#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Vojta therapy is not contraindicated in pediatric hematooncology and oncology patients


Authors: Jevič F. 1,2;  Vlčková B. 1;  Pavliňáková K. 1;  Kobesová A. 1
Authors‘ workplace: Klinika rehabilitace a tělovýchovného lékařství, 2. LF UK a FN Motol, Praha 1;  Ústav fyziologie, 3. LF UK, Praha 2
Published in: Rehabil. fyz. Lék., 30, 2023, No. 2, pp. 72-78.
Category: Original Papers
doi: https://doi.org/10.48095/ccrhfl202372

Overview

The topic of using Vojta reflex locomotion (VRL) in oncology patients has been discussed repeatedly in the Czech rehabilitation community, especially in patients with a combination of oncological diseases and neurological deficits. However, it has never been a subject to evidence-based professional discussions with any ultimate conclusion. We have focused on this topic intensively since 2013, integrating Vojta therapy (VT) as part of a comprehensive rehabilitation approach for pediatric patients with oncological diseases treated in a  Department of Pediatric Hematology and Oncology, 2nd Medical Faculty, Charles University, and Motol University Hospital. There was a need to combine VT with other physiotherapeutic approaches based on neurophysiological principles, especially in patients with drug-induced neuropathy and central nervous system tumours. However, an oncological diagnosis has often been considered to be a contraindication to the application of VRT. The main arguments of the proponents of VT contraindications are the undesirable increase in cellular metabolism and the influence of VRT on the autonomic nervous system. In the light of modern evidence-based literature dealing with exercise physiology and in comparison with other commonly used rehabilitation methods in pediatric oncology, these arguments appear to be unfounded. From the literature review, it is evident that, in addition to manual therapy, strengthening, aerobic and balance exercises as well as neurophysiological methods are commonly used in oncology patients. In 2019, the Pediatric Oncology Section of the Czech Society for Oncology, Czech Medical Association of J. E. Purkyně issued an official opinion paper which unequivocally supported the use of VRT in the rehabilitation of children with cancer of all types, including leukemia, and in all phases of oncological treatment. The copy of the opinion paper is attached at the end of this manuscript. VRT is not contraindicated in pediatric hemato-oncology and oncology patients and it can be used based on the present condition of the child and the rehabilitation goals.

Keywords:

Pediatric oncology – rehabilitation – contraindication – Vojta reflex therapy – reflex locomotion


Sources

1. Pavelka Z, Zitterbart P. Nádory centrálního nervového systému u dětí. Neurol Praxi 2011; 12(1): 52–58.

2. Sun LR, Cooper S. Neurological complications of the treatment of pediatric neoplastic disorders. Pediatr Neurol 2018; 85: 33–42. doi: 10.1016/j.pediatrneurol.2018.05.011.

3. Weaver L, Samkari A. Neurological complications of childhood cancer. Semin Pediatr Neurol 2017; 24(1): 60–69. doi: 10.1016/j.spen.2016.12.005.

4. SIOP Europe. Evropské standardy v péči o onkologicky nemocné děti. Varšava 2009. [online]. Dostupné z: http://www.epaac.eu/from_heidi_wiki/Czech.pdf.

5. Santos SDS, Moussalle LD, Heinzmann-Filho JP. Effects of physical exercise during hospitalization in children and adolescents with cancer: a systematic review. Rev Paul Pediatr 2020; 39: e2019313. doi: 10.1590/1984-0462/2021/39/2019313.

6. Rustler V, Hagerty M, Daeggelmann J et al. Exercise interventions for patients with pediatric cancer during inpatient acute care: a systematic review of literature. Pediatr Blood Cancer 2017; 64(11). doi: 10.1002/pbc.26567.

7. Baumann FT, Bloch W, Beulertz J. Clinical exercise interventions in pediatric oncology: a systematic review. Pediatr Res 2013; 74(4): 366–374. doi: 10.1038/pr.2013.123.

8. Sharma B, Allison D, Tucker P et al. Exercise trials in pediatric brain tumor: a systematic review of randomized studies. J Pediatr Hematol Oncol 2021; 43(2): 59–67. doi: 10.1097/MPH.0000000000001844.

9. Ospina PA, McComb A, Pritchard-Wiart LE et al. Physical therapy interventions, other than general physical exercise interventions, in children and adolescents before, during and following treatment for cancer. Cochrane Database Syst Rev 2021; 8(8): CD012924. doi: 10.1002/14651858.CD012924.pub2.

10. Bradt J, Dileo C, Myers-Coffman K et al. Music interventions for improving psychological and physical outcomes in people with cancer. Cochrane Database Syst Rev 2021; 10(10): CD006911. doi: 10.1002/14651858.CD006911.pub4.

11. da Silva Santa IN, Schveitzer MC, Dos Santos ML et al. Music interventions in pediatric oncology: systematic review and meta-analysis. Complement Ther Med 2021; 59: 102725. doi: 10.1016/j.ctim.2021.102725.

