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Manual therapiy: the intensive Neurophysiological Rehabilitation System, the Kozijavkin method


What is a day of treatment like?

Therapy begins on the second day; it is oriented to the individual requirements of each patient.
Therapy includes the preparatory, special whole-body massage, accompanied by a reflex therapy for the places of attachement of hypertonic and hypotonic muscles. the vertebral column is then corrected by unlocking.
Remedial gymnastics which are geared to each patient are intended to consolidate the achieved result and form new physiological movement patterns. This is supported by joint therapy, which involves mobilization of the large and small joints.
In addition, a bee poison therapy (apitoxin therapy) is used insofar a there are no allergic reactions known; a beeswax treatment is carried out otherwise.
Mechano and play therepies are provided in order to promote inner motivation; treadmill training or special fitness exercises (physiotherapy) take place as appropriate.


What are the characteristics of the individual therapeutic elements?


1. Unlocking the vertebral column
2. Joint therapy
3. Reflex Therapy
4. Remedial gymnastics
5. Massage
6. Rhythmical music therapy
7. Apitherapy


1. Unlocking the vertebral column

Objective: It is intended that a new functional condition of the entire body is achieved by releasing blockages at the level of the vertebral column joints, this enabling new patters of movement to be learned.

Method: A specially developed manual therapy in the form of a simultaneous, multistage mobilization of the locked vertebral column segments is at the heart of the Intensive Neurophysiological Rehabilitation System. This is begun in the lumbar area of the vertebral columnn after appropriate preparation. The dorsal vertebral column is then treated and, finally, the cervical vertebral column is unlocked. Several vertebral joints are relaxed by a rotation motion in respect of the body axis. In contrast with rotation inclassical manual therapy, which is always carried out forwards (ventrally), the principle underlying our metod is backward (dorsal) rotation via the Spina iliaca anterior superior.
The entire vertebral column is thus integrated into the unlocking therapy. Intensive mobilization of the cervical vertebral column is performed last. We unlock several segments here too using a special sudden rotation of the head.
These manipulations take place once a day for 12 days.
The remedial gymnastic measures of relaxation and mobilization continue in parallel.
Patients and their parents are actively integrated into these measures. They enter their exercises into a diary and record the changes.

Results: A completely new functional condition of the body is created by relaxing convulsions and contractures, by improving the circulation of blood and the metabolism and by braking pathological reflex patterns. This effect comes about both on the horizontal plane (vertebral column plane) as well as on the vertical plane (brain and bone marrow tracts).

2. Joint therapy

Objective: The greater or lesser functional blockages of the joints result in the joints and the surrounding structures (muscles, tendons, ligaments) becoming stiff. This leads to shrinkage (atrophy) and shortening of the musculature, faulty positioning of the joints (contractures) and inadequate circulation of the blood. Mobility is further restricted and a “normal” physiological position and movement of the body are no longer possible.
It is intended that the stiff joints be mobilized by modified neurophysiological correction in such a way that their mobility is lastingly improved.

Method: The large joints are treated first, then smaller joints (for example, hip, knee and foot joints). The joint is passively moved out of its neutral position (normal position) within its physiological radius of movement. This movement is supported by pulling and pressing on the joint and musculature, thus additionally increasing the scope of movement. Whereas larger joints are also relaxed by means of sudden blows to the joint cavities, smaller joints are relaxed by successive, very repid movements (fibrifllation). The intensity of the manipulations is increased in the course of the treatment.

Results: Extension of the volume of movement of the joints at the extremeties, stretching ofthe musculature and ligaments, relaxation of faulty joint positioning, improvement in circulation ofthe blood and the flow of lymph with accompanying optimum nutritional supply of the joints, even leading to spurts of growth.

3. Reflex Therapy

Objective: Stabilizing and matching reduced and increased tension of the musculature (hypotonia and hypertonia). Activating new functional and physiological possibilities of the body.

Method: Areas where the muscle has hardened (myotendionoses), sensitive points on the periosteum and classical acupuncture points are affected according to the experiences of Far Eastern medicine. A low-frequency power unit (Healthpoint) is used. This emits electrical current at low voltage with changing polarity, so that a varying effect, determined by the therapist, can be applied to the desired triggerzones. The therapist is in very close contact with the patient and directly checks the effects achieved by reflex therapy. The pathological horizontal and vertical reflex arcs are affected. This is given additional positive support by isotonic muscle expansion, elements of traction, vibration and bee poison therapy (apitherapy).

