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WO2008097130A2 - Tunique thérapeutique pour patients atteints de paralysie cérébrale infantile - Google Patents

Tunique thérapeutique pour patients atteints de paralysie cérébrale infantile Download PDF

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Publication number
WO2008097130A2
WO2008097130A2 PCT/RU2008/000036 RU2008000036W WO2008097130A2 WO 2008097130 A2 WO2008097130 A2 WO 2008097130A2 RU 2008000036 W RU2008000036 W RU 2008000036W WO 2008097130 A2 WO2008097130 A2 WO 2008097130A2
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WO
WIPO (PCT)
Prior art keywords
stripes
spasticity
suit
cortex
spiral
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Ceased
Application number
PCT/RU2008/000036
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English (en)
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WO2008097130A3 (fr
Inventor
Yelena Vladimirovna Filatova
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Individual
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Individual
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Publication of WO2008097130A3 publication Critical patent/WO2008097130A3/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices ; Anti-rape devices

Definitions

  • the utility model relates to medicine. It is a therapeutic suit to be used to restore the locomotor function of the patients having local cerebral injuries, mainly, for the children with cerebral spastic infantile paralysis.
  • the technology of physical rehabilitation of the patients with infantile cerebral paralysis is represented by different types of therapeutic physical training, massage and physiotherapy, the purpose of which is to reduce the pathologic spasticity of the limb skeleton muscles in orde r to restore the locomotor function of the patient.
  • many types of non- medicinal treatment are contraindicated for the patients having infantile cerebral paralysis with epileptic seizures, thus, limiting the available help for those patients and complicating prognosis for their development.
  • the patients with infantile cerebral paralysis are offered a therapeutic suit (underwear) to be worn under the outer clothes during the day to reduce the pathologic spasticity of the limb skeleton muscles.
  • Therapeutic underwear as a subsidiary means is widely used in medicine for treatment and prophylaxis of many diseased conditions: therapeutic stockings and pantyhose for varicose veins, bandages and supports for pregnant women with a threat of premature delivery, etc.
  • therapeutic stockings and pantyhose for varicose veins, bandages and supports for pregnant women with a threat of premature delivery, etc.
  • afferent kinesthetic being the basic one. Permanent efferent impulsation from the local lesion focus of the cortex causes spasticity of flexors while limb extensors being paretic, thus limiting the motor activity of the child having infantile cerebral paralysis.
  • afferent kinesthetic impulsation from spastic and paretic skeletom muscles has pathologic character, thereby fixing compensatory stereotypes of the motor reactions on the cortex level (fig. 1, 6).
  • inhibition of the development of the locomotor function slows down psycho-emotional and mental development of the child.
  • the suit facilitates physiotherapy exercising as well as practicing regular motor skills due to the vector of the limb movement being concurrent with the vector of elastic force of the spiral stripes.
  • the child has to apply less effort to overcome muscular spasticity. This factor, probably, stimulates the central nervous system (CNS) and acts as a starting point for speeding- up the developrment and restoration of all its divisions.
  • CNS central nervous system
  • the main task of the therapeutic suit as a subsidiary means for the physical rehabilitation o:f the patients with cerebral spastic infantile paralysis is the creation of the permanent extensive stream of new kinesthetic afferentation from limbs, which direction is opposite to the pathologic activity of the efferent impulsation from the local lesion focus of the cortex onto the limb muscles. It is achieved by the local influence on skin receptors and on muscle and teindon proprieceptors of the spiral stripes of high density with directed elastic threads, their direction being opposite to the spasticity.
  • new external permanent afferentation in the cortex division of the skin kinesthetic analyzer can, as time goes by, form a new 'artificial' dominant focus, capable of smoothing pathologic activity of the impulsation from the local lesion focus of the cortex (fig. 6, 7).
  • Arrows in the figure 1 show vectors of the 'twisting' influence of the pathologic efferent impulsation from the local lesion focus of the cortex to the upper and lower extremities of the patient having cerebral spastic infantile paralysis. 1 - the vector of the spasticity influence over the limb skeleton muscles of the patient with cerebral spastic infantile paralysis.
  • Figure 2 demonstrates the therapeutic suit - front and rear views.
  • Figure 3 shows spiral stripes on the front and rear parts of the pantyhose. 11 - upper circular stripes of the pantyhose, 12 - lower circular stripes of the pantyhose,
  • Figure 4 demonstrates the position of the front and back spiral stripes relatively to each other and their interweaving on the lateral side of the pantyhose (right lower extremity).
  • Figure 5 depicts the position of the front spiral stripes on the carpal and digital parts of the right glove.
  • Figure 6 represents the scheme of the skin kinesthetic analyzer.
  • Black arrows indicate the direction of the pathologic efferent impulsation from the local lesion focus of the cortex.
  • Figure 7 represents the scheme of the central departments of the skin kinesthetic and motor analyzers (sensorimotor zone of the cortex).
  • Black arrows indicate the direction of the pathologic efferent impulsation from the local lesion focus of the cortex.
  • Figure 8 depicts a neurophysiologic phenomenon of 'central relief.
  • Cerebral spastic infantile paralysis is characterized by increased muscular tone (spasticity) of the upper and lower extremities in the combination with muscular weakness (being paretic). It complicates or makes voluntary movements impossible.
