Neurological rehabilitation programs in Cosmosuit center are designed for children from 1.5 to 18 years old with congenital and acquired disorders of the central and peripheral nervous system, such as:

  • Cerebral palsy
  • Developmental delay
  • Encephalopathy of various origins
  • Consequences of strokes
  • Consequences of traumatic brain injuries
  • Consequences of spinal injuries
  • Consequences of neuroinfections (encephalitis, meningitis)
  • Spina bifida
  • Genetic and rare diseases
  • Autism
  • Consequences after the surguries of tumors
  • Arthrogryposis
  • Muscular dystrophy (Duchenne, Steinert, Becker-Keener, Rottauf, Erba-Rot)
  • Spinal muscular atrophy
  • Scoliosis, including juvenile kyphosis and poor posture

 

Based on the results of medical examination and received medical documentation, our team of specialists, headed by a neurologist,creates an individual rehabilitation plan for each patient. Such plan takes into account age, diagnosis, severity of neurological conditions and developmental features of the child.

The rehabilitation program lasts for 2, 3 or 4 weeks, depending on the recommendations of the neurologist and requests of the patient's family.

Depending on individual factors, the child receives up to 4-5 hours of rehabilitation per day, 6 days a week.

Each patient has a multidisciplinary team of 5-9 specialists.

A unique feature of the Cosmosuit center is that 3-4 physiotherapists carry out physical rehabilitation of one child.

During rehabilitation, we try to give recommendations and educate parents on the most effective methods and exercises to maintain a positive effect of intensive course at home.

Physical rehabilitation of children with neurological pathology is aimed at the following goals:

  • development of gross and fine motor skills
  • training of coordination
  • improvement of tactile perception
  • development of the skills of relaxation of respiratory skeletal muscles (diaphragmatic breathing)

The basic complex of intensive rehabilitation for children includes:

Medical massage
Medical gymnastics
Kinesitherapy in Adeli suit
Neuromotor development

Massage is one of the ways of harmonizing influence on the neural-reflex scheme.

Massage is an important stage in preparation of muscles for physical exercises that requires individual approach to each patient. Each group of muscles requires a special kind of massage.  During the massage, position of child's body must be constantly monitored. The position of head in relation to body, as well as the position of various parts of the body in relation to each other are very important.

Massage relaxes spasmed muscles and stimulates hypotonic muscles. We use different methods for activation and relaxation of muscles.

Cosmosuit specialists perform various types of massage from classical differentiated to segmented and pressure-point massage.

With the help of medical gymnastics a child with neurological pathology starts to feel active sensations in muscles. Exercises help to correct posture, normalize the tone and reduce or overcome pathological movements. The child begins to feel postures and movements correctly, and it becomes a powerful stimulus for development and improvement of his/her motor skills.

The main goals of medical gymnastics:
  • reduction of muscle hypertone and strengthening of underdeveloped and weak muscles
  • restoration of coordination and improvement of balance
  • educating the patient to use motor skills in accordance with the stages of ontogenesis to the age-related correspondence
Cosmosuit specialists use following methods of medical gymnastics:
  1. Vojta therapy. It is a unique technique based on the use of reflex locomotion and aimed at restoring and forming motor skills appropriate to the patient's age. The main goal of Vojta-therapy is activation of congenital movement patterns and their further development in full-fledged motor reactions. The patient's motor skills are brought to the motor abilities of children of his/her age step by step, from the most simple to more complex. Vojta-therapy creates the reaction of different levels of CNS integration, rhythmic and coordinated activation of the skeletal muscles. Reflex therapy activates functions of the muscles, spine, arms, legs and face that are necessary for everyday instinctive movements of the patient.

    The following movements can be restored due to the use of reflex locomotion:

    • straightening the body against the effects of gravity
    • “postural control" (balance of the body during movement)
    • “phase mobility" (purposeful steps and grasping movements)
  2. Bobath therapy is an approach based on stimulation of various body movements with the help of special positions of the body and limbs. It is based on two principles:

    • Suppression or elimination of tonic reflex activity, leading to a reduction and ordering of muscle tone.
    • Activation of motor reactions, such as getting up and keeping a balance in the appropriate sequence of development, followed by progress in elementary motor activity.

    Therefore, the method is based on re-training of the movement patterns by suppression of tonic reflex activity. Specialists select particular reflex-inhibitory positions for the patient, in which the nerve impulse is blocked to open up new ways for a variety of normal activities.

    The secret of treatment is in accurate and consistent choice of reflex-inhibitory positions, to which the child will adapt independently with ease in the course of time.

  3. Tekoryus gymnastics is a complex therapy aimed at development and increase in the range of movements in the large joints. Tekoryus gymnastics accelerates the development of such skills as the ability to get up and stand, move independently and walk up and down the stairs. Also gymnastics positively affects the improvement of the patient's speech and intellectual functions.

  4. Diagonal gymnastics has a beneficial effect on the musculoskeletal system, affecting not only the muscles and ligaments of the joint, but also nervous system and general reactivity of the body systems. Gymnastics helps to destroy pathological motor stereotypes and to create correct patterns of movement and postures instead. The therapeutic effect is caused by tonic, trophic action targeted at proprioceptive orifices and normalization of the afferent flow of impulses to the motor area of the cerebral cortex with further formation of different functions.

