Clinical Study

The objective of this program was, at the earliest possible age to measure babies' psychomotor skills, before treatment and therapy. This developed a baseline from which accurate measurements could be made of the skills during and after therapy. Then we could estimate the improvements realized by therapy through the baby's first year of development.

- METHODS -

Our specially developed questionnaire (Appendix 3) gave an opportunity to discover antenatal (prenatal) and intranatal risk factors. Antenatal risk factors are defined as uterine tonus, toxemia during pregnancy, abortive or premature delivery, fetus hypoxia, and arrested intrauterine fetus development. Intranatal risk factors are incisive asphyxia as a consequence of interuption of parturient function or parturient lesions, emergency and planned cesarean operations.

In this article, developed and compiled after two years of practice, ratable criterion for functional health of psychomotor growth of babies, with intrauterine and parturient CNS lesions, are presented. Patient medical charts were recorded on the basis of these ratable criterion. The first patient medical chart is for babies from ages 0 to 5 months (Appendix 1). The second chart (Appendix 2) is for babies from ages 5 to 12 months. Incremental monitoring of babies' functional health for psychomotor growth was performed with a numeric rating system.

Our medical rehabilitation clinic program includes sequential treatments:

1) Single sessions with babies with medical rehabilitation massage and reflexotherapy were initiated. These sessions were performed with authorial methodology (Patent № 2269330, 02.10.2006) - "Normal muscular tonus revitalizing method for babies with hyperkinetic cerebral apoplexy form from birth to 5 years old - ©".

In this method, reflexive stimulant points’ locations are initially diagnosed for each attaching band of tendinous-connectional apparatus to the periosteum. These reflexive stimulant points allow us a correction to the normal locations of these points on the normal physiological baby. The therapist uses forceful prodding with a finger to find the actual location of the reflexive stimulant points. It should be noted that these reflexive stimulant points only exist in babies for the first 1-2 years of life, so it is necessary to begin these treatments as early as possible in the baby's life.

Once we located reflexive stimulant points, we marked them by placing a pellet at the actual location. Fruit seeds, in particular apple seeds, which contain alpha-acids are usually used as pellets to mark these spots on the baby's body. Seeds are fixed in reflexive stimulous points with an anti-allergenic plaster. This method allows the distinction of pathological muscular tonus from normal muscular tonus and excludes muscualr tonus from babies' puerilism using less clinical observation time.

The duration of single baby sessions is 30 minutes. Quantity of sessions per baby is 10.

2) Group lessons are then conducted in pairs with mothers (5-7 mother-baby pairs).The junior group is for babies from 2.5 - 3 months to 5-6 months, and the older group is for babies 6-7 months old to 9-10 months and for impaired babies younger than 12 months. The sessions were conducted two times per week. Group sessions’ duration was 35 minutes in junior group, and 45-50 minutes in the older group.

There were 8 sessions in 1 unit of multiple sessions. This grouping of sessions into units allows monitoring babies' psychomotor growth in movement and helps to determine when to transfer more successful babies into an older group. To create a pleasant atmosphere for babies, mothers and therapists, group sessions were enhanced with music.

Every group session was partitioned into two parts. The first part of the sessions includes exercises for babies, focused on activating or rehabilitating inborn reflexes (footing - crawling on legs and hands, following a rattle, rolling over from back to stomach) and help in the formation of mesencephal location reflexes (chain symmetrical reflexes). All exercises are performed by the babies with the assistance of their mothers and a trained, medical coach, and are performed on wide tables.

The second part of group sessions are exercises performed on large, exercise balls, soft exercisers, and task-oriented creeping to an item, such as a pyramid or a soft toy, for the older age groups.

Mothers are trained and encouraged to help the baby carry on with this exercise regimine at home between clinical sessions. Working with their babies in the clinic provides them with the knowledge necessary to perform daily exercises with their baby at home.

As a result of the intensive physical rehabilitation therapy performed by the medical staff, we succeeded to recover normal psychomotor growth in 90-95% of cases for 8-9 month old babies who do not suffer from extreme anamnesis pregnancy complications. Based on the degree of anamnesis pregnancy complications, more intensive medical rehabilitation procedures are indicated.

These methods have reaped positive results. It appears that continued research is necessary to refine and expand this field of physical therapy. The participation by parents in the daily exercises performed at home seems to contribute greatly to the success of the program. I would like to try these methods for two other groups of babies - those with congenital problems that limit and deteriorate motor skills and healthy babies. Both groups could benefit from these treatments.