Intervention
ADVERSE EVENTS
We used the Template for Intervention Description and Replication TIDieR guide to describe Intensive Neurophysiological Rehabilitation System (INRS), also called Professor Kozyavkin Method [The aim of the INRS is to improve the functioning and quality of life of children with CP by enhancing their mobility and self-care functions. Children received an intensive course of treatment, according to INRS, for two weeks. Details of the INRS program were individualized depending on each child's abilities, but, in general, the intervention was not modified during the study.It included:-30 min of physical therapy aimed at gross motor training is performed daily and includes task-related personalized gross motor exercises, including bimanual activities, postural skills practicing, endurance, mobility, and balance training,-20 min of occupational therapy focused on developing skills necessary for the performance of everyday activities, including play and self-care imitated activities such as tying shoelaces, buttoning, threading beads, and games with the spiky ball,-5 min of spinal manipulative therapy: a variation of the spinal manipulation carried out in lumbar, thoracic, and cervical regions using high-velocity, low-amplitude thrusts techniques,-60 min of full body massage with reflexotherapy using different massage techniques together with isotonic and post-isometric relaxation techniques and applying low current electric stimulation of acupuncture points and myofascial trigger points, reinforced with wax and paraffin application-15 min of joint mobilization when the physical therapist pulls the large and peripheral joint smoothly beyond the range of passive movements by applying pressure to the tissues surrounding the joint,-20 min of computer game therapy when the child is training the movements needed in a functional context with special personalized games; the child can control the game character by moving their body and using special equipment, such as a motion-sensing input device for upper extremities training, dance mat for stepping games, and balance board for balance training,-15 min of gait training on a treadmill with/without suspension,-15 min of strength training (called "mechanotherapy") when muscle strength, endurance, flexibility, and posture are endorsed by applying special devices and technologies, such as suspension-based physical therapy, motorized movement therapy, and cycling,-30 min of group rhythmic gymnastics: adapted active games and dancing movements that are performed in a group of peers and families.More details about INRS are presented in the manual [The medical staff supervisor has assessed the quality of every component delivery. No adverse events have been reported during the intervention.