Remote effectiveness of medical habilitation with assessment of motor, coordination and oculomotor disorders in premature children aged 2 years

Abstract

Objective. To evaluate the long-term effects of the developed comprehensive medical habilitation (MН) of premature infants with assessment of motor, static-locomotor and oculomotor disorders at the corrected age of 2 years.
Materials and methods. The study included 212 premature infants with a gestational age of 26-36 weeks. Two groups were formed: group 1 — patients who underwent MA in accordance with the main directions of the developed methodology in full (n = 89); group 2 — patients, who underwent MA in accordance with standard approaches (n = 123). A cohort prospective longitudinal comparative study was conducted using the purposive sampling method. Inclusion criteria: premature infants with a gestational age of less than 37 weeks, spontaneous breathing, parental consent to the developed MH. Exclusion criteria: congenital malformations, genetic metabolic diseases, artificial lung ventilation, aggressive retinopathy, lack of parental consent for MH.
Results. The use of complex multimodal medical habilitation with the beginning of implementation in the neonatal period (up to 44 weeks of PCA) in the remote period (corrected age of 2 years) showed that premature babies have a 9-fold reduction in the risk of developing cerebral palsy (RR = 0.11, 95 % CI (0.03—0.45); p_{Cochrane — Mantel — Haenszel} = 0.0002), 4.8 times the risk of spastic paresis (RR = 0.21, 95 % CI (0.06—0.68); p_{Cochrane — Mantel — Haenszel} = 0.006); 4.4 times the risk of developing static-locomotor disorders (RR = 0.23, 95 % CI (0.11—0.45); p_{Cochrane — Mantel — Haenszel} = 0.006) and 3 times the risk of developing oculomotor disorders (RR = 0.33, 95 % CI (0.15—0.73); p_{Cochrane — Mantel — Haenszel} = 0.0049).
Conclusion. Thus, the early application of the complex multimodal medical habilitation developed by us with the beginning in the neonatal period in the late period (corrected age 2 years) shows its effectiveness.