Vojta therapy improves postural control in very early stroke rehabilitation: a randomised controlled pilot trial

Critical review of the evidence for Vojta Therapy: a systematic review and meta-analysis

Introduction

It is essential to link the theoretical framework of any neurophysiotherapy approach with a detailed analysis of the central motor control mechanisms that influence motor behavior. Vojta therapy (VT) falls within interventions aiming to modify neuronal activity. Although it is often mistakenly perceived as exclusively pediatric, its utility spans various functional disorders by acting on central pattern modulation. This study aims to review the existing evidence on the effectiveness of VT across a wide range of conditions, both in the adult population and in pediatrics, and analyze common therapeutic mechanisms, focusing on motor control modulation.

Aim

The goals of this systematic review are to delineate the existing body of evidence concerning the efficacy of Vojta therapy (VT) in treating a broad range of conditions, as well as understand the common therapeutic mechanisms underlying VT with a specific focus on the neuromodulation of motor control parameters.

Methods

PubMed, Cochrane Library, SCOPUS, Web of Science, and Embase databases were searched for eligible studies. The methodological quality of the studies was assessed using the PEDro list and the Risk-Of-Bias Tool to assess the risk of bias in randomized trials. Methodological quality was evaluated using the Risk-Of-Bias Tool for randomized trials. Random-effects meta-analyses with 95% CI were used to quantify the change scores between the VT and control groups. The certainty of our findings (the closeness of the estimated effect to the true effect) was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE).

Results

Fifty-five studies were included in the qualitative analysis and 18 in the meta-analysis. Significant differences in cortical activity (p = 0.0001) and muscle activity (p = 0.001) were observed in adults undergoing VT compared to the control, as well as in balance in those living with multiple sclerosis (p < 0.03). Non-significant differences were found in the meta-analysis when evaluating gross motor function, oxygen saturation, respiratory rate, height, and head circumference in pediatrics.

Conclusion

Although current evidence supporting VT is limited in quality, there are indications suggesting its potential usefulness for the treatment of respiratory, neurological, and orthopedic pathology. This systematic review and meta-analysis show the robustness of the neurophysiological mechanisms of VT, and that it could be an effective tool for the treatment of balance in adult neurological pathology. Neuromodulation of motor control areas has been confirmed by research focusing on the neurophysiological mechanisms underlying the therapeutic efficacy of VT.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=476848, CRD42023476848.

Stimulus zones of Vojta method and trunk control in children with spastic-type cerebral palsy: A quasi-experimental pilot study

BACKGROUND

Vojta method improves motor function by inducing a response by pressing the stimulus zones.

PURPOSE

To determine the effect of the stimulus zones on trunk muscle thickness, trunk control, trunk angle, and gross motor function in children with spastic-type cerebral palsy.

METHODS

A quasi-experimental pilot study was conducted with 19 children with spastic-type cerebral palsy divided into two groups: Vojta method group (n = 10) and general physical therapy group (n = 9). Each group underwent a 6-week intervention, and assessments were conducted to evaluate abdominal muscle thickness, trunk control, trunk angle, and gross motor function.

RESULTS

In the Vojta method group, the change rate in the thickness of the internal oblique and transversus abdominis increased significantly within the group (P < 0.05) and the difference (post-pre) of the transversus abdominis was higher (P < 0.05). The trunk angle increased significantly within the group when thoracic 7 and 11, lumbar 3, and sacrum 1 were supported (P < 0.05). There was a significant difference in trunk angle difference (post-pre) between groups when thoracic 11 and sacrum 1 were supported (P < 0.05). Segmental assessment of trunk control and gross motor function measure-88 scores were significantly increased within the group in all groups (P < 0.05).

CONCLUSION

The stimulus zones of the Vojta method could improve trunk control in children with spastic-type cerebral palsy through intra-abdominal pressure and anti-gravity movement.