12. Wang TS, Wang SF, Song WD et al. Neuromuscular electrical stimulation for cancer pain in children with osteosarcoma: a protocol of systematic review. Medicine (Baltimore) 2020; 99(30): e21311. doi: 10.1097/MD.0000000000021311.

13. Rustler V, Däggelmann J, Streckmann F et al. Whole-body vibration in children with disabilities demonstrates therapeutic potentials for pediatric cancer populations: a systematic review. Support Care Cancer 2019; 27(2): 395–406. doi: 10.1007/s00520-018-4506-5.

14. Rodríguez-Mansilla J, González-Sánchez B, Torres-Piles S et al. Effects of the application of therapeutic massage in children with cancer: a systematic review. Rev Lat Am Enfermagem 2017; 25: e2903. doi: 10.1590/1518-8345.1774.2903.

15. Pellegrini C, Caraceni AT, Massimino M et al. Development and field testing of a neuro psychomotor multidimensional grid for the assessment of children with cns tumour. Pediatr Hematol Oncol 2022; 39(2): 108–120. doi: 10.1080/08880018.2021.1948648.

16. Chisari M, Sensi R, Clerici CA et al. Action observation therapy in pediatric patients with neuromotor deficits of the upper limbs secondary to central nervous system tumours. Tumori 2019; 105(3): NP75–NP78. doi: 10.1177/0300891619880603.

17. Vojta V, Peters A. Vojtův princip: svalové souhry v reflexní lokomoci a motorická ontogeneze. Praha: Grada Publishing 1995.

18. Martínek M, Pánek D, Nováková T et al. Analysis of intracerebral activity during reflex locomotion stimulation according to Vojta’s principle. Appl Sci 2022; 12(4): 2225. doi: 10.3390/app12042225.

19. Hok P, Opavský J, Labounek R et al. Differential effects of sustained manual pressure stimulation according to site of action. Front Neurosci 2019; 13: 722. doi: 10.3389/fnins.2019.00722.

20. Sanz-Esteban I, Calvo-Lobo C, Ríos-Lago M et al. Mapping the human brain during a specific Vojta’s tactile input: the ipsilateral putamen’s role. Medicine (Baltimore) 2018; 97(13): e0253. doi: 10.1097/MD.0000000000010253.

21. Véle F. Kineziologie: přehled klinické kineziologie a patokineziologie pro diagnostiku a terapii poruch pohybové soustavy. 2. přeprac. vyd. Triton 2006.

22. Vařeka I, Dvořák R. Jak vlastně funguje Vojtova metoda? Rehabil Fyz Lék 2009; 16(1): 3–5.

23. Vojta V. Mozkové hybné poruchy v kojeneckém věku: včasná diagnóza a terapie. Praha: Grada-Avicenum 1993.

24. Bauer H, Appaji G, Mundt D. Vojta neurophysiologic therapy. Indian J Pediatr 1992; 59(1): 37–51. doi: 10.1007/BF02760897.

25. Sung YH, Ha SY. The Vojta approach changes thicknesses of abdominal muscles and gait in children with spastic cerebral palsy: a randomized controlled trial, pilot study. Technol Health Care 2020; 28(3): 293–301. doi: 10.3233/THC-191726.

26. Jung MW, Landenberger M, Jung T et al. Vojta therapy and neurodevelopmental treatment in children with infantile postural asymmetry: a randomised controlled trial. J Phys Ther Sci 2017; 29(2): 301–306. doi: 10.1589/jpts.29.301.

27. Torró-Ferrero G, Fernández-Rego FJ, Agüera-Arenas JJ et al. Effect of physiotherapy on the promotion of bone mineralization in preterm infants: a randomized controlled trial. Sci Rep 2022; 12(1): 11680. doi: 10.1038/s41598-022-15810-6.

28. Pleskova J, Koucky V, Medunova K et al. Reflex zone stimulation reduces ventilation inhomogeneity in cystic fibrosis: a randomised controlled cross‐over study. Pediatr Pulmonol 2021; 56(6): 1558–1565. doi: 10.1002/ppul.25350.

29. Orth H. Dítě ve Vojtově terapii: příručka pro praxi. České Budějovice: Kopp 2009.

30. Skaličková-Kováčiková V. Diagnostika a fyzioterapie hybných poruch dle Vojty. RL-CORPUS 2017.

31. Skaličková-Kováčiková V. Vojtova metoda není jen technika: vedení fyzioterapie dětského pacienta Vojtovou metodou: praktické zkušenosti. RL-CORPUS 2020.

32. Hradil V, Kittlerová-Trávníčková O. Rehabilitace v onkologii. Rehabil Fyz Lék 2007; 14(4): 135–146.

33. Kolář P et al. Rehabilitace v klinické praxi. Praha: Galén 2009.

34. Jevič F. Fyzioterapie u pacientů s akutní lymfoblastickou leukemií. II. mezinárodní kongres vývojové kineziologie. Olomouc 2017: 30.

