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


CHILD DEVELOPMENT DATABASE


(Definitions and questions in alphabetical order)


The definitions on this page, the remarks that accompany them, commit only their author, they are based upon 25 years of practical experience, and on a personal therapeutic approach of the postural and motor development disorders.

This symbol (DB) means that the previous word is available as definition in the database.



INDEX


A,B,C

appeal / axis (corporal - ) / balance / Botox / central coordination disorder (CCD) / cinesiology / corporal scheme / CP child question 1: stiff or floppy? /

D,E,F

fixed point (corporal - ) /

G,H,I

hyper-extension / innate - acquired / interactions in the development

J,K,L

locomotion / locomotion (reflex - ) /

M,N,O

motor function: automatical or conscious? / motor function (spontaneous - ) / neurocinesiology / ontogenese /

P,Q,R

pathing / pattern (motor - ) / phylogenese / plasticity - malleability / postural reactivity / posture / primary reflexes / proprioception / raising - uprighting / reciprocal function (postural - ) / rotation /

S,T,U

selective stabilization / synergy (muscular - ) / substitute (or deviant) pattern / support polygon / therapy (precocious -) / tonus (muscular - ) /

V,W,X,Y,Z

vibratory proprioceptive stimulation (V.P.S.) / Vojta concept / Vojta therapy: parents questions /



DEFINITIONS - QUESTIONS


Appeal:
Need, attraction to an object, a person or an activity, that urges the child to act. The visual appeal is an essential dynamic factor during the first trimester of development: to orient efficiently his head, the healthy baby uses complex postural automatisms including especially a supporting function on the upper limbs, the active stabilization and the symmetry of the corporal axis.
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axis (corporal-):
Longitudinal potential axis of the body (generally assimilated to the axis of the spine). During the 2 first months, the corporal axis can not be spontaneously aligned by the baby that is always asymmetrical; this asymmetry has however to be reciprocal (DB); in the opposite case, a postural anomaly can already be suspected. At the age of 3 months , the corporal axis will become automatically symmetrical thanks to a more precise coordination of muscular synergisms.
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balance:
Aptitude to guarantee the stability of the body in all circumstances (postural stability). Balance is impossible without a muscular action against the gravity. A posture is stable when the corporal gravity center (C.G.) projects inside the support polygon (potential surface delimited by the support points). When the C.G. is no longer vertically above this surface, the body is unstable, then the posture or the polygon have to be modified to avoid a fall. The postural stability has to be automatically insured to start any functional activity without displacement, but also during the locomotion.
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Botox in the treatment of the cerebral palsy, progress or nonsense...?
We see currently more and more prescriptions of Botox at children with CP with the declared purpose to reduce muscular contractures, to facilitate walking, and to enable the lengthening of muscles in the course of the bony growth. The prescribers of Botox tell frequently the parents that this product, by decreasing uncontroled muscular contractions , is susceptible to facilitate the physiotherapy...
The most frequent indication of the botox is the treatment of the triceps surae, considered as responsible of the foot hyper-flexion and generating the foot-stepping at children able to walk. The toxin decreases temporarily the reactivity of the concerned muscle through the partial inhibition of the local neurological function, what induces a localized mini-paresis.
The ambition of this therapeutic act is also to liberate a more supple movement under the action of other muscles (not concerned by the injection of botox), what would contribute to facilitate the motor rehabilitation.
At first sight, this therapeutic proposal may seduce, but it neglects however some fundamental aspects of the infantile development, of the CP pathogenic process , and of the modern physiotherapy. That is the reason why the generalization of the botox therapy calls several remarks.

1) The posturo-motor development of a child is an evolution in the long term, that lasts over fifteen years; a treatment can play a significant role only if it acts durably or if it is repeated when its influence decreases. Can we reasonably envisage the prolonged administration of a toxin (even slightly dosed) to children , and have we truly evaluated, with the necessary hinsight, the precise consequences in the long term of a such medication...? If the treatment is given according to a punctual mode, how is it susceptible to have , directly or indirectly, positive effects in the long term..?

