Influence of osteopathic correction on the terms of adhesion of fractures of the distal metaepiphysis of the radial bone

2018 ◽  
pp. 85-90
Author(s):  
D. B. Miroshnichenko ◽  
A. A. Perepechin ◽  
K. W. Ananyin
Keyword(s):  
Healing Process ◽  
Main Group ◽  
Upper Extremities ◽  
Diagnostic Methods ◽  
Control Group ◽  
Negative Consequences ◽  
Osteopathic Treatment ◽  
Colles Fracture ◽  
Plaster Bandage ◽  
Radial Bone

Introduction. In 26-43 % of fractures of the bones of upper extremities secondary displacement of fragments occurs in the plaster bandage. It is probable that osteopathic treatment of patients with bone injuries of upper extremities promotes more rapid recovery of impaired functions of the damaged structure preventing possible complications and disability and improving patients' quality of life. That is why it is viable to study the infl uence of osteopathic correction on the healing process of the Colles’ fracture with displacement of bone fragments.Goal of research - to evaluate the effect of osteopathic treatment on the process of adhesion of Colles’ fracture with the displacement of fragments.Materials and methods. 40 patients took part in the research. 20 of them formed the main group. The other 20 formed the control group. An osteopathic examination of patients was performed and somatic dysfunctions were found. The visual analogue scale of pain was used. In order to evaluate the terms of adhesion, an X-ray diagnostic method was used.Results. Osteopathic diagnostics showed that somatic dysfunctions of the left or right wrist were dominant in patients admitted to the trauma bay with Colles’ fracture. Patients of the main group showed a faster normalization of the microcirculation, which meant that negative consequences of edema were less likely to appear.Conclusion. The study of the effect of osteopathic treatment of fractures of distal metaepiphysis of radial bone should be continued. The focus should be on the development and use of new diagnostic methods, which can prove the positive effect of osteopathic treatment on the terms of adhesion of the radial bone.

scholarly journals Evaluation of the effectiveness of the use of osteоpathic methods of treatment of patients with chronic stone-free cholecystitis

2020 ◽  
Vol 19 (2) ◽  
pp. 101-106
Author(s):  
O. A. Pankov ◽  
V. V. Matvienko ◽  
V. K. Frolkov ◽  
V. A. Zhernov ◽  
M. M. Zubarkina
Keyword(s):  
Clinical Symptoms ◽  
Main Group ◽  
Point Of View ◽  
Control Group ◽  
Complex Therapy ◽  
Osteopathic Treatment ◽  
The Subject ◽  
Somatic Diseases ◽  
Based Medicine ◽  
Methods Of Treatment

Background. Osteopathic methods are used in practical medicine, but there is little scientific research in this area, especially in the treatment of somatic diseases. The purpose of the research is to evaluate the effectiveness of osteopathy in the complex therapy of patients with chronic stone-free cholecystitis from the point of view of evidence-based medicine. Methods. The study involved 114 patients who were divided into two groups, the control group and the main group, in which osteopathic procedures were applied. The functions of the gallbladder, bile and blood biochemistry, and cholecystokinin secretion were analyzed. Results. It was found that osteopathic methods significantly increased the effectiveness of standard therapy both in terms of regression of clinical symptoms of the disease and in the functioning of the gallbladder. It is proved that the main group of patients significantly increases the secretion of cholecystokinin, which correlates with an improvement in the biochemistry of bile and its allocation. It was found that the effectiveness of osteopathic treatment methods does not depend on the gender of patients. Conclusion. The results of the study indicate a fairly pronounced therapeutic effect of osteopathic procedures in the complex therapy of patients with chronic stone-free cholecystitis. The increase in the secretion of cholecystokinin is difficult to explain from the point of view of correction of functional blocks, and this problem remains the subject of further research.

scholarly journals ANTIBACTERIAL THERAPY OF PYOGENIC LIVER ABSCESSES

2021 ◽  
Vol 48 (1) ◽  
Author(s):  
V. V. Novak ◽  
V. O. Belinska
Keyword(s):  
Body Temperature ◽  
Antibiotic Therapy ◽  
Antibacterial Therapy ◽  
Anaerobic Bacteria ◽  
Main Group ◽  
Diagnostic Methods ◽  
Control Group ◽  
Liver Abscesses ◽  
Microbiological Examination ◽  
Facultative Anaerobic Bacteria

