The most often asked questions

What is Vojta method/Reflex locomotion?

 

Vojta method is a reflex therapy. In a certain position by stimulating certain anatomical points (called zones) we bring up a reflexive response.

By Vojta therapy we activate the central nervous system, as most of the problems we solve are based in Central nervous system. The root of motor problems

of most infants is in controlling the motion. Therefore it is important to activate the CNS and work with its directing of the motorics. Therefore it is not correct to work primarly with the muscles.

 

Reflex locomotion is activated from three main positions, which contain the features of the motor development. We activate the specific muscle coordination/interaction, which could be impaired. This impairment

is then the cause of stagnation, or abnormal motor development.

Diagnosing the child, the physiotherapist identifies the specific motor problem and affects it with his activation.

 

How the therapy proceeds

 

The child should be sent to a physiotherapist by a doctor after he diagnoses him/her. The physiotherapist, according to his own diagnosing sets the specific and individual therapeutic programme, its dose and frequency for the home therapy. The physiotherapist is responsible for the guidance of the therapy

and its effectivity. If by regular therapy the development is stagnating,

the therapist is obliged to search for the cause of this stagnation.

 

This could be insufficient frequency of the home therapy, low or high dose,

or a too demanding programme , that the mother cannot handle technically and the therapy is therefore loosing its effectiveness.

The cause can as well be in wrong indication of the specific therapeutic model. The child can as well be on the end of his/her possibilities, which means we already did reach his/her capacities.

 

The frequency of home therapy

 

The frequency of the home therapy should be exactly 4 times a day until reaching the age of one year. In case that the child starts to crawl, the frequency can be lowered to 3 times a day. The frequency should be regular, it can be compared with giving antibiotics. This is because the CNS in this age is able to remember what we have activated for about 3 hours and can use it in spontaneous movement. This means, that the child can use the new coordinational abilities , when he/she needs it, that means, when he/she wants to realize ideas adequate to his/her age.

By older infants, the frequency of the home therapy is normally 3 times a day. The frequency 3 and 4 times a day can move the child’s development forward. We use the 2 times a day frequency mainly for the maintainance of the state.

The 1x a day frequency we consider as not effective, as the pathological development with this frequency is faster, than the physiological models, which can not apply.

When the child travels to rehabilitation, this day he/she will not get the indicated frequency. If the therapy is missed only in the occasions of a rehabilitation, or a doctor control, it is not a problem. But it is necessary to keep it under control,

so it would not be regular to miss the therapy sessions, as that would be harmful for the continuance of the therapy/developmental progress.

We always must take into account the age, weight and the psychological state of the child.

 

What is a therapy dose?

 

The therapy dose (the duration of activation) is dependent on the age of the child and as well on the weight and psychological state of the child.

It is necessary to respect the dose, which the physiotherapist has indicated. Following of the dose instructions is bound with the load of the child.

If the load is too big for the child, it could have an exhausting effect.

If the high load, which is not convenient for the child is applied too often, the child can get to the state of chronical weariness.

If the child is exhausted, we can see it by his/her not having a mood to play, or have interest, he/she can loose taste/apetite, fall asleep or even sleep badly

and tends to wake up in the night. In this case, the motor development stagnates. In case, that the dose is too small, it will not be able to affect the child positively. The dose is set accurately, so it – with combination with the frequency of the therapy will cause the motorics of the child to evolve.

We always must take into account the age, weight and the psychological state of the child.

 

Child under 3 months: dose max. 2-7 minutes 4 times a day

Child between 3 and 6 months: 5-7minutes 4 times a day

Child older than 6 months : 10 minutes 4 times a day

Child 8 months old: 10-12 minutes 4 times a day

Child older than 1 year: 10-15 minutes (15 minutes being the maximum)

 

Can a regular therapy followed by crying of the child be harmful for the psychics of the child?

