RESTORATION OF MOTOR FUNCTIONS IN CHILDREN WITH DISEASES OF THE MUSCULOSKELETAL SYSTEM: A PRACTICAL ASPECT

Abstract

The article presents a comprehensive study of current issues in physical therapy and occupational therapy for children with various musculoskeletal disorders (MSDs). The fundamental transformation of the modern rehabilitation paradigm is analyzed, which consists in the final transition from the traditional biomedical model, focused exclusively on the pathogenetic mechanisms of the disease, to the humanistic biopsychosocial model. The latter is based on the conceptual provisions of the International Classification of Functioning, Disability and Health (ICF) and is focused on expanding the functional capabilities of the child and his active social integration.

The main attention is focused on detailing the practical aspects of the application of the world's leading kinesiotherapy techniques in pediatric practice. The author reveals the biomechanical mechanisms of action and the specifics of the implementation of neurodevelopmental treatment (NDT/Bobath), aimed at inhibiting pathological reflex circuits and stimulating physiological motor control. Special attention is paid to the method of proprioceptive neuromuscular facilitation (PNF) as an effective tool for stimulating muscle activity through the activation of proprioceptors. In the context of correcting deformities of the musculoskeletal system, the method of three-dimensional correction according to the Schroth method was analyzed, which allows achieving spinal stabilization in scoliotic disease through specific detorsion breathing and directed isometric tension.

The critical need for synergy of physical exercises with the use of technical rehabilitation tools is scientifically substantiated. It is proven that the use of verticalizers, individual dynamic orthoses, and exoprosthetic systems is a basic condition for the prevention of secondary degenerative-dystrophic complications (contractures, joint deformities) and ensuring the patient's autonomous mobility. Based on the analysis of representative clinical cases (infantile cerebral palsy in the form of spastic diplegia, idiopathic scoliosis, complex post-traumatic contractures), the high effectiveness of individualized intervention programs has been demonstrated. Special emphasis is placed on the implementation of gamification elements (game method and VR technologies), which allows significantly increasing the child's intrinsic motivation to perform multiple, similar motor tasks.

The conclusions emphasize that the key determinants of successful restoration of motor functions are the maximum early intervention, the use of the adaptive phenomenon of brain neuroplasticity, and a strategic partnership between the rehabilitation team and the family. The active involvement of parents in the therapeutic process is identified as the main condition for ensuring the continuity and intensity of rehabilitation activities in the home environment, which is critically important for the long-term preservation of the results obtained.