Intensive Neurophysiological Rehabilitation System — the Kozyavkin Method A Manual for Rehabilitation Specialists. Edited by Prof. V.I. Kozyavkin International Clinic of Rehabilitation Lviv – Truskavets - 2012 УДК 616-036.82 ББК З62-5,07 Content Introduction. .5 V.I. Kozyavkin 1. Anatomic and Physiological Features of Organ and System Development in Healthy Children . .8 К80 Intensive Neurophysiological Rehabilitation System — the Kozyavkin Method. 1.1. The Child’s Physical Development . .10 A Manual for Rehabilitation Specialists. 1.2. The Nervous System. .12 1.3. Sense Organs. .20 Edited by Prof. V.I. Kozyavkin. — Translation from Ukrainian. — Lviv: “Papuga” Publishing House, 2012.– 240p. 1.4. The Skin. .21 1.5. Urinary system. 22 Система інтенсивної нейрофізіологічної реабілітації – 1.6. Endocrine Glands. .22 Метод Козявкіна. 1.7. The Cardiovascular System. 23 Посібник реабілітолога / За ред. проф. Козявкіна В.І. – 1.8. Respiratory Organs . 25 Переклад з української. – 1.9. Muscular and Skeletal Systems. .28 Львів: Дизайн студія «Папуга», 2012.– 240с. 2. Sequence of Topical Clinical Diagnosis of Lesions of the Nervous System. 37 3. Perinatal Lesions of the Nervous System and Their Consequences. 45 ISBN 978-966-8041-80-8 3.1. Effects of Harmful Factors on the Embryo and Fetus. .46 3.2. Perinatal Lesions of the Nervous System. .47 Authors: V.I. Kozyavkin, M.O. Babadahly, H.P. Lun, O.O. Kachmar, 4. Cerebral Palsies, CP . .49 S.M. Hordiyevych, V.I. Lysovych, B.D. Voloshyn. 4.1. Clinical Picture of Lesions of Central Motor Neurons This book is essentially devoted to a new rehabilitation technology for treating (Central and Spastic Forms of Paralysis). .49 patients with organic neurological lesions – the Intensive Neurophysiological 4.2. Clinical Picture of Lesions of the Peripheral Motoneuron Rehabilitation System – known worldwide as Prof. Kozyavkin’s Method. (Flaccid, Atrophic, Atonic Forms of Paralysis). 51 The manual covers fundamental medical components of the rehabilitation sys- 4.3. CP Related Syndromes. .52 tem, and provides a detailed description of the diagnostic algorithm to examine 4.4. Main Clinical Motor Patterns of CP . 52 patients. We present a brief description of anatomical and physiological features in the development of healthy children’s organs and systems and diagnostic fun- 4.5 Abnormal Joint Variations in CP. 53 damentals related to perinatal lesions of the nervous system. 4.5.1. Abnormal Variations in Hip Joints in CP. .58 5. Types of Rehabilitation. 63 This manual is recommended for use by physical rehabilitation specialists, medi- cal personnel, doctors specializing in different medical fields and involved in 6. Methods for Treating Organic Lesions of the Nervous System. .67 rehabilitation, in particular child neurologists, pediatricians, orthopedists, neu- 6.1. Therapeutic Author (Copyright) Systems. .69 rologists, speech therapists, and specialized educators. 7. The Kozyavkin Method – the Intensive Neurophysiological Rehabilitation System. 71 7.1 Indications for INRS Treatment. 74 Translation from Ukrainian into English by Dialog, the Center of Foreign Languages 7.2. Contraindications for INRS Treatment. 74 7.3. The INRS Rehabilitation Program. 75 7.4. The INRS Diagnostic Algorithm. .75 7.4.1. First Level Screening. 75 © International Clinic of Rehabilitation, 2012. 7.4.2. Second Level Screening. 76 7.4.2.1. Anthropometry methods adapted to patients with organic lesions of the NS. 76 All rights reserved. Neither this book nor any section thereof may be reproduced in any form or 7.4.2.2. Measuring the patient’s blood pressure (BP) and heart rate. .77 by any means whatsoever without prior written permission from the International Clinic of Rehabilitation. 7.4.2.3. Measuring the circumference of the patient’s head and limbs. 77 7.4.2.4. Measuring the length of the patient’s limbs and feet. .78 ISBN 978-966-8041-80-8 7.4.2.5. Measuring the distance between the patient’s parted legs. .79 7.4.2.6. Manual Ability Classification System for Children with Cerebral Palsy 4-18 years . .79 7.4.2.7. Video recording of the patient’s gross motor functions . .85 Introduction 7.4.2.8. Gross Motor Function Classification System. .86 7.4.3. Third Level Screening. .95 Dear readers! 7.4.3.1. Neuropediatric examination scheme. .97 Improving a patient’s quality of life is 7.4.3.2. Neuro-orthopedic evaluation. .106 the main goal of medical rehabilita- 7.4.3.3. Somatic tests. 107 tion. This goal is universally accepted 8. Basic Complex of INRS Therapeutic Rehabilitation Measures . .110 in all civilized countries. To imple- 8.1. Biomechanical Correction of the Spinal Column. .110 ment such a program, it is necessary 8.2. Joint Mobilization. 111 to study, to generalize one’s experi- 8.3 Craniofacial Mobilization . 