A Case Report of Pediatric Rehabilitation for Hypoxic Ischemic Encephalopathy Associated With Global Developmental Delay

Hypoxic ischemic encephalopathy (HIE) is a critical condition affecting neonates due to oxygen deprivation and insufficient flow of blood to the brain. It is associated with high neonatal mortality and the risk of developmental psychomotor disorders, including cerebral palsy. The global epidemiology of HIE reveals significant disparities, with more advanced healthcare systems reporting lower incidence rates. The aim of the study is to contribute to the understanding of effective rehabilitation strategies for children with HIE and global developmental delay (GDD), with the goal of improving outcomes and quality of life for these individuals. This case report focuses on an 11-month-old male child with a history of perinatal HIE, highlighting the developmental challenges and interventions undertaken. The child showed delayed gross and fine motor development, sensory awareness deficits, and postural coordination issues. A comprehensive physiotherapy intervention plan was implemented, resulting in significant improvements in post-treatment outcome measures. This case highlights the importance of early and holistic physiotherapy interventions in addressing HIE patients' developmental delays and improving their quality of life.

Factors Influencing the Duration of Rehabilitation in Infants with Torticollis-A Pilot Study

Background and Objectives: Torticollis is a common pediatric condition, with an incidence of 0.3-2.0%. Studies show that an adequate, tailored, and early treatment helps 90% to 95% of children recover before the first year of life and 97% of patients recover if treatment starts before the first six months. To identify the relationships between variables considered essential in the recovery process of infants with torticollis, we included factors such as the type of torticollis, age at onset of treatment, gender, birth weight, mode of delivery, fetal position in the uterus, the presence of craniofacial deformities, regions affected by postural asymmetries, and duration of the rehabilitation program. The hypothesis of the study is that early initiation of therapy can contribute to achieving favorable outcomes in the recovery process. Material and Methods: This retrospective cohort pilot study was conducted within a rehabilitation facility, spanning a duration of 1 year. The study involved a population of 41 children aged between 0 and 6 months. The rehabilitation program consisted of the application of Vojta therapy. Each session lasted 20 min, with a frequency of three times per week. Results: A total of 41% of those who started therapy in the first 3 months of life were fully recovered after 4-6 weeks of therapy. Of infants who started therapy at 5 and 6 months of age, 15% showed no improvement in measurements from 14 to 16 weeks of age, at which point the use of a cranial orthosis was recommended, and 23% experienced a plateau in measurements from 10 to 14 weeks, requiring the use of a cervical collar in conjunction with therapy. Conclusions: The findings from the study suggest that there may be a correlation between early initiation of therapy and favorable outcomes in the recovery process. The primary factors influencing the duration of recovery were identified as the presence of body asymmetries and the age at which therapy was initiated.

Synergy of Muscle and Cortical Activation through Vojta Reflex Locomotion Therapy in Young Healthy Adults: A Pilot Randomized Controlled Trial

BACKGROUND

Vojta Therapy is a neurorehabilitation therapy that allows to activate reflex movement patterns. The scientific literature has shown its ability to generate muscle contractions. The activation of brain neural networks has also been proven. However, the relationship between these processes has not yet been demonstrated. For this reason, the aim of this study is to verify brain activation produced by recording with near-infrared spectroscopy and its relationship with muscle activation produced in the abdominal muscles recorded with surface electromyography.

METHODS

A total sample of 27 healthy subjects over 18 years of age was recruited. An experimental study on a cohort was conducted. Two experimental conditions were considered: stimuli according to the Vojta protocol, and a control non-stimuli condition. Abdominal muscle activation was measured using surface electromyography, and the activation of the motor cortex was assessed with near-infrared spectroscopy.

RESULTS

In relation to the oxygenated hemoglobin concentration (HbO), an interaction between the stimulation phase and group was observed. Specifically, the Vojta stimulation group exhibited an increase in concentration from the baseline phase to the first resting period in the right hemisphere, contralateral to the stimulation area. This rise coincided with an enhanced wavelet coherence between the HbO concentration and the electromyography (EMG) signal within a gamma frequency band (very low frequency) during the first resting period.

CONCLUSIONS

The results underscore the neurophysiological effects on the brain following tactile stimulation via Vojta Therapy, highlighting increased activity in pivotal areas essential for sensory processing, motor planning, and control. This activation, particularly evident in the Vojta stimulation group, aligns with previous findings, suggesting that tactile stimuli can not only evoke the intention to move but can also initiate actual muscle contractions, emphasizing the therapy's potential in enhancing innate locomotion and rolling movements in patients with neurological disorders.