2) The normal posturo-motor function is not a simple addition or juxtaposition of separate muscular actions. The harmonious control of posture and movement is based on the action of long musculo-aponevrotical chains, acting according to a coordinate pattern, automatically and constantly regulated by the central nervous system(CNS). This tonico - postural automatic regulation necessitates the constant contribution of muscular information, essentially given by proprioceptive ways, and generated by the activity of each muscular link of these chains. The artificial inhibition of one or several muscular elements of these chains can never contribute to an improvement of the automatic regulation, but contributes (on the contrary) to the impoverishment of the afferent message to the CNS. This qualitative and quantitative diminution of the proprioceptive flow can neither contribute to a more physiological programmation of the functional pattern, nor contribute to a any process of motor "apprenticeship"; it can only favor the appearance of a compensatory functional pattern excluding a bit more the natural function of muscular links inhibited by the toxin; this deviating process justly belongs to the pathological process and leads to the functional degradation frequently observed at the CP children.

3) The physiotherapy of a CP child, especially of a very young child, has to respect the GLOBALITY of the posturo-motor function, it has to be centered, from the first months of life, on the ACTIVATION of coordinate neuromuscular patterns that concern the whole body, and are often induced from the less patholoical corporal regions. One of the therapeutic major factors, usable by the modern therapist, is the progressive irradiation of the muscular activity to most pathological regions of the body, what contributes to their integration in a more physiological protocol of automatic regulation. This form of therapy has an important advantage, it uses only physiological means, without any addiction, it is painless, and usable in the long term without any secondary effect. A physiotherapist, experimented in this form of natural therapy, knows that it needs reactive muscles (even abnormally réactive.!!) to practice a structured therapy; he has therefore to consider the injections of toxin as a therapeutic NONSENSE, an illusion that can temporarily hide some flagrant aspect of the pathological situation without bringing any real and durable solution.

4) This attempt to "reduce", during a few months, the exaggerated reactivity of some muscles by injection of inhibiting products is not new; that was already applied in the years 60 to 70 by some european medical teams following CP children. The products were different, but the approach was identical and based on the same arguments. This treatment showed rapidly its limit and was generally forgotten.

5) The medico-technique information of parents of CP children is generally neglected, sometimes nonexistent. This gap reveals the disarray of the medical profession about pathological situations where the doctors too often think they have no really reliable therapeutic strategy to propose. Such medications would be less attractive for the prescribers if the physiotherapists were more aware about proprioceptive global rehabilitation techniques (the only techniques able to induce significant therapeutic results in the long term following of children with lesion of the CNS), and if the totality of concerned health professionals could be more motivated to explore seriously this therapeutic alternatives....back to index

central coordination disorder (CCD):
Diagnosis expression designating a temporary neurological situation of the baby when the clinic examination already reveals anomalies of the postural automatic reactivity (DB), with a delay or anomalies of the spontaneous motor function, with or without associated disorder of the reflexology. This transitory situation concerns essentially the first year of life, and can evolve either to a progressive neurologic standardization, spontaneous or helped by a proprioceptive physiotherapy (light disorders) (DB), or to the progressive realization of a cerebral palsy (severe disorders). It is the right time for a precocious proprioceptive therapy (DB) because of the great cerebral malleability (DB) and the rapid organization of the central nervous system during this period.
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cinesiology:
Qualitative study of the movement and of its components. The cinesiological approach of the development, is a qualitative study of the posture, the movement, used patterns, upright mechanisms, implied muscular games.
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corporal scheme:
Mental image of one's body that everyone get. The corporal scheme is gradually built thanks to the sensory, postural and motor experiences, and to the interaction with the environment. Sensory, postural or motor disorders are therefore liable to disturb the development of the corporal scheme.
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CP child: frequent question 1: stiff or floppy?:
Extract from an US web forum of neurology, 1998: My son is 2 years old. He has mild CP. He has mild ataxia and spastic diplegia. When he is sitting, he is stiff from his waist down and floppy from his waist up. When he is standing (he can only stand with support from us or furniture) he is just the opposite, weak in his legs and strong and stiff in his arms. Can anyone explain this? How can it switch like that?

