Vojta Method

It is a technique to treat physical and mental disability with the application of ” reflex locomotion “. It was given by Prof. Vaclav Vojta

In reflex locomotion, there is a coordinated, rhythmic activation of the total skeletal musculature and a CNS response at various circuit levels

PRINCIPLES

(1) 18 points in the body – crawling and reflex rolling

(2) placing the child in a particular position and simultaneous Stimulation of vital points can help improve CNS development

(3) Should be applied 4-5 times daily and withdraw if no improvement is noticeable after a year

(4) Following this protocol child learn normal movement pattern instead of abnormal ones

The Vojta Principle starts out from what is known as reflex locomotion.

Prof Vojta witnessed that these children responded to certain Stimulation in certain body positions with recurrent motor activities in the trunk and the extremities

The effects of this activation were positive, the children with cerebral palsy could first speak more clearly, and after a short time they could stand up and walk more assuredly

The Vojta method can be divided into 2
phases:

Reflex creeping (prone lying flat with the chest down and back up)

Reflex rolling (supine lying flat with the chest up and back down)

USES

By Following above mentioned principle it was observed that children with spastic cerebral palsy not present with spontaneous motor activity could now be completed more comprehensively with repeated Stimulation” Prof Vojta concluded that movement development in the infantile spastic might be subject to functional blockades “

Prof Vojta developed a holistic approach for these kinds of clinical manifestation in new-born babies, children and adults popularly called as  ” Vojta Therapy “

INDICATIONS

Congenital muscular torticollis

Cerebral palsy

Hip dysplasia

Infantile Postural Asymmetry

Spina Bifida

MECHANISM

The reflex locomotion elicited by Vojta therapy is associated with changes in cortical and subcortical brain activation. 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.

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Parkinson’s Disease

It is a long term degenerative disease of CNS that mainly affects the motor system. Caused due to substantia nigra, cells that make the chemical dopamine start to die. Dopamine acts like a messenger that tells another area of your brain when you want to move a part of your body.The typical appearance of parkinson’s patient is

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EPIDEMIOLOGY

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CAUSES

Oxidative Stress

Lewy bodies

Increasing age

Genetics mutations in the LRRK2, PARK7, PINK1, PRKN, or SNCA gene

Environmental factors

PATHOPHYSIOLOGY

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CLINICAL FEATURES

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PHYSICAL EXAMINATION AND DIAGNOSIS

Physical examination includes Medical history, Signs, posture, gait, appearance etc discussed below

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Imaging techniques applied includes
MRI, CT scan, PET, SPECT Imaging Testings and Dopamine transporter imaging are used to confirm parkinson’s disease

DIFFERENTIAL DIAGNOSIS

Idiopathic parkinson’s

Essential tremor

Huntington disease

Multi system atrophy

PHYSIOTHERAPY MANAGEMENT

Medical management includes use of drugs that increase dopamine levels like combination of Carbidopa-Levodopa, Dopamine agonists, MAO-B inhibitors, COMT inhibitors.

Physiotherapy management includes Exercises that require balance and preparatory adjustment of the body important along with rhythmic activities such as dancing, skipping and cycling that can maintain the ability to perform reciprocal movements.   Finally, exercises that promote attention and learning are beneficial. 

Types of exercises that do this:

Walking

Dancing

Yoga classes

Tai Chi classes

Stepping over obstacles

Marching to music with big arm swings

Sports (ping pong, golf, tennis, volleyball)

Aerobic/Jazz exercise classes  

The European Guideline provides a section that describes the use of motor learning. It takes the form of cued functional and dual task training, compensatory strategy training uses external cues, self-instruction and attention. Examples include:

Visual cueing

Auditory cueing

Attention

Proprioceptive cueing

Along with the same proper gait training, use of assistive devices like walkers rollators etc, balance and posture training and Movement strategy training are also prescribed

Rollators for Parkinson’s

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