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Private Rehabilitation Centre
‘EUROMED’
ul. Piastow 10
76-032 Mielno
Treatment Record
Patient’s Name: not disclosed
Patient’s DOB: 01.09.1994
Diagnosis: Infantile Cerebral Palsy
Initial medical examination carried out on 17th October 2000 showed that the patient:
was able to change his position from pronation to supination and vice versa,
was able to crawl on all fours,
was able to kneel down,
was able to move forward while kneeling,
was trying to move sideways while kneeling,
was able to take sitting position from recumbent position,
was able to sit up with his legs straight,
was able to take erect position from sitting position while holding on to something,
was able to stand on his own for a while,
was able to walk backwards using a walker
had muscular contractures: iliopsoas muscle, ischiocrural muscle and triceps muscles of calves,
had weak posture muscles.
This Treatment Report contains a record of 11 Rehabilitation Sessions that the patient took part in at
Euromed in Mielno. Each session lasted 28 days and involved intensive therapeutic treatment using
‘Adeli 92’ adapted cosmonaut suit. The first session took place in October/November 2000, the last
session mentioned at this report took place in August/September 2008.
Patient’s progress after each session was as follows:
1. October/November 2000 Rehabilitation Session
The following muscles were strengthened: large and medium buttocks muscles, oblique
and straight abdominal muscles, erector spinae, quadriceps muscles of thighs.
The following muscles were relaxed: iliopsoas muscle, ischiocrural muscle and triceps
muscles of calves.
The patient learned to take erect position from sitting on a chair, keep that position and
then sit back down on a chair. He managed to keep erect position for up to 10 seconds
and learned to make about 3 steps at a time by himself.
He also learned to walk on crutches, which he found rather easy; to change walking
speed and direction; to press his heels to the ground while walking; to straighten his
knee joints. He learned to make about 10 steps on only one crutch.
His spine became straighter.
2. August/September 2001 Rehabilitation Session
The following muscles were strengthened: postural muscles, abdominal muscles,
quadriceps muscles and arms muscles.
Triceps muscles of calves were relaxed.
Patient’s balance and coordination were visibly improved, as well as his side hip
stabilization and shoulders-hips dissociation.
The patient learned to move while kneeling more efficiently and to sit down
symmetrically and asymmetrically. He learned to get up from a chair with little help and
to stand by himself for 5 seconds.
The patient started walking more confidently on tripods and lifting his knees higher. He
learned to walk without help and to control his walk; he was able to make up to 10
steps.
3. April/May 2002 Rehabilitation Session
[It has been noted down that in October 2001 the patient had had a ‘Botox’ of adductor
muscles of thighs and triceps muscles of calves and had worn plaster casts on his feet,
which made it possible for him to learn to get up from a chair without help and keep
erect position and also to start walking on his toes while being held by one or both
hands.]
The following muscles were strengthened further: large and medium buttocks muscles,
oblique and straight abdominal muscles, erector spinae, quadriceps muscles of thighs.
The patient managed to cover longer distances walking while kneeling. He learned to
take sideways sitting position from kneeling position more confidently. When sitting, his
hips-shoulder dissociation was better.
He started taking erect position from sitting on a chair more confidently and keeping
erect position for up to a few seconds.
The patient started walking easily using just one cane. His unassisted walking skills
improved as well. He learned to stabilize his hips, lift his knees higher and place his feet
correctly on the ground while walking. He also learned to control the length of his steps.
His shoulders-hips dissociation improved.
4. May 2003 Rehabilitation Session
The following muscles were strengthened further: large and medium buttocks muscles,
oblique and straight abdominal muscles, erector spinae, quadriceps muscles of thighs.
The patient started taking sitting position from recumbent position more confidently.
His defense reflex and balance reflex while sitting improved and so did his shoulders-
hips dissociation.
He was taking erect position from sitting position. He was walking on tripods. He started
bending his hip joints and knee joints better. He also started better controlling his
walking speed and learned to stop whenever he wants to. The side stabilization of his
hips improved.
The patient started walking up and down the stairs holding on to the handrail with one
hand. His balance reflex while walking noticeably improved and so did his shoulders-hips
dissociation.
5. August/September 2003 Rehabilitation Session
The following muscles were strengthened further: posture muscles and abdominal
muscles, large and medium buttocks muscles, quadriceps muscles of thighs, arms and
legs muscles.
The patient learned to take erect position from kneeling on one knee with little help. He
started keeping erect position noticeably better, with his knees straight and moving his
body weight more to his legs.
