the general principles of medical aftertreatment at children

Regenerative medicine as the science, studies patterns of processes of conservation and restoration of functional reserves of the person by a purposeful dynamic estimation and correction of adaptive possibilities of the person at all stages of preventive maintenance including in system of medical aftertreatment [142].

Object of attention of regenerative medicine are functional reserves, and in essence adaptive possibilities of a human body. Thus, the regenerative medicine surveys a human body out of the so-called nosological approach, but estimates it samoreguljatornye abilities and adaptive possibilities [10, 23, 142].

Along with elimination of available risk factors, (overfatigue, vibration, an intoxication, etc.; disturbance of a regimen of day, a food, etc.) correction of the broken adaptive mechanisms of self-control is the first stage of improvement and preventive maintenance of neurologic diseases.

According to definition of committee of experts the CART, aftertreatment is a system of the state actions of the medical, psychological, social and economic character referred on restoration or conservation of health and homing of invalids in a society and to socially useful work. According to experts of the United Nations Organization, the person with restrictions of vital activity and social functions make about 10 % of the population of globe, that is more than 500 million persons. From them more than 100 million are children aged till 16 years.

The purpose of system of mediko-social aftertreatment is achievement in corresponding terms of proof optimum effect of the improvement adequate to possibilities of the given patient [11, 106].

The analysis of data of the literature shows, that approaches to

To regenerative treatment in Russia and in other developed countries of Western Europe were various. In our country aftertreatment included mainly medical aspects of correction, and the social link has been missed. In the West the return situation [86, 87] was observed.

Last decade it is considered value of medical aftertreatment solving for definition degree of reduction of social restrictions as the most significant for an individual [23].

In 70th years of the XX-th century in the foreign literature for the first time there was a term “quality of a life”. The quality of a life bound to health, is treated as “individual perception of the position in a life in a context with cultural medium and system of values in which the individual lives, and in the ratio with its purposes, expectations, standards and views” [23].

Thus, “the quality of a life bound to health” is the leader in definition of vital activity of the child and includes a subjective and objective estimation of social, mental and physical health. The arisen illness causes disturbance of function of an organism in the child, and as consequence, depression of quality of a life [46, 74, 75].

Thus, process of restoration or indemnification of the lost functions of the child should be referred on improvement of quality of a life and answer medical and social criteria.

At drawing up of the program of aftertreatment it is necessarily necessary to consider structure and organism function, activity of the person (that is how much possibilities of the child correspond social and to society physical requirements), participation in a society life (the social importance of the individual), gravity of disease and the individual forecast of development.

The aftertreatment program should meet following demands:

Integrated approach — a combination various medicamental, physical, psihologo-pedagogical, social, logopedic and defektologicheskih techniques, and also the special programs referred on stimulation of development of various functions of an organism, improvement of socialisation of the child (abilitatsija).

Etapnost — each subsequent stage of regenerative correction should consider results of the previous.

Individuality — the program should be made taking into account all features of an individual.

The multidisciplinary approach - experts of various specialities should take part in working out and realisation of the individual plan of regenerative correction (medical (neurologists, pediatrists, • physiatrists, physical therapists (impellent therapists, ergoterapevty), doctors of regenerative medicine, doctors of physiotherapy exercises, orthopedists, oculists, surdologi, refleksoterapevty, doctors of homoeopathic medicine and, other) and not medical (psychologists, logopedists, defektologi, teachers, social workers, etc.).

Continuity - accurate interaction between various sectionings of public health services, social protection, formation (female consultations, maternity homes, out-patient departments, hospitals, the centres and units of regenerative treatment and aftertreatment) [23] is necessary.

·po to data Cott G.A. [191], the complex program of rehabilitational correction and abilitatsii needs to be begun already immediately in a maternity home or specialised unit (unit of newborns, intensive care and resuscitation unit). So, it is convincingly proved, that long stay in chamber of an intensive care of the newborn child receiving

Scanty information by means of analizatornyh systems from environment (a uniform rumble of reanimation apparatus, monokolornaja colouring of walls of chamber, obezdvizhennoe position, etc.), promotes an atrophy of disks of optic nerves and relative deafness [74]. At this stage correction and the prevention of developing disturbances by special abilitatsionnyh and rehabilitational techniques is possible.

For achievement of good results in the course of regenerative correction the complex of actions should begin whenever possible earlier. The best results of aftertreatment of children as consider reabilitologi, are reached when regenerative treatment is begun immediately after stihanija the acute period [10, 96]. After an extract of the child from a hospital (or intensive care unit), its registration at the neurologist in an out-patient department, in the presence of changes in any structural component of quality of a life of an individual, the patient should be immediately referred to specialised unit (centre) of regenerative treatment.

All methods of regenerative correction at children can be parted on two big groups. The first group is a rehabilitational correction. The second group - programs abilitatsii.

Interpreting definition the CART, aftertreatment is a complex of actions referred on correction of defect or conservation of existing functions. The basic difference of aftertreatment also consists in it from abilitatsii. Abilitatsiju it is possible to define, how a complex of the techniques referred on stimulation of "normal" development of the child, development of new skills, the adaptation of the individual to varying conditions of environment and society [167].

It is necessary to underline, that the experts who are engaged abilitatsiej of the child, do not aspire to "cure" the patient. Their help is referred on working out of programs which stimulate independent development at

The child, the skills corresponding to its age and requirements. Also, the purposes abilitatsionnyh techniques is "painless" conducting the sick child having restriction of vital activity in collective (a family, a day nursery, a kindergarten), work with a family, working out of special adaptations for simplification of functioning of the patient and improvement of its quality of a life [107].

One of techniques abilitatsii is the program of an early intervention (Early Intervention Programs). For the first time, as a-independent direction of a rehabilitational current, it has appeared in countries of Western Europe v-80thive years of last century and, its active development in our country has in the early nineties begun. In the program of an early intervention the command medical (the neurologist, the pediatrist of development, the impellent therapist, etc.) and not medical (the psychologist, the special teacher, the expert in early communications) experts works. It multidjstsiplinarnaja a command, in ‘ which all its members have the peer rights ^ and the decision on what actions need to be spent to this or that child, are accepted jointly [71, 167].

The basic references for the organisation of medical aftertreatment have stated in 1992 Sverguzov L.M., equal Century A [132], some of which are actual for today: 1) one attending physician during all term of aftertreatment should conduct the patient; 2) all patients accepted on treatment should be captured a dispensary observation; 3) the elementary complex should consist of three procedures which are carried out for one course, at 2-3 basic courses на* 3 months of intensive treatment; 4) to consider specific features of an organism of the patient; 5) as much as possible to use in a complex various kinds of nonconventional treatment (physiotherapy, reflexotherapy etc.); 6) the office of functional diagnostics should supervise a state of health of observable patients regularly.

Thus, medical aftertreatment should be based on a universal system principle in this connection it is necessary to use methods and agents with system polymorphic character of action, especially it concerns aftertreatment questions at children's age [148].

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