  • the therapeutic suit is suggested to reduce the influence of the spasticity over the limb muscles. Its characteristic feature is elastic threads, inducted into fabric, spirally twisted and stretching in the direction opposite to the pathologic spasticity (fig. 2).
  • the therapeutic suit for the patients with cerebral spastic infantile paralysis can be of few modifications.
  • the therapeutic suit consisting of pantyhose, a long-sleeve shirt, gloves and a waist-band is used; in case of diplegia, upper extremities being spastic - a long-sleeve shirt, gloves and a waistband are used.
  • the therapeutic suit is knitted of natural dense fabric (silk, cotton, wool) with the addition of artificial fibers, the latter giving the fabric elasticity, flexibility, the ability to fit tightly, stretch -while moving and restore its original shape afterwards.
  • Spiral stripes, made of elastic threads, stretching in the direction opposite to spasticity are inducted into the main fabric, their density is enhanced.
  • every part of the suit that has a task to reduce the spasticity of the corresponding part of the body, there are two similar spiral stripes, front and rear, interweaving on the lateral side of the shirt, pantyhose and gloves (fig. 4, 5).
  • a full set of the therapeutic suit consisting of pantyhose, a shirt, gloves and a waistband (fig. 2, 3) is used for the cases of infantile cerebral paralysis with quadriplegia.
  • the pantyhose are used (fig. 3, 4).
  • Two upper stripes separate the pelvic part of the pantyhose from the left and right hips; two lower on the ankle level — separate left and right crus from the feet.
  • the ends of the elastic spiral stripes, working opposite to the spasticity, are inducted into those stripes.
  • the ends of the left and right spiral stripes of the front part of the pantyhose are inducted into the medial part of the upper circular band, on the bottom - into the lateral part of the lower circular stripes.
  • the front part of the stripes has the same direction as elastic stripes, that is, opposite to the direction of spasticity, back part - horizontal direction, perpendicular to the vertical axis of the limb.
  • the back part of the stripes has the same direction as elastic stripes, that is, opposite to the direction of spasticity, front part - horizontal direction, perpendicular to the vertical axis of the limb.
  • the width of the spiral stripes is about 2/3 of the half of the crus circumference on the ankle level that makes 2.0 - 4.0 cm.
  • the density of the spiral stripes several times exceeds the density of the main fabric of the suit, hip area having higher density than the ankle area.
  • soft fibres like velour
  • the feet of the pantyhose besides the circular stripe on the ankle level, have a heel area that continues back part of the circular stripe; heel and toe areas are both of the enhanced density (fig. 2, 3, 4).
  • the ends of the left and right front spiral stripe, working opposite to the spasticity, are inducted into the medial edge of the horizontal stripe and lateral edge of the sock.
  • the front part of the stripe, running on the rear part of the foot has the same direction as elastic stripes, that is, opposite to the direction of spasticity, back part (plantar) - horizontal direction.
  • the ends of the right and left spiral stripes, working opposite to the spasticity on the plantar area of the feet, are inducted into the medial edge of the lower part of the heel and lateral edge of the sock.
  • the back part of the stripes of the heel has the direction of elastic threads opposite to the spasticity, front part on the rear of the foot — horizontal direction.
  • heel and toe areas The density of the spiral stripes, heel and toe areas several times exceeds the density of the main fabric,, heel and plantar areas having higher density than the rear part of the foot.
  • heel and toe areas of the back part of the spiral stripes have soft fibres (like velour) with the height of 0.3 - 0.5 cm.
  • a long-sleeve shirt is used (fig. 2).
  • the length of the shirt on the average, is equal to the length of the backbone from the 7 th cervical vertebra to the 1 st lumbar vertebra; the length of the sleeve is approximately the length of the upper arm to the hand.
  • the front part of the shirt is made of knitted fabric.
  • the back is made of the main fabric with inducted stripes of elastic threads. The stripes are locaited in accordance with anatomical structure of the spine, the latter having the function of support.
  • the medial vertical stripe of 3.0 - 5.0 cm width corresponds with the position of the cervical, thoracic and lumbar spine.
  • Slant symmetrical stripes running from the medial vertical stripe, are directed upward, have the width of 2.0 - 3.0 cm and correspond with the muscular fibers of the broad and rhomboid muscles of the spine.
  • the density of the supporting stripes several times exceeds the density of the main fabric.
  • soft fibres like velour
  • the edge of the collar, arm-holes and bottom of the shirt and sleeves are edged with the circular stripes, made of elastic threads of high density with the width of 2.0 - 3.0 cm.
  • Spiral stripes of elastic threads working opposite to the spasticity, are knitted into the main fabric of the sleeves.
  • the ends of the left and right spiral stripes on the front part of the sleeves are knitted into the medial band of the arm-holes on the top, and into the lateral part of the circular stripes of the edge of the sleeves on the bottom.
  • the front part of the stripes has the same direction as elastic stripes, that is, opposite to the direction of spasticity, back part - horizontal direction, perpendicular to the vertical axis of the limb.
  • the back part of the stripes has the same direction as elastic stripes, that is, opposite to the direction of spasticity, front part - horizontal direction, perpendicular to the vertical axis of the limb.
  • the width of the spiral stripes is about 2/3 of the half of the arm circumference on the level of transition of the arm into the hand.
  • the density of the spiral stripes several times exceeds the density of the main fabric of the suit, upper-arm having higher density than the forearm.
