Effect of Professor Kozyavkin method on hand function in children with cerebral palsy

O.O. Kachmar, I.R. Mysula, A.D. Kushnir, B.Yu. Fedchyshyn, N.V. Melekh


Background. Impaired hand function is one of the key factors that restrict the ability of patients with cerebral palsy (CP) to perform everyday activities and self-care. Recent studies show effectiveness of intensive multicomponent methods of rehabilitation for improving hand function in children with CP. One of such methods is Intensive Neurophysiological Rehabilitation System, also known as Professor Kozyavkin method, a multicomponent system that combines various interventions into one intensive course. The aim of this study was to assess changes in hand function in children with CP after the two-week rehabilitation course by Kozyavkin method. Materials and methods. Thirty-two patients with bilateral spastic CP (aged 6–15 years, Manual Ability Classification System level I–III) have participated in the study. All patients underwent the two-week rehabilitation course by Kozyavkin method. Treatment lasted up to 5 hours per day and included physical therapy, occupational therapy, spinal manipulative technique, reflexotherapy, joint mobilization, computer game therapy, and other interventions. The primary outcome measure was Jebsen-Taylor hand function test and the secondary outcome measures were ABILHAND-Kids questionnaire, Box and Blocks test, and hand dynamometry. Results. Statistically significant improvement by 14.9 ± 38.0 seconds was observed during Jebsen-Taylor test for the dominant hand. Changes in Box and Blocks test were also statistically significant and were equal to 2.0 ± 3.7 points for dominant hand and 1.8 ± 2.8 points for non-dominant hand. Grip strength did not change; increase in ABILHAND-Kids score was not statistically significant. Conclusions. Hand function, particularly dexterity of both hands and unimanual functions of the dominant hand, had improved in children with cerebral palsy after the two-week treatment course by Kozyavkin method.


cerebral palsy; motor disorders; rehabilitation; hand; activities of daily living

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Arnould C., Bleyenheuft Y., Thonnard J.L. Hand functioning in children with cerebral palsy. Frontiers in Neurology. 2014. 5. 48.

Yevtushenko S.K. Etiology and Pathogenesis of Cerebral Palsy in Children (A New Look at an Old Problem) (Lecture). International Neurological Journal. 2014. 3(65).

Arner M., Eliasson A., Nicklasson S., Sommerstein K., Hägglund G. Hand Function in Cerebral Palsy. Report of 367 Children in a Population-Based Longitudinal Health Care Program. The Journal of Hand Surgery. 2008. 33(8). 1337-1347.

Arnould C., Penta M., Thonnard J.L. Hand impairments and their relationship with manual ability in children with cerebral palsy. J. Rehabil. Med. 2007. 39(9). 708-14.

Klevberg G., Østensjø S., Krumlinde-Sundholm L., Elkjær S., Jahnsen R. Hand Function in a Population-Based Sample of Young Children with Unilateral or Bilateral Cerebral Palsy. Phys. Occup. Ther. Pediatr. 2017. 37(5). 528-540.

Novak I., Honan I. Effectiveness of paediatric occupational therapy for children with disabilities: а systematic review. Australian Occupational Therapy Journal. 2019 Apr 10.

Plasschaert V., Vriezekolk J., Aarts P., Geurts A., Van den Ende C. Interventions to improve upper limb function for children with bilateral cerebral palsy: a systematic review. Developmental Medicine & Child Neurology. 2019. 61(8). 899-907.

Shierk A., Lake A., Haas T. Review of Therapeutic Interventions for the Upper Limb Classified by Manual Ability in Children with Cerebral Palsy. Seminars in Plastic Surgery. 2016. 30(01). 14-23.

Gordon A.M., Schneider J.A., Chinnan A., Charles J.R. Efficacy of a hand-arm bimanual intensive therapy (HABIT) in children with hemiplegic cerebral palsy: а randomized control trial. Developmental Medicine & Child Neurology. 2007. 49(11). 830-838.

Hoare B.J., Wasiak J., Imms C., Carey L. Constraint-induced movement therapy in the treatment of the upper limb in children with hemiplegic cerebral palsy. Cochrane Database Syst. Rev. 2007. (2). CD004149.

World Health Organization. International classification of functioning, disability and health: ICF. Geneva: World Health Organization, 2001.

Kozyavkin V., Babadahly M., Lun H. et al. Intensive Neurophysiological Rehabilitation System — the Kozyavkin Method. A Manual for Rehabilitation Specialists. Lviv, Ukraine: Papuga Publishing House. 2012. 240 p.