Comparing the Effectiveness of Physical Rehabilitation Interventions for Post-Stroke Function and Mobility Recovery: A Meta-Analysis

Various interventions to physical rehabilitation have been used after stroke, including musculoskeletal, neurophysiological, and motor learning interventions, with ongoing debates and controversies about their relative effectiveness. In this systematic review, we searched 3 international electronic databases (MEDLINE, Embase, and Cochrane Library) to identify relevant studies. We included only randomized controlled trials (RCTs) that directly compared motor relearning, neurophysiological, and musculoskeletal interventions for improving motor function in adult stroke patients. Risk of bias (RoB) assessment was performed using Cochrane's RoB tool, and meta-analysis was conducted using Revman 5.4 with a random effects model. Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations method. The meta-analysis for immediate outcome for physical rehabilitation included 9 RCTs for balance, 10 RCTs for gait velocity, 7 RCTs for lower extremity motor function and 8 RCTs for performance of activities of daily living. There was no statistically significant different on improvement of balance, gait velocity, lower extremity motor function and performance of activity among physical rehabilitation interventions. Moderate-level evidence supports that no single intervention is superior. Clinicians and therapist should consider individual patient characteristics, preferences, and available resources when selecting the intervention for stroke rehabilitation.

Thermographic of the Microcirculation in Healthy Children Aged 3-10 Months as an Objective and Noninvasive Method of Assessment

BACKGROUND

The aim of this study was to assess if thermography as an objective and non-invasive research tool is capable of identifying the changes in the surface temperature of the body as a response to muscle stimulation in Vojta therapy. The research group consisted of children aged 3-10 months with slight abnormalities of the motor pattern, subjected to individually selected stimulation elements according to Vojta.

METHODS

The Vojta method of spontaneous motor assessment and the thermovision method of assessing the microcirculation properties of muscles were used for the evaluation.

RESULTS

In the study group, changes in the microcirculation parameters of the extensor muscles of the back occurred immediately after the therapy at the first examination.

CONCLUSIONS

The analysis featuring an objective assessment allows physiotherapists to diagnose local temperature changes based on the effect of microcirculation parameters in the musculofascial structures.

TRIAL REGISTRATION

The research was conducted as a pilot study for a scientific project approved by the Commission for Scientific Research of the University of Health and Sport Sciences in Wroclaw No 24/2021. The study is currently in the registration process with the Australian New Zealand Clinical Trials Registry.

COMIRESTROKE—A clinical study protocol for monitoring clinical effect and molecular biological readouts of COMprehensive Intensive REhabilitation program after STROKE: A four-arm parallel-group randomized double blinded controlled trial with a longitudinal design

Introduction

While the role of physiotherapy as part of a comprehensive inpatient rehabilitation is indisputable, clear evidence concerning the effectiveness of different rehabilitation managements [interdisciplinary implementing the International Classification of Functioning, disability and health (ICF) vs. multidisciplinary model] and physiotherapy categories (neuroproprioceptive “facilitation, inhibition” vs. motor/skill acquisitions using technologies) are still lacking. In this study, four kinds of comprehensive inpatient rehabilitation with different management and content of physical therapy will be compared. Moreover, focus will be placed on the identification of novel biological molecules reflective of effective rehabilitation. Long non-coding RNAs (lncRNAs) are transcripts (&gt;200 bps) of limited coding potential, which have recently been recognized as key factors in neuronal signaling pathways in ischemic stroke and as such, may provide a valuable readout of patient recovery and neuroprotection during therapeutic progression.

Methods and analysis

Adults after the first ischemic stroke in an early sub-acute phase with motor disability will be randomly assigned to one of four groups and undergo a 3 weeks comprehensive inpatient rehabilitation of different types: interdisciplinary team work using ICF model as a guide; multidisciplinary teamwork implementing neuroproprioceptive “facilitation and inhibition” physiotherapy; multidisciplinary teamwork implementing technology-based physiotherapy; and standard multidisciplinary teamwork. Primary (the Goal Attainment Scale, the Patient-Reported Outcomes Measurement Information System, and the World Health Organization Disability Assessment Schedule) and secondary (motor, cognitive, psychological, speech and swallowing functions, functional independence) outcomes will be measured. A blood sample will be obtained upon consent (20 mls; representing pre-rehabilitation molecular) before and after the inpatient program. Primary outcomes will be followed up again 3 and 12 months after the end of the program. The overarching aim of this study is to determine the effectiveness of various rehabilitation managements and physiotherapeutic categories implemented by patients post ischemic stroke via analysis of primary, secondary and long non-coding RNA readouts. This clinical trial will offer an innovative approach not previously tested and will provide new complex analysis along with public assessable molecular biological evidence of various rehabilitation methodology for the alleviation of the effects of ischemic stroke.

