Vol 13, No 4 (2014)

Lack of organizational model of rehabilitative patients care with congenital heart disease determines the relevance of the scientific justification for the creation of a rehabilitation centers network for patients after surgical treatment of congenital heart diseases in the Russian Federation. Following methods were used: questionnaires, monographic description, analytical, statistical data processing. A questionnaire survey of parents 8940 patients discharged from hospital of Scientific center of cardiovascular surgery named after A.N. Bakuleva Russian Academy of medical sciences in terms from October 2004 to January 2012, legislative acts relating to the field of study, the sources of domestic and foreign literature, technical documentation, design solutions for construction of children’s rehabilitation center. Most respondents noted the lack of availability of cardiac care in the life area. At the optimal structure of the organizational model of rehabilitation services to children with congenital heart disease after inpatient treatment for congenital heart disease, or the patient is discharged at the place of residence or, if there is evidence to the follow-up care, is sent to the second stage of rehabilitation in children’s rehabilitation center. After the end of the second phase of the rehabilitation of the patient is discharged home under medical supervision in the life area. In the future, when indicated, as well as for preventive child is sent to 3rd stage of rehabilitation in spa cardiology center..

The fundamental parameters that determine the effectiveness of physical rehabilitation are: - the results of applying the method of «decision tree»: a motor factor, the general movement, gross motor, vestibular stability, tension index, the total power spectrum of neuro-humoral regulation of heart rate, amplitude of the mode, the indicator vagosympathetic balance, the heart rate in a state of relative calm, and its growth in response on the orthostatic test. - According to the discriminant analysis: variables reflecting the response of the organism to carry out functional tests (% HF-,% LF-waves) which allow to evaluate the adaptive capabilities of the child. Using cluster analysis identified the integral index - the index of the effectiveness of rehabilitation, the magnification that characterizes the positive effect of reducing technologies.

The article is devoted to the organization of specialized orthopedic care for children. The authors analyzed two decades of experience of the St. Petersburg Children’s Rehabilitation Center of Orthopedics and Traumatology. The best achievements in the early diagnosis and treatment of musculoskeletal lesions were considered at organization of the Center in 1994. The purpose of organizing this type of institutions is to provide a comprehensive diagnosis and non-surgical intensive inpatient treatment with simultaneous full pedagogical support. Therefore the standards of rehabilitative hospital were applied to the medical diagnostic unit recruiting, while the standards of children’s sanatorium - to the educational service recruiting. The generalization of the experience convincingly demonstrates a high socio-economic efficiency of the institution, especially in patients with diseases and injuries of the spine. Acquired experience allows us to recommend an expanding of such institutions network and not only orthopedic ones.

The results and effectiveness of using the innovative technologies through the formation of individual style in the children with disabilities are represented in the article. The study involved 140 subjects (preschool children, 76 boys and 64 girls). The innovative technologies included: activation therapy, intermitted hypoxia therapy and functional music. The prospects of the use the innovative technologies in the rehabilitation programs for the children with disabilities are shown.

Actions aimed at the development deviations prevention of children with severe perinatal medical history or explicit perinatal pathology are proved to be complex by nature and should be simultaneously aimed at the primary development categories of a child. Advanced approach which prevents development deviations appearance serves for timely and correct formation of experiences and skills of babies. Participation of family in medical correction program enables portioned and prolonged impact on the baby’s organism. Collaboration of family and Healthcare Center, parents’ concern in treatment results contribute to the abilitation effectiveness. Courses for parents ‘Healthy Child’ were set up within the framework of Children Healthcare Center in order to tackle their problems. Prophylaxis of neuro-psychic development deviations of perinatal risk group children is the concept of the Courses’ sphere of actions. Teaching work with pregnant women falls into perinatal pathology prophylaxis, over diagnosis and correction of CNS perinatal damage at home immediately after birth. As soon as the child is one month old the work with the young family in Healthcare Center is continued. Young mothers regularly attend the Courses ‘Healthy Child’ with babies depending on individually built abilitation program. It is not only a medical correction program but also an educational one since further abilitation work is carried out by parents at home. Abilitation program of children with perinatal pathology or risk factors of its formation is at the same time prophylactic as it prevents the appearance of formed deviations in the development categories of children. Representatives of various specialists participate in the program for the sake of comprehensive help to perinatal risk group children: neonatologist, neurologist, masseur and therapeutic physical training specialist. The program also involves non-medical specialists (perinatal psychologist, speech therapist, educational psychologist) who play a significant role in the development of a child. The following non-medical methods are used in the abilitation program: dry immersion, massage, fine finger motor skill training, kinesitherapy, conductive pedagogics, therapeutic physical training, senses development method, articulation gymnastics and finger gymnastics.

The article provides the scientific rationale for the use of high-frequency chest wall oscillation (HFCWO) in the treatment of bronchitis in children. Clinical observations and special studies conducted in 50 children aged 6 to 15 years. Proved the possibility of the use of HFCWO in children with bronchitis, defined its therapeutic efficacy. Established tolerability of procedures and absence of adverse reactions. Found a beneficial effect on clinical symptoms, mucociliary clearance, which was characterized by increased sputum discharge, rapid regression and disappearance of cough, wheezing, normalization auscultation picture at an earlier date than in the control group. Combined therapy with the inclusion of high frequency chest wall oscillation improves lung function, as evidenced by the curve «flow-volume» parameters, especially when initially discounted rates. Vibro-compressive effect from airway clearance device The Vest® improves chest excursion and lung drainage function in children with bronchitis.

In Udmurt Republic was derived chloride bromine-iodine brine, which high efficiency has been proven in the treatment of digestive diseases in adults with by sinusoidal modulated currents.This medical factor has stable chemical mineral content, a large daily output, and suggests the possibility of its application in the treatment of gastrointestinal diseases in children. It was conducted the evaluation of quality of life in 92 school age children with functional dyspepsia and their parents were treated in the Republican Children’s Clinical Hospital in Izhevsk on treatment with balneology and physiotherapy factors. The study was performed using a questionnaire PedsQL (version 4.0). Complex of medical actions included diet, standard medical therapy. As the main factor used SMT-phoresis chloride bromine-iodine brine. In the comparison group used SMT-therapy. After the treatment aspects of quality of life based on self-assessment above all questionnaire PedsQL categories rate were upward then before treatment. This regularity significantly was expressed in the group of patients treated with CMT-phoresis brine. aspects of quality of life «physical functioning» and «emotional functioning» reacted At the spa therapy. During research were found that children living in rural areas have lower quality of life (scale of emotional and social functioning) than their peers residing in the city. During therapeutic measures rural children are catching up, and by some measures (physical functioning) and redistilled from their peers. It was establish a high informative importance of quality assessment life of children as a reliable non-invasive test the effectiveness of spa therapy.

The article examines the opportunities and the need for medical rehabilitation of children with obsruktivnoy uropathy considering the pathogenesis of the disease. Differentiated application of physical factors at all stages of medical rehabilitation, their use in complex therapy of children with obstructive uropathy can reduce adverse drug treatment times, improve renal function, restore urodynamics and prevent disease progression. The stationary phase of medical rehabilitation with a view to apply nephroprotective laser therapy, polarized light, for the relief of infectious complications - currents supersonic frequency microwave electrotherapy to restore urodynamic-electric-, magnetic stimulation. It is important to continue the rehabilitation of these children at a sanatorium stage, with the inclusion of mineral water, mud treatments, physiotherapy.