  • Gloves are used to reduce the spasticity of hands and fingers. They are made of the main fabric, tightly fitting, hands, fingers and the fourth part of the forearm; begin with a circular stripe of high density, made of elastic thread. The width of the circular stripe is 1.0 - 3.0 cm.
  • the gloves have the same circular stripes of high density 0.5 - 1.0 wide, that separate every digital division from hand. The tips of the fingers are performed as 'thimbles' with the enhanced thread density.
  • Spiral stripes of elastic threads working opposite to the spasticity, are knitted into the bands.
  • the ends of the front right and left spiral stripes of the rear surfaces of the glove are knitted into the medial band at the beginning of the circular stripe, on the bottom - into the circular stripe of the long finger (fig. 5).
  • the rear part of the stripes has the direction of elastic threads, that is, opposite to the spasticity, palmar part - horizontal direction.
  • the ends of the left and right spiral stripes of the palmar part are knitted into the medial part at the beginning of the circular stripe, on the bottom - into the circular stripe of the long finger.
  • the palmar part of the stripes has the direction of elastic threads, that is, opposite to the spasticity, rear part - horizontal direction.
  • the width of the spiral stripes is, on the average, about half of the length of the circumference of the long finger, that is, 0.5 - 1.0 cm.
  • the density of the spiral stripes several times exceeds the density of the main fabric.
  • on the back part of the spiral stripes there are soft fibres of 0.2 - 0.5 cm high.
  • the ends of the front stripe are knitted into the medial part of the circular stripe (fig. 5) and lateral part of the 'thimble' of the palmar surface of the digits.
  • the rear part of the front stripe has the same direction as elastic threads, that is, opposite to the spasticity, palmar part - horizontal direction.
  • the width of the spiral stripes is, on the average, 0.3 - 0.5 cm.
  • the density of the spiral stripes several times exceeds the density of the main fabric.
  • on the back part of the spiral stripes there are soft fibres of 0.1 - 0.3 cm high.
  • the width and density of the spiral stripes on the thumb and index finger are higher than on the other fingers.
  • the waistband is 5.0 - 7.0 cm, is equal to the waist circumference plus 8 - 10 cm. It is made of elastic fabric of enhanced density with a number of clasps (snaps, hooks), regulating its length.
  • the waistband plays the supporting function in the therapeutic suit as its back and lateral parts are of bigger density than the front part. It is worn over pantyhose and a shirt (waistcoat).
  • pantyhose, a waistcoat and a waistband are used to reduce the muscular spasticity and improve the support function of the vertebra.
  • the waistcoat equal to the length of the backbone from the 7 th cervical vertebra to the 1 st lumbar vertebra, consists of back and front parts.
  • the front part is made of the main knitted fabric.
  • the back part is made of the main fabric with inducted stripes of elastic threads.
  • the stripes are located in accordance with anatomical structure of the spine, the latter having the function of support.
  • the medial vertical stripe of 3.0 - 5.0 cm width corresponds with the position of the cervical, thoracic and lumbar spine.
  • Slant symmetrical stripes, running from the medial vertical stripe are directed upward, have the width of 2.0 - 3.0 cm and correspond with the muscular fibers of the broad and rhomboid muscles of the spine.
  • the density of the supporting stripes several times exceeds the density of the main fabric.
  • the edge of the collar, arm-holes and bottom of the waistcoat are edged with the circular stripes, made off elastic threads of high density with the width of 2.0 - 3.0 cm.
  • waistcoat and gloves are used to reduce the muscular spasticity and improve the support function of the vertebra.
  • the sizes of the therapeutic suit correspond to the sizes of the regular children's clothes. If the fi gure does not fit the standard, parts of the suit can be combined or the suit can be individually tailored.
  • the suits of the same size can be differentiated by the density of the spiral stripes and the view of the main fabric.
  • the therapeutic suit for the patients with infantile cerebral paralysis is used as underwear to be worn under the child's regular clothes during the day while doing his/her activities.
  • the suit must be of the proper size and fit tightly; at the same time the spiral stripes should not be too compressive in order not to worsen blood circulation. If the stripes leave marks as redness, maceration, etc. on the skin, the suit with lower compression of the stripes should be worn.
  • a shirt or a waistcoat is worn directly on the body, pantyhose - on the diapers or pull-ups in case the child cannot control physiological functions of the body.
  • the therapeutic suit can be used for the difficult and medium-difficult conditions of the infantile cerebral paralysis, even in cases with the minimal activity. Taking into consideration the fact that wearing a suit gives a stream of new afferent kinesthetic afferentation, it is recommended to start wearing the suit for 1 hour a day, then, in a few days - for 2 hours, and so on.
  • Therapeutic physical exercising and regular physical activities are easier when done in a therapeutic suit as the vector of the movement of the limb coincides with the vector of the flexibility of the spiral stripes. While practicing, the child has to make a lesser effort to overcome muscular spasticity. This factor might promote the restoration of the locomotor function as well as enhance the effect from all types of physical exercising, used at rehabilitation.
  • the duration (month, year) of the use of the suit is not specified, it is necessary to adjust the suit to the increasing height of the child.
  • the therapeutic suit is relatively inexpensive subsidiary means for rehabilitation of the physically handicapped children and can be used in a daily life without any supervision of parents or medical personnel.

