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Authors: Bronnikova A.S., Khmelnitskaya A.I., Dolanova L.V.
Institutions: Children’s City Multidisciplinary Clinical Center of High Medical Technologies named after K. A. Raukhfusa, Saint Petersburg, Russian Federation.
Year: 2018

Abstract:
Conducting training in a virtual environment with biofeedback allows to improve patient’s motivation, contributes to better control of his body in space, contributes to the correct execution of exercises.

The purpose of the study:
To study the effect of training with the help of virtual biofeedback system “Habilect” based on infrared sensor on motor function of paretic lower limbs of patients with cerebral palsy and spastic diplegia, on motor function of lower limbs of patients with consequences of lower limbs injuries and motor function of the body of patients with posture disorders.

Materials and methods:

ICP, spastic diplegia. Indications: improvement of motor skills, strengthening muscles of the body, hip extensor muscles.

Consequences of lower limb injuries (incomplete rupture of PKS, incomplete rupture of meniscus, condition after arthroscopic resection of meniscus). Indications: restoration of full volume of movements in joints of the lower limbs, strengthening of muscles of the lower limbs, restoration of the correct walking stereotype.

Posture disturbance, scoliotic posture, scoliosis of the 1st degree. Indications: back muscles strengthening.

8 patients with cerebral palsy (5 girls, 3 boys) aged 10 to 17 years. From 1-1.5 years old the diagnosis of cerebral palsy was established, a category of disabled child. On admission: moderate or mild paresis of the lower extremities, move by spastico-paretic walk independently without using additional means. 4 patients with consequences of lower limb injuries (2 boys, 4 girls) at the age from 11 to 17 years. Duration of trauma / surgery from 1 to 12 months. Two patients had extension contracture (amplitude of movement in the knee joint 70-90 degrees), muscle strength 3-4 points. Gait violation had one patient – support on a cane. 9 patients with posture disorder (4 boys, 5 girls) aged 10 to 17 years. During the examination: back hypotension, asymmetry of the shoulder muscles, scapulae at different levels, increased pectoral kyphosis, asymmetric triangles of the waist. Tests were conducted: holding the bar on his elbows – 20 – 40 seconds, side bar – 10-30 seconds, lifting the body from the position lying on his back for 1 minute – 15-30 times. Rating scales: Holden 3-4 category Ashworth 1-3 points Paresis moderate or mild muscle state 3-4 points A group of patients with cerebral palsy, in addition to training with an instructor of the pysical therapy, was trained on a virtual biofeedback system “Habilect” for two weeks (20-30 minutes, 5 days a week). These patients had lower spasticity level, improved back and lower extremities muscles condition, better walking stereotype. Groups of patients with the consequences of lower limbs injuries and posture disorders received comprehensive rehabilitation, including training on the virtual biofeedback system “Habilect” during two weeks (20-30 min, 4 days a week). After the complex therapy, patients with the consequences of injuries of the lower limbs restored the correct stereotype of walking, muscle strength – 5 points, movement in the joints of the lower limbs is not limited, in full. The group of patients with posture disorders had visual posture improvement after the complex therapy. Improved performance in the tests: holding the bar on his elbows from 30 seconds to 1 minute, side bar – 20-40 seconds, lifting the body from the lying position on his back in 1 minute – 18-38 times.

Results and discussions:
Training with the use of virtual biofeedback “Habilect” based on infrared sensor is an effective method in the complex rehabilitation of children with cerebral palsy, the consequences of injuries to the lower extremities, as well as patients with impaired posture, helps improve motor skills and strengthen muscles of the body. This method can be a useful complement to traditional rehabilitation.