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Christin Dräger & Anne Hampel Vojta Therapy and Science Bachelor Thesis 2011 Presentation.

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Präsentation zum Thema: "Christin Dräger & Anne Hampel Vojta Therapy and Science Bachelor Thesis 2011 Presentation."—  Präsentation transkript:

1 Christin Dräger & Anne Hampel Vojta Therapy and Science Bachelor Thesis 2011 Presentation

2 Content Introduction Vojta Therapy Science Conclusion Questions

3 Introduction Why Vojta Therapy? What was the research goal? Relevance of the topic? Methodology

4 Vojta Therapy WHO is Dr. Vaclav Vojta? HOW did he discover Reflex Locomotion? WHAT is Reflex Locomotion? HOW does it work? WHAT are the effects?

5

6 Vojta Therapy: Dr. Vaclav Vojta 1917Born in Czech Republic Studied Medicine in Prague 1957Pediatric Neurology Specialization 1968Emigration to Germany (Cologne, Munich) 1990Return to Prague 1995Foundation “International Vojta Society” 2000Died in Munich (Germany)

7 Vojta Therapy: How it began… …Observing a change in spasticity …Observing specific reproducible muscle activity… … that changes with positioning and use of pressure points Conclusion: Existence of Reflex Locomotion!

8 Vojta Therapy: What is it? Reflex Locomotion (RL) Reflex Turning (RT)Reflex Crawling (RC) OntogenesisPhylogensis

9 Vojta Therapy: How to activate it? a) Positioning b) Pressure Points / activation zones c) Resistance / isometric contraction

10 Vojta Therapy: How is it integrated? Afferent input Partial patterns Unconscious process Muscle functions Depends on: neuronal mass, motivation, pathology

11 Vojta Therapy: What are the effects? Main Effects: Re-innervation trigger missing ideal movement patterns dissolve fixed pathological patterns Other Effects: e.g. ANS activation, speech …

12 a)Positioning: pre-stretch = more excitable + joint capsule receptors b) Pressure points: periost -> nociceptive, tendons c) Resistance: isometric contraction -> muscle strength, neuronal pathway construction? d)  Reflex Locomotion patterns: summation? Science

13 Central Pattern Generator

14 Neuronal Plasticity

15 Constraint Induced Movement Therapy (CIMT) Neuronal Plasticity

16 Summary Therapy concept based on observations  difficult structure, no real scientific foundation Practice vs. evidence remains problem BUT Summation of peripheral inputs Indications for CPG involvement Influence on neuronal pathway formation remains questionable (future research topic?) Practical implications

17 Conclusion Neurological explanation? Yes, partially. Further Research: Effectivity and Efficiency

18 Acknowledgements Client: Gabriele Reimann Coach: Rolf Hoogland Mechthilde Madlener and Anne von Reumont

19 Thanks for your attention!

20 Adde L, Rygg M, Lossius K, Øberg GK, Støen R. General movement assessment: predicting cerebralpalsy in clinical practise. Early Human Development. 2007;83,13-8. Barbeau H, McCrea DA, O´Donovan MJ, Rossignol S, Grill WM, Lemay MA. Tapping into spinal circuits to resore motor function. Brain Research Reviews.1999;30: Böhme B, Futschik M. Verbesserte Lungenfunktion nach Vojta-Brustzonen-Reiz bei bronchopulmonaler Dysplasie. Monatsschrift Kinderheilkunde. 1995;143: Bragelien R, Røkke W, Markestad T. Stimulation of sucking and swallowing to promote oral feeding in premature infants. Acta Paediatrica. 2007; 96(10): Carroll TJ, Barton J, Hsu M, Lee M. The effect of strength training on the force of twitches evoked by corticospinal stimulation in humans. Acta Physiol (Oxf). 2009;197(2): Courtine G, Gerasimenko Y, van den Brand R, Yew A, MusienkoP, Zhong H, et al. Transformation of nonfunctional spinal circuits into functional states after the loss of brain input. Nat Neurosci. 2009;12(10):1333–42. Eyre JA. Development and plasticity of the corticospinal system in man. Neuroal Plasticity. 2003; 10(1-2): Eyre JA, Miller S, Clowry GJ, Conway EA, Watts C. Functional corticospinal projections are established prenatally in the human foetus permitting involvement in the development of spinal motor centres. Brain. 2000;123: Felten DL, Józefowicz R. Netter´s atlas of human neuroscience. New Jersey: Icon Learning Systems; Gerasimenkoa Y, Roy RR, Edgerton VR. Epidural stimulation: comparison of the spinal circuits that generate and control locomotion in rats, cats and humans. Exp Neurol. 2008;209(2): Golding M. Circuits controlling vertebrate locomotion: moving in a new direction. Nat Rev Neurosci. 2009;10(7): Harkema SJ. Plasticity of interneuronal networks of the functionally isolated human spinal cord. Brain Res Rev. 2008;57(1): Harkema SJ, Hurley SL, Patel UK, Requejo PS, Dobkin BH, Edgerton VR. Human Lumbosacral Spinal Cord Interprets Loading During Stepping. J Neurophysiol. 1997;77: Haridas C, Zehr EP. Coordinated interlimb compensatory responses to electrical stimulation of cutaneous nerves in the hand and foot during walking. J Neurophysiol. 2003;90: Hart H. Fetal and infant movements and the young nervous system. Developmental Medicine and Child Neurology. 2006;48:547. International Vojta Society. Website: URL: [no further information retrievable] Karch D, Boltshauser E, Göhlich-Ratmann G, Gross-Selbeck G, Pietz J, Schlack HG. Physiotherapie auf neurophysiologischer Grundlage nach Bobath und Vojta bei Kindern mit zerebralen Bewegungsstörungen (Unter besonderer Berücksichtigung von infantilen Zerebralparesen) - Stellungnahme der Gesellschaft für Neuropädiatrie und der Deutschen Gesellschaft für Sozialpädiatrie und Jugendmedizin. Aktuelle Neuropädiatrie. 2004; Karch D, Glauche-Hiegler A. Neurophysiologische Grundlagen krankengymnastischer Behandlung bei infantilen Zerebralparesen - Ist ein Methodenstreit noch zeitgemäß? Krankengymnastik. 1993;45(10): References 1