    Muscles, inaccessible for voluntary motor activity, are being activated as part of the general coordination complex for diagonal gymnastics.

  5. Kabat’s method (PNF) allows to restore functional connections between the nervous system, which directs the motor act, and the muscles directly engaged in the movement. The method is based on the principles of body mechanics and neurophysiology. Work of the active muscles helps to activate affected muscles, associated with them. The peculiarity of the method lies in the fact that the physiotherapist creates the necessary stimulating action (tension, compression, twisting, pressure) on the certain parts of the patient's muscles. The PNF method is always carried out in a positive way and does not cause any pain to the patient.

    PNF improves the motor ability of paralyzed muscles and coordination of movements and expands the range of movements in the joints.

  6. Ball-trampoline-stretching. The essence of the technique is that the child is placed on an incompletely inflated ball with a diameter of 120 cm, that has a pronounced effect of the trampoline. Swaying it up and down is accompanied by the appearance of accelerations that exert a training effect on the child's vestibular apparatus and help to relax it. The resulting effect of the trampoline is strengthened by stretching exercises, also aimed at relaxation and recovery of reciprocal relationships in the joints of the trunk and extremities. Changing the direction and strengthening of tension during the exercise activates the work of most muscle groups of the body and limbs.

  7. Treatment by position is one of the effective ways to correct contractures. The individual rehabilitation program of a child takes into account assessment of the pathology of the musculoskeletal system and contains recommendations on the movement regime, orthopedic regime, orthopedic prophylaxis (positioning, recliners, orthoses, orthopedic shoes, weighting bags, etc.).

    The tasks of orthopedic treatment are as follows:

    • formation of the correct initial posture (lying down, sitting, standing, walking)
    • reduction of spasticity and improvement of the functions of weakened muscles

    Thus, compliance with the orthopedic regime is aimed at preventing the development of the patient’s contractures. The formation of contractures can lead to deterioration of balance and loss of acquired skills.

  8. Postisometric gymnastics and relaxation is a method of manual therapy, the purpose of which is muscle relaxation, stretching of soft tissues, removal of excessive tone and reduction of pain. Postisometric gymnastics mixes short intervals of active muscle work with its passive stretching. As a result, we have a persistent hypotension of muscles and the initial soreness disappears.

Adeli therapy helps to restore the correct system of starting afferentation and reflex activity. With the help of the technique, it is possible to influence the disturbed functional system of antigravitation, which in its turn allows to correct motor disorders.

Following tasks can be achieved with the help of the dynamic proprioceptive correction method (DPC):
  • reduction of intensity or neutralization of pathological tonic reflexes
  • reflex correction of muscle synergy
  • reflex correction of faulty positions of the trunk and lower limbs
  • development of locomotion act stereotype that is close to physiological

During kinesitherapy in the Cosmosuit center we actively use the Gross simulator. Gross Simulator helps to restore lost motor skills and teaches motor patterns necessary for life support (walking). The uniqueness and fundamental novelty of this simulator is that it keeps vertical position of the body in the process of patient’s rehabilitation. Physiotherapist can regulate the direction of the movement, i.e. change the speed or load of applied effort, taking into account the response of patient's body to the load. There is an opportunity to perform a movement both by patient himself and with the help of a physiotherapist.

The following tasks can be successfully solved during the training:
  • muscle relaxation in the presence of muscle hypertonia
  • stimulation of the weakened muscles and ensuring normal mobility of the joints of the upper and lower extremities and the spine
  • development of correct reflexes, training of balance and support

The main purpose of the sessions with a specialist in neuromotor developmnt is to obtain or restore the skills necessary to achieve maximum independence of a patient in everyday life.

We work with the patient on the basis of an assessment of his/her physical, communicative and cognitive skills and ability to perform daily tasks.

Neuromotor development is a method of intervention aimed at involvement of all areas of child’s development: from motor to communicative, cognitive, neuropsychological and emotional systems, thereby contributing to the harmonious integration of all these areas. Neuromotor development also includes locomotor training and fine motor skills development in a game form using a system of light projections (sensory room).

The main working tools are the games and empathic relations. Therapist stimulates the child to achieve increasingly complex tasks, globally testing his skills and abilities, through certain actions and specific goals.

 

After a personal examination, the neurologist may recommend additional therapies from the following list:

Hydrokinesitherapy
Hand therapy
Occupational therapy
Electrostimulation
Multisensory integration
UGUL therapy
Verticalization
Kinesio Taping
Thermotherapy
Speech and Feeding therapy
Psychological correction

Rehabilitation in water is a technique applied by specialized therapists that should not be confused with a generic swimming activity. Hydrokinesitherapy is beneficial for patients with neurological, orthopedic and psychomotor pathologies.

