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1 . 2021

Development of extended motor regime in patients with spinal cord injury based on the tolerance parameter to physical load in categories of the International classification of functioning

Abstract

Background. To organize an extended motor regime for children with spinal cord injury (SCI) is an actual task because of the lack of clear criteria justifying the choice of volume, intensity and regime of motor loading when developing a comprehensive program for rehabilitation at Stage I.

Aim - to study the response of functional systems to passive work and to define assessment criteria for extended physical activity which are applicable in clinical practice. To use the defined tolerance criteria in ICF categories for extending the motor regime in children with SCI at an early rehabilitation stage.

Material and methods. 61 children, aged 8-18, with isolated SCI below level C5 who were admitted to the Clinical and Research Institute of Emergency Pediatric Surgery and Trauma (CRIEPST) in 2018-2020 had a course of early rehabilitation. All patients were taken into a 25-day motor rehabilitation program. Before enrolling into the study, all children were tested for physical tolerance with the ergospirometry technique. A total physical tolerance (b4550 by ICF) was assessed with a four-step test having an increasing physical load; aerobic reserve (b4551) was defined by cardiorespiratory testing with O2 peak consumption (peak VO2); anaerobic threshold, fatigue (b4552) were assessed at a repeated test with the respiratory equivalent (RQ) at rest and at dynamics based on VO2 peak value.

Results and discussion. All children were divided into three groups depending on the results of their testing with stepped physical load increase. At the initial testing, only 24 (39.3%) children passed a four-step test. Given these findings and individual patient's potential, a personalized motor rehabilitation program was developed for each patient. At the repeated testing, 54 (94%) children passed the same test with a four-step load increase. Aerobic reserve at the end of rehabilitation course showed an increase of VO2 peak by 51%. It clearly indicates an improved tolerance to physical loading due to a properly developed program of motor rehabilitation.

Conclusion. A properly developed program for motor rehabilitation which takes into account indexes of physical tolerance, aerobic reserve and fatigue can improve physical tolerance and can promote the developed of a proper program for motor regime in patients with SCI.

Keywords:spinal cord injury, children, motor rehabilitation, tolerance to physical loading, ergospirometry, cardiorespiratory testing, total physical tolerance, aerobic reserve, fatigue

Funding. The study had no sponsor support.

Conflict of interests. The authors declare no conflict of interests.

Contribution. Concept and design, analysis of the data obtained, text writing, editing - Novoselova I.N.; research, provision and analysis of the data obtained - Ponina I.V.; research, exercise therapy classes, analysis of the data obtained - Machalov V.A.; editing, approval of the final version of the article - Valiullina S.A.

For citation: Novoselova I.N., Ponina I.V., Machalov V.A., Valiullina S.A. Development of extended motor regime in patients with spinal cord injury based on the tolerance parameter to physical load in categories of the International classification of functioning. ORGZDRAV: novosti, mneniya, obuchenie. Vestnik VSHOUZ [HEALTHCARE MANAGEMENT: News, Views, Education. Bulletin of VSHOUZ]. 2021; 7 (1): 101-11. DOI: https://doi.org/10.33029/2411-8621 -2021-7-1-101-111 (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Guzel E. Ulumbekova
MD, MBA from Harvard University (Boston, USA), Head of the Graduate School of Healthcare Organization and Management (VSHOUZ)

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