Analysis of the effectiveness of a rehabilitation suit in children with cerebral palsy based on comparative changes in resting-state functional brain networks
https://doi.org/10.56618/2071-2693_2025_17_3_111
EDN: WJGIOW
Abstract
INTRODUCTION. Cerebral palsy (CP) is the leading cause of motor impairment in childhood and calls for comprehensive rehabilitation approaches whose effectiveness must be objectively verified. Resting-state functional MRI (rs-fMRI) provides new opportunities to explore neuroplastic changes elicited by therapy.
AIM. To evaluate the impact of a rehabilitation course employing a neuro-orthopedic suit on clinical outcomes and resting-state functional connectivity in children with spastic forms of CP.
MATERIALS AND METHODS. Thirty children with spastic diplegia (Gross Motor Function Classification System, GMFCS levels II–III; mean age (8±3) years) were enrolled in a prospective study. All participants completed a 4-week rehabilitation program using the “Atlant” suit. Clinical assessments (GMFM-88, Modified Ashworth Scale, MACS, SATCo, goniometry) and rs-fMRI (Siemens 1.5 T) were performed before and after the course. Seed-based analysis focused on the sensorimotor network (SMN); intraand inter-network connectivity changes were examined. Statistics included paired t tests and Pearson correlation.
RESULTS. After the 4-week intervention, significant improvements were observed on all principal clinical scales: total GMFM-88 scores increased, spasticity on the Modified Ashworth Scale decreased, manual ability (MACS) and trunk control (SATCo) improved, and joint range of motion increased on goniometry (all p<0.05). rs-fMRI revealed strengthened functional connectivity between key SMN nodes (primary motor cortex and supplementary motor area) and a reduction of pathological hyperconnectivity between the SMN and the default mode network (DMN). Enhancement of SMN connectivity correlated with motor gains (r=0.65, p<0.01).
CONCLUSION. Use of the rehabilitation suit leads not only to clinical improvement but also to favorable reorganization of functional brain networks in children with CP. Resting-state network analysis is a sensitive tool for objectifying rehabilitation effects and elucidating mechanisms of neuroplasticity.
About the Authors
F. A. Tlizamova
Almazov National Medical Research Center
Russian Federation
Russian Federation
Fatima A. Tlizamova – Postgraduate Student at the Department of Radiology and Medical Imaging with Clinic
2 Akkuratova street, St. Petersburg, 197341
A. Yu. Efimtsev
Almazov National Medical Research Center
Russian Federation
Russian Federation
Alexander Yu. Efimtsev – Dr. of Sci. (Med.), Professor at the Department of Radiology and Medical Imaging with Clinic
2 Akkuratova street, St. Petersburg, 197341
G. E. Trufanov
Almazov National Medical Research Center
Russian Federation
Russian Federation
Alexander Yu. Efimtsev – Dr. of Sci. (Med.), Professor at the Department of Radiology and Medical Imaging with Clinic
2 Akkuratova street, St. Petersburg, 197341
N. E. Ivanova
Almazov National Medical Research Center
Russian Federation
Russian Federation
Natalya E. Ivanova – Dr. of Sci. (Med.), Full Professor, Distinguished Doctor of the Russian Federation, Corresponding Member of the Russian Academy of Medical and Technical Sciences, Academician of the Academy of Medical and Technical Sciences, Full Member of the Petrovskaya Academy of Sciences and Arts, Member of the Board of the Association of Neurosurgeons of Russia, Member of the Board of the Babchin Association of Neurosurgeons, Member of the Geographical Society of Russia, Doctor of Functional and Ultrasound Diagnostics, Head at the Scientific Department of Russian Neurosurgical Institute, Head at the Scientific Department, Polenov Neurosurgery Institute – the branch of Almazov National Medical Research Centre; Professor at the Department of Neurology and Psychiatry, Institute of Medical Education, Almazov National Medical Research Center
2 Akkuratova street, St. Petersburg, 197341
D. D. Dorokhova
Almazov National Medical Research Center
Russian Federation
Russian Federation
Daria D. Dorokhova – Resident Physician at the Department of Radiology and Medical Imaging with Clinic
2 Akkuratova street, St. Petersburg, 197341
A. G. Levchuk
Almazov National Medical Research Center
Russian Federation
Russian Federation
Anatoly G. Levchuk – Engineer at the Magnetic Resonance Imaging Department
2 Akkuratova street, St. Petersburg, 197341
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For citations:
Tlizamova F.A., Efimtsev A.Yu., Trufanov G.E., Ivanova N.E., Dorokhova D.D., Levchuk A.G. Analysis of the effectiveness of a rehabilitation suit in children with cerebral palsy based on comparative changes in resting-state functional brain networks. Russian Neurosurgical Journal named after Professor A. L. Polenov. 2025;17(3):111-122. (In Russ.) https://doi.org/10.56618/2071-2693_2025_17_3_111. EDN: WJGIOW
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