Caused by Kozyavkin© method changes in hand function parameters in children with spastic form of cerebral palsy and their EEGs, HRVs and GDVs accompaniments

Background. 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 and such a variety of changes is due to differently directed changes in the background activity of the nerve centers. Aime: 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. Material and research 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 muscular 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. The method of cluster analysis retrospectively highlighted two distinct groups-clusters. In 9 children, rehabilitation led to favorable changes in the parameters of the function of the hands, while in 3 children they turned out to be unfavorable. The method of discriminant analysis revealed that unfavorable changes are accompanied by a decrease in the asymmetry of the θ- and δ-rhythms, the spectral power density (SPD) of β-rhythm in loci F8 and Fp1, instead, it increases in loci O1 and T3, leading to left-sided lateralization of the β-rhythm. At the same time, the SPD of the α-rhythm in locus O1 and the θ-rhythm in locus F4 rises as well as its Deviation. These changes in the EEG are accompanied by a reduction in vagalis and an increase in sympathetic tones. Among the GDVs parameters, an increase in the area of the GD Image in the frontal projection, coupled with a decrease in its Entropy in the frontal and left projections, was found. Instead, favorable changes in the parameters of the hand function are accompanied by opposite changes in the listed EEGs, HRVs and GDVs parameters or their absence. Conclusion. Among 14 observed children with spastic forms of cerebral palsy caused by Kozyavkin© method changes in functional tests of hand are favorable in 11. Adverse changes in 3 children are accompanied by characteristic changes in a number of EEGs, HRVs and GDVs parameters, which in the long run will be corrected by electrostimulation of the corresponding nervous structures

ПРОГНОЗУВАННЯ ЗМІН МОТОРНОЇ ФУНКЦІЇ РУК ВНАСЛІДОК ЗАСТОСУВАННЯ МЕТОДУ КОЗЯВКІНА® У ДІТЕЙ ІЗ СПАСТИЧНОЮ ФОРМОЮ ЦЕРЕБРАЛЬНОГО ПАРАЛІЧУ ЗА ЇХ ПОЧАТКОВИМ РІВНЕМ, А ТАКОЖ ЗА ПОКАЗНИКАМИ ЕЕГ, ВСР ТА ГРВ

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 D2M 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 (D2M=116; p=0,011). Additional inclusion in the model the parameter of GDV leads to a further increase in the reliability of the forecast (D2M=222; p=0,011), which reaches the maximum with the consideration of the BB test of the right hand (D2M=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.Ранее мы сообщали, что у детей со спастической формой церебрального паралича (CФЦП) после двухнедельного курса реабилитации по методу Козявкина© тесты на моторную функцию рук менялись неоднозначно (у 11 из 14 улучшались, однако у 3 ухудшались), и такие изменения сопровождались разнонаправленными изменениями ряда параметров ЭЭГ, вариабельности ритма сердца (ВРС) и газорозрядной визуализации (ГРВ). Цель исследования – выявить особенности изменений параметров ЭЭГ, ВРС и ГРВ у детей с благоприятными и неблагоприятными изменениями параметров моторной функции рук, а также выяснить возможность предсказать характер изменений моторной функции рук по совокупности начальных параметров организма. Материал и методы. Объектом наблюдения было 14 детей (6 девочек и 8 мальчиков) в возрасте 8–15 лет с СФЦП. Состояние моторного развития по шкале GMFCS было на уровне II ÷ IV. Функциональное состояние рук по шкале MACS было на уровне II ÷ III. Оценка функции рук осуществлялась с помощью динамометрии (D), теста «коробка и блоки» (BB) и теста «девять лунок и кольев» (NHP). Мы регистрировали также компоненты мышечного тонуса с помощью устройства «NeuroFlexor» (Aggero MedTech AB, Швеция), параметры ВРС и EEГ одновременно с помощью аппаратно-программного комплекса «Cardiolab + VSR» и «NeuroCom Standard» (ХАИ Медика, Харьков, Украина), а также параметры ГРВ «GDV Chamber» («Biotechprogress», СПб, РФ). Результаты. Методом дискриминантного анализа выяснено, что прогнозирование только по полу, шкале MACS, ВВ тестом левой руки и вязкой компонентой мышечного тонуса, несмотря на безошибочность, все же недостаточно надежное (квадрат расстояния Mahalanobis D2M между кластерами 6,85; p=0,208). Зато дискриминантная модель на основе 7 параметров ЭЭГ и ULF полосы ВРС уже вполне надежна (D2M=116; p=0,011). Дополнительное включение в модель параметра ГРВ ведет к дальнейшему повышению надежности прогноза (D2M=222; p=0,011), которая достигает максимума при учете ВВ теста правой руки (D2M=262; p=0,002). Вывод. Характер изменений параметров моторной функции рук в результате курса реабилитации по методу Козявкина© кондиционируется как их начальным уровнем, так и совокупностью параметров ЭЭ, ВРС и ГРВ и подвергается надежному прогнозированию