POSMODEV Who are we Main markers of the postural development Questions, definitions Central Coordination Disorder (C.C.D.).
Cerebral Palsy (C.P.) motor education : myth or reality..? the Vojta concept Fitting for C.P. children Documentation and training




REFLEX LOCOMOTION ~


The reflex locomotion is the fundamental therapeutic process of the Vojta therapy.
The term "reflex" locomotion implies that the complete motor pattern does not appear spontaneously but only under peripheral stimulations, applied on different points of the body. However the provoked pattern concerns the whole body, including the four limbs.

V. Vojta described several automatic global patterns of which kinesiological characteristic components have been precisely defined. In the different publications the provoked pattern in the prone position has been called "reflex creeping"; the pattern obtained in the supine position has been called "reflex rolling".

These neuromotorial complexe activities have been meticulously studied for many years among from 2 - 3 years up until 15 years old CP children. This observation has allowed to deduce that some spontaneous postures that can be seen among the oldest CP children are already apparent at pathological infants, and even at pathological new-borns. That means that postural automatisms generated by the central nervous system (CNS) of a CP child have something common with these of a new-born or of a much younger child.

The complex muscular games observable during the reflex locomotion (therapy) at CP children can be obtained instantaneously with a valid new-born. It can be deduced that the muscular action provoked at this valid new-born, and the other one, artificially provoked by reflex means at a CP child, correspond to a common neurogenic process (functional pattern). A CP child go on exploiting motor patterns, coming from its new-born period, and whose progressive transformation could not normally occure because of the lesion of the CNS. Everything happens as if the motor development (ontogénèse) was blocked.

During the realization of the reflex locomotion, the child uses muscular activities that his CNS could not produce and control up till now. His nervous system is "riddled" with innumerable information about posture, body uprighting against the gravity, active stabilization of corporal segments in space, and movement. For example, the child creates actively peripheral support points, then his musculature can exert its traction to these support points and begin to insure the transfer of the corporal gravity center in space. These operations happen in a cyclic and reciprocal (reversal) way; we can say that all components of a true locomotion are here present.

All the local sequences of motor action composing global patterns of reflex locomotion are innate, and launchable from the birth, but they appear also, combined in various ways, in multiple stages of the normal motor development. It may be said that the valid child, during his motor development, does not invent anything, he rather takes the same materials and associates them differently to satisfy new needs. Activities that can be observed seem new, but they are in fact made of components drawn from preceding stages.From a combination into a new combination, from a synthesis into a new synthesis, automatisms evolve, become more and more efficient and precise, become more reliable and more economic.

During the normal development, the innovation is more in the art to associate available components (automatisms) that in a real creation. The development is a permanent adjustment, a constant remake or renewal, as a painter who obtains an infinity of nuances and motives with a limited and permanent number of fundamental colors from its paddle. The essential finality that activates this automatic evolution is the permanent need of the child to optimize his relationship with his environment.

In a pathological situation, this natural need of the child is, alone, not sufficient to launch the evolution of automatisms. The reflex locomotion has to play this role; it is a therapeutic means of soliciting innate postural automatisms, combining them, activating the control mechanisms in the CNS, in order obtain an increasingly effective regulation of its sensori-motor production.

Activation of the CNS: the "pathing" technique

The two main reflex locomotion patterns described by V. Vojta, the one in the prone position (creeping reflex), and the one in the supine and then lateral position (rolling reflex), are global. They can be provoked by stimulating precise points called "zones".

Generally the muscular activity intensity increases by the repetition of the stimulation or by combining zones. Thus the answer becomes more rapid and more intense. The global reaction is identical, independently of the stimulated side.

The application of a resistance against the provoked movement, increases its duration and activates again the muscular activity that was isotonic and becomes isometric (durable contraction, without change of muscle length). Simultaneously, the stimulation of one or several zones has to go on.

The conjunction of these stimulations on zones with the proprioceptive afferences from muscular origin, created by the application of resistances, generates a massive and constant centripetal nervous flow. This neurological mechanism of temporal and spacial summation induces the propagation of the motor answer through the entire body. One of the main information sources is the propioception of spinal muscles, that is the starting point of the most important centripetal way of the human body.

The therapist can then guide the irradiation of these muscular games, by modulating stimulations and by varying the resistances. That is literally an artificially "piloting" at a distance of provoked muscular games.

This very particular technique is called "pathing" (D: die Bahnung). It is extremely useful in many pathological situations of the young child because it can be used in order to:
activate a weak musculature
get an active correction of abnormal postures and movements
create a new corporal active experience of postures and movements and induce the integration of a new postural pattern, that means improve the automatic postural reactivity.
help the psychomotor development by improving the movements coordination, symmetry, uprighting, balance...
develop or improve the automatic tension regulation and muscular synergisms according to a physiological mode
prevent the installation of deformations by imbalance of muscular actions
to correct existent malformations
improve breathing
improve the sanguine circulation
improve swallowing and articulation
activate a lot of CNS functions
etc...

The application field of this therapeutic principle is therefore very large, it can naturally also be used in various adult pathologies by adapting, if necessary, practice conditions.

Therapeutic indications:

Severe and medium central coordination disorders
Light but asymmetrical central coordination disorders
Cerebral palsy
Muscular and neurogen torticolis
Peripheral Paralyses (child and adult), plexus lesions
Spina bifida
Congenital myopathies - congenital deformities (athrogryposis, club foot etc...)
Morbus-Down syndrome and other syndromes - motor delays
Various postural disorders (scoliosis, cyphosis)
Hip dysplasies
Adult hemiplegy (unexhaustive list)...

POSMODEV Who are we Main markers of the postural development Questions, definitions Central Coordination Disorder (C.C.D.).
Cerebral Palsy (C.P.) motor education : myth or reality..? the Vojta concept Fitting for C.P. children Documentation and training