20 Theoretical a Practical Differences between the Classical Implementation of the Vojta Method and VM2G Therapy
Therapy of Infants with the Classical Vojta Method
It is based on the biomechanical and anatomical concept viewed in 2D.
It uses only the planar surface of the table without other aids.
The stimulation is applied in two reflex zones.
In most patients, it utilises all stimulation reflex positions, i.e. supine position, position on the side and prone position.
Intensity of the stimulation may be increased or decreased in practice by the duration of the implementation of the therapy only.
There is no psychological dimension to working with the infant, and it is mainly focused on the performance of the reflex exercise.
It does not use any other stimulating, labilising, stabilising or adhesive aids.
It does not utilise the influence of gravity, the direction of the fall lines of tilted planes or the combination of transverse-longitudinal tilts of the surface of the medical lounger.
It doesn’t systematically utilise the possibilities of the continuous neuro-kinesiologic diagnostics or retrospective assessment of the records of the results of such diagnostics. Diagnostics of infants remains in the hands of paediatricians and paediatric neurologists.
The Vojta method performed in infants through the classical approach bears the risk of possibly inducing the pathological reflex response. Thus, it is necessary to perform it in a highly correct manner.
The above-mentioned factors, consequently, have lower therapeutic efficacy. It is manifested in the limited therapeutic results in infants at risk of the highest degree of the central coordination disorder and particularly in infants with congenital developmental defects of the central nervous system. The development of these children mostly leads towards some type of cerebral palsy and related psychomotor retardation.
VM2G Therapy for Infants
It is based on the biomechanical and anatomical concept seen in 3D.
It systematically utilises the biomechanical concept of muscular spiral loops.
In the practical treatment, it uses the medical lounge tilted in the transverse and longitudinal axes and many other aids including the children’s adjustable medical lounge for home exercise loaned or sold to the parents.
Stimulation is performed in several reflex zones. There are up to twenty-two zones that could be used at the same time.
Most infant patients can get by with the use of the reflex exercise in the supine position, which is very comfortable for the child. The exercise on the side and the stomach is used in about 10 % of cases.
Head zones are not utilised in VM2G method as it is uncomfortable for children. These zones are rarely used in infants with palsy of facial muscles.
Intensity of the reflex stimulation could be increased or decreased by several techniques:
The gradual tilt of the surface of the children’s adjustable medical lounge. The tilt can increase the effective intensity of the therapy or, conversely, the opposite tilt of the fall lines leads to facilitation of the induction of the stimulation. Thus, the strength of the stimulating reflex decreases (photos and videos);
Gradual adding of stimulating balls to reflex points can induce very fine regulation of the intensity of the therapeutic effect and a more exact local focusing of the therapy;
Adding small weights to the limbs and the possibility of their cranio-acral shift could significantly strengthen the course of the reflex;
The use of labile supports by inflatable discs and balls to puncta fixa on the body and the limbs can both intentionally regulate the direction of the intensity of the reflex and eliminate the creation of excessive reflex muscle response. Maintenance of these large muscle responses is unnecessarily exhausting for the exercising parents, and in the long run, it can lead to overload and pain in their muscle insertions in the forearm.
The use of adhesive mats significantly improves the targeting of the reflex and it also allows simple and efficient prevention of the undesirable movements of the infant. These mats are also used to remove the excessive reflex forces that make the therapy too physically demanding for the parents.
In cases of severe diagnosed central coordination disorders and proven developmental defects of the CNS that significantly put the future psychomotor development of the infants at risk, the use of stimulating therapeutic dress has proved to be beneficial. It allows the inducement of the therapeutic reflex with an extraordinary intensity that can be regulated electronically as needed.
The combination of the above-mentioned stimulation techniques enables precise variations of the performed stimulation therapy of the infants and allows the adjustment of the therapy according to the actual status and developmental degree of the infant as well as the possibilities and physical capabilities of the parents exercising with the children.
The duration of each session of the implemented therapeutic stimulation doesn’t have to be too prolonged thanks to the use of stimulation techniques. Consequently, it increases the comfort of the child and the exercising parents. The total completion of therapy is recommended after the accomplishment of basic motor development. This ensures that the future autonomic regulation of the posture of the body and its basic stereotypical movements would be completely alright. This prevents the development of motor disorders of the gross and fine motor skills including muscle discoordination into the future.
There is a focus on the continuous psychological work with the infant within VM2G therapy to habituate the child to the situation of the therapeutic stimulation. The parents are also provided with psychological support to motivate them in the therapy and to overcome crises that necessarily accompany the therapeutic process.
Before the initiation of the VM2G therapy itself, a thorough preliminary diagnostic examination of the child takes place. During each follow up, continuous thorough neuro-kinesiological examinations take place through observation of spontaneous and elicited motor skills, particularly by positional tests. Careful monitoring of the condition of the CNS of the infant is the basic precondition for the implementation of the exact, focused and adequately intensive therapy. Video recordings are made for every child in all therapeutic sessions for retrospective evaluation of the results of the diagnostics and for supervision check-ups. This allows for the easy organisation of an expert teleconference in cases of diagnostic and therapeutic doubts. For the therapeutic assessment of the spontaneous motor expressions of the infant, it is a great advantage to use the video recordings of the child’s parents as it facilitates the creation of a realistic picture about the motor expressions of the child in his/her home environment.
The performance of VM2G therapy in infants bears no risk of inducing a pathological reflex response because it works in ON – OFF regimen, i.e. the reflex runs correctly or it doesn’t run at all. Fears of inducing the pathological response are groundless.
The summary of these diagnostic and therapeutic measures is represented at a high level of therapeutic efficacy in infants at risk of all degrees of the central coordination disorders and in infants with diagnosed congenital developmental defects of the CNS. If these disorders were diagnosed early, the therapeutic efficacy would practically achieve 100 %. Subsequently, it can prevent the development of the cerebral palsy and the related psychomotor retardation.
