Anna Neduchalova, M. D.
The Sucklings´ Hospital, Kyjov, CZ

A child comes to our World with immature nervous system, a significant part of which develops only after the birth on the basis of functional connections between the centre and periphery, based on mutual transfers. It is necessary to be aware of the plasticity of the central nervous system (CNS) as well as of the fact that, coming from periphery to the centre, information need a certain time, which is decisive for development of a certain function.

A healthy, matured new-born is endowed with a number of locomotive abilities which are generally spontaneous. Both its spontaneous and provoked motivity (motorics) display more or less complicated and thus coordinated interplay of major or minor muscular groups. It is not a question of chaos, but individual reflex actions coordinated within space and time limits.

For a new-born child, whose CNS has been affected by any pathological influence before, in the course of, or shortly after the birth, it means a threat of not only direct damage of CNS, but also of deficiency of information coming from periphery, resulting in non-creation of appropriate connections in the CNS due to insufficiency of such a peripherial stimulation. Therefore it is obvious that if we want to provide therapy, this stimulation must be substituted in some way.

However, this substitution must be as approximate as possible to physiological information coming from periphery to the centre in the case of a normal child. This condition is met by the Vojta´s Method of Reflex Locomotion, based on phylogenetically old movement patterns representing evolutionary stadia of locomotion which any child must go through in its suckling age. As an alternative source of information the child is set to a certain position, and particular muscular groups are activated by pressing certain points within so called trigger zone. These points anatomically correspond with acupuncture points. It has been proved that through stimulation of acupuncture points endorfines and monoamines are washed out on certain levels of CNS. Stimulating points, which do not have the characteristics of acupuncture points, bring no such reactions. 

Therefore excitation coming from spots of acupuncture points or trigger zones is more important for the organism than excitation in other spots. That is why it is much more advantageous to use just these points for substitution of peripheral stimulation. Another significant conjunction can be seen in the relation between passages of acupuncture paths and passages of muscular chains, activated by basic locomotion patterns in the technique of Vojta´s reflex locomotion.

Infantile brain paralysis (IBP) is an early affection of CNS, with non-progressive character, involving a number of syndromes, mainly precipitating into locomotion disorders, disorders in development of motorics and muscular tonus, and it can also be connected with more or less substantial intellectual disorders. 

However, treatment of older children does not respect main lawfulness of mature of CNS, for when some of the forms of IBP has developed in full, it is always too late for a real treatment of the patient. In Czech Republic, principles of acupuncture in treatment of locomotive disorders of threatened children have been used in the seventies by Dr. Michaela Lidicka. Her main aim was to prevent appearance of pathological connections in CNS, and, on the other hand, to support creation of normal physiological connections and thus physiological locomotion, with the use of simulated stimulation which would in the most possible extent correspond with physiological stimulation.

Thus the main goal of the treatment is not the remedy of consequence, but only a subdue of influence of the cause! 

Dr. Lidicka had determined that it is necessary to start the treatment as soon as possible after the birth. Using principles of acupuncture for the first time in the second year of the child's life is just too late. With major locomotion disorders it is necessary to have started within the sixth month of age. With a hypoxic child it is recommended to have started with the therapy within two weeks after the birth at the latest.

The main goals of the treatment are:

1.  Supporting life

2.  Increasing neck tonus

3.  Prevention of spasms 

For stimulation of acupuncture points a needle or electric current can be used, however the quickest effect with the smallest children can be reached with a laser. We have been using a gas He-Ne laser, class IIIa, output 2mW, wavelength of the light emission 632.8 nm, with 2.5 to 10 Hz frequencies prevailing. It is also possible to use semiconductor biostimulation lasers with very good resulting effect. Selection of points depends on the age of the child, and especially on the particular level of motoric functions currently reached. Total time duration of one treatment does not exceed 10 minutes. It is recommended the laser treatment to be followed by rehabilitation immediately.