Clinical trial registration

NCT05323916, https://clinicaltrials.gov/ct2/show/NCT05323916.

Balance Rehabilitation Approach by Bobath and Vojta Methods in Cerebral Palsy: A Pilot Study

In cerebral palsy (CP) the basis for rehabilitation comes from neuroplasticity. One of the leading therapeutic approaches used in the management of CP is the NDT Bobath therapy and Vojta therapy consists in trying to program the ideal movement patterns for the age. The aim of our research was to analyze, from a functional point of view, the evolution of the biomechanical parameters characterizing the balance, in children with CP. The group of 12 subjects average age of 7 ± 3.28 years. The subject’s evaluation included a functional clinical evaluation by Berg pediatric scale and a biomechanical evaluation performed using the “Stabilometry footboard PoData 2.00” for evaluation the body weight distribution on the foot level. The rehabilitation program was developed based on two methods, NDT Bobath and Vojta. A 90-min physiotherapy session starts with a Vojta therapy activation, for 20 min. Between the two therapies there is a 10-min break, then the session continues with NDT Bobath exercises within the 3 physical exercises proposed for 60 min. 5 days per week, 6 months. The analysis of the data collected before and after the application of the rehabilitation program, regarding the using the Berg scale indicates a progress of 32.35%, (p = 0.0001 < 0.05) and the effect size is large. The evolution of the data that indicate the distribution of body weight at the level of the two lower limbs, at the two moments pre/post, evaluation. For left side a progress of 8.39%, (p = 0.027 < 0.05) but a small effect size of 0.86. For right side a progress of 10.36% (p = 0.027 < 0.05) and also a small effect size of 0.86. Analyzing the results, we find that there is a left-right rebalancing in most patients. The favorable results that were obtained by drawing up a physiotherapy program composed of the combination of the two Vojta and NDT Bobath methods are proof of the fact that both methods are based on the creation of a stimulating peripheral pressure, which, if maintained, generates an extended stereotyped motor response. A pattern of symmetrical muscle contraction is thus created and thus balance and postural control can be achieved. The left-right rebalancing, proven by the percentage distribution analysis of the weight at the lower segmental level, demonstrated that the body alignment approach through the Vojta method on the one hand and the inhibitory facilitating postures/exercises promoted by the NDT Bobath method, allows obtaining a symmetry.

Vojta Therapy Affects Trunk Control and Postural Sway in Children with Central Hypotonia: A Randomized Controlled Trial

(1) Background: Decreased trunk stability is accompanied by delay in motor development in children with central hypotonia. We investigated the effect of Vojta therapy on trunk control in the sitting position in children with central hypotonia. (2) Methods: In 20 children with central hypotonia, Vojta therapy was applied to the experimental group (n = 10) and general physical therapy to the control group (n = 10). The intervention was applied for 30 min per session, three times a week, for a total of six weeks. We assessed abdominal muscle thickness, trunk control (segmental assessment of trunk control), trunk angle and trunk sway in a sitting position, and gross motor function measure-88. (3) Results: In the experimental group, the thicknesses of internal oblique and transversus abdominis were significantly increased (p < 0.05). The segmental assessment of trunk control score was significantly increased (p < 0.05), and the trunk sway significantly decreased (p < 0.05). Gross motor function measure-88 was significantly increased (p < 0.05). (4) Conclusions: Vojta therapy can be suggested as an effective intervention method for improving trunk control and gross motor function in children with central hypotonia.

