тен Ю.В., Строзенко Л.А. — редактирование.Все соавторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.

Финансирование

Финансирование. Работа не имела финансовой поддержки.

Конфликт интересов

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов. 

Поступила 25

Поступила 25.08.2022 Принята к печати 20.09.2022 Опубликована 31.10.2022

Aim is to develop a comprehensive program of restorative treatment of posture disorders in children against the background of connective tissue dysplasia. 

Materials and methods

Materials and methods. Ninety children aged from 4 to 17 years were under observation. Of these, 60 patients with connective tissue dysplasia (CTD) were divided into an experimental group (30 children) and a comparison group (30 children). These CTD children were under medical supervision from 2010 to 2020. The reference group consisted of 30 conditionally healthy children of the same age. All children were comprehensively examined. All СTD patients during the entire period of dispensary observation underwent comprehensive restorative treatment using methods of physical therapy, swimming and teaching patients at the educational school “Posture Correction” for children. The data obtained were processed statistically.

Results

Results. Characteristic signs of hereditary disorders of connective tissue development were revealed in all CTD children. An increase in the concentration of oxyproline in the blood serum and an increase in urinary excretion of oxyproline and calcium were found. After 5 years from the start of rehabilitation measures, there was an increase in endurance of the back muscles, a minimum number of pathological manifestations, including arthritis, arthralgic syndromes, coccygodynia. Ten years later, at the age of 14 years, the children of the experimental group formed a good posture, a well-off muscular corset and a minimal number of complications. Patients of the comparison group during the observation process more often complained of a feeling of fatigue, prolonged, incurable pain in the thoracic and lumbar spine, weak muscle corset.

Conclusion

Conclusion. If CTD signs are detected in children, long-term dispensary observation should be carried out in outpatient conditions with the inclusion of a set of exercises of physical therapy and other rehabilitation measures. With the initial CTD manifestations on the part of the spine, children should be recommended to use a back support or a semi-rigid corset for the duration of increased loads, lessons, and long training sessions.

Contribution

Contribution:Metalnikov A.I. — concept and design of the study, collection and processing of material, writing the text, statistical processing of the material;Ten Yu.V., Strozenko L.A. — editing.All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment

Acknowledgment. The study had no sponsorship.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Received

Received: August 25, 2022Accepted: September 20, 2022Published: Octoder 31, 2022

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The authors declare that there are no conflicts of interest present.