Classical Vojta Method Therapy with Preschool Children
Most often, it is used with children with developed cerebral palsy impairment.
To keep the child in the necessary reflex positions, forced stimulation zones are implemented along with the restraint of excessive and disturbing movements of the child. This results in displeasure and, consequently, children try to avoid the pressure of the fingers and hands. Therapists and parents are subsequently forced to further increase the pressure.
The method of stimulation and lack of possibility to explain the importance of the therapy to the children rationally lead to psychological tension between the parents and their children. It is very challenging for the therapist to succeed with the available method of treatment.
VM2G Therapy with Preschool Children
From the age of 1 to about 5 years of age, it is possible to implement the VM2G in children with CP and in children with less severe developmental impairments of the autonomic regulation of the posture of the body and the regulation of the basic stereotypical movements.
The most typical patients at this age are the children with impaired stereotypical gait, most apparent in turning the toes inward while walking, sometimes in the stumbling and falling because toes cross while running.
The important part of VM2G therapy is the preparation of the children for the therapeutic stimulation itself. Non-forceful implementation and gradually distracting the child’s attention from the reflex stimulation must prevail. The goal of this approach is to form the preconditions for the gradual process of mental habituation of the child to repeated home therapy situation.
It has proved to be beneficial to implement the VM2G therapy during the sleep in the children with diagnosed CNS disorders in terms of “light brain dysfunction”. They are very hyperactive and suffer from concentration disorders, so it is extremely difficult to distract their attention. There have been proven results in the improvement of the regulation of the motor skills and in maturation of the superior brain structures with subsequent reduction to complete remission of the brain’s functional impairments.
VM2G therapy enables gradual and non-forceful increasing in the reflex stimulation with technical tools.
Classical Vojta Method Therapy with School Children, Adolescents and Adult Patients
The Vojta method is used in many motor disorders in older children, adolescents and adult patients. The complication that is similar to younger groups of patients is the very implementation of the reflex stimulation through two points stimulated by the fingers of the therapist. This form is very exhausting for the therapists and parents who practice the therapy at home. Biomechanical preconditions of the larger body create a strong reflex response based on the premise: “The action induces the reaction of the same intensity and opposite orientation.” The exercise becomes physically demanding; sometimes it’s almost unbearable. Thus, the duration of the stimulation is restricted to tens of seconds. Too short duration of the stimulation and the impossibility to increase the intensity of the therapy result in insufficient utilisation of the possibilities offered by the Vojta method. Concurrently, the physical demands on the therapists and the parents of the patients is limiting and often leads to a reduction in the number of therapeutic sessions and ending of the Vojta method therapy. Patients who undergo the classical Vojta method perceive it as uncomfortable and even painful at the place of stimulation.
The therapy doesn’t use any other stimulating, labilising, stabilising or adhesive aids.
It doesn’t use the influence of gravity, fall lines of the tilted surfaces or the combination of the transverse-longitudinal tilts of the surface of the medical lounge.
The above-mentioned factors result in lower therapeutic efficacy and limited therapeutic results.
VM2G Therapy with School Children, Adolescents and Adult Patients
It uses the surface of the table tilted in the transverse and longitudinal axes and several other aids in practical therapy.
Stimulation is implemented in many reflex zones. There are up to twenty-four reflex zones that can be used concurrently.
In the utter majority of patients in this age group, we can get by with utilisation of the reflex exercise in the supine position, which is very comfortable. The exercise on the side and in the prone position is used only in about 5% of cases.
The intensity of the reflex stimulation in the basic supine position on the medical lounge without tilt could be increased and decreased by several techniques:
The gradual tilt of the surface of the children’s adjustable medical lounge. The tilt can increase the effective intensity of the therapy or, conversely, the opposite tilt of the fall lines leads to facilitation of the induction of the stimulation and the strength of the stimulating reflex decreases (photos and videos);
Gradual adding of stimulating balls to reflex points can induce very fine regulation of the intensity of the therapeutic effect, and more exact local focusing of the therapy.
Adding small weights (0.5 to 2.5 kg) on the limbs and the possibility of their cranio-acral shift could significantly strengthen the course of the global reflex.
The use of labile supports through the assistance inflatable discs and balls for puncta fixa on the body and the limbs can both intentionally regulate the direction of the intensity of the reflex and eliminate the creation of excessive reflex muscle response. Maintenance of these great muscle responses is unnecessarily exhausting for the therapists and exercising parents. In the long run, it can lead to overload and pain in their muscle insertions in the forearm.
The use of adhesive mats significantly improves the targeting of the reflex. These mats are also used to remove the excessive reflex forces that make the therapy too physically demanding for the parents.
In cases of diagnosed severer disorders, the use of stimulating therapeutic dress has proved to be beneficial. It allows the inducement of the therapeutic reflex with extraordinary intensity that could be regulated electronically as needed.
The combination of the above-mentioned stimulation techniques enables precise variations of the performed stimulation therapy in the children, adolescents and adult patients. It also allows the adjustment of the therapy according to their actual status. VM2G therapy respects the possibilities and physical capabilities of the therapist, parents or partners exercising with the patients at home.
The duration of each session of the implemented therapeutic stimulation doesn’t have to be too prolonged thanks to the use of stimulation techniques. It increases the comfort of the patient and all people exercising with them.
It is interesting that the effect of the VM2G therapy has also been proven in a patient in vigil coma.
The set of these therapeutic factors has been proven by high therapeutic efficacy in several disorders of the musculoskeletal apparatus. The use of VM2G seems to be efficient in all age groups up to elderly patients in their nineties.