Criteria for determining the optimal orientation of rehabilitation measures in children with the consequences of cerebral palsy

Cerebral palsy (cerebral palsy) is the leading chronic disease in children, leading to disability. Correction of motor function disorders in children with the consequences of cerebral palsy is carried out by the complex application of various non-drug rehabilitation methods, among which massage plays an important role. The purpose of the study is to conduct a comparative analysis of the influence of various types of therapeutic massage on the adaptive capabilities of the body of children with the consequences of cerebral palsy. The study involved 15 children aged 10 to 15 years with different forms of cerebral palsy, who were divided into 3 experimental groups (EG 1, EG 2, EG 3). EG 1 (n = 5) included subjects who underwent a course of classical therapeutic massage. Children of EG 2 (n = 5) underwent connective tissue massage, and in EG 3 (n = 5) — deep-woven. The study of the adaptive capabilities of children was carried out using the method of cardiorhythmography on the hardware and software complex “Varicard”. Statistical processing of the results of the study was carried out with the determination of arithmetic mean values and standard deviation. The reliability of the differences was determined on the basis of the Mann – Whitney U-test and the Wilcoxon W-test. As a result of the study, data were obtained indicating the multidirectional influence of various types of therapeutic massage on the heart rate variability of children with cerebral palsy. Classical massage had a predominant effect on the central regulatory mechanism (SI, SDNN, heart rate, TР), providing a reduction in tension in the regulatory system, а connective tissue — stimulates the activity of the autonomous circuit by activating the parasympathetic part of the vegetative nervous system (a significant increase in the proportion of HF waves and a decrease in the proportion of LF waves in the total power of the spectrum). Deep-woven massage affects mainly the central ergotropic mechanisms, which are closely related to the psycho-emotional state and the functional state of the cerebral cortex. Thus, to determine the type of therapeutic massage, it is necessary to take into account the individual typological characteristics of children with cerebral palsy, as well as the effect of massage on the indicators of autonomic regulation of heart rhythm.