That's a very typical question and a sensible observation from the parents. The classic answer to this question is the fluctuation of the muscular tonus (DB), that appears in every kind of CP because of the central nervous system disorder. But some neurologists and therapists in Europe have another vision:
1) standing, sitting, and all the locomotor functions are based on primary, innate, global mechanisms, that improve progressively in the course of the development. Their coordination improves, so that they can no longer appear under their initial form.
2) This improvement of the coordination is compromised by the central lesion of the CP child; he has to find another way to assure the stability of his postures and movements. All what we can see is a combination of compensation activities. As the optimal motor pattern (DB) is not available, the CP child has to use a basic pattern in which the main components are a rest of the neonatal activity:
- Stiff legs: when you stand up a new-born child on his legs, he gives a reflex push (called "support reaction")
- Stiff arms: when you put a finger in the hand of a new born he grips firmly (grasping reflex) to his trunk.
- Floppy trunk: a new born child cannot maintain his trunk aligned etc... the comparison could go on...
That also means that an adequate physiotherapy, instead of standing or sitting exercises, has to offer to the child a chance of developing a better automatical coordination. That's a very specific proprioceptive work. To get an idea about that work, just have a look at "Vojta concept" (DB).
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fixed point (corporal):
To control his posture despite the gravity, a baby has to create actively support points, or fixed points, from which he will be able to stabilize, then to erect, his body in the space. The geometrical surface connecting these fixed points is called support polygon (see on this site: development / table). The first main support points are created on the upper limbs (6 first months in the prone position ) then on the lower limbs (trimesters 3 and 4). The active creation of these support points demands a very precise muscular coordination. The main problem of children with a cerebral lesion for example, is a muscular coordination deficit compromising the creation of the fixed points. It is then unavoidable that these children try to stabilize their posture by postural compensation patterns (DB). These motor succedaneas are however very different in their organization of an optimal pattern, a lot less efficient, and make gradually perennial the stereotyped motor function that characterizes the cerebral palsy.
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hyper-extension: frequent posture of CP children, that can be occasional or quasi -constant, characterized by rejecting the head backwards and a global stiff extension of the trunk and of the limbs. This pathological posture results from a severe disorder of motor coordination, it disturbs the daily life and the therapy. It has been often thought, but wrongly, that to reduce this attitude it is positive to place the child in flexion, or to roll shoulders forwards. This frequent error, if it is repeated in the daily life, has for consequence to favor the spine cyphosis and the progressive degradation of the upper limbs mobility, already very compromised at these children. Moreover, hyper-extension alternates often with very clear forwards bending of the trunk, because of the insufficiency of the postural control; hyper-extension is the only child's means to support the posture, it is nearly always a (DB) compensation mechanism, used for various purposes, to straighten the trunk as well as to show anger, for example. The only reasonable solution comprises two elements:
-1) during the therapy: research techniques stimulating the active alignment of the vertebral axis with support points at the four limbs.
2) daily life: select fittings using support areas corresponding to the end of the first normal development trimester. More information about this point: click here back to index

