The Development of Method of Joints Hypermobility Diagnostics for Children 4 – 6 in the Process of Physical Rehabilitation Practice

Kalinichenko I. A., Dyachenko Y. L., Skiba O. A.

CONTENTS

Scentific article

The modern system of estimation of the state of joints on a background hypermobility of joints is quality, as indexes are estimated on a ball scale, and informing of such estimation is high. However there is a row of defects that need further addition and modification of the adopted method during the inspection of children of preschool age. Thus, the above-mentioned facts ground for realization of attempt to complement the existent esti- mation of hypermobility of joints. Aim of the article – to ground and work out the method of diagnostics of arthral hypermobility for children 4-6 in the process of physical rehabilitation practice. In research took part 602 children from four to six years (43,60% boys and 56,40% girls). To the plan of research it is included: determination of presence and degree of hypermobility of joints after the method of Carter – Wilkin- son – Beighon with the use of row of parameters : passive bending of both little fingers, passive bending of thumbs, unbending of elbows, hyperextension of knees, inclination of trunk forward with a distance-finding to sex; determi- nation of quantitative description of these parameters of hypermobility of joints (goniometry) is with further determi- nation of age-old-sexual limits by means of method of standard deviations; mathematical and statistical treatment. In practice during diagnostics of the state of arthral vehicle of children with the displays of дисплазії the method of Carter is most used – Wilkinson – Beighon. The estimation of degrees of hypermobility after the indicated method includes the ball scale of exposure of the above-mentioned descriptions, and the sum of points is divided by degrees. But in orthopaedic experience, especially when speech ідеться about prophylactic and restoration measures, it is important to watch minimum changes arthral to the vehicle in the process of physical rehabilitation. In addition, such approach does not give an opportunity to take into account the age-old-sexual features of development of локомоторного vehicle of children, as only after three-year age there is stabilizing of the state of collogen fibres. With the aim of determination of changes of indexes of hypermobility for children 4 – 6 by means of goniometry the quantitative estimation of indexes of flexibility was conducted in joints, namely: passive bending of right little finger, passive bending of the left little finger, passive bending of right thumb, passive bending of the left thumb, hyperextension right ulnar to the joint, hyperextension left ulnar to the joint, hyperextension right genicular to the joint, hyperextension of the left knee-joint, inclination trunk forward with fixed touch hand to area support. The next step of addition of existent methodology was determination of norm of quantitative age-old-sexual values each of offer Carter – Wilkinson – Beighon of descriptions of flexibility of joints. The analysis of indexes of goniometric inspection gave an opportunity to define the limits of mobility of joints for children and conduct a quantitative estimation with determination of features of arthral displays on a background the different degree of hypermobility. During research by us descriptions of arthral signs divided after the degree of hypermobility of joints and limits are certain taking into account age-old and sexual features. Quantitative description of indexes of hypermobility of joints for children gives an opportunity to control as separate changes of arthral displays so general of flexibility of joints. In rehabilitation practice it is possible to control minimum positive or negative changes from the side of arthral vehicle, especially in the period of intensive bone height of children, having regard to the physiology features of this specific process. The corresponding quantitative indexes of arthral displays will allow effectively to elect and send rehabilitation events to strengthening of their ligamentary vehicle. During the use generalization of the got results is set that physiology mobility of joints is inherent 14,45%% the inspected contingent, easy degree of hypermobility – 27,73%, middle degree – 45,18±3,01%, and expressed are 12,62%% children.

children, hypermobility of joints, locomotorium, diagnostics

• Беленький А. Г. Гипермобильный синдром – системное не воспалительное заболевание соединительной ткани / А. Г. Беленький // Новости медицины и фармации. – 2007. – № 3 (207). – С. 3-4.
• Боровиков В. STATISTIKA. Исскуство анализа данных: для профессионалов // В. Боровиков. – СПБ.: ПИТЕР – 2003. – 688 с.
• Вдосконалення заходів профілактики за допомогою розробки і впровадження у практику методів скринінг-тестування, визначення критеріїв професійної орієнтації у дітей та підлітків зі сколіотичною хворобою / В. А. Улещенко, І. В. Рой, М. М. Вовк [та ін.] // Наукові засади Міжгалузевої комплексної програми «Здоров’я нації». –Вип. 1 (за ред. А. М. Сер- дюка). – К., 2007. – С. 230–254.
• Викторова И. А. Клинико-прогностические критерии дисплазии соединительной ткани / И. А. Викторова, Д. С. Кисе-лёва // Российские медицинские вести. – 2009. – Т. XIV, № 1. – С. 102–111.
• Кадурина Т. И. Наследственные нарушения соединительной ткани в детской ортопедической практике / Т. И. Кадури-на, О. Л. Белоног, В. Г. Арсентьев // Детская хірургія. – 2011. – № 4. – С. 45–47.
• Охапкіна О. В. Віково-статеві особливості клінічного перебігу диспластико-залежної патології у дітей / О. В. Охапкіна// Вісник проблем біології і медицини. – 2011. – Вип. 2, Т. 1. – С. 147–149.
• Поворознюк В. В. К вопросу о синдроме гипермобильности / В. В. Поворознюк, Е. И. Подлианова // Боль. Суставы. Позвоночник. – 2012. – №1 (05). – С. 145–149.
• Beighton P. Hypermobility of joints / P. Beighton, R. Crahame, H. Bird. – London : Berlin; New York, 1990. – 182 р.

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