International Clinic of Rehabilitation

Increasing number of patients, constant development and expansion of our rehabilitation system and the need of the patients for the comfortable accommodations forced the creation of a new rehabilitation facility.

In the summer 2003 in the ecologically clean area near the mountains, in the health resort Truskavets a new 14 thousand sq. m International Clinic of Rehabilitation was opened. The new building, situated near a lake, is created in the Secession architectural style, distinguished by the escape and release from the old traditions and dogmas. All the lobbies of the clinic are ornamented with flower decorative patterns made with stained glass with internal lighting. Stylized snowdrops and violets symbolize spring revival of the nature. Decorative patterns and ornaments are part of the art- therapy aimed at stimulating of the patient’s motivation for recovery, and freedom from disease. Internal decorations, parquet and furniture was made with the birch, a tree, known for its healing influence. The medical departments of the clinic are situated on the first and ground floor of the clinic and in the tower. Diagnostic departments were planned bearing in mind the main task of the diagnostics in Intensive Neurophysiological Rehabilitation System – assessment of the functional condition of the child, his adaptation and compensatory possibilities. Contemporary diagnostic equipment makes a wide range of Neurophysiological examinations, tests of respiratory and cardiovascular systems, extensive study of gross motor functions, gait analysis, and hand functions possible.Spacious rooms of the rehabilitation department with comfortable furniture and modern rehabilitation equipment ensure that training sessions may be carried out effectively and provide for the comfort of the patients and the medical personnel. Special rooms for the mechanotherapy and physical therapy are equipped with the gear for strength training, improvement of movement coordination, gait training, and gradual body adaptation to its new functional state. Several rooms are specially equipped for training in the biodynamical movement correction program and sessions of computer game training. Computer network and specially developed software automate storing and analysis of all the medical data. The Clinic also includes 100 living suits, which provide all the necessary comfort for the patients and accompanying persons during the entire rehabilitation course. Modern interior design, nice furniture, comfortable beds make the stay in the clinic suitable and cozy. Spacious one, two or three-room suites with the living space of over 24 sq. m, are equipped with phone, refrigerator, TV, and Internet connection. Roomy bathrooms with the space of 6 sq. m are accommodated to the special needs of the habitants. Standard services – laundry, ironing, clothes repair, etc are available for guest use. Room security is provided by electronic locks and a reliable access control system. Most technological processes of the clinic are automated according the technology of the “Clever House”. A comfortable restaurant, which seats up to 180 people is situated on the second floor of the clinic. Self-serving tables adapted for people with disabilities feature a large assortment of meat, fish and vegetable dishes, different juices, fruits and confectionaries. Patients, parents and accompanying persons may spend free time in a bar located on the first floor of the clinic. Different drinks, snacks and confectionaries are served here in a cozy setting.

What to bring along at the time of treatment?

Note: No report should be more than one year old at the beginning of treatment.

How much therapy time appertains to one treatment course?

Therapy is held due to the individual program about 4 hours a day. The program is estimated on 12 days individually for each patient.

Intensive Neurophysiological Rehabilitation System – the Kozijavkin Method.

The Kozijavkin Method (Intensive Neurophysiological Rehabilitation System, INRS) – is a highly effective treatment for patients with Cerebral Palsy, low back pain and consequences of trauma and organic lesions of the nervous system.

INRS is a multimodal rehabilitation system in which the influence of one component is complemented and intensified by the others. Its main component is a biomechanical correction of the spine and large joints in combination with a set of treatment modalities: reflexotherapy, physical therapy, special massage therapy, rhythmical group exercises, mechanotherapy, apitherapy

Suit Spiral with the program of biodynamical movement correction has been created to develop correct movement patterns.

Stimulating compensatory possibilities and brain plasticity, this method creates a new functional state which opens the possibility for faster motor and mental development of the child.
Different rehabilitation modalities of this system complement and intensify each other, and are aimed at the main task of rehabilitation: improvement in the quality of the patient’s life.

It is important to stress that the Kozijavkin Method is not alternative to existing rehabilitation approaches; it complements and significantly increases the efficiency of many other existing rehabilitation systems. The new functional state, created by the INRS, opens new wide possibilities for the development of the child and enhances the results of other rehabilitation treatments. The Kozijavkin Method was created 15 years ago in the Ukraine and thus far, more than 15, 000 patients have been treated by this method, including about 7, 000 from Germany, Austria, Switzerland, and France.

