PHYSICAL REHABILITATION FOR PARESIS

Paresis is the reduction of muscle strength with limited number of voluntary movements due to the damage to central and peripheral nervous system. In my practice, I have often dealt with pareses of varied origin. Most commonly, these pareses were caused by birth traumas, meningitis, encephalitis, non-compensated hydrocephaly (condition after shunting), atlantoaxial instability, condition after glutaric aciduria, as a result of tetralogy of Fallot defect, strokes,transient ischemic attacks. At present, scientific-and-technological progress has made a significant contribution to the development of neurology and neurosurgery, although, rehabilitation is essential after neurological and neurosurgical interventions. It is the rehabilitation that helps to improve patient's condition making it maximally close to absolute health. Physical rehabilitation in pareses often involves complex massage, physical therapy (PT) and external balneotherapy. Tonic muscle tension is a normal physiological state of the human body, and is accomplished as a reflex. It is impossible to perform movements without it, as well as to maintain the position of the body. Muscle tone keeps the body ready to perform an action. This is its main purpose. Tone (Latin: tonus, Greek: tonos – tension) – is a long-lasting persistent excitation of the nerve centers and muscle tissue that is not accompanied by fatigue. The tone of nerve centers is the state when the nerve centers continuously send impulses to the organs and tissues, maintaining their corresponding functional state – normotonus. These all scientifically based definitions indicate the norm of the anatomical and physiological functions of the musculoskeletal system and the central and peripheral nervous systems. But, unfortunately, certain pathologies, traumas or infections may affect normal functioning of these systems or damaged organs in different age periods. Diseases and injuries of the nervous system are treated in a complex manner, and physical rehabilitation plays one of the leading roles. Physical rehabilitation is a system of measures for restoration, or compensation of physical capacity, intellectual abilities, improvement of the functional state and physical qualities, psychoemotional stability and adaptive reserves of the human body by means and methods of physical training, elements of sports, massage, physiotherapy, natural factors. When it comes to physical rehabilitation of adult patients, the main goal is to restore the lost functions and occupational skills as soon as possible. In case of pediatric patients, the main task of rehabilitation is to as soon as possible restore the physiological processes of musculo-skeletal system, self-service skills and play activities and stop the disease progression. Rehabilitation program is developed on the basis of main rehabilitation means and methods: massage, curative physical training (which is divided into combined developing exercises, special exercises and lead-up exercises), external balneotherapy with phytotherapy, kinesiotherapy, physiotherapy. However, considering the biodynamics of this pathology and the type of lesion, one should pay attention to an individual result. For example, patient's age, professional characteristics, physical preparation for the disease, and even the person's character and his/her psycho-emotional state are very important. These factors are important in developing a rehabilitation program, while the efficiency and accuracy of patient's recovery will depend on them.