Abstract Purpose of the study. To study the features of the microbial landscape, to develop an algorithm for antibacterial therapy in patients with pyogenic liver abscesses. Prove the effectiveness of the developed algorithm in the treatment of such patients. Materials and methods. The results of treatment of 79 patients with pyogenic liver abscesses were analyzed. The mean age of patients was 48,4 ± 4,7 years, with men predominating (62,9%). The inclusion criterion was the presence of pyogenic liver abscesses, the exclusion criteria were cholangiogenic and specific abscesses. The main group consisted of 44 patients operated on minimally invasive technologies based on modern diagnostic methods. They received a comprehensive conservative therapy, which took into account antibacterial treatment according to the developed algorithm. The tactics of surgical treatment of 35 patients in the control group did not differ from the main one. The groups did not differ significantly in age, sex, comorbidity, severity of the disease and the results of microbiological examination. Results. The number of inoculations of microorganisms from the purulent center was dominated by monoinfection – 86,4–88,6% of cases, which was mostly aerobic. Most of them were facultative anaerobic bacteria of the genus Enterobacteriaceae, namely Kl. pneumoniae – 34,1–40,1%. Less than a quarter of patients (11,4–13,6%) isolated cultures are represented by microbial associations – aerobic-anaerobic and aerobicaerobic. However, aerobic-aerobic infection prevailed – 75,0–83,3%. MRSA strains of staphylococci were isolated in 5,7–6,8% of patients. Treatment began on the first day of hospitalization. Empirical treatment was immediately prescribed, followed by antibiotic replacement, if necessary, based on the results of microbiological examination and determination of the sensitivity of the isolated cultures. According to microbiological studies, in patients with AP most of the isolated microorganisms (71,4–90,9%) were sensitive to linezalide and taigecycline. These antibacterial drugs were reserve drugs and were prescribed in extremely severe cases in the absence of sensitivity to other drugs. The effectiveness of treatment was evaluated by clinical data and improvement of laboratory parameters (normalization of body temperature and leukocyte formula). Conclusion. Carrying out adequate combined antibiotic therapy for patients with AP according to the developed algorithms, along with surgery, allowed to reduce the recovery time of patients: for 2–3 days normalization of body temperature (t = 5,66176; P < 0,000001) and leukocyte formula (t = 8, 56860; P < 0,000001) patients of the main group in comparison with control patients. In turn, this contributed to a probable reduction in the length of stay of the patient in the hospital for 3 days (t = 3,95561; P = 0,000116). Keywords: liver abscess, ultrasound semiotics, sonography intervention, classification of abscesses, antibiotic therapy.

scholarly journals AUTOLOGOUS BONE MARROW ASPIRATES IN THE TREATMENT OF CHRONIC WOUNDS

2020 ◽  
Vol 18 (5) ◽  
pp. 564-568
Author(s):  
S. D. Fedzianin ◽  
Keyword(s):  
Bone Marrow ◽  
Chronic Wounds ◽  
Healing Process ◽  
Autologous Bone Marrow ◽  
Main Group ◽  
Control Group ◽  
Wound Healing Process ◽  
Phase 2 ◽  
Wound Surface ◽  
Red Bone Marrow

Background: The problem of treating chronic wounds remains topical.Aim: To develop a method for the treatment of chronic wounds, which is based on the use of autoaspirates of the red bone marrow. Material and methods: The sternum was punctured by the needle of I.A. Kassirsky and red bone marrow was collected. The wound surface was treated with a Folkman spoon. An automyeloaspirate was introduced into the edges of the wound and applied to the surface of the wound.The 47 patients with chronic wounds were examined. The main group consisted of 24 patients. The area of the wounds is 87.75+11.51 cm2.The control group consisted of 23 patients. The area of the wounds is 88.52+13.71 cm2.Results: The duration of the phase of formation and maturation of granulation tissue in the main group was 5 (4.75; 7.0) days, and in the control group it was 12 (9.0; 16.0) (p <0.05).Conclusions: The developed method enables to significantly reduce the duration of phase 2 of the wound healing process by 7 days.

scholarly journals Results of osteopathic treatment of infants with psychomotor developmental disorders