More than 40 families from the United States have also traveled to the Ukraine to experience this treatment.

Already in 1993 the rehabilitation system has been officially recognized by the Ukrainian government. Due to the high level of success with the Kozijavkin Method, it has received international approval and has been included in the encyclopedic edition of child orthopedics by the well-known German professor Frits Niethard (1998) as one of the four most effective approaches to the rehabilitation of Cerebral Palsy.

Statistical analysis of the medical records of a group of 12 256 patients, treated by the Kozijavkin Method confirmed high efficiency of this rehabilitation system.

Muscle tone normalization was noted in 94% of patients, improvement of the head control in supine position was noted in 75% of patients, 62% patients who were unable to sit before the treatment have learned to sit, 19% of patients began to walk without assistance, and 87% of patients, after the treatment, were able to open their spastically fisted hand.

Rehabilitation by the Kozijavkin Method is carried out in Lviv and Truskavets (Ukraine). In July, 2003, the International Clinic of Rehabilitation was opened in Truskavets. It offers the latest technology in Medical Rehabilitation


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 attachment 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 as there are no allergic reactions known; a beeswax treatment is carried out otherwise.

Mechano and play therapies are provided in order to promote inner motivation; treadmill training or special fitness exercises (physiotherapy) take place as appropriate.

Unlocking the vertebral column

It is intended that a new functional condition of the entire body be achieved by releasing blockages at the level of the vertebral column joints, thus enabling new patterns of movement to be learned. 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 column 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 rotating motion in respect of the body axis. In contrast with rotation in classical manual therapy, which is always carried out forwards (ventrally), the principle underlying our method is backward (dorsal) rotation via the Spina iliaca anterior superior.

The unlocking of the vertebral column joints and the use of additional therapies improve also the condition of the patients with chronic neurological problems, vertebral column complaints, post–traumatic situations (craniocerebral traumas) as well as headaches and migraine.

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.

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 breaking 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).

Joint therapy

The greater or lesser functional blockages of the joints results 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.

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 rapid movements (fibrillation). 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 extremities, stretching of the musculature and ligaments, relaxation of faulty joint positioning, improvement in circulation of the blood and the flow of lymph with accompanying optimum nutritional supply of the joints, even leading to spurts of growth.


Objective: Relaxing hypertonic musculature, reducing muscle tensions (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 myotendinoses, 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.

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.

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 (myotendinoses), 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 trigger zones. 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).
       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.).

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 of the patient, stimulating processes of plasticity in the brain.
       Method and Results: Based on the classical principles of physiotherapy, which are individually varied from patient 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 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.


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 bee poison 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.

Rhythmical music therapy

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

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.


Means of mechanotherapy are used for strengthening muscles, improvement of coordination and correction of movement patterns. Lower extremities' training is done using lever devices. Adjusting levers, weights and number of repetitions the optimal training regime is set.
       Treadmill and cycling devices are used for the correction of lower extremity movement patterns. For the upper extremities we use primarily bloc devices. Devices like "Vibroextensor" which combines action of heat, vibration and mechanical massage of the para-vertebral regions are also used.

Which patients are suitable for the treatment?

Patients (children, adolescents and adults) with infantile cerebral paresis: spastic, dystonic, atactic forms of hemiparesis, diparesis, tetraparesis.

Patients with a condition after trauma: after polytrauma (accident), stroke, in each case at least 6 months after the event.

Patients with vertebral column complaints:

  1. osteochondrosis
  2. cervicalgia syndrome
  3. thoracalgia syndrome
  4. lumbalgia syndrome
  5. shoulder-hand syndrome
  6. epicondylitis
  7. Visceropathies, i.e. impairments to the vegetative nervous system, e.g. functional cardiac and respiratory complaints
  8. Headaches and Migraine
  9. Bronchial asthma
  10. Arthroses

Which are not suitable for the treatment?

