Ha Sun-Young, Sung Yun-Hee
Department of Physical Therapy, Graduate School, Kyungnam University, Changwon 51767, Korea.
Department of Physical Therapy, College of Health Sciences, Kyungnam University, Changwon 51767, Korea.
Children (Basel). 2021 Oct 15;8(10):918. doi: 10.3390/children8100918.
The development of motor function is related to the development of neural pathways in the white matter. Children with developmental delay (DD) and hypotonia have reduced motor function, and their neural pathways are observed differently from those of typically developed children. We investigated changes in neural pathways through diffusion tensor imaging (DTI) after utilizing the Vojta approach. The participant was a child with DD and hypotonia, and had delayed motor function. Although he had no brain damage on magnetic resonance imaging findings, damage to the neural pathway was confirmed through DTI due to cytomegalovirus infection in the mother's womb. From 11 months of age, the Vojta approach was performed for a total of 8 months. In this study, we found that in CST, the left FA and right TV increased in follow-up DTI more than in the initial DTI. In CRP, Wallerian degeneration was observed in the left FA, MD, and TV in follow-up DTI. GMFM-88 improved after intervention. The structural change of neural pathways through the Vojta approach influenced the improvement of gross motor function. Therefore, it is thought that the Vojta approach can be suggested as a meaningful intervention for children with DD and hypotonia.
运动功能的发展与白质中神经通路的发育有关。发育迟缓（DD）和肌张力低下的儿童运动功能降低，其神经通路与正常发育儿童的神经通路表现不同。我们在采用vojta疗法后，通过扩散张量成像（DTI）研究神经通路的变化。参与者是一名患有DD和肌张力低下的儿童，运动功能延迟。尽管他在磁共振成像检查中没有脑损伤，但由于母亲子宫内的巨细胞病毒感染，通过DTI证实了神经通路受损。从11个月大开始，共进行了8个月的vojta疗法。在本研究中，我们发现，在皮质脊髓束（CST）中，随访DTI中的左侧各向异性分数（FA）和右侧丘脑腹侧核（TV）比初始DTI增加更多。在皮质桥脑束（CRP）中，随访DTI中左侧FA、平均扩散率（MD）和TV出现了华勒氏变性。干预后全身运动功能测试量表（GMFM-88）有所改善。通过vojta疗法引起的神经通路结构变化影响了粗大运动功能的改善。因此，认为vojta疗法可作为对DD和肌张力低下儿童有意义的干预措施。
