Abstract
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.