Česky
Can you briefly explain what the Vojt method is?
The Vojta Method is a comprehensive medical concept discovered by Czech child neurologist Professor Václav Vojta. It is used in the treatment of both central and peripheral movement disorders. In Vojta's method there is a link between diagnosis and therapy. Its timely application and precision of execution are important, on which the success rate directly depends. Diagnosis is based on examination of primitive reflexes, position tests and readings of the child's spontaneous motor behaviour. In the therapy, which we call reflex locomotion, specific muscle interactions are activated in precise starting positions using trigger zones. The resulting movement is induced reflexively, i.e. without the conscious participation of the patient.
What is the aim of Vojta therapy?
If we stick to infancy, then our goal is primarily to detect qualitative deficiencies in movement patterns early on and to positively influence them through therapy. To do this, we use the innate movement patterns that are stored in the subcortical centres of the brain. By activating them, we prevent the development of replacement motor skills. If replacement motor patterns have already developed and become fixed, then we try to at least weaken them. Optimally, the child should be "guided" as naturally as possible through each stage of development to good independent walking. For severe diagnoses, where we suspect that walking will never be possible, we try to at least prevent the development of muscle contractures, joint damage, severe scoliosis, etc.
What makes the Vojt method so unique compared to other methods?
The Vojta therapy is the only one that incorporates the principle of locomotion, which is reflexively equipped during activation. This means that during the therapy we directly provoke the automatisms necessary for forward movement through the activation of the crossed model, without which coordinated climbing on all fours and therefore walking is not possible. The locomotion principle consists of automatic work with the centre of gravity, uprighting against gravity and phasic movement. Exactly these three components appear quite automatically in the motor development of a healthy child. The centrally handicapped child has all these three components, which are the basis of all physiological movement from A to B, grossly impaired. We are able to use reflex locomotion to introduce these components into spontaneous motor expression. Unfortunately, no other therapy can do this.
Is it possible to replace the Vojta method with another method?
In my opinion, there is no other alternative for infants and especially for those with central disabilities. Recently, many new therapeutic approaches have emerged which do not always honour the principles of natural motor development. Parents, for example, if they have a child with a central disability, logically look for other ways to help them. This is especially the case when they have already had years of Vojta therapy, they are exhausted, the therapy may not be going as well as they would have liked, and they are finally realizing that their child will have a permanent disability. This is exactly the situation when they want to "quit" the Vojta Method. It is very difficult for a physiotherapist to convince such parents that changing the method will do their child no good. The therapist can only convince the parents by positive results of the therapy, it is good to remember that. Combining the Vojta method with many other physical activities can also be a big problem. The central nervous system, which is damaged, can then easily become overloaded.
When should one start Vojta Method therapy for babies who have a deviation?
Generally speaking, as soon as possible, if there is a reason to do so, of course. Therapy is indicated on the basis of diagnosis, which must be carried out mainly in time, i.e. ideally in the first trimester. If the child does not have a serious problem and gets into therapy late, he or she may come out with only slight deficiencies at the level of faulty posture. However, if he has a central disorder and does not appear in therapy until the third trimester or later, it is certain that we have wasted the most valuable period when we could have worked reflexively with the child. The outcome will never be as good as if we had started therapy early. It is little known among the general public that a child is not born with cerebral palsy (CP) but gradually develops into it. If we intervene therapeutically early in borderline children, we can reverse the development of infantile cerebral paresis.
Why is it so important to start with the Vojta method preferably in the first three months of life?
In a healthy child, around one month after birth, the maturation of the central nervous system (CNS) leads to a fundamental change in posture and physiological mobility begins to develop rapidly. However, in a child with a central disorder, this automatism is not realised or is reduced. At the moment when the child does not have physiological movement patterns available, he begins to develop alternative, pathological ones. This surrogate motor system develops rapidly, gradually becomes fixed during the second trimester, and by the end of the third trimester the basic building blocks of the motor system are fully embedded in the child's motor repertoire. If the muscles are repeatedly engaged in the wrong mode, their shortening and eventually ligamentous transformation occurs. Structurally altered muscles, through their unbalanced strokes, exert a formative effect on the bone and joint structures, where irreversible morphological changes gradually occur. Damaged joints are often the target of orthopaedic surgery. Therefore, it is very important to start therapy at a time when replacement motor skills are not yet developed, let alone fixed, in order to prevent these irreversible changes if possible.
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