Vojta Therapy

The therapeutic use of reflex locomotion enables elementary patterns of movement in

patients with impaired central nervous systems and locomotor system to be restored once
more—at least in part—, i.e. they become accessible once more. Reflexlocomotions are
activated “reflexogenically”. “Reflex”, in the sense of reflex locomotion, does not refer to the
kind of the neuronal regulation, but is rather related to therapeutically applied external
stimuli and their predefined and always identical, “automatically” present movement
responses.
In Vojta Therapy, the therapist administers goal-directed pressure to defined zones on the
body in a patient who is in a prone, supine or side lying position. In everyone—regardless of
age—such stimuli lead automatically and involuntarily, i.e. without actively willed
cooperation on the part of the person concerned, to two movement complexes:
Reflex creeping in a prone lying position and reflex rolling  from a supine and side lying
position. Reflex creeping leads to a type of creeping movement, while reflex rolling begins
from a supine lying position, and transforms, via a side lying position, into the so-called
quadrupedal gait.
In reflex locomotion, there is a coordinated, rhythmic activation of the total skeletal
musculature and a CNS response at various circuit levels. The motor reactions, stimulated
by pressure from a defined starting position and which proceed regularly and cyclically, can
already be completely stimulated and reproduced as often as desired in the new-born.
All motor movements that appear in us in the development of grasping, rolling, crawling,
standing up and walking are therefore activated visibly. They are – according to Prof Vojta –
also already present in children, in a stage of development, in that children do not yet
possess these abilities spontaneously.
Through therapeutic use of reflex locomotion, the – involuntary – muscle functions
necessary for spontaneous movements in everyday life are activated in the patient,
particularly in the spine, but also in the arms and legs, the hands and feet, as well as in the
face.
Prof Vojta assumed that repeatedly stimulating these “reflex-like” movements lead to
something like “freeing a switch” or “new networking” within functionally blocked networks
of nerves between the patient’s brain and spinal cord.

Goal of the Therapeutic Use of Reflex Locomotion

Through the use of the reflex locomotion, the elementary components of man's uprighting
and locomotion, i.e.
1. Equilibrium of the body when moving (“postural regulation”)
2. Uprighting of the body against gravity
3. Goal-directed grasping and stepping movements of the limbs (“phasic mobility”)
should become accessible and usable once more. 
The Difference from Other Physiotherapy Techniques and
Methods
In Vojta Therapy movement functions, such as grasping, rolling over from the back onto the
stomach or walking, are not practised. Rather, the therapeutic activation of reflex
locomotion facilitates access, via the central nervous system, to the individual segmental
patterns of movement necessary for a specific movement or activity.
After Vojta treatment, these segmental patterns are more available spontaneously to the
patient. Regular repetition of the “normal movement” stored in the brain prevents evasion
movements being practised. In any case, these would only be a substitute for the actual,
and therefore desired, “normal movement”.

Activating Vegetative and Other Automatic Reactions

With reflex locomotion, along with the “major” motor processes, also specific reactions such
as:

 conjugate eye movement (oculomotor activity) 

 tongue movements, jaw movements (orofacial motor activity)

as well as vegetative functions such as:

 regulation of bladder and bowel function 

 breathing 
 sucking and swallowing

can be activated and manipulated.

Reflex Locomotion and its Relation to Normal Motor Development

In all, the segmental patterns of reflex locomotion include all the building blocks of human
motor development up to walking unaided. Through regular Vojta Therapy, the segmental
patterns are “activated” in the central nervous system so that the activated state persists
beyond the therapy, and the child/adult’s spontaneous movements are positively influenced.
According to clinical experience, a patient (child/adult) has a much more comprehensive—
even normal—body posture after activation through reflex locomotion. This also gives the
patient increasing emotional security to cope with the world around him and to build up
experience.

Vojta Therapy in Childhood

Vojta Therapy can equally be used in new-born babies as in children. It is indicated on the
basis of a medical diagnosis and the accordingly formulated therapy goal.
Best results are obtained when the patient has not yet developed and established any so-
called substitute motor patterns. In patients with established “substitute motor activity”, the
goal of treatment is to activate and maintain physiological patterns of movement, as well as
to reduce non-established abnormal patterns of movement and to integrate them into
normal motor processes, all the way to complete mastery of conscious motor activity.

New-Born Babies Crying in Vojta Therapy

The therapeutically desired activated state often expresses itself during treatment in new-
born babies as crying. This understandably leads to parents feeling concerned, and makes
them assume that it is “hurting” their child. At this age, however, crying is an important and
appropriate means of expression for the little patients, who react in this way to
unaccustomed activation. As a rule, after a short familiarisation period, the crying is no
longer so intense, and in breaks from exercise as well as after the therapy, new-born babies
calm down immediately. In older children who can express themselves in speech, crying no
longer occurs.

Vojta Therapy in Adulthood

In adults with acquired impairments that handicap the peripheral and central nervous
regulation of movement, Vojta Therapy can be used even in the acute phase of illness, i.e.
very early, as well as in the subsequent rehabilitation.