Assessment of Viscoelastic Parameters of Muscles in Children Aged 4-9 Months with Minor Qualitative Impairment of the Motor Pattern after Vojta Therapy Implementation

The aim of this study was to assess if there are any objective changes in the viscoelastic parameters of the erector spinae muscle after Vojta stimulation. The study involved 22 healthy children at an average age of 7 months and with an Apgar score of 8-10 points, who were referred for rehabilitation due to a slight delay in the phases of psychomotor development. The first group consisted of 11 children with increased muscle tone (IMT) and the second group consisted of 11 children with non-increased muscle tone (nonIMT). All study participants received a one-time Vojta therapy session, which was continued for 4 weeks by parents at home. The viscoelastic parameters of the dorsal extensor muscle were measured three times. In the first study group, changes in the viscoelastic parameters of the extensor muscles of the back occurred immediately after the therapy at the first examination, whereas changes in the supporting and extensor function of the limbs occurred in both groups at the second examination. Analysis featuring an objective assessment allows physiotherapists to diagnose local changes in the viscoelastic parameters after the implementation of therapy. These studies are the first pilot studies to be continued with a 30- or 60-day follow-up.

Efficacy of Rehabilitation Therapy and Pharmacotherapy on Children with Cerebral Palsy: A Meta-Analysis

Background. Cerebral palsy (CP) has a serious impact on children’s multiple motor functions and life behavior. Rehabilitation therapy or pharmacotherapy alone has been proven to have a good effect on patients’ strength and gait. However, the efficacy of rehabilitation combined with pharmacotherapy for CP in children needs to be further explored. This study is aimed at assessing the effectiveness of this combined method on life function and social behavior in children with CP. Methods. PubMed, China National Knowledge Infrastructure, WanFang Data, EMBASE, and Web of Science databases were searched for all kinds of literature related to the treatment of pediatric CP published between 2000 and 2021. Basic information and experimental data from the literature were screened and extracted, and a meta-analysis was performed using Stata 16. Results. A total of 605 studies were retrieved, and finally, 10 studies involving 805 pediatric patients were included in the analysis. The analysis results showed that rehabilitation combined with pharmacotherapy could improve the treatment effective rate in children with CP compared with the control group using either alone ( $\text{RR}=1.184$ , 95% CI (1.102, 1.273), $P<0.001$ ). In addition, in terms of social behavior, the combined therapy could significantly improve activities of daily living ( $\text{SMD}=2.94$ , 95% CI (1.66, 4.22), $P<0.001$ ), motor ability ( $\text{SMD}=1.86$ , 95% CI (0.75, 2.96), $P=0.001$ ), adaptability behavior ( $\text{SMD}=2.82$ , 95% CI (0.45, 5.18), $P=0.019$ ), language behavior ( $\text{SMD}=3.08$ , 95% CI (0.95, 5.22), $P=0.005$ ), social behavior ( $\text{SMD}=3.78$ , 95% CI (2.22, 5.35), $P<0.001$ ), and fine motor behavior ( $\text{SMD}=3.52$ , 95% CI (1.17, 5.86), $P=0.003$ ). Conclusion. The current study shows that rehabilitation combined with pharmacotherapy can effectively improve the recovery, quality of life, and social behavior of children with CP.

Electromyographic Response of the Abdominal Muscles and Stabilizers of the Trunk to Reflex Locomotion Therapy (RLT). A Preliminary Study

Reflex locomotion therapy (RLT) was developed by Vaclav Vojta in 1954 as a diagnostic and treatment tool. This therapy is mainly used to rehabilitate children with motor disorders and risk of cerebral palsy. It is also used for adults with neurological and motor impairment. RLT is based on specific postures and regular stimulation points through which a series of reflex responses are triggered. The neurophysiological mechanisms of this therapy have recently been discovered. This study aims to objectively evaluate muscular responses at the abdominal level after stimulation in the first phase of reflex rolling by showing, with surface electromyography analysis (sEMG), the muscular activity in trunk stabilizing muscles (rectus abdominis, external oblique, internal oblique, and serratus anterior) before, during, and after the application of RLT. A total sample of 27 healthy subjects over 18 years of age was recruited. An experimental study on a cohort was conducted. Two experimental conditions were considered: stimuli according to the Vojta protocol, and a control non-STI condition. Regarding muscular electrical activity, statistically significant differences were determined in all muscles during right-sided stimulation in the VSTI condition (p < 0.001), but not in the non-STI condition. The mean increase in muscle activity in the VSTI condition during the first stimulation ranged from 7% to 20% in the different abdominal muscles. In conclusion, an sEMG response was observed in the abdominal muscles during stimulation of the pectoral area as described in RLT, compared to stimulation of non-described areas.

