FORECASTING CAUSED BY KOZYAVKIN© METHOD CHANGES IN HAND FUNCTION PARAMETERS IN CHILDREN WITH SPASTIC FORM OF CEREBRAL PALSY AT THEIR BASELINE LEVELS AS WELL AS EEG, HRV AND GDV

Abstract

Earlier we reported that in children with spastic forms of cerebral palsy (SFCP) after two-week course of rehabilitation by Kozyavkin© method the hand function tests changed ambiguously (in 11 children out of 14 were improved, but in 3 worsened), and these changes were accompanied by a variety changes in a number parameters of EEG, HRV and gas-discharge visualization (GDV).

The aim of this study – to identify the peculiarities of changes in the parameters of EEG, HRV and GDV in children with favorable and unfavorable changes in the parameters of the functions of the hands as well as to find out the possibility of predicting the direction of changes in motor function of the hands on the set of initial parameters of the organism.

Material and Methods. The object of observations were 14 children (6 girls and 8 boys) aged 8–15 years with SFCP. State motor development at GMFCS was on II–IV level. Functional status of the hand with MACS was at II–III level. The estimation of hand function carried out by Dynamometry (D), Box and Block Test (BB) and Nine Hole Peg Test (NHP). We registered also components of muscle tone by device “NeuroFlexor” (Aggero MedTech AB, Sweden), HRV and EEG parameters simultaneosly by hardware-software complex “Cardiolab+VSR” and “NeuroCom Standard” respectively (KhAI Medica, Kharkiv, Ukraine) as well as GDV parameters by “GDV Chamber” (“Biotechprogress”, St-Pb, RF).

Results. Using the method of discriminant analysis, 18 parameters were identified, the totality of which the initial state of children and their state after the various consequences of rehabilitation are significantly different from each other. It was found that prognostication by gender, the MACS scale, the BB test of the left hand and the viscous component of muscle tone, despite the uncertainty, is still not sufficiently reliable (the square of Mahalanobis distance D²_M between the clusters is 6,85; p=0,208). Instead, a discriminant model based on 7 parameters of the EEG and ULF power band of HRV is quite reliable (D²_M=116; p=0,011). Additional inclusion in the model the parameter of GDV leads to a further increase in the reliability of the forecast (D²_M=222; p=0,011), which reaches the maximum with the consideration of the BB test of the right hand (D²_M=262; p=0,002).

Conclusion. The character of the changes in the parameters of the motor function of the hands due to the course of rehabilitation by Kozyavkin© method is conditioned both by their initial level and by the set of parameters of EEG, HRV and GDV and is subject to reliable prediction.