bmjourБайкальский медицинский журналBaikal Medical Journal2949-0715Irkutsk State Medical University10.57256/2949-0715-2023-4-53-63bmjour-176Research ArticleОригинальные статьиOriginal articlesПАТОФИЗИОЛОГИЧЕСКИЕ АСПЕКТЫ АБИЛИТАЦИИ И РЕАБИЛИТАЦИИ ДЕТЕЙ ИЗ ДОМОВ РЕБЕНКА С ЗАДЕРЖКОЙ НЕРВНО-ПСИХИЧЕСКОГО РАЗВИТИЯ ПСИХОСОЦИАЛЬНОГО ГЕНЕЗАPATHOPHYSIOLOGICAL ASPECTS OF HABILITATION AND REHABILITATION OF CHILDREN FROM CHILDREN’S HOMES WITH NEURODEVELOPMENTAL DELAY OF PSYCHOSOCIAL GENESIShttps://orcid.org/0000-0002-7999-8656ДубоваяАнна ВалериевнаDubovayaAnna V.dubovaya_anna@mail.ruhttps://orcid.org/0000-0002-2231-9018ЯрошенкоСергей ЯрославовичIaroshenkoSergey Ya.sergyaroshenko@gmail.comФедеральное государственное бюджетное образовательное учреждение высшего образования «Донецкий государственный медицинский университет имени М. Горького» Министерства здравоохранения Российской Федерации, Донецкая Народная Республика, г. ДонецкРоссияDonetsk State Medical University named after M. GorkyRussian Federation202325122023245363Copyright © Дубовая А.В., Ярошенко С.Я., 20232023Дубовая А.В., Ярошенко С.Я.Dubovaya A., Iaroshenko S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bmjour.ru/jour/article/view/176

Психоэмоциональный стресс у институализированных детей приводит к значительному напряжению регуляторных систем. Обоснование комплекса абилитационно-реабилитационных мероприятий, направленного на снижение стрессового фактора и создание условий "догоняющего" развития является актуальной проблемой.

Цель исследования

Цель исследования: создание и апробация эффективности комплекса абилитационно-реабилитационных мероприятий, направленных на снижение депривационного давления и стрессогенности окружающей среды.

Материал и методы

Материал и методы: в исследование включены 114 воспитанников домов ребенка гг. Донецка и Макеевки и 44 ребенка из семей в возрасте от 3 до 7 лет. Комплекс абилитационно-реабилитационных мероприятий включал оптимизацию режима дня, закаливающие процедуры, музыкотерапию, лекотерапию и сказкотерапию, сеансы индивидуальной игры и игры в малых группах по 2–3 человека в отдельной игровой комнате, фототерапию яркими лампами солнечного спектра, обогащенную сенсорную среду, повышение физической активности, дифференцированную медикаментозную поддержку: L-карнитин, глицин, гопантеновая кислота, комплекс магния и пиридоксина. Нервно-психическое развитие изучали с помощью "Денверского скринингового теста" и "Формализованной карты исследования психоневрологических функций" по И. А. Скворцову и Н. А. Ермоленко. Функции регуляторных систем оценивали по уровню кортизола и мелатонина слюны, нейротрофического фактора головного мозга сыворотки крови.

Заключение

Заключение: сравнение результатов оценки параметров нервно-психического развития подтвердило эффективность предлагаемого комплекса абилитационно-реабилитационных мероприятий. Восстановление функции регуляторных систем подтверждено нормализацией ритмов синтеза кортизола, мелатонина, а также значительным (в 3 раза) увеличением содержания нейротрофического фактора головного мозга в сыворотке детей основной группы.

Background. Psycho-emotional stress in institutionalized children leads to significant tension in regulatory systems. Justification for using a complex of habilitation and rehabilitation measures aimed at reducing the stress factor and cre-ating conditions for “catch-up” development is an urgent problem.The aim of the study. To create and to test the effectiveness of a complex of habilitation and rehabilitation measures aimed at reducing deprivation pressure and environmental stress.Material and methods. The study included 114 children from children’s homes of Donetsk and Makeevka and 44 chil-dren from families aged 3 to 7 years. The complex of habilitation and rehabilitation measures included optimization of the daily routine, conditioning exercises, music, toy and fairy tale therapy, sessions of individual play and play in small groups of 2–3 people in a separate playroom, phototherapy with bright solar spectrum lamps, enriched sensory envi-ronment, increased physical activity, differentiated drug support with L-carnitine, glycine, hopantenic acid, magnesium and pyridoxine complex. Neuropsychic development was studied using the Denver Screening Test and the Formalized Card for the Study of Psychoneurological Functions according to I.A. Skvortsov and N.A. Ermolenko. The functions of regulatory systems were assessed by the level of cortisol and melatonin in saliva, and brain-derived neurotrophic factor in blood serum.Conclusion. A comparison of the results of assessing the parameters of neuropsychic development confirmed the effec-tiveness of the proposed complex of habilitation and rehabilitation measures. Restoration of the function of regulatory systems was confirmed by normalization of the rhythms of cortisol and melatonin synthesis, as well as by a significant (3-fold) increase in the content of brain-derived neurotrophic factor in the blood serum in children of the main group.

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The authors declare that there are no conflicts of interest present.