Stages of physical rehabilitation in children with perinatal pathology of the central nervous system

Introduction. Phasing is the leading principle of medical rehabilitation, in which a sick child can receive a course of rehabilitation measures at all stages of medical care. The aim of the review is to determine the importance of physical rehabilitation in children with perinatal damage to the central nervous system (CNS). We have conducted a literature search on the topic in the following databases: PubMed, Google Scholar, RSCI, search depth of 10 years. The main principles of medical rehabilitation in children with perinatal lesions of the CNS are: correction of developmental disorders, starting from an early age, the use of a complex of various non-medicinal technologies, regularity, continuity, as well as integration into the work of relatives of a sick child, which implies their involvement in a continuous rehabilitation process. The range of physical methods used at different stages of rehabilitation in children with perinatal pathology is quite wide and includes tactile and kinesthetic stimulation of palms and fingers, massage, therapeutic gymnastics, kinesotherapy, hydrokinesotherapy, physiological positioning, gymnastics according to the method of V. Voit, kinesiotaping, fitball gymnastics, and physiotherapy. The stage-by-stage nature of medical rehabilitation, the timeliness of rehabilitation care, its continuity in various institutions, following a single concept in motor rehabilitation, and an integrated approach based on the anatomical and functional features of the development in children with perinatal CNS damage are the basis for effective recovery and contribute to the realization in the child’s motor and intellectual potential.

Contribution:
Kharitonova N.A., Basargina M.A., Lupandina-Bolotova G.S., Konova O.M. — concept and design;
Kharitonova N.A., Lupandina-Bolotova G.S., Illarionova M.S., Mitish M.D., Presnyakova E.D. — collection and processing of material;
Kharitonova N.A. — writing the text;
Kharitonova N.A., Basargina M.A., Konova O.M. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

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

Received: January 20, 2025
Accepted: March 18, 2025
Published: April 29, 2025

1. Liljin E.T., Doskin V.A. Pediatric Rehabilitation [Detskaya reabilitologiya]. Moscow: Littera; 2011. https://elibrary.ru/qlqopr (in Russian)

2. Nechaev V.S., Magomedova Z.A. The medical rehabilitation: history and definitions. Problemy sotsialnoy gygieny, zdravookhraneniya i istorii meditsiny. 2017; 25(4): 221–5. https://elibrary.ru/zmqrdv (in Russian)

3. Bombardirova E.P., Yatsyk G.V., Zainiddinova R.S. Non-drug rehabilitative treatments in neonatal infants with perinatal nervous system lesions. Rossiyskiy pediatricheskiy zhurnal. 2011; 14(3): 55–60. https://elibrary.ru/nxbjwb (in Russian)

4. Yatsyk G.V., ed. Algorithms for Diagnosis, Treatment and Rehabilitation of Perinatal Pathology in Small Children [Algoritmy diagnostiki, lecheniya i reabilitatsii perinatal’noy patologii malovesnykh detey]. Moscow: Pedagogika-Press; 2002. https://elibrary.ru/scmntz (in Russian)

5. Gace V., Olenev A.S., Kriuchkova D.I., Shuravin V.M. Preterm labour – a medical and social problem. Vestnik Rossiiskogo universiteta druzhby narodov. Seriya: Meditsina. 2016; (2): 110–5. https://elibrary.ru/twcvhl (in Russian)

6. Ohuma E.O., Moller A.B., Bradley E., Chakwera S., Hussain-Alkhateeb L., Lewin A., et al. National, regional, and global estimates of preterm birth in 2020, with trends from 2010: a systematic analysis. Lancet. 2023; 402(10409): 1261–71. https://doi.org/10.1016/s0140-6736(23)00878-4

7. Belyaeva I.A., Bombardirova E.P., Tokovaya E.I., Kharitonova N.A., Lazurenko S.B., Turti T.V., et al. Non-drug habilitation of children with perinatal affections of the nervous system. Voprosy sovremennoy pediatrii. 2017; 16(5): 383–91. https://doi.org/10.15690/vsp.v16i5.1802 https://elibrary.ru/ztiyjj (in Russian)

8. Pavlinova E.B., Savchenko O.A. Predictors of adverse neurological outcomes in premature infants: a modern view of the problem. Meditsinskiy vestnik Yuga Rossii. 2024; 15(3): 77–82. https://doi.org/10.21886/2219-8075-2024-15-3-77-82 (in Russian)

9. Shklyarenko A.P., Kovalenko T.G., Ulyanov D.A. Adaptive physical education service for premature infants: first-year rehabilitation means. Theoriya i praktika fisicheskoy kultury. 2021; (10): 86–8. https://elibrary.ru/ivqejg (in Russian)