2021 ◽  
Vol 102 (6) ◽  
pp. 827-834
Author(s):  
V R Veber ◽  
I A Egorova ◽  
E R Zinkevich ◽  
A E Chervotok
Keyword(s):  
Functional Status ◽  
Developmental Disorders ◽  
Standard Treatment ◽  
Integrated Approach ◽  
Main Group ◽  
Functional Health ◽  
Psychomotor Development ◽  
Control Group ◽  
Health State ◽  
Osteopathic Treatment

Aim. To compare the effectiveness of osteopathic treatment of infants with psychomotor development disorders with standard treatment in terms of functional status. Methods. The study was conducted at the Yaroslav-the-Wise Novgorod State University and the Institute of Osteopathic Medicine named after V.L. Andrianov, between 2020 and 2021. The study included 49 children with delayed psychomotor development, of which: the main group consisted of 26 children receiving osteopathic treatment; the control group consisted of 23 children treated with standard therapies. Data gathered included the indicators of the functional health state, complaints of parents, assessed neurological, vegetative, and osteopathic statuses, the psychomotor development in the children according to the ZhurbaMastyukova scale, performed neurosonography. The results were processed using descriptive statistics followed by checking for the significance of the difference by using the Student's t-criterion for related samples. Results. A comparison of the effectiveness of osteopathic and standard treatment of infants with a delay in psychomotor development by indicators of the functional status was carried out. The need for an integrated approach to therapeutic and diagnostic procedures was substantiated. The number of subjective complaints about the health of children from parents in the main group decreased, while in the control group, it remained the same. Neurological status in children of both groups improved, but the changes are more pronounced in the main group (p 0.05). The outcomes of the treatments indicate for improving psychomotor development of the children in the main group, in the control group, such an increase was only 13.0% (p 0.001). Conclusion. The results of the study showed that osteopathic treatment of infants with psychomotor development disorders is more effective than standard complex treatment, which is reflected in the improvement of functional health indicators.

scholarly journals Rationale for the use of osteopathic correction in the treatment of patients with chronic lower limb vein disease

2020 ◽  
pp. 111-121
Author(s):  
A. S. Shmeleva ◽  
I. B. Mizonova
Keyword(s):  
Quality Of Life ◽  
Saphenous Vein ◽  
Lower Limb ◽  
Classification System ◽  
Main Group ◽  
Control Group ◽  
Osteopathic Treatment ◽  
Ceap Classification ◽  
Vein Disease

Introduction. Despite the constant improvement of treatment methods, chronic lower limb vein disease (CLLVD) remains an urgent and not completely solved problem. Therefore the search for new methods of this disease treatment is actual. The effectiveness of osteopathic treatment of patients with CLLVD has been shown in recent years. But despite this the use of osteopathic treatment in this area has not been widely used today because further research, generalization of results and creation of an evidence base are required.The goal of research — is to substantiate the possibility of osteopathic treatment for patients with CLLVD C1–C3 (according to the international classification system CEAP).Materials and methods. The study involved 20 patients suffering from C1–C3 CLLVD. The main group (10 people) receiving osteopathic treatment and the control group (10 people) receiving standard treatment were formed by simple randomization. At the beginning and the end of the study there were evaluated osteopathic status of study participants, changes in pain intensity by visual analogue scale (VAS), changes in quality of life according to the questionnaire CIVIQ (Chronic Venous Insufficiency Quality of Life Questionnaire), and changes in the diameter of the saphenous veins of the lower extremities.Results. Osteopathic examination of patients with CLLVD C1–C3 (according to the CEAP classification system) prior to the treatment allowed to establish the presence of somatic dysfunctions of the regional (lumbar and pelvic regions, structural and visceral), and local (diaphragm, sigmoid and caecum) level. The use of osteopathic correction in the main group compared with medical treatment in the control group leads to a statistically significant (p<0,05) decrease in the number of regional biomechanical dysfunctions of the lumbar and pelvic region, visceral components, and local somatic dysfunction of the diaphragm. The use of osteopathic correction in the main group leads to a statistically significant (p<0,01) more expressed reduction in pain intensity and improved quality of life compared to the control group receiving medication. Both osteopathic correction and standard medical treatment are accompanied by a significant (p<0,05) decrease in the diameter of the small saphenous vein of the affected limb, as well as the diameter of the large saphenous vein (only in the group that received osteopathic correction). There were no cases of adverse treatment outcome.Conclusion. The infl uence of the somatic dysfunctions osteopathic correction on the development of chronic lower limb venous disease (classes C1–C3 according to the CEAP classification system) was studied. It was shown that this infl uence is not inferior to the standard medical method of treatment. The patients′ life quality improves, the experienced pain level decreases, and the subcutaneous veins diameter decreases. In comparison with the control group using the drug method of treatment, there is a statistically significant more expressed decrease in the number of somatic dysfunctions. The obtained results suggest the possibility of osteopathic correction using for C1–C3 class CLLVD according to the international classification system CEAP.  

