In recent years increased the prevalence of functional disorders among children and adolescents. They predominate in the skeletal muscle (23,3%), nervous system and mental sphere (15.8 per cent), endocrine system and metabolism (13,6%) [Baranov A. A., 2005]. In this regard, it is appropriate to talk about somatic dysfunctions. It is known that “somatic dysfunction is impaired function of related components of somatic system: skeletal, articular and myofascial structures and their vascular, lymphatic and neural elements” (who, 2005). Somatic disorders lead to profound disorders of all organs and systems [Auquier O. 1997; Frymann V. M. 1998; Lopushansky, P. G., 2001]. This makes it important to diagnosis, interpretation of somatic dysfunctions and their manifestations to substantiate effective methods of treatment [B. Grenier 1986; Bobko, J. N. 2000; Lopushansky, P. G. 2001; Bratova E. A. 2004; Kulikov, A. M. 2004; Krivonosov, I. V. 2005.
To further improve the medical care of children and ensure its necessary implementation in practice of effective methods of diagnostics, treatment and rehabilitation [Sharapova O. V. 2005]. In recent years, widespread in clinical medicine have received diagnostic and therapeutic techniques included in the set of classical orthopedics and manual medicine. One of the most important tasks in the field of perinatal medicine is to create a system of prediction, early diagnosis, development of standardized programmes for the treatment and rehabilitation of patients in the neonatal period and during all subsequent age periods of life [Volodin N. N. 2004.
However, a number of aspects of children’s health in relation to the assessment of risk factors for the development of somatic dysfunction and the frequency of their occurrence is not solved fully. Insufficiently investigated features of the functional state and correction of adaptive capabilities of the organism in young children with somatic dysfunction. This necessitates the development of programs of manual technology of rehabilitation treatment in the correction of functional shifts in children of early age with somatic dysfunction. Not enough questions designed predictive assessments of the effectiveness of rehabilitation treatment of somatic dysfunction in children, as important events in the protection of their health.
^ The purpose of the study . improving the quality of diagnosis and effectiveness of programs of rehabilitation of children of early age with somatic dysfunctions through the application of modern technologies of regenerative treatment.
To achieve this goal it was necessary to solve the following problem.
For many years the accounting data to estimate the contribution of somatic dysfunction in the structure of morbidity of children of early age.
To develop a predictive model of the severity of somatic dysfunction in children in the first 3 years of life.
To evaluate the functional state of the organism at somatic dysfunctions, to identify the features most important parameters, the nature of the functional changes in children depending on age and gender characteristics and the severity of the violations using modern diagnostic technologies of restorative medicine.
To substantiate and to develop the best program manual technologies of rehabilitation treatment for the rehabilitation of children of early age with somatic dysfunction.
A comparative evaluation of the effectiveness of therapeutic and rehabilitation measures (standard program and the manual technology of rehabilitation treatment) in children with somatic dysfunction.
To substantiate the criteria and algorithm of the forecast of success of rehabilitative treatment of children with somatic dysfunction.
^ Scientific novelty. For the first time on the basis of complex clinical-physiological examinations revealed features of the functional state of children of early age with somatic dysfunction. The role of the clinical, physiological and functional parameters in the dynamics of somatic dysfunction of varying severity and choice of optimal programs of treatment and rehabilitation in children with the purpose of improving their health and quality of life.
The author first proved that the nature and degree of severity of functional changes in the organism of children significantly correlated with age and severity of somatic dysfunction. In the dynamics of observation when exposed to a standard software manual technology restorative treatment new data have been obtained concerning the characteristics of the functional state of the cardiovascular system in young children with somatic dysfunctions (boys and girls up to 1 year). According to the results of the multiple correlation and factor analyses the new data allow to clarify some features of compensatory reactions during the development of somatic dysfunctions in children of early age.
It is established that manual methods of rehabilitation technologies of treatment and diagnostics objectively reflect pathophysiological disturbances of the functional state of organism of children with somatic dysfunction. Scientifically proved to use manual technologies in the correction of infringements of a functional condition of an organism of children with somatic dysfunction.
We first studied the nature of somatic dysfunction and the assessment of their contribution in the structure of morbidity of children of early age. Analyzed the main risk factors for the development of somatic dysfunctions and their prevalence depending on the age of the children. The interrelation of the main risk factors with indicators of functional state of organism of children and their importance in the development of somatic dysfunction in different age periods of a child’s life. A leading role (with a total contribution to the total dispersion of about 83%) factors in the pathology of childbirth, the condition of the fetus and the health of the mother during pregnancy in the structure of risk factors for the development of somatic dysfunction that should be considered when creating the system of protection of health of children of early age.
Performed research and the obtained materials expand scientific understanding of the diagnostic significance of modern chiropractic diagnostic technology, rehabilitation medicine in the comprehensive assessment of young children with somatic dysfunctions, which is important for the diagnosis and selection of optimal rehabilitation programs rehabilitation treatment and monitoring its effectiveness.
^ Practical significance. The results of the conducted research allowed to substantiate scientifically the organizational-methodological recommendations for integrated assessment and forecast of the success of restorative treatment in young children that allows to increase the effectiveness of prevention, treatment and rehabilitation measures to maintain and restore their health.
Identified the main risk factors of somatic dysfunction, criteria and algorithm for prediction of somatic dysfunction of varying severity that allows you to control, accounting and risk management and directly aimed at the development of organizational-methodical principles of protection of health of children of early age. The proposed set of valid indicators manual testing for the diagnosis of the condition and optimize the process of rehabilitation in children with somatic dysfunction.
In dynamics over the next (immediately) and long-term periods (1-2 years and age of children, equal to 5-6 years) when exposed to a treatment and rehabilitation (the common standard programs and manual technologies of rehabilitation treatment) evaluated functional profiles of children (cardiovascular, musculoskeletal, digestive and nervous system, somatic, speech therapy status and psychomotor development). This allows us to develop practical recommendations to control the development and status of children as the most important events in the protection of their health.
The peculiarities of the functioning of the organs and systems of child organism, allowing to estimate the degree of tension of regulatory mechanisms during somatic pathology early age and adaptive capacity of the organism, as a methodological basis of prevention of diseases. The features of psychomotor development of children of different ages with somatic dysfunctions in the dynamics of rehabilitation treatment (immediately, in 1-2 years and at the age of 5-6 years.
The work reflected in practical activities of doctors of children’s polyclinics of St. Petersburg, city of rehabilitation centers when conducting medical and rehabilitative measures, as well as in the educational process of the medical Academy of postgraduate education departments and departments of medical universities of the country in the training of physicians in Pediatrics, neurology and rehabilitation medicine.
^ The main provisions for the thesis defense.
1. Developed the criteria and algorithm for prognosis of the severity of somatic dysfunctions based on the frequency of occurrence of possible risk factors, and relationship with indicators of functional state of organism of children, improve the effectiveness of prevention, treatment and rehabilitation measures in the system of protection of health of children of early age.
2. Widespread somatic dysfunction in the structure increased child morbidity, manifested by unfavorable functional shifts in cardio-respiratory system, disorders in the activity of the musculoskeletal, digestive, and urogenital systems, neurology, speech therapy and orthodontic status, as well as in psychomotor development require the development of new technologies of restorative medicine and testing a model of rehabilitation of children of early age with somatic dysfunction.
3. High performance programs manual technologies in the diagnosis and correction of adverse functional changes in somatic dysfunction determine the feasibility of their use in the practice of restorative treatment in young children.