innate - acquired:
Every child is born with a motor, sensory, relational patrimony. The birth is especially a change of environment and physical conditions to which the baby will have to adapt this patrimony. The gravity is an obstacle to outclass but also a permanent reference whom nervous system needs to manage the motor evolution. The proprioception (DB) plays an essential role in the transformation of the innate behaviours into new behaviours including all mechanisms of the postural antigravitical control . In the course of his development, the child can only conscious discover a tiny part of these transformations. The motor development is therefore especially a constant mutation from elementary automatisms in more complex automatisms. The essential catalyst of these mutations is the relational appeal (DB) of the child towards his environment. One sees therefore that the sensory development, the mental development and the motor development are intimately linked.
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interactions in the development: The separation of the different development aspects (sensory, motor, mental, ...) is artificial, it corresponds to a didactic need, and facilitates the comprehension of an evolution in which all factors are in permanent interaction. Stages of the postural and motor development are the expression of the psychological and sensory evolution, but they are simultaneously the tool and the mediator of this evolution. For example, the control of the posture contribute to a richer relationship with the environment, which necessitates a more and more precise postural and motor activity. Thus, the body is gradually used according to increasingly coordinate patterns, automatically enslaved to variable finalities according to circumstances.
Nevertheless, it is possible to classify postural and motor strategies into three main categories responding to fundamental needs of the baby: orientation, consumption, locomotion.
Orientation necessitates, from the first trimester, the development of the support function of the upper limbs to stabilize the spine, to raise the head in the space, and to improve thus the output of the telereceivers (eye, ear, nose). The orientation need is behind the symmetrical support on 2 elbows (3 month) or the support on hands (6 month).
Consumption, necessitates rapidly the installation of the body in a stable attitude, and the liberation of the sensory organs such as mouth, or hands. The need to consume the environment contributes to the appearance of prehension, of hands-feet meeting, of sitting etc...
Locomotion (DB) reveals a need to appropriate and to consume also distant objects. The perception of the distant environment, generates a frustration of the child who wants now to consume what he sees at a distance too, and takes therefore locomotive initiatives. Postural and motor strategies used for the locomotion requisition generally the upper limbs to reorganize all the corporal structure ( rolling, creeping, quadrupedic locomotion, ...).
In this interactive context, we understand why spontaneous postures of a child can show the quality of his motor, but also sensory and mental development.
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locomotion:
Function of the living beings by which they insure actively the displacement of their whole organism. The passage from a posture to another can be also considered as a locomotive act. The locomotion is composed of 3 indissociable elements: a) postural automatical reactivity (DB) b) raising-uprighting (DB) c) movement. Each of these components is automatically managed by the nervous system. In the course of the ontogenese (DB), the locomotion transforms into passing by transitory locomotive modes increasingly coordinated until the bipedal locomotion at the beginning of the second year. The timing of this evolution can be moderately variable from a child to another, but the director scheme and the fundamental cinesiological components of this evolution are rigorously identical for all the healthy children because they live in the same gravity conditions. All the children use particularly a crossed pattern (DB) with torsion of the corporal axis.
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locomotion (reflex -):
The reflex locomotion has been described by the Prof. V. Vojta (neurologist). It is a set of motor coordinated patterns (DB) , artificially activated by adequate stimulations since the birth. These provoked activities contain all mechanisms of the human locomotion and are used in a therapeutic purpose. (more information, see on this site : rehabilitation / Vojta concept).
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motor function: automatical or conscious?
It's often said that the acquisition of a new motor capacity necessitates first an aware apprenticeship to automate then the learnt gesture. In the course of the normal development, the motor act is effectively always released by the intention to get a particular result; the gesture is therefore finalized, but that does not mean that its realization is aware, indeed the concrete realization of the movement and the control of an attitude are entirely automatic. Need to act generates an action that begins with an improvisation on the basis of already refered and immediately available automatisms. That's why the first action is not always perfectly adapted to the situation; but in the course of this action, the nervous system is constantly informed about the progress of operations and their results by its various afferent sources (vision, and particularly the proprioception ...) and modifies instantaneously its motor production. The movement never finishes therefore exactly as it began, it becomes more precise in the course of its own realization and by the repetition. It is only a posteriori, and very partially, that we can acquire a relative conscience of the realized movement whose management has been automatic from the beginning to the end.
back to index. More details about this theme: read this page.

