The primary goal of the outcome studies of the Intensive Neurophysiological Rehabilitation System is the assessment of those functions which influence the quality of life, the main aim of our rehabilitation treatment. Therefore, the studies evaluate gross motor function, fine motor function of the hand and mental development.
A four-level diagnostic algorithm has been worked out for the complex patient evaluation. It includes the preliminary selection of patients for treatment, obtaining data necessary for the development of individual rehabilitation programs, observation of the changes in the patients’ conditions during the treatment and preparation of the home program for the patient.
In 2002 extended analysis of the medical data of 12.256 patients treated with Intensive Neurophysiological Rehabilitation System has been reported.
In this group 89% of the patients were children with different forms of Cerebral Palsy, 6% - with disorders of the spine, 3% with residual conditions after the damage of central nervous system (stroke, brain trauma), and 2% with other conditions.
Among the CP patients 73% had spastic quadriplegia, 16% spastic diplegia, 7% hemiplegia, 2% hade hypotonic form and 2% - hyperkinetic.
The largest age group consisted in the patients from 7 to 14 years – 36%. Unfortunately, only 3% of the patients began treatment below 4 years of age.
Before the treatment in our clinic patients have tried other rehabilitation methods: 73 % neurodevelopmental therapy (Bobath), 59 % rehabilitation by Vojta, 18% conductive education by Petö, and 22% other treatment methods.
37% of patients were treated in the Clinic for the first time. 26% came for the second treatment,. 14% of patients for the third visit, 9% for the fourth visit, and 14% for five or more times.
One of the important clinical signs of the CP is the alteration of muscle tone.
The Ashworth Scale was used for the assessment of muscle tone. Among the group of 10.793 patients with spastic forms of Cerebral Palsy 93% of patients experienced a reduction in muscle tone. In 7% of the cases, the muscle tone remains unchanged.
Range of passive and active joint movements is one of the important rehabilitation goals. presents the changes of active and passive movements range in large joint in a group of 10.793 patients with the movement limitation before the treatment.
After the treatment, the range of passive movement increased in 91% of the cases. The volume of active movements increased in 84%. Passive and active movements remain unchanged in 8 and 15 % of cases respectively, and there was some reduction of the movements’ volumes in only 1%.
We have developed a scale of gross motor function which was used to evaluate a group of 12.256 patients following treatment. 75% of patients without prior head control in the supine position, had learned to control their head. 62% of patients who were unable to sit, had learned to sit, 28% of patients had learned to crawl, 41% of patients who earlier were unable to stand, had learned to stand; and 19% of patients began to walk without assistance.
The ability of the hand to grasp an object and release it are both important functions for independent life and both components are often disturbed in CP. The Sollerman Hand Test (1995) was used to evaluate the grasp function. Improvement of fine motor skills was noted in 87% of the patients that had problems with grasp before the treatment. Hand function was unchanged in 13%, and there was no deterioration in any case.
Once the child with CP returned home, further improvement of motor function was noted in 45% of cases if therapy was continued at home. In 47%, achieved results remained at the same level and the results were deteriorated in only 8%, mostly after infection, diseases or surgery.It was noted that the Kozyavkin Method of rehabilitation resulted in improvement not only of movement and posture but also in the development of the psychological and mental function of the CP patient. 300 patients with CP were evaluated together with the Ukrainian Research Institute of Neurology and Psychiatry. Using the British Picture Vocabulary Scale significant increase of the intelligent quotient after the treatment was noted. In the case of the patients with spastic quadriplegia, the scores increased from 76 to 89 points.