Method for predicting the development of scoliosis

FIELD: medicine, diagnostics.

SUBSTANCE: the present innovation deals with predicting the development of idiopathic scoliosis at applying more simplified techniques of investigation. It is necessary to test patients to detect their leading hand, leading eye and leading ear and calculate the coefficient of encephalic asymmetry C by the following formula: C=(Cr-Cl)/(Cr+Cl+Ca), where Cr - the quantity of tests at predominance of right hand, eye, ear; Cl - the quantity of tests at predominance of left hand, eye, ear; Ca - the quantity of tests at the absence of predominance of either right or left hand, eye, ear; and predict the probability of development of idiopathic scoliosis in patients at C being within 0.50-0.85 interval.

EFFECT: higher accuracy of prediction.

2 tbl

 

The invention relates to medicine, namely to methods for predicting the occurrence in children idiopathic scoliosis.

Idiopathic scoliosis - curvature of the spine with torsion curvature - is one of the kinds of degenerative diseases of the spine. The etiology of idiopathic scoliosis until the present time is not set.

To date, the known methods aimed at the differential diagnosis of early-stage idiopathic scoliosis by biochemical analysis (1) or to identify possible progression of scoliotic deformities on the basis of color asymmetry between the concave and convex sides of each vertebra within scoliotic arc (2).

A common shortcoming of these methods focused on the diagnosis of existing scoliosis, is that they cannot be used effectively to predict the possibility of developing scoliosis, i.e. to predict the propensity of a patient to the scoliotic spinal deformity before it appears.

A known method for predicting the risk of developing degenerative diseases of the spine concentration of glucosamine in the serum of patients (3). However, using this method allows to get information about the status of connective tissue metabolism, you cannot set a specific view on the strophic diseases of the spine, i.e. to allocate the risk of the development of idiopathic scoliosis.

As the closest technical solution to the claimed achieved result the selected predictor of spinal deformities in children, which in clinical studies to stop children at an early age of three years, the detection of a static brake failure and - in the presence of longitudinal platypodia is forecasting the development of the child static scoliosis. To verify and Refine the prognosis of the child above five years conduct additional research using computer planography and stabilography and the asymmetry static load in the frontal plane, the presence of asymmetric flexion installations in the knee and hip joints confirm the forecast of development of static scoliosis (4).

The disadvantage of this method is that it is, in essence limited to the establishment of the relationship between functional disorders of the feet of the child and his musculoskeletal system without detection of physiological reasons, resulting in the development of the disease, which significantly decreases the efficiency of forecasting the development of scoliosis. In addition, the known method is complex, because it is essentially a two-step and requires for sure what Noah diagnosis of scoliosis - use of computer planography and stabilography, which is not always possible in the conditions of medical institutions.

The etiology of idiopathic scoliosis is not installed, it is unclear what genetic (or other) factors are key in it occurs in children of different ages. This is indicated by the term itself, denoting this scoliosis is idiopathic, i.e. those arising without apparent reason. The presented invention is the result of the study, which established the relationship between the development of idiopathic scoliosis and certain characteristics of functional asymmetry of the brain of the child.

The technical result to be solved by the invention is the establishment of certain specific parameters manifestations of functional asymmetry of the brain in children, indicating a high probability of onset idiopathic scoliosis. The basis for a finding of high probability of occurrence of idiopathic scoliosis are representations of physiological dependence, individual manifestations of functional brain asymmetry and irregularities in the formation of the child's muscular the body, the tone of which is functionally connected with the asymmetry of brain function.

According to the invention a method for predicting the development of scoliosis is testing patients fordetermination they have a dominant hand, eye and ear, the calculation of the coefficient of asymmetry of the brain ToACby the formula

ToAC=(Cp-Kl)/(Kp+Cl+Cabout),

where Kpthe number of test cases with a predominance of the right hand, eye, ear;

Tolthe number of test cases with a predominance of the left hand, eye, ear;

Toaboutthe number of test cases in which there was no predominance of right or left hand, eye, ear, and forecasting the development of scoliosis in patients with KACin the range of 0.50 -0,85.

The essence of the method is established by the authors of the correlation between the emergence and development of idiopathic scoliosis with the peculiarities of the nervous regulation functions, in particular with interhemispheric asymmetry of the brain. Research conducted by the authors, has led to the conclusion that the functional asymmetry of the brain is directly related to the formation of muscle tone of the body of the corset, which, in turn, determines the development of idiopathic scoliosis.

The inventive method is carried out as follows. Patients children aged 3 to 7 years - test to determine they have a dominant hand, eye and ear. At this age, children completed the formation of functional asymmetry of the hemispheres of the brain.