Analysis of Intracerebral Activity during Reflex Locomotion Stimulation According to Vojta’s Principle

Vojta’s therapy is a widely used approach in both the prevention and therapy of musculoskeletal disorders. Changes in the musculoskeletal system have been described repeatedly, but the principles of the approach have not yet been clarified. The objective of our study was to evaluate changes of intracerebral activity using electromagnetic tomography (sLORETA) that arise during reflex locomotion stimulation of the breast trigger zone according to Vojta’s therapy. Seventeen healthy women took part in the experiment (aged 20–30 years old). EEG activity was recorded 5 min prior to the reflex locomotion stimulation, during stimulation, and 5 min after the stimulation. The obtained data were subsequently processed in the sLORETA program and statistically evaluated at the significance level p ≤ 0.05. The analysis found statistically significant differences in the frequency bands alpha-2, beta-1, and beta-2 between the condition prior to stimulation and the actual stimulation in BAs 6, 7, 23, 24, and 31 and between the resting condition prior to stimulation, and the condition after the stimulation was terminated in the frequency bands alpha-1, alpha-2, beta-1, and beta-2 in BAs 3, 4, 6, and 24. The results showed that reflex locomotion stimulation according to Vojta’s therapy modulates electrical activity in the brain areas responsible for movement planning and regulating and performing the movement.

Reflex Locomotion Therapy for Balance, Gait, and Fatigue Rehabilitation in Subjects with Multiple Sclerosis

This study evaluates the effects of a rehabilitation program based on reflex locomotion therapy (RLT) on balance, gait, and fatigue in patients with multiple sclerosis (MS). Twenty-three patients diagnosed with MS participated in this study. Reversal design was carried out. The assessment tools included the Berg Balance Scale (BBS), the Performance Oriented Mobility Assessment (POMA), the Fatigue Severity Scale (FSS) and the instrumental analysis of the gait recorded by Vicon Motion System^®. We analyzed spatio-temporal parameters and kinematic variables of the hip, knee, and ankle joints. Additionally, the Client Satisfaction Questionnaire (CSQ-8) was administrated. We did find a significant improvement in balance and gait tools after the RLT period. Regarding instrumental analysis, the statistical analysis of spatio-temporal parameters showed a significant improvement in stride length, double support, and velocity after the RLT period. Concerning kinematic parameters, the analysis showed improvements in hip and knee range of motion (ROM) after RLT period. RLT could improve gait and balance in patients with MS. The patients reported a high level of satisfaction with the therapy received.

Vojta Approach Affects Neck Stability and Static Balance in Sitting Position of Children With Hypotonia

Purpose

In this study, the effect of the Vojta approach on neck stability and static balance in children with hypotonia was studied.

Methods

Seventeen children with hypotonia were randomly divided into the Vojta approach group (n=9) and the general physical therapy group (n=8). Each group was applied intervention for 30 minutes per session, 3 times a week, for a total of 4 weeks. Ultrasonography was used to measure deep neck flexor muscle thickness, craniovertebral angle (CVA) to measure neck alignment along the spine segment, and Balancia software program to measure static balance.

Results

In the Vojta approach group, the deep neck flexor muscle thickness was significantly increased (P<0.05), and the CVA was significantly improved (P<0.05). In addition, path area among static balance was significantly improved (P<0.05).

Conclusions

The Vojta approach can be suggested as an effective intervention method for improving neck stability and static balance in children with hypotonia.

Innate Muscle Patterns Reproduction During Afferent Somatosensory Input With Vojta Therapy in Healthy Adults. A Randomized Controlled Trial

OBJECTIVE

Vojta therapy describes stereotypic widespread motor responses as a pattern of tonic muscle contractions during a peripherical pressure stimulation. The present work proposes to characterize the responses at muscles level to a specific tactile input based on Vojta therapy, assessed by sEMG, compared to a sham stimulation in healthy subjects.

METHODS

Surface electromyography (sEMG) signal was acquired with dipolar electrodes placed at wrist extensors of both forearms, right tibialis anterior, and top part of rectus abdominus, ground channel placed over the right olecranon. It was amplified and digitized by a 4-channel hub Biosignalsplux device (Plux Wireless Biosignals S.A., Lisboa, Portugal), sampled at 1000 Hz with 16-bit per channel. A continuous 10-minute record of the sEMG signal from the four electrodes were registered. Resting EEG during the first minute before the stimulation period was recorded by 64 active electrodes.