motor function (spontaneous):
The spontaneous motor function of a baby during the first year expresses the quality of the development and the degree of maturation. Contrarily to some fréquent ideas, all the healthy children use the same postural fundamental mechanisms through the different stages of the ontogenese; they have indeed a common problem to solve: to control automatically their corporal posture despite the gravity. In order to attain this, they have the same anatomical means (the musculature), the same system of management (the nervous system) and the same phylogenetical potential (DB). The optimal solutions to this problem will be therefore the same for everyone and it is only the possible presence of a pathological process, depriving the child of a part of its means, that will constrain him to alter his postural mechanisms and to use less effective motor strategies. The alteration of postural mechanisms used by the children varies according to the nature of pathologies, that's why the attentive and codified examination of the spontaneous motor function provides information about the quality of the motor, but also sensory and mental development.
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neurocinesiology (children): observation method of spontaneous and provoked postures and movements of a child (in defined conditions), in order to deduce some information about his neurological functional situation and about the quality of his development back to index

ontogenese:
Development of the individual since the fertilized ovule until the adult state
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pathing:
fundamental technique of proprioceptive stimulation used during the Vojta therapy. "pathing" consists of stimulating the global muscular contraction from pressures applied on reflex zones. As soon as the movement appears, the therapist opposes a resistance that allows to prolong artificially its duration, to correct its direction, to improve the dosage of the muscular synergies by recruitment of supplementary neuronal connections that induce a better motor coordination. pathing obtains for the patient a new sensory image of its own body.
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pattern (motor-):
Framework, global architecture of the posture and of the movement. An economic and precise organization of the posture enables the optimal execution of the finalized motor act. This functional totality never appears at random: each functional motor pattern includes precise raising mechanisms and a coordinated postural reactivity that concern the whole body, even when the wished action concerns apparently only one corporal region (for example: writing).
The different forms of human locomotion are based on a crossed pattern, including a twisting effect of the corporal axis.
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phylogenese:
Evolution of the animal and vegetable species in the course of the generations
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plasticity - malleability:The organization of the human nervous system is not definitive at the birth. The neuronal network can develop multiple different types of connections, it can also lose some of them. This structural plasticity is influenceable by adequate stimulations, that are systematically to research in precocious rehabilitation programs. back to index

