title: [The regulation of balance in the children presenting with severe cerebral palsy following the treatment with the use of the locomotor training in combination with the electrical stimulation of leg muscles and spinal cord].
abstract: One of the cerebral palsy (CP) symptoms is the impairment of the ability to maintain upright standing. The objective of the present study was to investigate the effect of the locomotor training combined with electrical transcutaneous spinal cord stimulation (TSCS) and functional electrical stimulation (FES) of the muscles to facilitate the restoration of the vertical posture function in the children presenting with cerebral palsy.
  
  
  METHODS
  This article is designed to present the results of the study that included 19 patients at the age from 6 to 12 years. The severity of the CP clinical manifestations was estimated to be around 3 in accordance with The Gross Motor Function Classification System (GMFCS). All the patients underwent 15 half-hour daily sessions of robotic mechanotherapy with the use of a locomotor training device. In 8 patients from the main group, each locomotor training session was accompanied by the TSCS and FES procedures. The patients of the control group underwent the locomotor training alone.
  
  
  RESULTS
  The dynamics of regaining the standing posture regulation was evaluated by stabilometry that has revealed a significant increase of postural stability in the children of the main group in comparison with those in the control group. It was apparent as a statistically significant (p<0.05) reduction of the length and the area of the center of pressure (COP) projection with open eyes (the 167 mm and 112 mm2 decrease of the median, respectively). In addition, the tendency toward the normalization of the COP projection in the sagittal plane was documented.
  
  
  CONCLUSIONS
  The present study has demonstrated the normalization of the impaired balance control system in the children presenting with the severe form of cerebral palsy under the influence of the combined treatment with the use of transcutaneous spinal cord stimulation and functional electrical stimulation of legs muscles supplemented by the locomotor training.
authors: The Turner Scientific Research Institute for Children̓s Orthopedics under the Ministry of Health of Russian Federation, Pushkin, Saint Peterburg, Russia.
authors: I E
authors: IE
authors: Nikityuk
authors: Pavlov Institute of Physiology, Russian Academy of Sciences, Saint Peterburg, Russia; 'Kosyma' Ltd., Moscow, Russia.
authors: T R
authors: TR
authors: Moshonkina
authors: Pavlov Institute of Physiology, Russian Academy of Sciences, Saint Peterburg, Russia; 'Kosyma' Ltd., Moscow, Russia.
authors: Yu P
authors: YP
authors: Gerasimenko
authors: The Turner Scientific Research Institute for Children̓s Orthopedics under the Ministry of Health of Russian Federation, Pushkin, Saint Peterburg, Russia.
authors: S V
authors: SV
authors: Vissarionov
authors: The Turner Scientific Research Institute for Children̓s Orthopedics under the Ministry of Health of Russian Federation, Pushkin, Saint Peterburg, Russia.
authors: A G
authors: AG
authors: Baindurashvili
mesh_terms: D002547:Cerebral Palsy / Q000628:therapy*; D002648:Child; D005081:Exercise Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007866:Leg / Q000503:physiopathology; D008124:Locomotion; D008297:Male; D018482:Muscle, Skeletal / Q000503:physiopathology; D004856:Postural Balance; D013116:Spinal Cord / Q000503:physiopathology; D004561:Transcutaneous Electric Nerve Stimulation / Q000009:adverse effects / Q000379:methods*