Randomized controlled study of the effectiveness of osteopathic manipulative correction for muscular torticollis due to birth injury

2019 ◽  
pp. 6-18
Author(s):  
Yu. O. Novikov ◽  
D. E. Mokhov ◽  
J.-P. Amigues ◽  
G. M. Musina ◽  
A. R. Shaiakhmetov
Keyword(s):  
Cervical Spine ◽  
Muscle Tone ◽  
Pain Syndrome ◽  
Main Group ◽  
Controlled Study ◽  
Control Group ◽  
Annual Review ◽  
Birth Injury ◽  
Osteopathic Treatment ◽  
Muscular Torticollis

Introduction. Muscular torticollis (MT) is the most common lesion of the musculoskeletal system in children, ranking third in pediatric practice. There are references in the literature confi rming high effi cacy of manipulative therapy, but in Cochrane′s 2015 Annual Review, experts did not fi nd evidence of the effectiveness of the manipulations. We carried out research in order to determine the effectiveness of osteopathic manipulative correction (OMC) in children with muscular torticollis (MT) due to birth injury (code for ICD X: P 15.8).Goal of research — to study the gradual effectiveness of OMC on the basis of clinical and instrumental studies and ultrasound examination of the relationship between the bone structures and the cervical muscles.Materials and methods. 57 children aged 0–7 years with muscular torticollis due to birth injury were examined. All patients were randomly divided into 2 groups. Patients of the main group (32 children) received osteopathic treatment. Each child received from 3 to 5 sessions, depending on the severity of the birth injury and the duration of postural disorders. The time gap between the sessions was 2–3 weeks. Patients of the control group (25 children) received physiotherapy, massage and orthosis every day for 2 weeks. Along with the neurological examination the study of the effectiveness of treatment included assessment of the pain syndrome with the use of the behavioral numerical scale FLACC, and the assessment of the muscle tone with the help of the kinesthetic examination. Angle of rotation in the cervical spine was measured with the use of the goniometer. Moreover, all children underwent sonography of the cervical spine in order to determine the position of the tooth axis, with the calculation of the coeffi cient of asymmetry. The state of the musculus rectus capitis major (MRCM) and musculus sterno cleido mastoideus (MSCM) was also assessed.Results. It was observed that after OMC the clinically signifi cant improvement started earlier in patients of the main group. This improvement manifested by complete elimination or signifi cant reduction of biomechanical and tone disorders in the neck. Pain syndrome, measured with the help of the FLACC scale, signifi cantly decreased both after treatment and in catamnesis after 6 months (p0,05). When intercomparing left and right muscles in the groups, signifi cant differences were revealed (p0,05).Conclusion. The use of OMC (3 to 5 treatment sessions with the intervals of 2–3 weeks) in patients with MT is more effective than the treatment with the use of physiotherapy, massage and orthotics, which was received by patients every day for 2 weeks. This allows to recommend OMC for wider clinical use in this category of patients.

scholarly journals Neurotic State Characteristics of Mothers of Children with Cerebral Palsy

2020 ◽  
pp. 130-152
Author(s):  
A.N. Pevneva ◽  
Keyword(s):  
Cerebral Palsy ◽  
Psychological Health ◽  
Time Perspective ◽  
Main Group ◽  
Diagnostic Methods ◽  
Control Group ◽  
Raising Children ◽  
Structural Hierarchy ◽  
Children With Cerebral Palsy ◽  
Individual Variables