35. Jevič F, Medunová K, Vlčková B. Erfahrung mit Vojta-Therapie bei onkologischen Kinderpatienten. Vojta-Symposium – DAS VOJTA-PRINZIP – GEGENWART UND ZUKUNFT Symposium anlässlich des 100. Geburtstags von Prof. MUDr. Václav Vojta; 50 Jahre Vojta-Diagnostik und Therapie in Köln, Deutschland 2017.

36. Jevič F, Vlčková B, Medunová K. Zkušenosti s Vojtovou reflexní lokomocí u onkologických pacientů v pediatrii. Janskolázeňské sympozium. Janské Lázně 2016.

37. Jevič F, Medunová K, Ptáková K. Možnosti rehabilitace u dětských hematoonkologických a onkologických pacientů. XXVII. Konference dětských hematologů a onkologů ČR a SR. Praha 2017.

38. Jevič F. Einfluss der Vojta-Therapie auf die Feinmotorik und Lokomotion der hämatoonkologischen Patienten im Kindesalter (poster); Vojta-Symposium – DAS VOJTA-PRINZIP – GEGENWART UND ZUKUNFT Symposium anlässlich des 100. Geburtstags von Prof. MUDr. Václav Vojta; 50 Jahre Vojta-Diagnostik und Therapie in Köln, Deutschland 2017.

39. Medunová K. Fyzioterapie u onkologických dětských pacientů po operaci zadní jámy lební. Mezinárodní kongres vývojové kineziologie. Olomouc 2017.

40. Braam KI, van der Torre P, Takken T et al. Physical exercise training interventions for children and young adults during and after treatment for childhood cancer. Cochrane Database Syst Rev 2013; (4): CD008796. doi: 10.1002/14651858.CD008796.pub2.

41. Mc Ardle WD, Katch FI, Katch VL. Exercise physiology: nutrition, energy, and human performance. Lippincott Williams et Wilkins 2010.

42. Katch VL, McArdle WD, Katch F et al. Essentials of exercise physiology. Lippincott Williams et Wilkins 2011.

43. Hargreaves M, Spriet LL. Skeletal muscle energy metabolism during exercise. Nat Metab 2020; 2(9): 817–828. doi: 10.1038/s42255-020-0251-4.

44. Bea JW, Blew RM, Howe C et al. Resistance training effects on metabolic function among youth: a systematic review. Pediatr Exerc Sci 2017; 29(3): 297–315. doi: 10.1123/pes.2016-0143.

45. Opavsky J, Slachtova M, Kutin M et al. The effects of sustained manual pressure stimulation according to Vojta Therapy on heart rate variability. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2018; 162(3): 206–211. doi: 10.5507/bp.2018.028.

46. Estévez-González AJ, Pérez-Ruiz M, Cobo-Vicente F et al. Effects of physical training on heart rate variability in children and adolescents with chronic diseases: a systematic review and meta-analysis. Int J Sports Med 2022; 43(8): 679–686. doi: 10.1055/a-1524-2421.

47. Rensen N, Gemke RJ, van Dalen EC et al. Hypothalamic-pituitary-adrenal (HPA) axis suppression after treatment with glucocorticoid therapy for childhood acute lymphoblastic leukaemia. Cochrane Database Syst Rev 2017: 11(11): CD008727. doi: 10.1002/14651858.CD008727.pub4.

48. Mostoufi-Moab S, Halton J. Bone morbidity in childhood leukemia: epidemiology, mechanisms, diagnosis, and treatment. Curr Osteoporos Rep 2014; 12(3): 300–312. doi: 10.1007/s11914-014-0222-3.

49. Menconi M, Fareed M, O’Neal P et al. Role of glucocorticoids in the molecular regulation of muscle wasting. Crit Care Med 2007; 35 (Suppl 9): S602–S608. doi: 10.1097/01.CCM.0000279194.11328.77.

50. Davies JH, Evans BAJ, Jenney ME. Skeletal morbidity in childhood acute lymphoblastic leukaemia. Clin Endocrinol (Oxf) 2005; 63(1): 1–9. doi: 10.1111/j.1365-2265.2005.02263.x.

51. Treadgold B, Kennedy C, Spoudeas H et al. Paediatric neuro-oncology rehabilitation in the UK: carer and provider perspectives. BMJ Paediatr Open 2019; 3(1): e000567. doi: 10.1136/bmjpo-2019-000567.

52. Schmidt-Andersen P, Kaj Fridh M, Gottlob Müller K et al. Integrative Neuromuscular Training in Adolescents and Children Treated for Cancer (INTERACT): study protocol for a multicenter, two-arm parallel-group randomized controlled superiority trial. Front Pediatr 2022; 10: 833850. doi: 10.3389/fped.2022.833850.

Labels
Physiotherapist, university degree Rehabilitation Sports medicine
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#