  1. Congenital anomalies of the vertebral column and of the central nervous system, such as in cases of Spina bifida.
  2. Post-traumatic patients in the acute phase (first six months).
  3. Spondylolisthesis.
  4. Osteoporosis of the vertebral column.
  5. Acute inflammations and infectious diseases of the central nervous system and follow-on effects.
  6. Very serious epilepsy and convulsions resulting from a very wide range of causes.
  7. Hydrocephalus in the decompensation phase, microcephaly.
  8. Conditions after operations on the vertebral column.
  9. Slipped disk.
  10. Sub-compensated or decompensated diseases of the internal organs (e.g. condition after heart attack, etc.).
  11. Acute arthritis.
  12. Malignant tumours of the bones or in the area of the central nervous system (brain, vertebral marrow).

What is the age of the patients who can be treated?

This is dependent firstly on their diseases. Treatment is possible as of an age of 6 months; the prognosis is usually best for younger children, especially in cases of infantile cerebral paresis. The earlier therapy is started, the greater are the chances for the success of the treatment and rehabilitation, since the child's brain has a great ability to compensate (plasticity) and pathological movement patterns have not yet fully developed.

Were there complications as a result of the treatment?

No. There are no known complications in connection with the treatment.                      

It is necessary to take an individual decision in limit cases as to whether there is any sense in following a treatment according to the method of Prof.V.Kozijavkin MD.

What can be done at home in addition to therapy?

The changes in the patients should be noted very objectively, for example, in a diary.

Changes might involve:

The unlocking of the vertebral column joints and the use of additional therapies improve also the condition of the patients with chronic neurological problems, vertebral column complaints, post–traumatic situations (craniocerebral traumas) as well as headaches and migraine.

When should a further stay in Ukraine take place?

The length of the period between the treatments is discussed and agreed; both the degree of disability on the part of the patient and his or her reaction to the treatment are important. When the condition of the patient has stabilized, the period between the treatments increases, until possibly one check-up per year is necessary. The body is usually ready after 6 to 8 months for another intensive period of therapy. Now, during a further stay in our rehabilitation centre, and depending on the clinical picture of the patient, physiotherapies, treadmill training and a special joint unlocking system of the key joints involving a modified manual therapy that we have also developed are additionally used in the second "intensive correction phase", frequently in addition to the therapeutic procedures which have already been used during the first block of therapy.

Treatment results

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 Kozijavkin 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

Biodynamical Correction Suit

The suit consists of a system of elastics straps which are wrapped spiral-like across the body and extremities. Imitating the positions of the main muscle groups, they provide the necessary corrective force.

The straps can be attached to the special supportive elements for trunk and extremities (vest, shorts, knee, elbow, foot and wrist pieces). Velcro attachments on the straps allow for various adjustments to be made relative to the corrective action desired.

The biodynamical correction suit is used to enhance remedial gymnastic exercises, mechanotherapy, treadmill training, training with play therapy devices, and plain movement activity of the child.

The development of a new movement pattern and the correction of the posture of the patient is attained through the sum of forces, applied by the appropriate placement of elastic straps. Attention is paid to the individual sides of a patient's muscular-skeletal system and the goals of treatment.



Dolphin-Imitator causes wavy vibrations of the body much like the movements of a dolphin in the water.

An individual selection of frequency and amplitude provides movement wave's which pass along the whole spine and body.

The wavy vibrations assist successful spinal joints mobilization, relax spastic and overstrained muscle groups, and improve blood supply and trophicity of the muscle-skeletal system.

This effect can be enhanced by comfortably positioning the patient, and by adding acoustic or visual stimulation during the treatment.


Hand Game-Trainer

Hand Game-Trainer combines a mechanical training device with exiting computer games.

Doing an exercise to develop movement in certain joints with Hand Game-Trainer is at the same time playing a computer game, which stimulate to movement's speed and amplitude enlargement, train speed of reaction and improve movement coordination.


Training Chair

The training chair provides a method for developing body movement coordination and improvement of postural control. The training chair is equipped with a special system of sensors, which determine position and movement of the body in three dimensions. The information is transmitted to a computer which operates a computer game. Taking his part in the game, the patient directs a virtual object by bending forth and back, tilting to the side and rotating his trunk.

Colorful, attractive, exiting, animated computer games turn physical training into an effective treatment procedure.




Scheduled treatment courses for year 2005

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