117 ence, to search, and to introduce 8.4. Reflexotherapy. .118 innovations and information technology in order to develop new and more 8.5. Special Massage Systems. .122 effective rehabilitation methods for our patients. 8.6. Remedial Exercises. .130 Motivation and information constitute particularly important components 8.6.1. Remedial Exercises Using the Pavuk (Spider) System. 139 in our medical rehabilitation system. However, this should not be information 8.7. Spiral – the Biodynamic Corrector . 141 just for the sake of information. Through knowledge gained through modern 8.8. Multivector System for Modeling Movements technology, information should be put into practice, first, by acquiring practi- of the Spinal Column Using Virtual Reality and Games Therapy. .143 cal expertise and skills, and further, by translating them into action focused on 8.9. The Dolphin Apparatus for Passive Joint Mobilization good results. These results, in turn, generate new information, new knowledge, of the Spinal Column and Limbs. 143 and new skills. 8.10. Dance Movement Therapy in the INRS Rehabilitation Program. 144 The clinic’s scientific work is conducted in close cooperation with the 8.11. Mechanotherapy. 147 P. Shupik National Medical Academy of Postgraduate Education, the Ukrain- 8.12. Cycling. 148 ian Research Institute of Clinical and Experimental Neurology and Psychiatry, 8.13. Correcting Gait on the Treadmill. .149 the Danylo Halytsky Lviv Medical University, the Munich Children's Center, 8.14. Vibration Therapy. .150 the Moscow Scientific and Practical Center for Pediatric Psychoneurology, the 8.15. Apitherapy. .153 Tokai University in Japan, Karolinska Institutet in Sweden, etc. 8.16. Games Therapy. .154 On behalf of more than 40,000 patients from 60 countries, and on my own 8.16.1 Hand Training Device . .169 behalf, I would like to thank a professor who devoted her whole life to CP pa- 8.16.2 Training Chair. .170 tients – Ksenia Oleksandrivna Semenova. Almost 25 years ago, when Profes- 8.16.3 Universal Game Device. .172 sor Semenova headed the All-Union medical commission, she objectively and 8.17. Світлотерапія в СІНР. .174 impartially became acquainted with our rehabilitation method, examining a 9. Factors Limiting Rehabilitation According to Kozyavkin’s Method. 176 group of patients treated for cerebral palsy, and confirmed this radically new 9.1. Neurological . 176 direction for rehabilitation, which is now officially called the Intensive Neuro- 9.2. Orthopedic. 176 physiological Rehabilitation System. 9.3. Somatic . 176 There is a host of important reasons for publishing a teaching manual con- 10. Information Technology in Standardizing cerning the rehabilitation of patients of all ages suffering from the effects of and Organizing Medical Rehabilitation. 177 organic lesions of the nervous system and cerebral palsy. Unfortunately, the 11. Music Therapy in the INRS Program. .180 number of such patients has not decreased, and the search for the most effec- 12. Motivation as an Aspect of Rehabilitation in the INRS Program. 183 tive methods continues. The best criterion illustrating the actual effectiveness 13. Reference. .188 of rehabilitation treatment is obtaining a positive result, whereas the tool for 14. Appendix. 190 success is the applied treatment method. 5 Dear readers! Before you lies a manual about the Intensive Neurophysiologi- Professor V.I. Kozyavkin has created a fundamentally new, modern, and highly ef- cal Rehabilitation System designed for rehabilitation specialists and medical fective rehabilitation system for patients with Cerebral Palsy, which has received wide personnel. We hope that it will be useful for doctors working in different spe- recognition both in Ukraine and abroad. This system includes a high rehabilitation po- cialized fields, as well as for specialized educators, speech therapists, psycholo- tential in the context of extending the scope of its application, namely for rehabilitating gists, and development pathologists working in rehabilitation treatment. not only children with cerebral palsy, but also children and adults suffering from various organic lesions of the nervous system, as well as other neurosomatic pathologies. I wish all our readers and colleagues all the best for further creative search We recommend that V.I. Kozyavkin’s intensive neurophysiological rehabilitation and great success for the benefit of our children. system should be put into practice not only in preventive healthcare facilities in Ukraine Volodymyr Ilyich Kozyavkin, but also in similar institutions abroad. Doctor of Medical Sciences, Professor P.V. Voloshyn, Director of Institute of Neurology, Psychiatry, Honoured Worker of Science and Technology, and Narcology, National Academy of Medical Sciences