Pediatric Hematology/Oncology and ImmunopathologyPediatric Hematology/Oncology and ImmunopathologyВопросы гематологии/онкологии и иммунопатологии в педиатрии1726-17082414-9314Fund Doctors, Innovations, Science for Children48710.24287/1726-1708-2021-20-1-114-127ORIGINAL ARTICLESОРИГИНАЛЬНЫЕ СТАТЬИClinical analysis of video recordings of the basic motor patterns (CLAVIR) for the assessment of movement disorders in children and adolescents with acute lymphoblastic leukemiaКлинический анализ видеоизображения базовых двигательных стереотипов «КЛАВИР» для оценки двигательных нарушений у пациентов детского возраста и подростков с острым лимфобластным лейкозомhttps://orcid.org/0000-0002-3868-0510MitrakovN. N.МитраковН. Н.
Russian Federation

Head of Medical Rehabilitation Center of the Outpatient Department,

1 Samory Mashela St., Moscow 117997

заведующий центром медицинской реабилитации консультативного отделения,

117997, Москва, ул. Саморы Машела, 1

lokomokolya@gmail.comhttps://orcid.org/0000-0002-8168-9588ShcherbukhaA. V.ЩербухаА. В.
Russian Federation

Moscow 

Москва

https://orcid.org/0000-0002-4176-7406ShafranP. A.ШафранП. А.
Russian Federation

Moscow 

Москва

https://orcid.org/0000-0001-7578-9657VoroninK. A.ВоронинК. А.
Russian Federation

Moscow 

Москва

https://orcid.org/0000-0002-8084-1277LayshevaO. A.ЛайшеваО. А.
Russian Federation

Moscow 

Москва

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian FederationФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева» Минздрава РоссииEramishantsev City Clinical Hospital, Moscow Health DepartmentГБУЗ г. Москвы «Городская клиническая больница им. А.К. Ерамишанцева Департамента здравоохранения г. Москвы»Russian Children's Clinical Hospital of Pirogov Russian National Research Medical University of the Ministry of Healthcare of the Russian FederationРоссийская детская клиническая больница ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России210420212011141271704202117042021Copyright ©; 2021, «D. Rogachev NMRCPHOI»Copyright ©; 2021, ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава России2021«D. Rogachev NMRCPHOI»ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава Россииhttps://creativecommons.org/licenses/by/4.0https://hemoncim.com/jour/article/view/487

Movement disorders arising in pediatric patients with acute lymphoblastic leukemia (ALL) during treatment require a more differentiated approach to diagnosis and the choice of rehabilitation methods. The aim of this study was to investigate the conceptional structure of supine-to-stand (STS) transition patterns and to develop a method for the diagnosis of movement disorders and the assessment of the effectiveness of medical rehabilitation in children and adolescents with ALL. We carried out a prospective comparative non-randomized study. The study was approved by the Independent Ethics Committee and the Scientific Council of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation. The study included 184 children who were assigned to three groups. Group 1 (study group) included patients with ALL treated at the Center (n = 48, the median age was 14.0 years). Group 2 (control group) included patients with various serious diseases (acute myeloid leukemia, primary immunodeficiency, CNS malignancies, bone tumors, etc.) who also underwent treatment at the Center (n = 69, the median age was 14.5 years). Group 3 (control group) included healthy children and adolescents (n = 67, the median age was 14.2 years). We analyzed the characteristics of video recordings of the supine-to-stand process in apparently healthy children (Group 3) and in the patients treated at the Center (Groups 1 and 2) and then performed comparative analysis. We managed to detect, document, and divide into phases the video-based criteria of invariant characteristics of the acyclic locomotor pattern of the STS movement (from a supine to standing position with both feet on the floor). We identified the STS movement phases and clinically significant variants of STS transition patterns which were easily detectable on the video recordings. The objectivity of the analysis of the video-based criteria of invariant characteristics of the STS movement was achieved by the registration of timing characteristics of the locomotion pattern phases on video recordings. By calculating the coefficients of variation for observations from different angles and inter-researcher variability, we detected the most representative phases of the STS movement pattern on video recordings. A quantitative analysis of the STS test performance revealed significant differences between healthy controls and children with oncological diseases. The clinical analysis of video recordings of the basic motor patterns (CLAVIR) contributes a substantial amount of objective data to the clinical assessment of the diagnostic supine-to-stand test results in children and adolescents treated for ALL. 

Возникающие у пациентов детского возраста с острым лимфобластным лейкозом (ОЛЛ) в процессе лечения двигательные нарушения требуют более дифференцированного подхода к диагностике и выбору реабилитационных технологий. Цель работы: изучить смысловую структуру паттерна вертикализации (из положения лежа на спине в положение стоя) и разработать методику диагностики двигательных нарушений и оценки эффективности медицинской реабилитации у детей и подростков с ОЛЛ. Было проведено проспективное сравнительное нерандомизированное исследование. Работа поддержана независимым этическим комитетом и одобрена ученым советом ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава России. Всего в исследовании приняли участие 184 ребенка, которые были распределены на 3 группы. Группа 1 (исследовательская) – пациенты с ОЛЛ, проходившие лечение в Центре (n = 48, медиана возраста 14 лет). Группа 2 (контрольная) – пациенты с различными тяжелыми заболеваниями (острый миелоидный лейкоз, первичные иммунодефицитные состояния, злокачественные заболевания центральной нервной системы, опухоли костей и т. д.), также проходившие лечение в Центре (n = 69, медиана возраста 14,5 года). Группа 3 (контрольная) – здоровые дети и подростки (n = 67, медиана возраста 14,2 года). Исследовались характеристики видеоизображения процесса вертикализации у условно здоровых детей (группа 3) и у пациентов Центра (группы 1 и 2) с последующим сравнительным анализом. Удалось выявить, формально описать и этапировать критерии видеоизображения инвариантных черт ациклического локомоторного стереотипа вертикализации из положения лежа на спине в положение стоя на двух ногах на горизонтальной поверхности. Выявлены этапы вертикализации и клинически значимые варианты паттернов вертикализации, легко детектируемые на видеоизображении. Объективизация анализа видеокритериев инвариантных черт ациклического локомоторного стереотипа вертикализации достигнута путем регистрации временных характеристик видеоизображения этапов локомоторного стереотипа. В результате расчетов ракурс-независимости и межисследовательской вариабельности были выявлены наиболее репрезентативные этапы видеоизображения локомоторного стереотипа процесса вертикализации. Анализ количественных характеристик локомоторного теста вертикализации позволил обнаружить статистически достоверные для данной выборки отличия здоровых детей от пациентов с онкологической патологией. Клинический анализ видеоизображения рефлексолокомоций «КЛАВИР» дает значительный объем объективных данных при клинической оценке диагностического теста вертикализации у пациентов детского возраста и подростков, получающих лечение по поводу ОЛЛ. 

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