 
 
 
 
 
Use of reflex creeping in adults

Vojta Therapy seeks renewed access to previously healthy patterns of movement with the
goal of preventing aftereffects, such as pain, or restriction of function and strength. As a
desired side effect, the treatment in progress sends out impulses that have an activating
effect on the higher cortical functions (motivation, concentration, patience, speech
acquisition, multi-tasking, perception and the psyche).
The overarching goal of Vojta Therapy is to reconstruct the patient’s everyday competence.
That means that treatment shall enable the patient to get involved once more as best he
can in all activities, family, school, work, free time and similar, as he requires.
Range of Effects for Vojta Therapy
The broad range of effects of Vojta Therapy benefits patients of every age with quite
different illnesses, e.g.

 cerebral palsy 
 spinal scoliosis 
 hip joint dysplasia and dislocation

Even in severe cerebral movement disorders, there is a markedly positive influence on and
favourable change in uprighting mechanisms or support functions and the ability to
communicate. Vojta Therapy can be used as standard therapy in physiotherapy for almost
every movement disturbance and for numerous illnesses, e.g.:

 disturbance in central coordination in infancy 

 movement disturbances resulting from damage to the central nervous system (incl.
cerebral palsy, apoplexy, MS) 
 peripheral paralysis of the arms and legs (e.g. plexus paresis, spina bifida (split
spline), paraplegia, etc.) 
 various myopathies 
 complaints and impairment of functions within the spinal column, e.g. curvature of
the spine (scoliosis) 
 orthopaedic/traumatologically relevant conditions of the shoulders and the arms, the
hips and the legs 
 co-treatment of malformation of the hip (hip joint dysplasia or dislocation) 
 problems in the breathing, swallowing and chewing functions

Contraindications for Vojta Therapy

Vojta Therapy should not be used in:

 acute feverish or inflammatory conditions 

 vaccinations with live vaccines following doctor’s orders (as a rule 10 days after
vaccination) 
 existing pregnancy in patients 
 certain illness, as e.g. imperfect osteogenesis, heart disease etc.

In all illnesses that impact on patient’s general condition, Vojta Therapy can be carried out
for shorter sessions, depending on the tolerance level of the patient, but does not have to
be ruled out.

Effects of Vojta Therapy on Patient Development and Communication

With Vojta Therapy, there is the positive change in movement coordination in grasping,
uprighting against gravity, walking and speaking. As a consequence of this change, the child
or adult is afterwards able to express his wishes and needs more easily and
comprehensively and to fulfil them spontaneously. Patients are less frustrated, and seem
happier and more balanced. Older children or adults say that after Vojta treatment they feel
“lighter” when they move. Such a positive emotional basis leads to a visibly improved ability
to communicate. Overall, Vojta Therapy gives the patient significantly improved possibilities
for motor learning as he negotiates the world around him.
Aside from Vojta Therapy, no constant observation or corrective intervention by the parents
is necessary, so the new-born baby or child can move freely and spontaneously. According
to the Vojta Principle, there are no incorrect postures that could hinder the success of the
treatment.
Because Vojta Therapy “activates” postural and movement functions in the new-born baby
or child’s central nervous system, the improved level of movement that they reach in the
required few and short daily therapy units can, as a rule, be maintained over the whole day.
As a result, this also encourages the little patient to develop self-reliance and independence
from adults. This is a desired goal of the treatment. Vojta Therapy likewise encourages
parents in their parental role: In daily Vojta Therapy, the child experiences physical contact
and a parental guidance that conveys security. Vojta Therapy thus strengthens the parent-
child relationship and leads to new, enhanced experiences for the child.

Frequency and Exercise Intensity in Vojta Therapy

Reflex locomotion is an extremely effective therapy, especially for new-born babies and
infants; it is also unfamiliar and very strenuous. Like many other physiotherapies, Vojta
Therapy places considerable demands on parents or caregivers.
For Vojta Therapy to be successful, it should as a rule be performed several times a day on
new-born babies and infants. A therapy session lasts between five and twenty minutes.

Duties of Parents/Caregivers in Vojta Therapy

Since parents or caregivers perform the therapy several times a day, they play a decisive
role in Vojta Therapy.
In the treatment of adult patients, Vojta Therapy can be performed by a spouse, life partner
or someone close. In this instance, therapy is, as a rule, performed several times a week.

Instruction and Performance of Vojta Therapy

As well as the primary illness, exercise intensity and accuracy determine the effectiveness
and ultimately the success of the Vojta treatment. After referral to Vojta Therapy by the
doctor, the Vojta therapist draws up an individual programme and determines the goals of
therapy jointly with the patient/parents. The therapy programme is then determined at
regular intervals in accordance with the patient’s development.
              
 
 
 
 
 
Precise instruction from the Vojta therapist reassures the mother about treating her child at
home

Parents or caregivers are as a rule promptly instructed in how to perform Vojta Treatment
so that therapy on the patient can be started at home and that the necessary treatment
intensity is ensured.
Regardless of age, the patient is then expected regularly at the Vojta physiotherapist’s
outpatient clinic.

Vojta Therapy in Interdisciplinary Treatment Teams

Prof Vojta saw improvement in automatically regulated body posture as a basic prerequisite
for progress in the patient’s receptivity, perception, speech, learning etc. Thus, Vojta
Therapy improves the requirements for special educational, logopaedic, occupational and
other kinds of therapy. The Vojta Therapy has, therefore, an important, fundamental place
in interdisciplinary treatment teams.

How can the effectiveness of Vojta Therapy be proven?

Vojta Therapy has proved itself worldwide in many patients ranging from new-born babies
to adults. Reflex locomotion, as observed by Prof Vojta, its effects and therapeutic
successes have been scientifically tested many times and empirically confirmed. There have
moreover been isolated evidence-based studies.

Examinations into the Psychological Effects of Vojta Therapy

The suspected negative effects of Vojta Therapy, especially the psychological ones, on
sensomotor development and communicative and social behaviour in new-born babies or
children treated have been examined by various authors. They placed particular attention
on the comparison with untreated or differently treated children as well as the effects on the
mother-child relationship. These studies showed, however, that Vojta Therapy entails no
negative effects from a psychological point of view, but rather that it can also have a
positive effect on the psychological level.