postural reactivity:
Automatic function of the nervous system that consists of constantly managing and adapting the global corporal posture from the proprioceptiv data. The automatic postural reactivity is a basic function included in every motor finalized activity . This function evolves in the course of the development, it can be tested from the birth. Precocious disorders of the postural automatic reactivity may announce the ulterior appearance of a cerebral palsy.
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posture:
Actively obtained and maintained attitude . The optimal postural control necessitates a precise automatic coordination of muscular games by the nervous system. The global control of the corporal posture is preliminary to the realization of every finalized movement: the gesture emerges from the posture. The posture has therefore to be constantly and automatically actualized during the locomotor or motor act. This automatical and permanent actualization is managed at different levels of the nervous system, that is the postural reactivity (DB).
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primary reflexes:
Characteristic reflex group of the neonatal and postnative period. Most of them disappear gradually in the course the first months; in fact they are integrated to a superior coordination , as it may be proved by their possible resurgence in some later pathological situations, or their persistence in a few forms of cerebral palsy. They show a neonatal nervous maturity level. The configuration of these reflexes, their period of validity is precisely defined, they are therefore a reliable element of the precocious development evaluation .
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proprioception:
Sensitivity of bones, muscles, tendons and articulations, informing on the static, the balance function, the displacements of the body in the space, etc...
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raising - uprighting:
Capacity of the child to control automatically the effect of the gravity on his body to align the corporal axis, to build a symmetrical posture, and to erect gradually the body in the space. Raising (uprighting) automatisms develop from innate primary elements, perfect in the course of the ontogenese and participate in the locomotion. Their evolution is compromised in case of disorder of the postural reactivity (see this word).
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reciprocal function (postural - - ):
All forms of human locomotion (creeping, quadrupedic, walking) are constituted of an operational cycle, whose successive phases repeat alternately from one side of the body to the other side in the opposite direction. Thus the final posture of each cycle is the initial posture of the following cycle. In a normal development, this reciprocity has to appear very precociously. For example, during the first months, when the posture of the child is still asymmetrical, this postural global asymmetry has already to be reciprocal, it means that it has to invert (like in a mirror) when the child turns his head. An monolateral asymmetry (head always turned to the same side with the corresponding global posture) is always suspect .
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rotation:
a) Most of the trunk muscles and of the limbs roots muscles have an oblique situation compared with the corporal axis. Every motor activity uses long muscular chains whose general disposition is therefore oblique too . When these chains act in synergism they induce inevitably a twisting effect on the corporal axis, that means a vertebral rotation.
b) Every coordinate movement begins with the stabilization of the vertebral axis from peripheral fixed points (DB), to guarantee a stable posture allowing the precise movement orientation.
c) The different forms of human locomotion are based on a crossed pattern, including a twisting effect of the corporal axis (see: locomotion).
These 3 observations show that the fine control of the vertebral rotation is a fundamental element of the postural and motor normal evolution. Every rehabilitation program must necessarily take this fact into account.
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selective stabilization:
The plasticity (see this word) of the central nervous system is very important during the first months of life. Potentially available neurological itineraries for the transmission of impulse are, in this period, overabundant. A selection is gradually done , with degeneration of the few solicited connections, while the most used connections get their maturity, and take on the responsibility of various functions: that is the selective stabilization. This process offers a functional compensation appropriateness in case of neurological lesion; it decreases at the end of the first year, and that corresponds to a diminution of the central malleability. Every lesion of the central nervous system has therefore to be detected very precociously and followed by a neurological appropriate rehabilitation (proprioceptive and glogal) to preserve the best chances of satisfying functional evolution.
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substitute (or deviant) pattern:
In case of severe CC D (DB), the child is unable to manage automatically and efficiently his postures and his movements in the daily life; he musts therefore resort to the immediately available primary automatisms. The CCD disrupts and brakes the transformation of these automatisms. They become therefore gradually, with the repetition, the framework of a limited range of stereotyped motor strategies. These substitute or deviant patterns are the only way for the child to satisfy the daily life needs; they slow down the development of the motor autonomy.
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support polygone:
Potential polygon delimited by the corporal fixed points (see this word) . This polygon is naturally invisible, nevertheless it is a fundamental cinesiological datum during the examination of a child, to better understand his postural organization and possibly to guide a therapy.
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synergy (muscular - ):
Automatically coordinated action of various muscular groups to get a functional result.
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therapy (precocious -):
The precocious screening of severe CCD (DB), with clear neurological anomalies, allows the rapid installation of a precocious proprioceptive physiotherapy. Ideally, it would have always to begin during the first trimester of life to make the best use of the nervous system plasticity (DB). When the therapy begins in the course of the third or the fourth trimester, the intelligent child, uses already regularly in the daily life substitute or deviant patterns (DB), to establish a motor relationship with the environment. The repetition of these abnormal motor activities contributes to integrate them definitively and concretizes the installation of the CP ( cerebral palsy). A very precocious global physical therapy prevents this phenomenon and preserves some odds of a more physiological postural and motor evolution.
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tonus (muscular - ):
Permanent and involuntary tension state of the muscular tissue, depending from the peripheral and central nervous system. The appreciation of the muscular tonus is based on various small means (often varying from one examiner to the other) rather than on a clearly codified and unanimously recognized methodology . There is no measure unit of the muscular tonus. The tonus varies at one time according to the state of the person, according to her activity; in some pathologies the muscular tonus may be, at the same time, very different from a corporal region to the other. In these conditions the muscular tonus can be an useful element of observation to characterize some pathological situations, but constitutes in no case a decisive criterion in the therapeutic argument choice composing a motor rehabilitation program.
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Vojta concept:
More about the Vojta concept, click here:
Vojta back to index