 

The crying of the child is not a burder, nor a reaction on a painful stimul. It is a form of communication, which the child uses commonly in certain age, when he/she wants something. For example when he/she is hungry, thirsty or he/she does not like something, like changing the dipers, dressing, putting on the cap, or so..

He/she does not like the therapy either, as it is demanding for him/her.

He/she does not like, that he/she has to stay in one position and what is more, he/she has to perform effort when doing the excercises.

 

It is not convenient to calm the child down in the time of activation between the excercises, or to distract the child from therapy (singing, showing toys, reading a fairy-tale, poems..).

The child should do the exercise shortly and without interruptions.

This way he/she learns, that the therapy is “work”, that it takes some time and then it ends.

This way he/she will get used to the situation. By crying he/she only tells, that he/she does not like it. If he/she stops crying shortly after activation (after leaving the position), everything is alright.

In case, that he/she keeps crying even a longer while after the activation,

it is necessary to find out, what he/she is telling us and react on this.

 

Interrupting the therapy with the intention of calming the child down

 

In activation it is necessary for the child to concentrate on the therapy. Distracting the child is not the way to make him/her accept the therapy.

Calming the child down does not lead to his/her relaxation, but leads to an even bigger/higher stress. The child might think the therapy has come to an end, but finds out, that it is going to continue. What is more, the breaks prolong the duration of the therapy session which leads to overloading the child. If the parents do the excercises with the child 10 minutes without any interruptions, he/she accepts, that this 10 minutes he/she is working and then is finished.This leads to the acceptation of the therapy and the child is not defending.

 

What is ment by instructing a parent into therapy?

 

The visit of a physiotherapist is aimed mainly on instructing the parent for hometherapy. This instruction is a work of the physiotherapist with the parent of the child, who will be applying the therapy at home in the indicated frequency and dose. The idea, that the parents come to the physiotherapist to make him do the therapy with their child is a misconception. The child is being cured by constant and regular home therapy and not by the visit at the physiotherapist.

Another argument against the concept of the child being cured by the physio is that the child bears the load better from a parent and worse from a foreign person, which a physiotherapist surely is, even when the child has a good relationship with him.

The instruction with the physio is always longer and with a bigger load than the indication for home therapy. The instruction normally lasts 45 to even 60 minutes. The child is not in action all the time, as there are as well breaks for explanations. This is not ideal, but the parents come to the physiotherapist to learn how to work with the child, which is not possible to do in a 10 minutes time.

The main part of the visit at the physiotherapist is aimed purely on corrections, or forming the therapy programme, not on the treatment itself. That is why it is not convenient to visit the physiotherapist too often (every day, or every second day), as it disturbs the frequency and dose of the home therapy and the child would constantly be overloaded.

We try to shorten the process of instructing the parent as much as we can.

The difference is by the children that come from a bigger distance and stay in the town for a so called intensive training. These come to see the physio 2 times a day. The infants aged 6-12 months can bear the load, which a concentrated instruction brings for maximum 3 days. Older children can bear even a 5 days treatment in the frequency of 2 times a day. For learning the essential home programme 3 days are normally enough no matter the age of the child.

As stated before, it is necessary to realize, that the therapeutic effect lies mainly in the reagular home therapy and the instruction suits more for keeping the quality of the therapy, which the parent performs regularly at home.

 

Is there a danger of overloading the child with regular home therapy?

 

As stated before, the home therapy should be performed in the optimal dose, the duration of the activation being indicated by the age of the child. From this reason it should not come to overloading the child.

If it eventhough comes to the chronical overloading of the child (the child has problems with falling asleep, or sleep itself, has aversion to food..), for example the parents add other activities to the child, which the physio has not indicated, we lower the dose-the duration of each therapy session, not the frequency, which we try to keep at 4 times a day. We try to analyze the regime/schedule of the child and the therapy performed at home to detect the cause/reason and do the correction. In about three weeks from this correction, a positive change occurs.

