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Improved lung function by Vojta-therapy in bronchopulmonary dysplasia
Abstract
We studied pulmonary mechanics both before and 45 minutes after chest physiotherapy according to Vojta in 11 spontaneouslv breathing infants (birth weight < 1500 gm, mean age at time of study 16 weeks, range 9-26 weeks) with bronchopulmonary dysplasia (BPD). The physiotherapist exerted a pressure with his thumb onto the 6th anterior rib at the level of the midclavicular line in the direction of the spine for several minutes. The full reflex response that was required according to the study protocol consisted of the typical change in whole-body positioning with an extension of the spine, chest expansion, and a contraction of the ahdominal wall muscles. We measured continuosly the airflow of spontaneous breathing with a pneumotachometer and the esophageal pressure with a miniature pressure sensor. The signals were online digitized and processed by a computer. For each measurement, at least 80 breathing cycles were evaluated. After Vojta's therapy, lung compliance was higher (P = 0.006 paired t-test) and the ratio work of breathing per tidal volume was smaller (P = 0.002). Airway resistance tidal volume, and minute ventilation did not change. We conclude that Vojta's therapy may transiently improve pulmonary mechanics and reduce work of breathing in infants with BPD. We therefore suggest to implement Vojta's therapy in the management of BPD.
... After reading the title and abstract, 145 new articles were initially discarded for not meeting the eligibility criteria for article type, full text availability, and language. By contacting the authors, an attempt was made to recover the articles excluded because the full text was not available [19][20][21], but this action was unsuccessful, leaving 38 articles for full text revision. Subsequently, 28 articles were eliminated for not meeting the type of intervention criteria , leaving 10 articles to review (Figure 1). ...
... After reading the title and abstract, 145 new articles were initially discarded for not meeting the eligibility criteria for article type, full text availability, and language. By contacting the authors, an attempt was made to recover the articles excluded because the full text was not available [19][20][21], but this action was unsuccessful, leaving 38 articles for full text revision. Subsequently, 28 articles were eliminated for not meeting the type of intervention criteria , leaving 10 articles to review (Figure 1). ...
Preterm birth carries a higher risk of respiratory problems. The objectives of the study are to summarize the evidence on the effect of chest physiotherapy in the treatment of respiratory difficulties in preterm infants, and to determine the most appropriate technique and whether they are safe. Searches were made in PubMed, WOS, Scopus, Cochrane Library, SciELO, LILACS, MEDLINE, ProQuest, PsycArticle and VHL until 30 April 2022. Eligibility criteria were study type, full text, language, and treatment type. No publication date restrictions were applied. The MINCIR Therapy and PEDro scales were used to measure the methodological quality, and the Cochrane risk of bias and Newcastle Ottawa quality assessment Scale to measure the risk of bias. We analysed 10 studies with 522 participants. The most common interventions were conventional chest physiotherapy and stimulation of the chest zone according to Vojta. Lung compression and increased expiratory flow were also used. Heterogeneities were observed regarding the duration of the interventions and the number of participants. The methodological quality of some articles was not adequate. All techniques were shown to be safe. Benefits were described after conventional chest physiotherapy, Vojta’s reflex rolling, and lung compression interventions. Improvements after Vojta’s reflex rolling are highlighted in the comparative studies.
This case report demonstrated physical function improvement of a 31-year-old male, four years post cerebral vascular compromise, with 32 weeks of Chiropractic adjustive and Dynamic Neuromuscular Stabilization (DNS) rehabilitation care.
Chiropractic care occurred weekly over a 32 week care program with the inclusion of DNS treatments over the final 16 weeks. Functional changes were tracked via Low Back Bournemouth assessment, objective findings and independent clinical examination.
Throughout care the patient progressed with non-assisted ambulation, global improvement in balance and movement pattern, decreased Low Back Bournemouth assessment scores from 43% to 23%.
This therapeutic approach reduced the patient's physical disabilities, enhancing quality of life.
Chiropractic adjustive care combined with DNS treatment improved functional deficits warranting consideration in subsequent care investigations.
Migraine is a complex disorder of the brain characterized by severe headache, photophobia, phonophobia, and nausea. This case report demonstrated the reduction of a 49-year-old female's chronic migraine symptoms after 12 weeks of Vojta/Dynamic Neuromuscular Stabilization (DNS) therapy.
Vojta/DNS treatment occurred either in the office or at home over a 12-week period. Symptoms were tracked via a patient diary, a VAS pain scale, and a Headache Disability Index (HDI).
The patient's migraine symptoms were typically of 3 days duration, a frequency of 8-10 times per month, and an intensity of 10/10 on a VAS pain scale. After a 12-week trial of Vojta/DNS care, subjective improvements were noted, with a reduction in frequency to 1-2 times per month, duration of 12 h at most, and decreased intensity to a 2/10 on a VAS pain scale. HDI scores dropped from 48% to 34%.
This therapy reduced the patient migraine sysmptoms in frequency, duration and intensity. This therapy is not well-known in North America despite its use for over 40 years in Europe.
This case demonstrated that Vojta/DNS treatment over a 12-week period helped manage the patient's migraines and could be a possible treatment option for future research.
To study the effect of stimulation of sucking and swallowing on weaning from nasogastric (NG) feeding and length of hospital stay in premature infants.
Randomized controlled trial with blinded evaluation. Premature infants on NG feeds and post-menstrual age (PMA) less than 36 weeks who had poor ability to suck were randomized to receive one daily session of stimulation according to Vojta or no intervention other than standard nursing care.
Of 36 infants, 18 received stimulation and 18 were observed without intervention. Mean gestational age at birth was 32.2 weeks (SD 2.4) versus 31.4 (2.3) weeks, p = 0.27, and PMA at study entry 35.1 weeks (0.8) versus 34.4 (0.9) weeks, p = 0.01, respectively. NG feeding was discontinued at 36.8 weeks (0.9) versus 36.3 (0.9) weeks' PMA, p = 0.25, and they were discharged at 37.8 weeks (0.9) versus 37.7 (1.3) weeks, p = 0.81.
The stimulation programme did not result in earlier weaning from NG feeding or earlier discharge. However, such studies may need to be large to limit the possibility of type II errors.
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