The method of determining the dominant hand includes nine tests. Test apadravya - is to determine the control arms, making beats on the palm of the other hand (more active leading hand). The test facility hours is the definition of the hands, making institution hours (ignorant hand fixes the clock). Test crossing arms (pose of Napoleon) is the denition of the hands, which quickly goes on the forearm of the other hand and lays down on top. In the test for interlocking fingers is leading the hand, the thumb of which falls from above. The test for the simultaneous action of the hands is that the patient draws one arm circle and the other a square. Then the procedure of changing hands. Leading is a hand drawings which are made more accurately and completely. Tapping-test is performed as follows. On a piece of paper, draw a rectangle, divided into 6 squares. The patient within a certain time dots in each square with one hand. Count the total number of points and calculated the average number of dots in one square. Then on another sheet of paper draw the same rectangle, divided into 6 squares, and the procedure is repeated for the other hand. Leading is a hand, which corresponds to higher average number of dots in one square. The test measurement values montevago bed of the thumb. Leading is a hand which corresponds to the large size of the nail bed. Test n is lifting from the floor of the subject. Leading is the hand by which the patient picks up the object from the floor. Test the accuracy of hitting the target. The patient throws, for example, a dart at a target hanging on the wall. Leading is the hand that provided the greatest number of hits on the target.

When determining the leading eye uses three tests. Test winking one eye. During blinking, the patient closes the ignorant eye. Test looking in the telescope" is that the viewing subject through rolled in "telescope" paper is patient leading eye. The last test trial of Rosenbach - is that the patient records at the tip of the pencil and combines the past with any point. Leading is the eye, when closing which the pencil is shifted in his direction.

The definition of the leading ear is performed using dieticheskogo listen to when on the right and left ear of the patient through headphones serves various combinations of one-syllable words. Then the patient is asked to write the words he remembered. The essence of the test is that the patient plays a greater number of words submitted in the leading ear.

The duration of the entire set of tests is not more than 30 minutes. After completion of the test the patient is calculated coefficients of asymmetry is of the mind To AC(as in the motor field - hands, and touch the sphere of - sight, hearing) by the formula

ToAC=(Cp-Kl)/(Kp+Cl+Cabout),

where Kpthe number of test cases with a predominance of the right hand, eye, ear;

Tolthe number of test cases with a predominance of the left hand, eye, ear;

Toaboutthe number of test cases in which there was no predominance of right or left hand, eye, ear.

Out of the entire group of patients distinguish those who have aACis in the range from 0.50 to 0.85 and predict their likelihood of developing idiopathic scoliosis. The value of KACsuggests that the patient is "right" or "left", i.e. it is dominated by the function of the right or left hemisphere. On the prediction of the development of scoliosis signACno effect, it is important only its absolute value.

The proposed method was tested on two groups of children aged three to seven years. In the first group (80 people) consisted of children who have scoliosis, the second (60 people) - children with no such diagnosis. In the group of children suffering from scoliosis, most had ToACin the range of 0.50 to 0.85 are in the group of healthy children ToACin the range of from 0.50 to 0.85 were minority children.

In research and comparative analysis)ACin groups of patients and healthy children were received following re ulitity (table 1 and 2).

The results of determination of the asymmetry on the leading leg, %

Table 1
Type peripheral asymmetry / Leading legChildren with scoliosis (80 people)Children without scoliosis (60 people)
GirlsBoysOnlyGirlsBoysOnly
Left3,703,707,40**13,4010,0023,40**
Right46,3036,3082,60**33,3023,3056,60**
"Ravenoville"6,303,7010,00*11,708,3020,00**
* Differences significant at p<0,05.

** P<0,01

The average values of the coefficient of asymmetry of the surveyed children

Table 2
Values ForACChildren with scoliosisChildren without scoliosis
55,14*32,05*
* The difference is significant PR is p< 0,05

LITERATURE

1. RF patent №2188426, CL G 01 N 33/52, 2002

2. RF patent №2195870, class. And 61 In 6/02, 2003

3. RF patent №2204138, CL G 01N 33/52, 2003

4. RF patent №2147829, class. And 61 In 5/00, 2000 (prototype).

A method for predicting the development of scoliosis, including testing of the patient, characterized in that when testing the patient to determine his leading hand leading eye and ear, calculate the coefficient of asymmetry of the brain CAS by the formula

CAS=(CP-CL) (CP+CL+Co),

where KP is the number of tests with a predominance of the right hand, eye, ear;

CL - number of tests with a predominance of the left hand, eye, ear;

To the number of test cases in which there was no predominance of right or left hand, eye, ear,

and when Cam is in the range of from 0.50 to 0.85 predict the probability of development of idiopathic scoliosis.



 

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