This kind of therapy exploits the physical characteristics of water, such as absence of gravity, to evoke the motor patterns that were lost or never acquired . Furthermore, water facilitates the learning of the movement itself

The hand therapy therapy is conducted by an experienced occupational therapist and is focused on the:

 

  • Development of a focus on the subject and hand
  • Development of stereotypes of the movement of hands
  • Improvement of the ability to grab items
  • Improvement of fine motor skills
  • Reduction of shoulder tension
  • Correction of hypertone

The main goal of occupational therapy is to develop or restore the skills needed to achieve maximum independence of patient in their daily life activities. While working with the patient occupational therapist evaluates physical, communicative and cognitive skills of the patient and his/her ability to carry out everyday tasks.

Electrostimulation helps to prevent muscle atrophy, as well as improves muscle tone.

The sessions of multisensory integration are conducted by a an occupational therapist or a neuromotor development therapist in a specially equipped sensory room.

Objectives of the therapy are:

 

  • Training or restoration of  lost fine motor skills
  • Elimination of learning and writing difficulties
  • Elimination of the fear of sounds and light
  • Correction of gross motor skills
  • Correction of body and limb movements
  • Development of speech&language skills
  • Development of concentration of attention
  • Development of visual and auditory abilities

UGUL is a special suspension system designed for individual kinesitherapy aimed to load the locomotor system. With the help of a unique method of suspension and block therapy, you can both load and relieve the muscles approaching the state of weightlessness.

Kinesitherapy with the use of UGUL helps to develop the skills that are impossible to reach in the conditions of a standard approach in rehabilitation. Such gymnastics significantly expands the range of exercises for children and adults with various forms of motor development. The use of the body mass redistribution in the simulator allows to stimulate the work of muscles and to strengthen the correct motor stereotypes in the brain. It is possible to conduct a specific extension of joint and spine. It is used for individual exercises, active with suspension, support, dosing resistance, as well as for intermediate tension. Kinesiotherapy helps to reduce muscle tone, expand the movement amplitude of the joints, improve blood circulation, increase muscle strength and form the coordination of movement.

Verticalization ensures the normal functioning of the organism in a natural vertical position. Verticalization can effectively improve and stabilize the cardiovascular system, as well as activate the work of the musculoskeletal system. At the same time, verticalization not only accelerates the rehabilitation process, but also significantly reduces the risk of secondary complications associated with prolonged immobility of the patient.

The use of verticalization helps to achieve the following goals:

  • prevention of contractures in the joints of the lower extremities
  • decrease of spasticity and improvement of the muscle tone for the lower extremities of the trunk
  • increase of muscle strength and prevention of the lower limbs muscle hypotrophy development
  • adaptation of the cardiovascular system to physical activity

Verticalization can be carried out at the earliest stages of intensive rehabilitation, as it allows to activate functional reorganization of the central nervous system.

Kinesio taping is a time-tested therapeutic method using an elastic tape. This mode of treatment stimulates the functions of various tissue systems. The main goal of kinesio taping is to provide physiological mobility of damaged joints and muscle tissue. Thus, tape facilitates correct fixation of the joints, without limiting their mobility. In addition, tape helps to reduce the strain on the spastic muscles and at the same time gives the necessary elasticity to the paretic muscles. All this helps to control the movement.

With the use kinesio tape it is possible to:

  • improve muscle activity by regulating the tone
  • stop stagnant processes of edema and bruising
  • improve stability and volume of movement in joints
  • increase muscle strength during exercise

This method has a vast potential for influencing completely different levels of pathological processes and various mechanisms of physiological regulation. Kinesio taping increases the effectiveness of other methods, as well as prolongs the effect of therapy.

It activates the blood supply of tissues, as well as the functions of the nervous, hormonal and immune systems.

The speech and feeding therapist in Cosmosuit works with patients with the following complaints:

 

• Eating disorders (dysphagia) that result from neurological and traumatic injuries, as well as other changes. The speech and feeding therapist teaches the patient to bite, chew and swallow.

• Imbalance of orofacial musculature or changes in oral functions (resting position, swallowing, chewing, phonemic articulation).• Evolutionary language disorders, such as  delayed or mistaken speech, including specific language disorders.

• Specific learning disabilities, such as difficulty in reading (dyslexia), counting and writing (digraphy and dysrophography).

• Dysphonia, or change and / or weakness of voice.

• Dysarthria or difficulty in articulation due to neurological conditions (cerebral palsy, Parkinson's disease, multiple sclerosis and others).

• Disorders of fluent speech (stuttering)

• Difficulties in communication or speech of genetic origin (for example, Down syndrome) or acquired at the age of development (for example, neonatal and prenatal meningoencephalitis, and others), as well as acquired in adulthood (aphasia, dementia and others).

• Difficulties in communication and language in people with developmental disorders (autism).

• Communication difficulties due to deafness or sociocultural concerns.

Psychologist works with patients with mental retardation, mental subnormality and autism spectrum disorders.

The main task of the psychologist is to reveal the patient's reserve abilities, identify the areas of immediate and actual development, as well as the prospects for inclusion in the educational and socio-cultural environment.

Psychological services are provided not only for children, but also for their parents and other family members.  Parents play a very important role in the effective rehabilitation of the child. Psychologist helps to understand the child's developmental features, identify the best forms of behavior and parents' attitudes towards their child, as well as to eliminate psycho-emotional stress and create motivation.

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