21 References 2 Karch D, Schulz P, Haberfellner H, Berger H., Bauer H, Naß G, Ernst W, Glauche- Hiegeler A, Haberfellner U, von Voß H. Krankengymnastik auf neurophysiologischer Grundlage nach Bobath und Vojta bei zerebralen Bewegungsstörungen im ersten Lebensjahr – Dissens und Konsens. Year and publisher unknown. Laufens G, Seitz S, Staenicke G. Vergleichend biologische Grundlagen zur angeborenen Lokomotion, insbersondere zum „reflektorischen Kriechen“ nach Vojta. Zeitschrift für Physiokalische Therapie, Bewegungstherapie, Massage, Prävention und Rehabilitation. 1991;5: Laufens G, Reimann G, Poltz W, Schmiegelt F. Behandlungserfolge und Bedingungen der Vojta-Therapie bei MS-Patienten. Krankengymnastik. 1996;4: Madlener M. Die Vojta-Therapie: Anwendung, Wirksamkeit und Nachweis [bachelor thesis]. Berlin: Alice Salomon University of Applied Sciences; Martin JH, Friel KM, Salimi I, Chakrabarty S. Activity- and use-dependent plasticity of the developing corticospinal system. Neurosci Biobehav Rev. 2007;31(8): McCrea DA. Spinal circuitry of sensorimotor control of locomotion. Topical Review Journal of Physiology. 2001;533(1):41–50. McCrea DA, Rybak IA. Organization of mammalian rhythm and pattern generator. Brain Res Rev. 2008;57(1): Nederlandse Vereniging van Revalidatieartsen. Conceptrichtlijn Diagnostiek en behandeling van kinderen met spastische Cerebrale Parese Niethard FU. Preliminary treatment of congenital hip dislocation using physical therapy based on neurophysiology. Z Orthop Ihre Grenzgeb.1987; 125(1): Payne VG, Isaacs LD. Human motor development: a lifespan approach. 3rd ed. Mountain View: Mayfield; p Reimann G. Untersuchungen zu Verluaf und Effizienz einer Vojta-Physiotherapie an ausgewählten Patienten in der Sauerlandklinik Hachen. Krankengymnastik. 1991;(1): Rossignol S, Dubuc RJ, Gossard JP. Dynamic sensorimotor interactions in locomotion. Physiol Rev. 2006;86: Rowe MJ, Tracey DJ, Mahns DA, Sahai V, Ivanusic JJ. Mechanosensory perception: are there contributions from bone-associated receptors? Clinical and Experimental Pharmacology and Physiology. 2005;32: Salimi I, Friel KM, Martin JH. Pyramidal tract stimulation restores normal corticospinal tract connections and visuomotor skill after early postnatal motor cortex activity blockade. The Journal of Neuroscience. 2008;28(29): Selter S. Die Anwendung der „Vojta-Therapie“ in der Orthopädie an der exemplarischen Darstellung der kindlichen Hüftdysplasie [thesis within exam course for Manual Therapy] Vojta V, Peters A. Das Vojta-Prinzip: Muskelspiele in Reflexfortbewegung und motorischer Ontogenese. 3rd ed. Berlin: Springer; Vojta V. Die zerebralen Bewegungsstörungen im Säuglingsalter:Frühdiagnose und Frühtherapie. 8th ed. Stuttgart: Thieme; 2008.

22 Questions


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