Kachmar O., Mysula I., Kushnir A., Voloshyn T., Matiu-shenko O., Hasiuk M., Hordiyevych M. Changes in motor functions in children with cerebral palsy after the course of intensive neurophysio­logical rehabilitation: a single-blind study. International Neurological Journal. 2019. 5(107). 5-11.

Kachmar O., Voloshyn T., Hordiyevych M. Changes in muscle spasticity in patients with cerebral palsy after spinal manipulation: case series. Journal of Chiropractic Medicine. 2016. 15(4). 299-304.

Kozyavkin V.I., Kachmar O.O., Lysovych V.I. A retrospective analysis of the results of treatment with Intensive Neurophysiological Rehabilitation System. International Neurological Journal. 2018. 3(97). 14-20.

Schiariti V., Selb M., Cieza A., O’Donnell M. International Classification of Functioning, Disability and Health Core Sets for children and youth with cerebral palsy: a consensus meeting. Developmental Medicine & Child Neurology. 2015. 57(2). 149-158.

Kozyavkin V., Kachmar O., Markelov V., Melnychuk V., Kachmar B. Web-based Home Rehabilitation Gaming System for Ba­lance Training. Journal of Accessibility and Design for All (CC). 2014. Special issue. 104-116.

Kozijavkin V., Kachmar O. Correction of Movement Utilizing the “Spiral” Suit — an Important Part of the Kozijavkin Method. Cerebral Palsy Magazine. 2004. 14-18.

Jebsen R., Taylor N., Trieschmann R., Trotter M., Howard L. An objective and standardized test of hand function. Archives of Physical Medicine and Rehabilitation. 1969. 50. 311-319.

Mathiowetz V., Volland G. et al. Adult norms for the Box and Block Test of manual dexterity. Am. J. Occup. Ther. 1985. 39(6). 386-391.

Araneda R., Ebner-Karestinos D., Paradis J., Saussez G., Friel K., Gordon A., Bleyenheuft Y. Reliability and responsiveness of the Jebsen-Taylor Test of Hand Function and the Box and Block Test for children with cerebral palsy. Developmental Medicine & Child Neuro­logy. 2019. 61(10). 1182-1188.

Arnould C., Penta M., Renders A. et al. ABILHAND-Kids: A measure of manual ability in children with cerebral palsy. Neurology. 2004. 63(6). 1045-1052.

Hasiuk M., Arnould C., Kushnir A., Matiushenko O., Kachmar O. Cross-cultural adaptation and validation of the Ukrainian version of the ABILHAND-Kids questionnaire. Disability and Rehabilitation. 2019 Jun 19. 1-10.

Reedman S., Beagley S., Sakzewski L., Boyd R. The Jebsen Taylor Test of Hand Function: A Pilot Test-Retest Reliability Study in Typically Developing Children. Physical & Occupational Therapy in Pediatrics. 2015. 36(3). 292-304.

Norman G., Sloan J., Wyrwich K. Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Medical Care. 2003. 41. 582-92.

Charles J., Wolf S., Schneider J., Gordon A. Efficacy of a child-friendly form of constraint-induced movement therapy in hemiplegic cerebral palsy: a randomized control trial. Developmental Medicine & Child Neurology. 2007. 48(8). 635-642.

Dong V., Tung I., Siu H., Fong K. Studies comparing the efficacy of constraint induced movement therapy and bimanual training in children with unilateral cerebral palsy: A systematic review. Developmental Neurorehabilitation. 2012. 16(2). 133-143.

Sakzewski L., Gordon A., Eliasson A. The State of the Evidence for Intensive Upper Limb Therapy Approaches for Children with Unilateral Cerebral Palsy. Journal of Child Neurology. 2014. 29(8). 1077-1090.

Saussez G., Brandão M., Gordon A., Bleyenheuft Y. Including a Lower-Extremity Component during Hand-Arm Bimanual Intensive Training does not Attenuate Improvements of the Upper Extremities: A Retrospective Study of Randomized Trials. Frontiers in Neurology. 2017. 8.

Bleyenheuft Y., Ebner-Karestinos D., Surana B., Paradis J., Sidiropoulos A., Renders A. et al. Intensive upper- and lower-extremity training for children with bilateral cerebral palsy: a quasi-randomized trial. Developmental Medicine & Child Neurology. 2017. 59(6). 625-633.

Reid L., Rose S., Boyd R. Rehabilitation and neuroplasticity in children with unilateral cerebral palsy. Nature Reviews Neurology. 2015. 11(7). 390-400.


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