BACKGROUND: The problem of rehabilitation of patients with severe traumatic brain injury has been and remains very important and relevant for both adults and children. Patients with severe traumatic brain injury often develop severe physical, mental, emotional and cognitive impairments, which are often difficult to correct and require long-term treatment, including rehabilitation, relying solely on the body's potential, which is accompanied by a heavy financial burden for the patient, his family, and society in general. The introduction of new diagnostic methods, the improvement of resuscitation measures, the use of modern methods of neurosurgical intervention and timely rehabilitation can increase the proportion of children who survived after severe traumatic brain injury and their quality of life. AIM: to evaluate the effectiveness of medical rehabilitation of children with severe traumatic brain injury with the participation of a multidisciplinary rehabilitation team and relatives of patients. MATERIALS AND METHODS: The study included 50 children with severe traumatic brain injury. Two groups were distinguished by the randomization method: the main group 25 patients (50%) and the control group, which included 25 patients (50%). The follow-up period was 1 year after the onset of severe traumatic brain injury. In the main group, an individual plan for early rehabilitation was drawn up on the 2nd day after a severe traumatic brain injury in intensive care. At the first stage of rehabilitation, which is carried out in the intensive care unit and the neurosurgery department, an individual medical rehabilitation plan was developed for the children of the main group, depending on somatic indicators and the severity of the condition, and a rehabilitation diagnosis based on the International classification of functioning, disability and health was established. In the control group, after transfer from the intensive care unit to the specialized neurosurgical department, patients received basic rehabilitation therapy: articular gymnastics, paraffin therapy, and psychological support. RESULTS: In the main group, more effective changes were noted in domains associated with impaired structure and function of the nervous system, which led to improved activity and participation, self-service. In patients of the control group, there were no significant changes in the state of functions, activity and participation. CONCLUSION: The early start of complex medical rehabilitation of children with severe traumatic brain injury reduces disability and accelerates the process of the patient's socialization, which is more clearly demonstrated by the International classification of functioning, disability and health approach. The use of International classification of functioning, disability and health for with severe traumatic brain injury in children in medical rehabilitation departments is a good tool for setting rehabilitation goals, choosing rehabilitation measures and assessing the effectiveness of rehabilitation.
The frequency of underweight in children with cerebral palsy is about 60–70%. A benefit of nutritional support in children with cerebral palsy are underestimated. The use of nutritional support during active physical rehabilitation can have a positive effect on not only body weight, but also the component composition of the body and their rehabilitation potential.The aim of our study was to evaluate the effectiveness of nutritional support – a hypercaloric (1,5 kcal/ml) polymer formula with fibers (Pediashure 1,5 Fiber, Abbott) in children with cerebral palsy.Characteristics of children and research methods. Anthropometric indicators (body weight, height, body mass index, triceps skinfold thickness, subscapular skinfold thickness, mid-upper arm circumference, shoulder muscle circumference) and body composition were studied in 15 underweight children with cerebral palsy aged 4–10 years with the level of motor disorders GMFCSIII–IV. They were prescribed of nutritional support with a hyper caloric mixture (1,5kcal/ml) with fiber lasting 3months during active physical rehabilitation.Results. Against the background of nutritional support, there was a significant increase in body weight, height, z-score of body weight, mainly due to musculoskeletal, active cell and lean mass. In addition to correcting the nutritional status of children with cerebral palsy, an improvement in their motor abilities was noted.
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