 

What is the content of the therapy?

 

The content of the therapy and its quality is another parameter, which cures the child. One session should include reflex turning and reflex creeping. In the age of 8 months we add the first position to these models. In 3 weeks time, the child should have the full programme, which assures the basic treatment.

 

The combination of therapeutical approaches

 

It is vital to concentrate on the therapy, which is improving the state of the child at minimal load for the child, home therapist and the whole family as well.

For the parents it is very complicated to set the home regime and the whole common life of the child for the child not to be overloaded and to have a normal childhood.

The child has to be able to play and not be burdened, that there is some therapy to be done. The same applies for the home therapist, which is normally the mother. She as well has another works at home, has a husband, possibly a second child, and for the child in therapy she has to prepare another programme, than just the therapy. By this we mean a normal daily regime, as by a healthy child.

The effort to improve the state of the child as much as possible often leads to overloading. The parents add other and another therapeutic methods, often without the knowledge of their therapist, or sometimes even after a therapists recommendations.

Continual overloading of the child with the home therapy combined with another therapies in various institutes then lead to chronical exhaustion.

Chronical exhaustion then leads to a stagnation in development. Effective is, to make the maximum of work in minimal time.

 

Home therapy and the therapy with a physiotherapist

 

The child always bears the therapy better from the home therapist in the home environment. The therapy with the physiotherapist is very exhausting for the child, mainly for the psychics of the child. For this reason, Vojta promoted that the child should get the therapy at home, not in a health institute.

The reasoning, that the therapist is better educated would not get by.

Vojta therapy is not complicated and the child cooperates with the parents in the way, that he/she is not escaping from the position, so they can activate more precisely and better.

In escaping, the child is defending with movement and it is necessary to fix him/her more, so we have chance to activate the position.

The physiotherapist activates the child in a higher volume and less frequency comparing to the indication of the home therapy. Like this, the child does not have an adequate frequency, nor dose.

It is necessary to realize, that the child is cured not only by the correct therapy, but as well adequate frequency and dose of therapy. For a better understanding of a parent, this can be compared to taking antibiotics. By antibiotics, nobody questions, that it is necessary to hold the frequency and dose for the therapy to be effective.

 

The leading of the childs therapy

 

The therapist, who is in charge of the child, is responsible for leading the therapy, which means, that he is responsible for the adequate dose, frequency and content of the therapy.

Based on the analysis of the childs state and the therapy in process the therapist evaluates the effectivity of the therapy. If he valorizes/evaluates, that the indicated models are not moving the child forward, he has to be looking for the cause of this state. The problem can be in not keeping the dose, frequency, or the models could have not been indicated correctly to positively influence the state of the child.

The cause can be for example when the therapy is too complicated for the mother to handle and therefore she makes technical problems.

The leading of the therapy includes to correctly adjust in what frequency should the mother with child come for therapy to the consulting room. This is according to how they are doing at home and according to the results they made.

The home therapy has to be going well, otherwise the requested result will not appear.

 

What is the speed of development

 

The speed of development is regurarly controlled by the physio, which belongs to the leading of the therapy. It is the evaluation of the effect of the indicated models in the meaning of content, dose and frequency. The development speed should be fluent. It can as well be fastened, slowed or even stopped.

It is dependent on the state of the child, his/her capacities, abilities of the home therapist and compliance of the therapy indications in the home environment.

 

Tiredness/exhaustion and the expressions of the child

 

If the child is continually overloaded by a high dose of therapy, it can get into the state of chronical exhaustion. This would manifest by the childs not thriving.

The child has no appetite, is not gaining weight, has problems with falling asleep and with sleep itself, wakes up durig the night, is smiling less, or not at all.

The acute tiredness is not a problem, the child “sleeps out of it”. That can happen during the rehabilitation, when the mother is learning a new model, the child gets tired and falls asleep deeply even without feeding. Out of this he/she sleeps out and is OK again.