Rehabilitation in children ( Pediatrics )

Rehabilitation in Pediatrics has its own specifics due to the peculiarities of child's organism. The effects of many diseases, defects of development affect adaptive capacity child's body, not allowing to count such a child is quite healthy. The who Constitution defined health is a state of physical, mental and social well-being in the absence of disease or infirmity. Restoring health to a sick child in all aspects, including functional, should be the center of attention of a pediatrician.

Rehabilitation in Pediatrics — a clearly defined stage in the harmonious system of health care for children. It begins at the moment of occurrence of disease, injury, or defect of development, and ends with the restoration of physical, mental and social well-being in the absence of payment or counter the pathological deviations of the morphological or functional nature.

The availability and effectiveness of rehabilitation depend not only on social conditions but on a proper understanding of each doctor its objectives and characteristics.

The goal of rehabilitation in Pediatrics — is not only to get sick child health, but also to develop his physical and mental functions to an optimum level.

Place of implementation of rehabilitation measures in Pediatrics are all institutions of health and education, and the child's family to ensure the restoration of his health at a certain stage. Medical rehabilitation is carried out usually at several institutions. Of these, the most important maternity hospital (maternity ward); children's clinic (an outpatient clinic, consultation); patient care; rehabilitation; specialized hospital; sanatorium division of the hospital; specialized children's sanatorium; health camp of sanatorium type;nurseries, nursery school, boarding school.

Comprehensive use of various means of rehabilitation in accordance with the plan of restoring health and functional capacity of the sick child require a special approach to issues of organization and methodology. Domestic and foreign experience of rehabilitation treatment has a number of fundamental provisions: rehabilitation of a sick child should be carried out within the facility with all types of rehabilitative treatment, and also having established contacts with other medical and rehabilitation institutions;

— rehabilitation of sick child should begin at the earliest stages of the disease, accounting for natural and organic part of the therapeutic measures, complementing and enriching the complex treatment;

— the rehabilitation process should be carried out continuously until the maximum recovery of the health of the child;

— rehabilitation at each stage is comprehensive;

— individual character as rehabilitation programs and use of funds taking into account the peculiarities of the child's personality and identity of pathological and functional changes;

— the ultimate goal of rehabilitation is to return the child to its usual conditions of life, study, and with the necessary changes — adapting to new conditions of life.

A child returning after ordinary treatment in an institution or home environment, can not without costs some effort to adapt quickly to the conditions, it would seem that his usual life. These efforts do not always lead to success, and in some cases there is a relapse or a new disease. Therefore, to fully restore the health of the child required a radically new organization of treatment and rehabilitation with extensive use of health-protective regime, diet therapy, pharmacology, physical therapy, massage, physiotherapy, psychotherapy.

The whole process of rehabilitation of a sick child can be divided into three stages: clinical, health and adaptation.

First stage — clinical (stationary). At this stage ensures not only restoration of function of the affected systems, but also training the body of the child to the next stage of rehabilitation. To solve these problems using pharmacology, diet, physical therapy (see physiotherapy), massage (see Massage and physiotherapy in paediatrics), physiotherapy. Great value, depending on the extent and nature of the disease, has the diet (see diet therapy). Fasting — during the acute phase, vitamin, calorie and easily digestible — in the recovery period. The first stage of rehabilitation is estimated by biochemical parameters, ECG, functional parameters.

The second phase of rehabilitation — sanatorium. It is crucial to normalize the function of the affected systems along with the restoration of the functions of other organs and systems. Special attention is paid to the extension of physical and mental activities of the child in accordance with his age and individual characteristics. This stage of rehabilitation of a sick child is carried out in specialized health centers. Focuses on diet, tempering procedures, physical therapy, physical therapy.

After sanatorium treatment functional parameters are normalized. The success of rehabilitation is determined by positive dynamics of growth and development of the child. A significant role in the evaluation of the results of sanatorium treatment is the presence of the child positive emotions, good health, normal sleep and appetite. An indicator of the completion of the sanatorium stage of rehabilitation must be regarded as the absence of clinical, radiological and other characteristics of the pathological process.

The third stage of rehabilitation — adaptive. At this stage is achieved normalization of the functional parameters, characteristic of this age, providing the return of the child to its usual conditions of life and study. The adaptation stage of rehabilitation can be carried out in a specialized center. The contents of rehabilitation interventions is determined by the condition of the child and the degree of adaptation of functional systems. Completed the third stage of rehabilitation complete restoration of health.However, in chronic diseases (heart disease, asthma, poliomyelitis, etc.), the task of rehabilitation is not only to achieve a state of maximum compensation functions of the patient's body, but also in maintaining the state of this compensation. Such children continue to be at the dispensary at the clinic, where the doctors observe the health status of the child (inspection, tests, functional tests, etc.). These children rehabilitation has been delayed for a certain period of time, moving from a return to the first and second stages during periods of exacerbation.Rehabilitation program in compressed form is recorded in a special map.

Diseases of the joints

Congenital dislocation of the hip

Congenital clubfoot

Flaccid paralysis of muscles upper limbs in newborns

Hypotrophy at children of early age

Exudative diathesis

Dyspepsia simple

Gastrointestinal diseases

Constipation (flatulence)

Colitis in children older

Torticollis in children at an early age

Physiotherapy in pulmonary diseases in children

Violation of posture and scoliosis

Hereditary neuromuscular diseases


Chafing of the skin

Acute pneumonia

Paralysis of the brachial plexus


Flat feet

Damage to the facial nerve

Poliomyelitis (children's spinal paralysis)

Umbilical hernia in children

Rickets in children

Enuresis ( bedwetting )

Disease prevention and psycho-emotional overload in children

The use of saunas (baths) for disease prevention and treatment of children

Immunoprophylaxis of infectious diseases

V.I. Dubrovsky,
Academician of the Russian Academy of Natural Sciences,
IANPO and the New York Academy of Sciences,
Doctor of Medical Sciences, Professor,
A.V. Dubrovskaya, pediatrician

1. see Methodical recommendations to carrying out of preventive measures aimed at protecting and promoting the health of students in secondary schools (Recommendation No. 206-Wed from 15 Jan 2008)

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