Osteopathic correction in complex rehabilitation of children who have undergone cochlear implantation

Abstract

Introduction. Currently, the only way to rehabilitate patients with deafness is cochlear implantation (CI). CI includes not only surgery, but also rehabilitation carried out by a whole group of specialists. This is a multi- stage, labor-intensive, complex, long-term process of developing and maintaining speech function, so there is a constant search for new approaches and methods that could increase the effectiveness of ongoing rehabilitation measures. Previous studies have  demonstrated that osteopathic correction in preschool children reduces  the severity of speech disorders, contributes to the regression of speech therapy disorders, and helps in the correction of certain forms of dysarthria. Of particular interest is the work in which the authors demonstrated the existence of relationships between certain somatic disfunctions and the presence of disturbances in peripheral sound conduction and/or central sound conduction in children with sensorineural hearing loss. The question of the possibility of using osteopathic correction in the rehabilitation of children with pathologies of hearing and speech function (since, in addition to the consequences of highly invasive surgical intervention, children who have undergone CI, as a rule, have delayed speech development), seems promising for study.The aim was to study the results of the use of osteopathic correction in the rehabilitation of children who have undergone CI.Materials and methods. A randomized controlled prospective study was conducted from March 2022 to December 2022 on the basis of the Federal State Budgetary Institution RNTSCAiS FMBA of Russia, FSBI NMCIO FMBA of Russia. 36 children aged from 17 to 37 months were under observation. Depending on the treatment used, all observed patients were divided into 2 groups using a simple randomization method: main (20 people) and control (16 people). Patients in both the main and control groups received standard rehabilitation treatment. Each patient of the main group additionally underwent a single session of osteopathic correction lasting from 45 to 60 minutes. All patients were assessed for osteopathic status, time of connection and adjustment of the cochlear implant, and quality of life.Results. In children after CI, global neurodynamic disorders and regional biomechanical disorders in the regions of the head, neck, and dura mater were most often detected. After treatment, only patients in the main group showed a statistically significant (p<0,05) decrease in the frequency of detection of both global neurodynamic and the above-mentioned regional biomechanical disorders. A single session of osteopathic correction contributes to a significant reduction in the time of connection and adjustment of the cochlear implant, which can be considered as a favorable factor for subsequent rehabilitation measures. Against the background of the ongoing rehabilitation, a statistically significant increase in the level of quality of life was obtained in both groups, however, in the main group this indicator was statistically significantly higher.Conclusion. For children who underwent CI, the most characteristic was the presence of a global neurodynamic disorder, as well as regional biomechanical disorders at the level of the head, neck and dura mater. A single session of osteopathic correction can significantly reduce the time of initial connection and adjustment of     a cochlear implant, as well as improve the quality of life of this category of patients. This allows us to recommend the inclusion of osteopathic correction in comprehensive rehabilitation programs for children who have undergone cochlear implantation.