RESULTS

Statistically significant differences were showed between sham and experimental group. Experimental group participants were subjected to cluster analysis based on their muscle activation patterns, generating three different models of activation. Differences in the previous resting cortical activity in left superior frontal area were found between clusters that activated limb muscles and the cluster that did not.

CONCLUSIONS

Vojta specific stimulation area activates innate muscle responses assessed by sEMG in healthy subjects, compared to a sham stimulation.

SIGNIFICANCE

This characterization might be helpful to the prescription and application of Vojta therapy in an individual-basis for non-neurophysiologically damaged adult subjects.

Changes of Neural Pathways after Vojta Approach in a Child with Developmental Delay

The development of motor function is related to the development of neural pathways in the white matter. Children with developmental delay (DD) and hypotonia have reduced motor function, and their neural pathways are observed differently from those of typically developed children. We investigated changes in neural pathways through diffusion tensor imaging (DTI) after utilizing the Vojta approach. The participant was a child with DD and hypotonia, and had delayed motor function. Although he had no brain damage on magnetic resonance imaging findings, damage to the neural pathway was confirmed through DTI due to cytomegalovirus infection in the mother's womb. From 11 months of age, the Vojta approach was performed for a total of 8 months. In this study, we found that in CST, the left FA and right TV increased in follow-up DTI more than in the initial DTI. In CRP, Wallerian degeneration was observed in the left FA, MD, and TV in follow-up DTI. GMFM-88 improved after intervention. The structural change of neural pathways through the Vojta approach influenced the improvement of gross motor function. Therefore, it is thought that the Vojta approach can be suggested as a meaningful intervention for children with DD and hypotonia.

Feasibility and efficacy of the Vojta therapy in subacromial impingement syndrome: a randomized controlled trial

Subacromial impingement syndrome (IS) is a common disorder associated with functional impairment and disability of the shoulder. The aim of this study was to evaluate the efficacy of Vojta therapy (VT) techniques compared with standard therapy (ST) in patients with subacromial IS. A randomized controlled trial was performed, with 60 patients with IS (mean age, 61±12 years) randomized into two groups: ST (n=30) and ST plus Vojta therapy (SVT, n=30). Both received 15 treatment sessions over 4 weeks. Outcome measures included pain intensity, functionality, joint range of motion (RoM), strength, and quality of life measurements. The efficacy of both treatments was analysed, both comparatively and separately, immediately after completion of treatment and after 3 months. After the intervention, both groups showed statistically significant differences in visual analogue scale (P=0.001), RoM (P<0.01), and strength (P<0.001), which were also seen 3 months after the intervention. SVT is more efficient in both the short and medium term in reducing pain, improving functionality, increasing articular RoM and strength, and offering a better quality of life in IS patients.

The implementation of a reflex locomotion program according to Vojta produces short-term automatic postural control changes in patients with multiple sclerosis

BACKGROUND

Imbalance is common in people with multiple sclerosis.

OBJECTIVE

To examine the effectiveness of a Vojta locomotion reflex program as short-term automatic postural control in patients with Multiple sclerosis.

METHODS

Quasi-experimental controlled trial with a pretest-post-test design.

PARTICIPANTS

People with Multiple Sclerosis (N = 21) able to walk 100 m but unable to maintain 30-s tandem stance with arms alongside the body.

INTERVENTION

in two consecutive weeks two interventions were conducted: Vojta group(A) and standard therapy group(B). Primary outcome were: Berg Balance scale (BBS), Tandem test, 10 m Walk in the 1st session (pre and post) then at the end of the study 2 weeks later.

RESULTS

Intervention A had significant results in contrast to intervention B in BBS when referred to equilibrium variables (p = 0.026) and Tandem test (p = 0.01). In the 10 m Walk test a significant improvement was seen in both interventions, p = 0.00 in group A, p = 0.038 in group B. In addition, an association was found between the variable Core activation and the main equilibrium variable (BBS) in the intervention A.

CONCLUSIONS

The results suggest that Vojta therapy has a short-term effect improved balance in everyday skills according to BBS and the other tests (walking) in people with MS compared to a standard therapeutic procedure. www.ClinicalTrial.gov.

REGISTRATION NUMBER

NCT03887507.