Immediate Effects of Vojta Therapy on Postural Control in Older Adults

Falls and balance impairments are major health concerns in older adults because they are associated with functional decline, loss of independence, fear of falling, and increased healthcare burden. Postural control is a key modifiable factor related to fall risk. Subtle changes in postural regulation may not be fully captured during quiet standing alone; therefore, more demanding standing tasks may provide additional information about the ability of the postural control system to adapt to reduce base of support and increased sensorimotor demands.

Reflex Locomotion Therapy according to Vojta is a non-pharmacological neurorehabilitation approach based on sustained somatosensory stimulation applied to specific body zones. This stimulation is intended to activate automatic postural and movement patterns and may influence neuromotor control mechanisms involved in postural regulation. Although Vojta therapy has been used mainly in pediatric and neurological populations, evidence regarding its effects on postural control in older adults remains limited.

This exploratory randomized assessor -blinded study examined the acute effects of a single session of Vojta therapy on stabilometric variables of standing postural control in robust and prefrail older adults. The study was designed to characterize postural response under both quiet and challenging balance conditions, with special interest in task-dependent changes that could be relevant to fall-related postural control.

Centre of pressure variables were selected to provide a multidimensional characterization of postural control. Positional variables, including root mean square displacement in the mediolateral and anteroposterior directions, were used to characterize the magnitude of postural sway. Within the dynamic dimension, root mean square acceleration was considered the primary variables of corrective postural adjustments, complemented by mean velocity as a secondary variable of sway dynamics and postural effort. Spectral variables, including mean power frequency and dominant frequency in the mediolateral and anteroposterior directions, were used to describe the frequency domain organization of postural sway across the five standing conditions. Nonlinear variables, including sample entropy and Higuchi fractal dimension, were used to explore temporal regularity, predictability, and complexity of center of pressure fluctuations. Together, these measures were intended to capture complementary aspects of postural control beyond traditional sway magnitude.

Inclusion criteria

• - Community-dwelling adults aged 60 years or older
• Residents of Santiago, Chile.
• Classified as robust or prefrail according to the FRAIL scale: robust=0 positive criteria; prefrail= 1-2 positive criteria
• Functional performance compatible with safe standing balance assessment, defined as a Short Physical Performance Battery (SPPB) score of 9-10 points
• Able to stand independently and safely perform standing balance assessments
• Sufficient cognitive ability to understand and follow simple instructions, assessed using the abbreviated Mini Mental State Examination with a cut-off score of 13 points or higher
• Able to provide written informed consent

Exclusion criteria

• - Neurological conditions affecting postural stability, such as stroke, Parkinson disease, multiple sclerosis, or other relevant neurological disorders.
• Musculoskeletal disorders, chronic pain, or lower limb prosthesis affecting mobility or balance assessment
• Permanent use of assistive devices for standing or walking
• Vestibular disorders, including vertigo
• Use of medications with potential effects on balance according to clinical history
• Any medical condition preventing safe participation in the intervention or stabilometric assessment