rospedРоссийский педиатрический журнал имени М.Я. СтуденикинаM.Ya. Studenikin Russian Pediatric JournalФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/1560-9561-2021-24-6-433-436detnbsrosped-399Research ArticleОБЗОРЫREVIEWSЭффективность использования тренажёра «Экзобот» детьми с церебральным параличомEfficacy of using of the apparatus «Exobot» on the gait of a child with cerebral palsyhttps://orcid.org/0000-0003-2375-844XТабеЕвгения ЭженовнаTabeEvgeniya E.

Канд. мед. наук, зав. отделением амбулаторной нейроортопедии ФГАУ «НМИЦ здоровья детей»

e-mail: dr.tabe@mail.ru

Candidate of Medical Sciences, Head of the Department of Outpatient Neuro-orthopedics, National Medical Research Center for Children’s Health

e-mail: dr.tabe@mail.ru

dr.tabe@mail.ruhttps://orcid.org/0000-0001-8579-2227ШарковСергей МихайловичSharkovSergei M.

Доктор мед. наук, проф., руководитель операционного блока ГБУЗ Морозовская ДГКБ ДЗМ, проф. каф. детской хирургии и урологии-андрологии им. проф. Л.П. Александрова, ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова» Минздрава России (Сеченовский Университет)

e-mail: sharkdoc@mail.ru

sharkdoc@mail.ruФГАУ «Национальный медицинский исследовательский центр здоровья детей» Минздрава РоссииNational Medical Research Center for Children’s HealthФГАУ «Национальный медицинский исследовательский центр здоровья детей» Минздрава России; ГБУЗ «Морозовская детская городская клиническая больница» Департамента здравоохранения г. Москвы; ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)National Medical Research Center for Children’s Health; Morozovskaya Children Municipal Clinical Hospital; I.M. Sechenov First Moscow State Medical University202120022024246433436Copyright © Табе Е.Э., Шарков С.М., 20242024Табе Е.Э., Шарков С.М.Tabe E.E., Sharkov S.M.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/399

Детский церебральный паралич (ДЦП) характеризуется непрогрессирующим поражением головного мозга, но прогрессирующим каскадом вторичных заболеваний опорно-двигательного аппарата. Характерные изменения при ДЦП вызывают дисфункцию голеностопного, коленного и тазобедренного суставов, что сказывается на биомеханике ходьбы и приводит к трансформации последней в патологическую. Цель работы: определить влияние тренажёра «Экзобот» на биомеханику ходьбы детей с ДЦП. В обзоре авторы проводят сравнение нормальной и патологической биомеханики ходьбы детей с ДЦП с использованием Амстердамской классификации патологической походки, которая включает 5 типов в зависимости от положения коленного сустава и стопы по отношению к горизонтальной поверхности в фазе середины опоры. Несмотря на уровень развития ребёнка с ДЦП по классификации больших моторных функций и тип походки по Амстердамской классификации, все дети в фазе движения начинают контакт не с пятки, а с переднего отдела стопы. Это влечёт за собой ухудшение контроля баланса туловища и повышение затрат энергии на вертикализацию. Походка ребенка с ДЦП в тренажёре «Экзобот» за счёт фиксации стопы, голеностопного сустава и системы карабинов и эластичных тяг начинается всегда с пятки. Тем самым формируются правильный паттерн шага и мышечная память у ребёнка с ДЦП. Отмечается улучшение контроля за балансом равновесия со стороны больного ДЦП, повышается его мотивация к двигательному развитию.

Участие авторов

Участие авторов:Табе Е.Э. — сбор и обработка материала, написание текста;Шарков М.С. — редактирование.Все соавторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.

Финансирование

Финансирование. Исследование не имело финансовой поддержки.

Конфликт интересов

Конфликт интересов. Авторы подтверждают отсутствие конфликта интересов.

Поступила 23

Поступила 23.11.2021Принята к печати 17.12.2021Опубликована 29.12.2021

 

 

Cerebral palsy is characterized by non-progressive brain damage but a progressive cascade of secondary diseases of the musculoskeletal system. The characteristic changes in the infantile cerebral palsy lead to dysfunction of the ankle, knee and hip joints, which affects the biomechanics of walking and leads to the pathological transformation.

Purpose

Purpose: to determine the effect of the Exobot simulator on the walking biomechanics of children with cerebral palsy. The review compares the normal and pathological biomechanics of walking in children with cerebral palsy, starting from the Amsterdam classification of pathological gait, which includes five types depending on the position of the knee joint and foot concerning the horizontal surface mid-support phase. Despite the child’s level with cerebral palsy according to the classification of global motor functions and the type of gait according to the Amsterdam classification, all children in the contact phase begin contact not from the heel but the forefoot. This entails a deterioration in the control of the trunk balance and an increase in the energy consumption for verticalization. The gait of a child with cerebral palsy in the  Exobot simulator, due to the fixation of the foot, ankle joint and the system of carabiners and elastic rods, always begins from the heel.

Thus, the correct step pattern and muscle memory are formed in a child with cerebral palsy. There is an improvement in the control over the balance on the part of the child, his motivation for motor development increases.

Contribution

Contribution:Tabe E.E.  — collection and processing of material, writing text;Sharkov S.M. — 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: November 23, 2021Accepted: December 17, 2021Published: December 29, 2021

 

 

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