Connection of a certain kind of movement with energetic layers:

1.  Crawling - corresponding to energetic layer Tai-Yang, path points Si, Bl

2.  Turning - corresponding to energetic layer Shao-Yang, path points Gb and Te

3.  Ingestion - (movements connected to ingestion) - layer Yang-Ming, paths St and Li

4.  Food processing - (sources of energy) - layer Tai-Yin, paths Sp and Lu

5.  Blood circulation, neural reactions - layer Shao-Yin, paths Ki and Ht

6.  Defending functions - (active energy) - layer Jue-Yin, paths Pc and Lr 

Virtually we use:

1.  Always Gv 15, Gv 16, GV 20

2.  According to the level of motorics:

1. crawling Vojta I: path points Si and Bl
   most frequently Si 3, Bl 62, can be supplemented by Bl 15, Bl 16, Bl 17, Bl 23 - point Em 3 extra composing hypertonus of dorsum muscles

2. crawling Vojta II, with elbows and knees support: 
   Li 4, Li 11, St 36 - activation of hand muscle triceps brachii
   Te 5, Gb 41 - to support side body muscular tonus 
   Gb 30 - for weakness of gluteal muscles

3. Movements connected with spacial turning of Vojta turns:
   Te 5, Gb 41, also possible Gb 21, Gb 29, Gb 34, Te 15
   Gb 40 - to control biceps
   Also possible use of path points Pc and Lr/Lr 14
   Te 5, Gb 41, Gb 42 - when the muscles are firm and support coordinated moves

4. Child grabbles: 
   Axial hypotonics in connection with acral hypertonics can be frequently found
   We use: Gb 30 - gluteal muscles
   Bl 31, Bl 32, Bl 36, or Gv 14 when stand up problems appear
   To improve lower fixators and diaphragm - Bl 17
   Wrong tonus of musculus quadratus lumborum - Bl 23
   Support of knee abduction - Sp 10, adjusts hypotonics of thighs and hypertonics of calves

5. Progression of monkey walk to human walk:
   Sp 2, Sp 3

Disorders in position of lower and upper extremities

Foot abduction: three points Sp 5, Ki 2, Ki 6
Instep: Ki 2, also possible Ki 3, Ki 7, Sp 4, Sp 5 + Gb 40
Pes Calcaneovalgus: Sp 5
Pes Equinovarus: Gb 40, Bl 62
Achilles Tendon: Bl 60, also possible Ki 3 opposite with a needle
Carpus in abduction: Pc 6
Carpus in adduction: Te 5

The points most frequently used for extremities hypertonics:

Upper extremities: Si 3
Lower extremities: Bl 60
Ki 1 can also be used as a distance point to ease facial spasms
(recommended to be used at the beginning and at the end of therapy, time 1 minute,
Frequency 2 Hz, Output 2 mW) 
Home massages Si 3, Te 5, Gb 41 also recommended.

Eye disorders:

Nystagmus: Gb 41
Strabismus: Em 1, Em 2
On the ear it is also possible to use Milani´s Triangle, area of corpus callosum, hypothalamus,
area of inner muscular spasms, ACTH from both sides.

Within the endangered group of children, intensive therapy consisting of combination of acupuncture, lasertherapy, and rehabilitation can save those children, whose CNS has at least a certain reserve. Combination of all these methods, furthermore supplemented by magnetotherapy in our hospital, has an advantage in quicker improvement when compared to plain reflex locomotion. There is also a possibility of inducing psychic, sensorial, and educational functions through appropriate choice of acupuncture points.

In order to decrease the occurrence of locomotion disorders in population it is especially necessary:

1. not to undervalue influences which may cause damage to sensitive CNS of foetus and a new-born, 

2. not to undervalue early symptoms of damage to CNS as well as early symptoms of abnormalities from normal development,

3. to use reflex as the cornerstone of locomotion in therapy,

4. to go by achieved state of development during re-education in order avoid delopping pathological locomotion stereotypes.

***

Kyjov, December 7th, 1999