EFFECTIVENESS OF THE COMBINED USE OF ROBOTIC KINESIOTHERAPY AND BOTULINUM THERAPY IN THE COMPLEX REHABILITATION OF CHILDREN WITH CEREBRAL PALSY

摘要

Objective: The objective of this study is to evaluate the effectiveness of combined use of robotic kinesiotherapy and botulinum therapy in the complex rehabilitation of children with spastic diplegia. Methods: In the research, 162 children were participated in the age from 4 to 6 years with spastic diplegia. The main group was carried out using robotic kinesiotherapy with the help of the Lokomat complex and intramuscular injection of botulinum toxin type A (BtA), as a part of complex rehabilitation. Children from the control group received rehabilitative treatment with traditional methods. Results: During the comparative study of groups, higher results were obtained in the main group, where average according to Gross Motor Function Measure 88 increased from 69.99 to 76.41 with a difference of 6.42 points (p=0.0001). In the control group, this indicator increased from 67.01 to 69.41 with a difference of 2.4 points. In the main group, a moderate coupling was noticed between overall motor activity improvement and muscle tone improvement (rs=0.411, p=0.001). Herewith, the correlation was pronounced more with children of the III level in Gross Motor Function Classification System (rs=0.483, p=0.002) in comparison with the II development level (rs=0.304, p=0.042). Conclusion: Research results indicated that the children with spastic diplegia have significant improvement in motor characteristics when the combined applying of robotic walking and botulinum therapy compared with conventional therapy. In our opinion, the data obtained allow to recommend this method as one of the perspective methods of rehabilitation treatment for children with spastic forms of cerebral palsy.