The research topicality is determined by the state policy priorities in the field of preservation, strengthening and restoration of mental and psychological health as important indicators of the individual’s quality of life as well as the development of preventive measures aimed at protecting health of mothers and children, developing a support system for families with children with mental and physical needs, improving their living conditions and strengthening the institution of the family. The goal of the research is to identify the neurotic features of a mother whose child is suffering from cerebral palsy. From 2006 to 2009 in the study participated 132 respondents: 66 mothers raising children with cerebral palsy, and 66 mothers of neurotypical children. The restudy in 2015-2017 was conducted on a sample of 96 mothers, 48 respondents in each group. Research methods we used are theoretical analysis of literature, psych diagnostic methods, longitudinal method, correlation research as well as methods of mathematical statistics. In the process of analyzing the results for mothers raising children with cerebral palsy there has been revealed a painful nature of the detected neurotic state characteristics followed by positive dynamics but their values are low and vary within its margins. On the contrary, the indicators of neurotic state characteristics for mothers of neurotypical children vary within the norm along with the statistically significant manifestation of their anxieties and worries. Neurotic depression of MG66 respondents occupies a dominant position in the structural hierarchy of the scales of the questionnaire which eventually gives way to the manifestation of anxiety and hysterical type of response to life situations. The structure of neurotic state is characterized by a differentiation of the respondents from main group, while in control group it is more integrated. Over time the structure of neurotic state characteristics in the main group respondents retains relative stability, and in the control group respondents it is transformed, complicated and differs in hierarchy and greater differentiation: individual variables acquire the status of autonomous ones where the additional research is required. Statistically signifi-cant differences in the severity of neurotic state characteristics for the main group and control group respondents in the time perspective were found. The neurotic state characteristics of mothers whose children have cerebral palsy are characterized by different severity levels of indicators in all structural components with their positive dynamics in the time perspective, the predominance of neurotic depression and its changeability by anxiety and over-reaction to everyday life situations.

scholarly journals Impact of the impulse electrophoresis of the blood plasma on the wounds healing and formation of cicatricial tissue in experiment

2019 ◽  
Vol 86 (11-12) ◽  
pp. 69-71
Author(s):  
G. V. Terehov ◽  
M. V. Chukhraiev ◽  
M. V. Kostyliev ◽  
S. P. Galych ◽  
O. Yu. Furmanov ◽  
...  
Keyword(s):  
Blood Plasma ◽  
Healing Process ◽  
Main Group ◽  
Laboratory Animals ◽  
Control Group ◽  
Surgical Access ◽  
White Rats ◽  
Electrophoresis Method ◽  
Group 5 ◽  
The Impact

Objective. To study in experiment the impact of the impulse electrophoresis of the blood plasma method on the wounds healing process in postoperative wounds. Materials and methods. The investigations were conducted on 15 white rats, to which in aseptic environment under intraabdominal narcosis the hip surgical access through the skin and muscles was conducted with subsequent layered closure of the wound, using separate knots. Ten laboratory animals were included into the main group, in whom transdermal introduction of the blood plasma, using the impulse electrophoresis method, was conducted on the 4th, 7th, 10th and 14th postoperative days. Into a control group 5 white rats were included, in which transdermal introduction of the blood plasma was not applied postoperatively. In all the laboratory animals the wounds have healed primarily. On the19th day postoperatively the laboratory animals were extracted from the experiment, and the near suture skin was investigated, using histological methods. Results. The surgical access healing in the hip skin and muscles with formation of normotrophic cicatrices was observed in the main group of the laboratory animals. Hypertrophic cicatrix in the operative intervention zone have been formatted in the laboratory animals of a control group on the 19th postoperative day. Conclusion. More qualitative healing of the wounds with formation of normotrophic cicatrix while application of transdermal introduction of the blood plasma, using the impulse electrophoresis method, was confirmed in experimental investigation in laboratory animals of the main group. Excessive creation of collagen was omitted in the laboratory animals of the main group, what have promoted formation of more thin and tender cicatrix, which have become slightly visible up to the end of experiment.

scholarly journals Global osteopathic treatment in the therapy of patients with chronic tension headache

2020 ◽  
pp. 18-27
Author(s):  
V. O. Belash ◽  
I. I. Bruk
Keyword(s):  
Neck Region ◽  
Tension Headache ◽  
Clinical Effectiveness ◽  
Main Group ◽  
Control Group ◽  
Adult Women ◽  
Head Region ◽  
Treatment Regimens ◽  
Before And After ◽  
Osteopathic Treatment