The patient started keeping erect position unassisted and walking forward by himself
and backward/sideways with assistance. His steps became more symmetrical and
phased.
His shoulder girdle and hip muscles became more relaxed, which led to better balance.
6. April 2004 Rehabilitation Session
The following muscles were strengthened further: posture muscles and abdominal
muscles, large and medium buttocks muscles, quadriceps muscles of thighs, arms and
legs muscles.
The patient managed to take erect position from kneeling on one knee with little help.
He continued keeping erect position noticeably better, with his knees straight and
moving his body weight more to his legs.
The patient was able to keep erect position unassisted and walk forward and sideways
by himself. His steps were more symmetrical and phased.
His shoulder girdle and hip muscles were more relaxed, which led to better balance.
The patient learned to walk one step up the stairs and one step down unassisted.
Patient’s manual dexterity improved.
7. August/September 2004 Rehabilitation Session
The following muscles were strengthened further: posture muscles and abdominal
muscles, large and medium buttocks muscles, quadriceps muscles of thighs, arms and
legs muscles.
The patient was taking erect position from kneeling on one knee with little help. He
continued keeping erect position noticeably better, with his knees straight and moving
his body weight more to his legs.
The patient was able to keep erect position unassisted and walk forward and sideways
by himself, he also learned to make a few steps backward unassisted. His steps became
even more symmetrical and phased. Lumbar lordosis appeared straighter.
He improved the skill of walking up and down the stairs.
Patient’s legs appeared straighter while standing and walking. He also started better
controlling his upper body and head.
The patient was more dexterous and fit.
8. August/September 2005 Rehabilitation Session
The following muscles were strengthened further: posture muscles and shoulder girdle.
Muscular contractures of iliopsoas muscles, adductor muscles of thighs and biceps
muscles of the right arm appeared less severe.
The patient was taking erect position from sitting on a chair with no assistance and
more confidently. He was walking by himself showing better side hip stabilization and
shoulders-hips dissociation. He kept leaning to one side while walking.
He still had problems with standing by himself and stopping while walking.
9. August/September 2006 Rehabilitation Session
The following muscles were strengthened further: large and medium buttocks muscles,
oblique and straight abdominal muscles and quadriceps muscles of thighs.
The patient stopped dragging his right leg round while walking. He had been doing it
before the rehabilitation session. He also learned to put his knee joint correctly while
making steps forward but still kept his knee joints slightly bent while walking.
His side hip stabilization and shoulders-hips dissociation got noticeably better.
The patient learned to walk slower. His arms were resting downward and his posture
was evidently better. It became easier for him to change walking direction and to stop.
10. August/September 2007 Rehabilitation Session
Posture muscles were strengthened further.
Patient’s side hip stabilization improved and so did individual phases of making steps.
Shoulders-hips dissociation while walking was still insufficient but smoothness of
patient’s moves improved.
The patient walked very confidently on tripods. His posture was better while walking
and it was easier for him to change walking direction and to stop.
11. August/September 2008 Rehabilitation Session
Posture muscles were strengthened further.
The patient was keeping his knee joints and hip joints straighter while standing. His
steps became more symmetrical. The movement of his right leg while walking became
more confident.
Patient’s side hip stabilization improved further slightly and shoulders-hips dissociation
got noticeably better.
His defense reflex and balance reflex by his sagittal plane and frontal plane improved,
what was clearly noticeable during balance beam exercises.
The patient improved the skill of walking up and down the stairs.
After each session the patient was given a list of exercises to be done at home in order to preserve the
positive effects of rehabilitation. These exercises included but were not limited to: side stabilization of
the hip; standing stabilization; balance exercises; crawling on all fours; moving forward and sideways
while kneeling; walking forward, backward and sideways with and without assistance; taking sitting
position from recumbent position; taking erect position from sitting position; muscles relaxing and
strengthening; walking on crutches and many more.
It is highly recommended by the specialised therapist Dr Koprek that the patient takes part in more
Rehabilitation Sessions in future.
stamped and signed by
Dr Janusz Koprek
Specialized Locomotor System Therapist
and Healthcare Administrator
91-716 Lodz, ul. Nowopolska 7
mob: 0607169392
tel: 0426562581, -6404342
05R/GP 1953
&
Dr Wieslawa Krzysztofik-Bogacka
Pediatric Specialist & Specialised Physiotherapist
Ul. Wawozowa 14/1, tel: 3412785
Koszalin
