Neurorehabilitation in children neurorehabilitation in children with cerebrovascular insult: Why are we late?

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Hristina Čolović ,

Hristina Čolović

University of Nis , Niš , Serbia

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Dragan Zlatanović ,

Dragan Zlatanović

University of Nis , Niš , Serbia

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Vesna Živković ,

Vesna Živković

University of Nis , Niš , Serbia

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Anita Stanković ,

Anita Stanković

University of Nis , Niš , Serbia

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Dejan Nikolić

Dejan Nikolić

University of Belgrade , Belgrade , Serbia

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Abstract

Pediatric stroke (PS) is a rare disease with the global incidence of 1.2 -13/100,000, but nevertheless, is an important cause of disability in children. What makes it a challenging research topic is its alarming upsurge in the prevalence of 35%. The most prevalent motor deficit in that regard is hemiparesis in 50% to 80% of children with PS. Literature review. The following databases were used for the purpose of this study: PubMed, Medline, Scopus, Google Scholar. Asymptomatic clinical picture and a very rare use of indicated hyperacute recanalization therapy make rehabilitation the primary therapeutic approach in children affected with PS. The present studies suggest that the greater capacity of brain neuroplasticity in children can be relevant in recovery, but also indicate some specific consequences of injury made to a developing brain. Robotic neurorehabilitation (RNR) activates brain neuroplasticity, i.e. stimulates new motor learning which contributes to motor function recovery after brain damage. RNR, in combination with virtual reality, is able to expand the effects of conventional rehabilitation, the children find it interesting, and it motivates them to be actively involved in time-consuming, specific, high-intensity exercises. Motor recovery is intensified by learning and repetition of tasks, with a robot providing additional strength in the performance of movements, with continual measurements of objective parameters. Conclusion. The recommendations for use of RNR in children affected with PS are based on expert consensus and weak evidence, since there is lack of randomized, controlled studies.

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