Vibratory proprioceptive stimulation (V.P.S.): 30 years of researches, led especially in France by the C.N.R.S. (team of prof. J.P. Roll), have demonstrated the therapeutic interest of the vibratory stimulation of muscular tendons.
Applied according to precise parameters and in a chosen postural context, the transcutaneous stimulation of tendons by vibrations is a powerful painless and targeted means, to activate the muscular proprioception , and important regions of the central nervous system .
The V.P.S. exploits the cerebral malleability (*); it generates sensory effects as the perception of illusory movements , but also motor effects as the activation of coordinate kinetic chains, and can also be used as antalgic .
These sensori-motor effects can be used in neurological rehabilitation by children and adults, without any secondary effect; the V.P.S. is not only compatible, but can be coherently and complementarily associated with another proprioceptive manual therapy such as Vojta.
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Vojta therapy: parents question:
Question 1: Our son was born prematurely, suffered IVH and PVL, with resultant hemiplegia. He is now 6 months corrected age and we are beginning Vojta Therapy. Today was our son's second therapy session. So far we are working with only a single exercise, to strengthen his diaphragm, I believe. The exercise consists of applying pressure to his rib cage on one side below the nipple and above the last rib for a period of 10 seconds or more as he allows. He must face towards the side being manipulated or straight ahead. We repeat this exercise four times on each side per session, with three sessions each day. Am I correct that this is to strengthen his diaphragm?

Answer 1: The problem of your child is not "strength" but coordination of the pattern and therefore of the movement.
a) we use a stimulation on the thorax reflex zone (pression), we get a contraction of the diaphragm; thats naturally very useful for breathing!...
b) but it's also the start point of a larger global reaction of many muscles (thorax, shoulder blade, spine, arms and legs). we exactly know what should be this reaction in an optimal development at every age and try to develop it artificially.
To see the
good reaction click here and have a look at the picture "e" (3 months). A child able to create this posture is already aligned, symmetric, stable, and can turn his head in both directions without loosing his balance...! Do you imagine what it means for an hemiparetic baby to live for the first time a symmetric, aligned, balanced posture...? it's a greatful experience! That's a 100% automatic experience; he will have only a very partial consciousness of that much later. Tnhat's a so fabulous experience that he loses its usual corporal points of reference, and that's why he cries! (it's not painful). In the normal development, this stage (3 months) is the body preparation to the "hand taking"; that's why a child will begin to take an object with his hand at 4 months...

Question 2: Is this pressure meant to compress the lungs thereby making him work harder to breath?

Answer 2: Not only "harder" but above all "different" and "better". Better breathing means with a specific activity of the abdominal muscles. 80% of these muscles are oblique and very important to turn from the back to the prone position (on his stomach!). Do you understand how useful it could be when you told me recently " he rolls on to both sides by himself but never over on to his stomach without assistance"...? rolling: pict."h".

Question 3: What the heck is stimulated by the pressure? Is it particular nerves located at the point where the pressure is applied? A pattern of nerves as the pressure is diffused over the ribcage? The muscles themselves, by directly stimulating a contraction? The result of pressure on the internal organs? Proprioceptive sensitivities that help him locate his muscles? What is the physiological mechanism underlying the effectiveness of this first exercise? And why this particular spot on the thorax and not somewhere else? I'll certainly keep doing what I've been doing, but I'd sure like to know, not so much why for its own sake, but why so that we can be as effective as possible.

Answer 3: certainly not one particular nerve, but all what you say in your question together...and more... Contraction of the diaphragm and abdominal muscles, pressure on the lung and pleura, pressure on the mediastinus because of the abdominal contraction, activity of the intercostal musculature, stimulation on the rib periost, pressure and movement in the rib - spine joints, etc... many different afferent ways are activated simultaneously. Why on that point?... because anywhere else we cannot get the same effect! Don't forget it was an empiric discovery. We don't understand completely why, but we observe exactly what happens and how the answer progresses. Another reason is: each "zone" is able to provoke a complete pattern of reflex locomotion by a new-born healthy child. back to index



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