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  • Health & Medical Sciences (AREA)
  • Nursing (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Rehabilitation Tools (AREA)
  • Professional, Industrial, Or Sporting Protective Garments (AREA)

Abstract

Les mouvements volontaires sont des systèmes afférents complexes, qui reposent sur différents types d'afférentation, sachant que la kinesthésie est une afférentation de base. Les patients atteints de paralysie cérébrale infantile ont des impulsions kinesthésiques afférentes pathologiques rares en raison de l'hypertonie spastique des muscles fléchisseurs, ce qui limite l'activité motrice (figure 1). En conséquence, l'invention concerne une tunique thérapeutique en tissu à ajustement serré qui comporte des bandes en spirale à base de fils élastiques, étirables lorsque le patient fait des mouvements dans la direction opposée à l'hypertonie spastique pathologique des muscles squelettiques des membres, ce qui permet de stimuler en permanence les organes kinesthésiques périphériques externes au niveau de la peau (figure 2). Les signaux émis par différentes parties de la peau, des muscles, des articulations et des tendons vont dans le troisième champ sensoriel primaire du cortex, à proximité immédiate du quatrième champ moteur primaire, lequel joue un rôle central dans la régulation de l'activité motrice (figure 6). On part du principe que le fait de porter la tunique décrite permet de créer un nouveau centre dominant 'artificiel' dans les parties susmentionnées du cortex. Compte tenu de phénomènes neurophysiologiques, la 'concurrence relative à la distance finale commune' et 'l'activité centrale de soulagement pathologique (figures 6, 7, 8) des impulsions efférentes provenant du centre de lésion local du cortex à destination des muscles des membres sont partiellement ou totalement équilibrées, ce qui crée les conditions d'une expansion de l'activité motrice. Ladite tunique peut devenir un auxiliaire relativement peu onéreux pour la réhabilitation d'enfants physiquement handicapés et peut être utilisée dans la vie quotidienne pour tel ou tel degré de handicap dû à la paralysie cérébrale infantile.
PCT/RU2008/000036 2007-02-05 2008-01-24 Tunique thérapeutique pour patients atteints de paralysie cérébrale infantile Ceased WO2008097130A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
RU2007104243 2007-02-05
RU2007104243 2007-02-05

Publications (2)

Publication Number Publication Date
WO2008097130A2 true WO2008097130A2 (fr) 2008-08-14
WO2008097130A3 WO2008097130A3 (fr) 2008-10-16

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Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2054907C1 (ru) * 1992-01-31 1996-02-27 Акционерное Общество Закрытого Типа "Аюрведа" Устройство для лечения больных с нарушением позы и двигательной активности
RU2131232C1 (ru) * 1998-09-15 1999-06-10 Аверьянов Андрей Игоревич Комбинезон для лечения больных детским церебральным параличом и больных с последствиями черепно-мозговой травмы
RU21511U1 (ru) * 2001-05-29 2002-01-27 Шамарин Тимофей Григорьевич Костюм для лечения детского церебрального паралича
RU2266082C1 (ru) * 2004-12-10 2005-12-20 Аверьянов Андрей Анатольевич Устройство для нейро-ортопедической реабилитации

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WO2008097130A3 (fr) 2008-10-16

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