10. Pankratieva L.L., Volodin N.N. Methodological problems of rehabilitation of premature children. Pediatriya. Zhurnal imeni G.N. Speranskogo. 2019; 98(2): 14–8. https://doi.org/10.24110/0031-403X-2019-98-2-14-18 https://elibrary.ru/vxfvao (in Russian)

11. Molloy E.J., Branagan A., Hurley T., Quirke F., Devane D., Taneri P.E., et al. Neonatal encephalopathy and hypoxic-ischemic encephalopathy: moving from controversy to consensus definitions and subclassification. Pediatr. Res. 2023; 94(6): 1860–3. https://doi.org/10.1038/s41390-023-02775-z

12. Cizmeci M.N., Wilson D., Singhal M., El Shahed A., Kalish B., Tam E., et al. Neonatal hypoxic-ischemic encephalopathy spectrum: severity-stratified analysis of neuroimaging modalities and association with neurodevelopmental outcomes. J. Pediatr. 2024; 266: 113866. https://doi.org/10.1016/j.jpeds.2023.113866

13. Caeyenberghs K., Clemente A., Imms P., Egan G., Hocking D.R., Leemans A., et al. Evidence for training-dependent structural neuroplasticity in brain-injured patients: a critical review. Neurorehabil. Neural. Repair. 2018; 32(2): 99–114. https://doi.org/10.1177/1545968317753076

14. Sun J., Wang X., Sun R., Xiao X., Wang Y., Peng Y., et al. Microglia shape AgRP neuron postnatal development via regulating perineuronal net plasticity. Mol. Psychiatry. 2024; 29(2): 306–16. https://doi.org/10.1038/s41380-023-02326-2

15. Zhauniaronak I.V., Smychek V.B. Risk factors for neurological disorders at an early age in premature babies with different gestational ages. Neurologicheskiy zhurnal imeni L.O. Badalyana. 2024; 5(2): 99–107. https://doi.org/10.46563/2686-8997-2024-5-2-99-107 https://elibrary.ru/xsvicq (in Russian)

16. Lemyre B., Chau V. Hypothermia for newborns with hypoxic-ischemic encephalopathy. Paediatr. Child Health. 2018; 23(4): 285–91. https://doi.org/10.1093/pch/pxy028

17. Karaganova E.Ya., Shalina R.I., Delsuz S.F., Kunyakh Zh.Yu. Hypothermia in the treatment of neonates who have undergone severe asphyxia. Immediate and long-term results. Rossiyskiy vestnik akuschera-ginekologa. 2023; 23(4): 50–7. https://doi.org/10.17116/rosakush20232304150 (in Russian)

18. Proietti J., Boylan G.B., Walsh B.H. Regional variability in therapeutic hypothermia eligibility criteria for neonatal hypoxic-ischemic encephalopathy. Pediatr. Res. 2024; 96(5): 1153–61. https://doi.org/10.1038/s41390-024-03184-6

19. Sharafutdinova D.R., Balashova E.N., Pavlovich S.V., Ionov O.V., Kirtbaya A.R., Zubkov V.V. Efficiency of recombinant human erythropoietin in extremely and very low birth weight infants. Neonatologiya: novosti, mnenie, obuchenie. 2018; 6(3): 41–53. https://doi.org/10.24411/2308-2402-2018-13001 https://elibrary.ru/yofxnj (in Russian)

20. Perepelitsa S.А. Early rehabilitation of newborns moved by perinatal hypoxia. Fizicheskaya i reabilitatsionnaya meditsina, meditsinskaya reabilitatsiya. 2020; 2(1): 71–8. https://doi.org/10.36425/rehab19287 https://elibrary.ru/iewibi (in Russian)

21. Khan M.A., Petrova M.S., Degtyareva M.G., Mikitchenko N.A., Smotrina O.U., Shungarova Z.Kh. Modern physical rehabilitation technologies for children with perinatal lesions of the central nervous system. Vestnik vosstanovitelnoy meditsiny. 2021; 20(4): 57–64. https://doi.org/10.38025/2078-1962-2021-20-4-57-64 https://elibrary.ru/pwfnuf (in Russian)

22. Basargina M.A., Fisenko A.P., Bombardirova E.P., Smirnov I.E., Kharitonova N.A., Illarionova M.S. Modeling of the sanogenetic developing environment and starting non-drug habilitation of premature infants. Rossiyskiy pediatricheskiy zhurnal. 2019; 22(6): 380–7. https://elibrary.ru/cbrlkw (in Russian)

