Demographic and clinical and functional characteristics of children with disabilities as the basis for choosing the type of rehabilitation program

Authors:

Karasaeva Lyudmila Alekseevna – Grand PhD in Medical sciences (Dr. Med. Sci.), Professor, Head of the Department of Healthcare Organization and Medical and Social Expertise of the Institute of Continuing Professional Education, Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, 11/12 Bolshoy Sampsonievsky Ave, 194044 St. Petersburg, Russian Federation; e-mail: ludkaras@yandex.ru; https://orcid.org/0000-0001-5621-0240.

Paramoshko Vadim Vladimirovich – Director of the Children’s Center of the Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, 11 Bolshoy Sampsoniyevsky Ave, 194044 St. Petersburg, Russian Federation; e-mail: vad-doc@yandex.ru.

Ivanova Violetta Andreevna – Head of the Department of Medical Rehabilitation, Children’s Center of the Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, 11 Bolshoy Sampsoniyevsky Ave, 194044 St. Petersburg, Russian Federation; e-mail: abstraction@yandex.ru.

Goryainova Marina Vladimirovna – PhD in Medical sciences (Cand. Med. Sci.), Associate Professor, Department of Healthcare Organization and Medical and Social Expertise of the Institute of Continuing Professional Education, Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, 11/12 Bolshoy Sampsonievsky Ave, 194044 St. Petersburg, Russian Federation; e-mail: marina-goryainova@mail.ru; https://orcid.org/0000-0001-8904-8614.

Kuptsova Ekaterina Sergeevna – senior lecturer, Department of Healthcare Organization and Medical and Social Expertise, Institute of Continuing Professional Education, Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, 11/12 Bolshoy Sampsonievsky Ave, 194044 St. Petersburg, Russian Federation; e-mail: kitten1441@yandex.ru.

Zhvakina Mariia Aleksandrovna – Head of psychological and social rehabilitation department, medical psychologist, Children’s Center of Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, 11 Bolshoy Sampsoniyevsky Ave, 194044 St. Petersburg, Russian Federation; e-mail: zhvakina.m@mail.ru.

Bolod Svetlana Olegovna – Deputy head for expert work of the Main Bureau of Medical and Social Expertise in Moscow region, 6 Kokkinaki Street, 125319 Moscow, Russian Federation; e-mail: bolod_so@msemo.ru; https://orcid.org/0000-0002-5765-7690.

Sokurov Andrey Vladimirovich – Grand PhD in Medical Sciences (Dr. Med. Sci.), Associate Professor, Director of the Institute of Additional Professional Education, AlLre^t Federal Scientific and Educational Centre of Medkal and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: ansokurov@yandex.ru; https://orcid.org/0000-0002-3736-2895.

Annotation:

Introduction. The adoption of the Concept of Comprehensive Rehabilitation/Habilitation of Disabled People and Children with Disabilities in the Russian Federation allowed us to understand the importance of organizing comprehensive rehabilitation or habilitation of children with disabilities at a new level. The implementation of the main provisions of the Concept in our country is carried out in the form of pilot projects in two subjects of the Russian Federation, upon completion of which new organizational and methodological approaches will be developed, including the use of electronic certificates in the comprehensive rehabilitation/habilitation of children with disabilities. Of course, at present, in practical rehabilitation, it is important to test the mechanisms of a differentiated approach to the selection of certain types of rehabilitation/habilitation programs and to determine the priority of including individual rehabilitation measures in them. In St. Petersburg, the children’s rehabilitation and rehabilitation center has organized a comprehensive rehabilitation/habilitation of disabled children for the consequences of diseases that caused the child’s disability. Rehabilitation/habilitation of children with disabilities is carried out with the participation of an interdisciplinary team, which, depending on the choice of rehabilitation measures, included specialists of different profiles. It is well known that demographic and clinical and functional indicators influence the choice of rehabilitation programs for children with disabilities, which served as the basis for setting the goal of this work.

Aim. The study and analysis of demographic and clinical and functional characteristics of children with disabilities undergoing rehabilitation in a children’s rehabilitation and rehabilitation center.

Materials and methods. Materials: data from diagnostic reports of specialists, report data on the rehabilitation of patients of the Children’s Rehabilitation Center for 2023. Methods: data copying, expert assessments, statistical, analytical.

Results. In 2023, 170 children aged 0 to 17 years received services under comprehensive rehabilitation programs in the Children’s Rehabilitation Center. The gender indicators of children with disabilities are represented by 98 boys (57.5%) and 72 girls (42.5%). When children with disabilities were admitted to the Children’s Rehabilitation Center, specialist doctors clarified clinical diagnoses and, based on the predominant type of pathology and leading disorders of body functions, children were included in two different rehabilitation programs: “Correction of unformed higher mental functions, emotional and volitional disorders and behavioral reactions, speech deficiencies” and “Restoration of motor skills, movement and walking patterns”. The duration of each program was 20-25 bed days. During the implementation of the programs, the indications for the inclusion of children in a particular program were clarified, their individual duration was determined, the composition of the necessary rehabilitation measures and the validity of the participation of various specialists of the interdisciplinary team in it.

Discussion. The demographic characteristics of the contingent subject to rehabilitation consisted in the prevalence of disabled children aged 0 to 7 years, the least in need of rehabilitation were children aged 15 to 17 years.
The clinical and functional characteristics of children with disabilities depended on belonging to different nosological forms, among which the most priority position was occupied by the diseases “Other brain lesions” (G93) – 59.1%, in second place – “Cerebral palsy” (G80) – 18.2%, in third place – “General disorders of psychological development” (F84) – 5.5%. It was found that the vast majority of disabled children, 71.3%, needed rehabilitation under the program “Correction of unformed higher mental functions, emotional-volitional disorders and behavioral reactions, speech deficiencies”, among them were disabled children not only with disorders in psychophysical development, but also children with motor disorders.

Conclusion. Demographic and clinical and functional characteristics determined the inclusion of children with disabilities in various types of rehabilitation programs. Since measures for the formation of higher mental functions and emotional-volitional disorders were in demand, individual approaches to correctional measures were formed during the rehabilitation process, which led to the reformatting and strengthening of the basic multidisciplinary team with the inclusion of speech therapists, social educators, and educational psychologists.

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