Results:
- Reinforcing the effect of muscle relaxation, which is achieved by correcting the vertebral column joints.
- Increasing muscle tone in the case of hypotonia, reducing it in the case of hypertonia, by creating new possibilities of movement, making the radius of motor action larger.
- Improving the circulation of the blood and thus the nutrition of the muscles, joints, tendons and ligaments as well as that of the central nervous system.
- Having an effect on disturbed vegetative functions (flow of saliva, sweat, etc.)


4. Remedial gymnastics

Objective: Gradually activating the patient’s possibilities of movement for building up a new, optimum pattern of movements and improving movement coordination, activating the inner motivation ofthe patient, stimulating processes of plasticity in the brain.

Method and Results:
- Based on the classical principles of physiotherapy, which are individually varied from pationt to patient.
- The activation of the patient’s possibilities of movement is carried out gradually: from simple to complicated movements, from passive to active movements, from the centre (brain) to the peripheral regions of the body.
- The movements in the joints are carried out actively and passively up to the physiological limit; the number of repetitions, the speed and accuracy of the movement are increased on all planes.
- Exercises for reducing the supporting area and for developing the spatial feel of the body are gradually applied.
- Use of special breathing exercises, especially in the case of patients with athetoses (these are diseases with continuous, involuntary, slow movements of the ends of the limbs) as well as for the purpose of learning the physiological function of respiration by play; This function of respiration is usually not very well developed in the case of patients in the phase after craniocerebral trauma. The special breathing exercises result in the entire body being better supplied with oxygen, and this contributes to the stabilization of the entire respiratory situation.
- For activating inner motivation: demonstrating the new functional possibilities by using elements of play, dance, music as well as participating in special sports competitions (patients’ Olympics).
- Use of special biomechanical computer game programs which have been developed in the rehabilitation centre for activating and improving the control of movements in the joints and in precision motor skills, coordination with induction by direct feedback for the patients.

5. Massage

Objective: Relaxing hypertonic musculature, reducing muscle tension (myotendinoses) and relaxing contractures as well as stimulating hypotonic musculature. Preparing for unlocking the vertebral column joints and intensifying its results.

Method: Heavily dependent on the sensitivity of the masseur, who searches out myotendiones, trigger zones and contractures and individually treats them according to the classical principles of massage, point massage, extension massage, acupressure and lymph drainage. A whole-body massage is carried out, which leads to a decompression and relaxation of all the joints. The massage accordingly relates to muscles, tendons, ligaments, joints and the entire vertebral column.

Results: The massage leads to a stimulation of the mentioned elements as well as to a reflex effect on the internal organs and on the entire metabolism of the patient treated. There is also an optimization of the muscle tone, resulting in an improved functional condition of posture and movement. This has an effect on the entire body.

6. Rhythmical music therapy

Objective: Combining physical exercises with music, dance and rhythm for promoting coordination and mobility as well as motivation.

Method: Tuition is organized for groups of 5 - 10 patients, using music, dance and games.
Warming-up phase: for warming up the muscles.
Loading phase: heavy loading in a playful way (promoting coordination, mobility of the joints, stabilization of the cardiovascular and respiratory systems). In addition, inner motivation and social adaptation are promoted in the group. The patients’ parents are actively integrated into the therapy.
Concluding phase: reducing the load and slowly returning to normal.

Results: The patient’s coordination and synchronicity of movement, rhythm, social behaviour, improvisation as well as confidence in his or her own abilities and the possibility of a new form of expression and creativity are promoted. Melody and rhythm lead to linguistic expressivity also being stimulated.

7. Apitherapy (bee poison therapy and beeswax therapy)

Objective: Supporting the entire body thanks to the local action of the bee poison (apitoxin) (for improving circulation of the blood and the metabolism) and to the systemic action of the bee poison (stimulating metabolism, immune strength, hormone levels, circulation of the blood), which affects the entire body.

Method: The therapeutic properties of bee products such as bee poison, honey and wax have been known since medicine was practised in ancient times; today, they are researched as to their chemical composition and effective mechanisms. Direct bee poison is not used in the rehabilitation centre: the sting is removed from the bee and introduced into the patient’s skin where desired. This leads to a reduction in the patient’s fear and pain factors and to a simpler dosing and determination of where the beepoison needs to be applied for exploiting its local effect. Beeswax is used therapeutically in the form of hot compresses, applied once per day on various parts of the body.

Is every patient given the bee sting therapy?
No, only the beeswax therapy is carried out in the case of patients with allergies; the bee sting therapy is not used.

How many bee stings does a patient need?
The doctor who is treating the patient decides on an individual basis. 2 - 3 bee stings per day are used at most, beginning on the fourth day of the stay until the end of the treatment circle.

More information under: www.reha.lviv.ua