Vojta Therapy

Original Editor - Saimat Lachinova
Top Contributors - Saimat Lachinova  

Description

Vojta-Therapy is a dynamic neuromuscular treatment method based on the developmental kinesiology and principles of reflex locomotion. This method is supposed to treat patients with disorders of central nervous system and musculoskeletal system. It was developed by child neurologist Prof. Vaclav Vojta in the 20th century and now used predominantly in Europe.

What is a reflex locomotion?

Reflex is an involuntary movement as a response to external stimuli. Locomotion is defined as an ability to perform a movement from one place to another. In reflex locomotion, there is a coordinated, rhythmic activation of the total skeletal musculature and a CNS response at various circuit levels.[1]

Indication

According to Vojta, this therapy can be applied to the patients of any age group and can be used as standard therapy in physiotherapy for almost every movement disturbance and for numerous illnesses:

Implementation

The application of 4 Vojta therapies.[2]

Vojta describes 10 different zones that are available to stimulate the motor patterns of reflex locomotion. A light pressure on certain stimulus zone (muscles or bones) and resistance to the current movement is applied to cause patient's involuntary motor response and performance of certain movement patterns. [3]

The Vojta method can be divided into 2 main phases:

  1. Reflex creeping (lying flat with the chest down and back up)
  2. Reflex rolling (lying flat with the chest up and back down)

Reflex locomotion is activated from the three main positions:

  • prone,
  • supine,
  • side lying.

Intervention mechanism

The reflex locomotion elicited by Vojta therapy is associated with specific changes in cortical and subcortical brain activation when compared to the sham treatment.[4] Tactile stimulations on pre-defined zone of body activates central nervous system. If stimulation is given correctly and repeatedly, motor pattern generated are learned by brain and could be executed voluntarily by an individual.[5] Moreover, it can activate vegetative and autonomic reactions such as eye coordination, jaw and tongue movements, bowel and bladder coordination, sucking, swallowing and breathing. [1]

Evidence

There is a lack of high level evidence for justifying the usage and effectiveness of Vojta therapy. Some case reports, controlled and experimental studies are available.

Only one high quality randomized controlled study was found. Research results showed that the statistically significant effect on infantile postural asymmetry was achieved in the Vojta group compared to Neurodevelopmental treatment (Bobath approach, massage). Authors state that the results may be explained by Vojta more intensive muscle activation due to relatively precisely guided movement responses to triggered reflexes.[6]

Resources

Additional facts

  • Vojta therapy is an officially recognized treatment modality for infant asymmetry in Germany and paid by health insurance.[6]
  • The International Vojta Society, in cooperation with various clinics and institutions in Germany and other countries, regularly offers Vojta courses and Vojta workshops in special topics concerning Vojta Therapy and Diagnostics.[1]

References

  1. 1.0 1.1 1.2 International Vojta Society.Vojta Therapy: Reflex Locomotion – The Fundamentals of Vojta Therapy. [online] [Accessed 16 Jun. 2018].
  2. Lim, H., & Kim, T. Effects of Vojta therapy on gait of children with spastic diplegia. J Phys Ther Sci, 2013; 25(12):1605-8.
  3. Gajewska, E., Huber, J., Kulczyk, A., Lipiec, J., & Sobieska, M. An attempt to explain the Vojta therapy mechanism of action using the surface polyelectromyography in healthy subjects: A pilot study. J Bodyw Mov Ther, 2017; 22(2): 287-92.
  4. Hok, P., Hluštík, P., Kutín, M., Opavský, J., Grambal, A., Tüdös, Z., Kaňovský, P. Changes in brain activation after therapeutic stimulation using Vojta therapy: Controlled study. Clin Neurophysiol, 2014;125(5): e34.
  5. Gharu, R. G. Effect of Vojta Therapy and Chest Physiotherapy on Preterm Infants with Respiratory Distress Syndrome-An Experimental Study.Indian J Physiother Occup Ther ,2016;10(4):72-6.
  6. 6.0 6.1 Jung, M. W., Landenberger, M., Jung, T., Lindenthal, T., & Philippi, H. Vojta therapy and neurodevelopmental treatment in children with infantile postural asymmetry: a randomised controlled trial. J Phys Ther Sci 2017;29(2): 301-6.
  7. 유대경.소아vojta완). Available from: https://www.youtube.com/watch?v=NB-X4WeQeQg [last accessed 16/06/2018]
  8. moosh36. Reflex locomotion RC1 to RC2.Available from:https://www.youtube.com/watch?v=JgpQ1AaeZfs [last accessed 16/06/2018]
  9. Veronika Panton. Vojta´s method - Head Predilection - Tilting head to left or right shoulder. Available from: https://www.youtube.com/watch?v=GwQFkQd_PuU [last accessed 16/06/2018]