23. Aksenov D.V., Zakharova N.I., Lavrentev S.N., Goryunova A.D., Ryumina I.I. Features of the transition of newborn children with pathology from tube feeding to breastfeeding. Meditsinskiy sovet. 2024; 18(19): 38–45. https://doi.org/10.21518/ms2024-488 https://elibrary.ru/cejsyn (in Russian)

24. Malysheva M.V., Nalobina A.N. Physiological substantiation of the formation of complexes of physical therapy for premature infants of the first year of life. Sovremennye voprosy biomeditsiny. 2021; 5(3): 239–49. https://doi.org/10.51871/2588-0500_2021_05_03_21 https://elibrary.ru/iieraz (in Russian)

25. Potapchuk A.A., Kazanskaya E.V. Physical rehabilitation of the children under one year with perinatal injuries of CNS. Uchenye zapiski Sankt-Peterburgskogo gosudarstvennogo meditsinskogo universiteta imeni I.P. Pavlova. 2016; 23(3): 24–7. https://elibrary.ru/xwqkfn (in Russian)

26. Lupandina-Bolotova G.S., Klochkova O.A. The key poses concept in the motor development assessment and rehabilitation of a child in the first year of life. Detskaya i podrostkovaya reabilitatsiya. 2023; (1): 42–50. https://elibrary.ru/flaxqz (in Russian)

27. Pavlyukova E.V., Davydova I.V., Lazurenko S.B., Yatsyk G.V., Konova O.M., Zimina E.P. Opportunities for prevention and rehabilitation treatment of the consequences of perinatal central nervous system damage in premature infants. Pediatricheskaya farmakologiya. 2018; 15(2): 159–67. https://doi.org/10.15690/pf.v15i2.1872 https://elibrary.ru/upgcpo (in Russian)

28. Voita V., Peters A. The Voita Principle. The Play of Muscles During Reflex Translational Movement and in Motor Ontogenesis [Printsip Vojty. Igra myshts pri reflektornom postupatel’nom dvizhenii i v dvigatel’nom ontogeneze]. Springer; 2016. (in Russian)

29. Kiselev D.A., Levkov V.Yu., Gubanov V.V., Kozlovsky I.V., Laisheva O.A., Panyukov M.V. Rehabilitation of patients diagnosed with infantile cerebral palsy using reflex gymnastics by Vojta method. Rossiyskiy meditsinskiy zhurnal. 2021; 27(1): 27–32. http://doi.org/10.17816/0869-2106-2021-27-1-27-32 https://elibrary.ru/bkyvrr (in Russian)

30. Kazanskaya E.V. Physical rehabilitation as a part of recovery treatment of prematures with CNS malfunctions. Nauchno-teoreticheskiy zhurnal «Uchenye zapiski». 2008; (12): 21–5. https://elibrary.ru/kubmdd (in Russian)

31. Basargina M.A., Dyaykina V.V., Mitish M.D., Lazurenko S.B., Maslennikova V.A., Kharitonova N.A. Choice of tactics for feeding premature babies with functional immaturity of movements of the articulatory apparatus (part 1). Neonatologiya: novosti, mnenie, obuchenie. 2021; 9(3): 16–22. https://doi.org/10.33029/2308-2402-2021-9-3-16-22 https://elibrary.ru/emnthj (in Russian)

32. Poluyanova E.D., Lupandina-Bolotova G.S., Basargina M.A. Hydrokinesotherapy in young children. Rossiyskiy pediatricheskiy zhurnal. 2023; 26(S4): 60. https://doi.org/10.46563/1560-9561-2023-26-S4-60 (in Russian)

33. Konova O.M., Akhmadullina D.I., Turti T.V., Ryazanov M.V. The influence of the pearl baths on the dynamics of cerebral circulation in the children presenting with the consequences of perinatal lesions in the central nervous system. Voprosy kurortologii, physiotherapy and lechebnoy fizicheskoy kultury. 2014; 91(1): 22–4. https://elibrary.ru/rvzpgp (in Russian)

34. Suvorova-Blanes N., Ermachenko N. Kinesiological Taping in Pediatrics [Kineziologicheskoe teypirovanie v pediatrii]. BBalance Tape; 2022. (in Russian)

35. Conradt E., Tronick E., Lester B.M. Evidence for neurobehavioral risk phenotypes at birth. Pediatr. Res. 2025; 97(1): 99–106. https://doi.org/10.1038/s41390-024-03353-7