Introduction. Headache is one of the most common outpatient complaints from patients. According to various authors, annually 90 % of adult women and 83 % of adult men suffer from headaches; its frequency reaches 200 cases per 1000 population and does not tend to decrease. Herewith the tension headache (TH) is the most common variant of headaches in the general population. Modern methods of tension headache treating suggest the long-term use of antidepressants and muscle relaxants. And it may not give a lasting effect in some cases. Also, due to the small number of TH diagnoses by doctors among the population, people have to save themselves from a headache. As a result, the majority of the population suffering from TH takes analgesics uncontrollably. It fi nally leads to another severe type of headache — abusal headache. All these dictate the necessary of searching new methods of treatment, primarily non-medication, one of which could be osteopathy.The goal of research — to evaluate the clinical efficacy of the global osteopathic treatment of patients with tension headache.Materials and methods. A prospective, controlled, randomized trial was performed from 01.2018 to 03.2019 on the basis of the «Clinic of Regenerative Medicine» (Shakhty town) and V. I. Lenin MBUZ GBSMP. There were of 36 patients with a verifi ed diagnosis of chronic tension headache aged 20 to 40 years under supervision. Patients depending on the used treatment methodology were divided by the simple randomization method (using the envelopes method) into two groups: the main (20 people) and control (16 people). Patients of the main group received traditional therapy including medication, massage of the back and cervical-collar zone, physical exercises, and physiotherapy treatment. And in addition to these treatment methods patients of the main group received global osteopathic treatment, 3 procedures with an interval of 5–7 days. Patients in the control group received only standart therapy according to the same described above scheme. All the patients, regardless of the group, underwent an osteopathic examination before and after the course of therapy, with the formation of an osteopathic conclusion, and the severity of pain and asthenia was assessed.Results. The decreasing of regional and local somatic dysfunctions quantity in patients of the main group was observed during the treatment. Statistically signifi cant differences were obtained in the occurrence frequencies of somatic dysfunctions: region of the head, region of the neck, region of the dura mater; vertebral-motor segments СVII–DIII, abdominal diaphragm, I rib (p<0,05). A statistically signifi cant decrease in the pain severity and asthenic conditions (p<0,05) was also recorded after the treatment in the main group. There were no signifi cant changes of these indicators in the control patients group.Conclusion. Based on the study, it can be concluded that osteopathic correction in the complex treatment of patients with chronic tension headache can increase the clinical effectiveness of traditional treatment regimens. The obtained results propose a further deeper study of the osteopathic correction possibilities in the treatment of this patients group. 

scholarly journals Cervical somatic dysfunction in young infants: clinical manifestations and osteopathic correction results

2019 ◽  
pp. 33-41 ◽  
Author(s):  
E. V. Stroganova ◽  
O. N. Shadrin ◽  
Yu. O. Kuzmina
Keyword(s):  
Cervical Spine ◽  
Soft Tissue ◽  
Motor Development ◽  
Clinical Manifestations ◽  
Soft Tissue Injuries ◽  
Neurological Status ◽  
Main Group ◽  
Control Group ◽  
Young Infants ◽  
Osteopathic Treatment

Introduction. Currently, not enough attention is paid to diagnosis and treatment of cervical spine soft tissue injuries in newborns. Clinical evidence of soft tissue birth injuries in cervical spine is scarce and masked by symptoms of ischemic damage to the central nervous system. This leads to the fact that they are downplayed and timely treatment is not carried out. The effectiveness of osteopathy treatment in somatic dysfunctions diagnosis and correction for this natal pathology is underrepresented.Goal of research — to investigate the osteopathic correction effect of cervical somatic dysfunctions onabnormalities in the neurological status of young infants. Materials and methods. The study involved infants from 1 to 6 months, divided into main and control group, each of 20 patients. The control group infants received routine neurological treatment, in the main group osteopathictreatment was added. Neurological syndromes plotted against time and cervical somatic dysfunctions intensity were assessed in all infants.Results. When analyzing the treatment results, statistically signifi cant decrease in total number of neurologicalsyndromes is stated, as well as cervical somatic dysfunctions intensity decrease. By the end of follow-up period in main group infants statistically signifi cant improvement in following symptoms was found: head malposition,body posture, delayed motor development and nervous-refl ectory irritability syndrome.Conclusion. Based on the results of the study, the osteopathic treatment effi cacy has been proven, which allows us to recommend it in management regimen for infants with neurological disorders.

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