Evseev N F, Il'ina E R
Zh Nevropatol Psikhiatr Im S S Korsakova. 1979;79(10):1364-8.
In clinical conditions 189 patients with infantile cerebral paralysis were examined, and ways of their medical, family, social, and working rehabilitation were analyzed. The medical rehabilitation appeared to be the most effective in patients with pareses of the extremities and speech disorders. The prognosis as regards the working capacity was the most favourable in patients with mild and mode;ate pareses (hemi-, para-, and fetrapareses) and unfavourable in patients with severe hyperkinesias, pronounced oligophrenia, and combined pathology (hyperkinesias + tetrapareses; tetrapareses + debility and/or speech disorders). While specifying the disability groups attention was paid to the degree of the function impairment (mild, moderate, grave) and to the working prognosis. Patients with pronounced tetrapareses and contractures in all the joints, grave hyperkinesias in all the four extremities, and imbecility were classed with disability group I: those with pronounced para-, hemi-, and tetrapareses, extensive hyperkinesias, combination of the motor disorders with debility were placed into disability group II. While classing patients with disability group III the character and degree of the function impairments, the patients profession, contraindicated factors of the work, and compensatory potentialities were taken into account. The studies have shown that the existing scepticism with regard to the working capacity prognosis in patients with infantile cerebral paralysis is due to insufficient elucidation of their working potentialities in literature.
对189例小儿脑瘫患者进行了临床检查，并分析了他们的医疗、家庭、社会和职业康复途径。医疗康复在伴有肢体瘫痪和言语障碍的患者中似乎最为有效。工作能力的预后在轻度和中度瘫痪（偏瘫、截瘫和四肢瘫）患者中最为有利，而在严重运动亢进、明显智力低下和合并病变（运动亢进+四肢瘫；四肢瘫+虚弱和/或言语障碍）的患者中则不利。在确定残疾组别时，关注的是功能损害程度（轻度、中度、重度）和工作预后。所有关节均有明显四肢瘫和挛缩、四肢均有严重运动亢进以及低能的患者被归入一级残疾组；有明显截瘫、偏瘫和四肢瘫、广泛运动亢进、运动障碍合并虚弱的患者被归入二级残疾组。在将患者归入三级残疾组时，考虑了功能损害的性质和程度、患者职业、工作禁忌因素和代偿潜力。研究表明，目前对小儿脑瘫患者工作能力预后的怀疑是由于文献中对其工作潜力的阐述不足。
