Experience of using a new medical simulator for correcting spasticity of the upper limb in complex rehabilitation of children with hemiplegic cerebral palsy

Background. The hemiplegic form of cerebral palsy (CP) is the most prognostically promising in terms of the possibilities of correction and social adaptation of disabled children. However, the main limitation of successful rehabilitation is severe limb muscle spasticity, because so reducing muscle hypertonicity is a priority task in this disease.
The aim. To evaluate the effectiveness of improved method for correcting of upper limb spasticity in children with the hemiplegic form of CP.
Materials and methods. An open, non-randomized, prospective, comparative study was conducted involving two groups of patients with spastic hemiplegia with predominant damage to the upper limb, compared to the case-control type. The control group of children (n = 20) was treated using standard methods – drug therapy, exercise therapy, massage, physiotherapy; the main group (n = 20) was additionally prescribed exercises on the new medical simulator "Glove". The study participants in the groups were compared by gender, age and severity of motor impairment. The course in comprehensive rehabilitation lasted 10 days. The effectiveness of the improved method for correcting upper limb spasticity was assessed by studying the dynamics of motor function indices using scales for assessing muscle tone (modified Ashworth scale) and manual skills (Frenchai and ARAT tests, V.G. Bosykh and N.T. Pavlovskaya method).
Results. The additional inclusion of training using the new medical simulator for correcting upper limb spasticity "Glove" in the rehabilitation program for children with hemiplegic CP allowed achieving a significantly better treatment result with a significant decrease in muscle tonus, an increase in the volume and accuracy of movements, including in the section of small differentiated acts, with the elimination of the phenomenon of the «learned non-use» phenomenon.
Conclusions. The use of a new medical simulator in the complex therapy of children with spastic hemiplegia allows increasing its effectiveness relative to standard rehabilitation methods. However, the question of the long-term effect remains open and requires an assessment of longer-term use of the simulator in the interhospital period.

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