Modeling neurophysiological and psychomotor relevant criteria in children with motor dysfunction

Zh. L. Malakhova, A. Tynterova, S. V. Korenev, O. A. Tikhonova, L. A. Perminova, S. Botman
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Abstract

Background. Cerebral palsy is the most common cause of childhood disability among diseases of the nervous system, the prevalence of which averages 2.5 cases per 1,000 children.Aim. To identify relevant indicators in relation to the prediction of delayed rates of neuropsychic development in children and the formation of cerebral palsy in children 5–8 years old using mathematical modeling.Materials and methods. The study included 100 patients aged 5–8 years: 79 patients with neurological disorders and deviations in psycho-speech development, 21 patients – comparison group. The examination of children in both groups included: analysis of the child’s life history, analysis of psychomotor development in the first year of life, analysis of morbidity in the first year of life, assessment of psychomotor development at the time of the study, electroneuromyography using stimulation and superficial electroneuromyography, as well as ultrasound examination of the lower leg muscles with assessment of the functional state and muscle density using fibroscan.For statistical processing of the obtained data, descriptive statistics were performed. Determination of the statistical significance of indicators was carried out using the Kolmogorov–Smirnov test for continuously distributed values and Fisher’s exact test for discrete values. One-hot coding was used to represent categorical features. The analysis of the obtained data was carried out using a Python program using the pandas, numpy, scikit-learn, and boruta libraries.Results and conclusion. For children with deviations in neuropsychic development, significant early diagnostic markers are parameters of psychomotor development and neurological status (age when the child began to hold his head, decreased strength of the flexors of the foot and hip, level of walking) and instrumental examination (ultrasound of muscles thighs, electroneuromyography) – changes in the density and parameters of electrical excitability of muscles, which can serve as an early diagnostic sign of the development of motor dysfunction and an indicator for the formation of a trajectory of rehabilitation therapy.
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运动功能障碍儿童的神经生理和心理运动相关标准建模
背景。脑瘫是导致儿童残疾的最常见的神经系统疾病,其发病率平均为每千名儿童 2.5 例。通过数学建模,确定预测儿童神经心理发育延迟率和 5-8 岁儿童脑瘫形成的相关指标。研究包括 100 名 5-8 岁的患者:其中 79 名患者患有神经系统疾病和言语心理发育偏差,21 名患者为对比组。对两组儿童的检查包括:分析儿童的生活史、分析出生后第一年的精神运动发育情况、分析出生后第一年的发病情况、评估研究时的精神运动发育情况、使用刺激和浅层电神经造影术进行电神经造影,以及使用纤维扫描仪对小腿肌肉进行超声波检查,评估功能状态和肌肉密度。对连续分布的数值采用 Kolmogorov-Smirnov 检验,对离散数值采用 Fisher's 精确检验,以确定指标的统计意义。采用一热编码表示分类特征。对所获数据的分析是通过使用 pandas、numpy、scikit-learn 和 boruta 库的 Python 程序进行的。对于神经心理发育有偏差的儿童,重要的早期诊断标志是心理运动发育和神经状况参数(儿童开始抬头的年龄、足部和髋部屈肌力量下降、行走水平)和仪器检查(大腿肌肉超声波、电神经肌电图)--肌肉电兴奋性密度和参数的变化,这可以作为运动功能障碍发展的早期诊断标志和康复治疗轨迹形成的指标。
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