Vaclav Vojta, MD

 

Pavel Kolar a pediatric P.T. who worked closely with Pr Vojta has developed a systematic approach incorporating the reflex locomotion techniques alongside testing of the deep spinal stabilization system and developmentally-based exercises.

University Hospital Motol, Prague Czech Republic

Kolar is famous in sports medicine circles in Europe having treated many Olympic and professional sports athletes.  He is the Director of the Rehabilitation Department, University Hospital Motol, School of Medicine, Charles University, Prague, Czech Republic. This is the largest hospital in Central Europe, with over 4,000 beds.

In 1998 my teacher Dr. Karel Lewit told me “developmental kinesiology is the basis for everything we do.”

Pavel with Ken Crenshaw, ATC (head trainer MLB Arizona Diamondbacks)

Pavel with Dr Karel Lewit

Currently Kolar’s work which he calls Dynamic Neuromuscular Stabilization (DNS) is taught throughout the world. I have hosted him since the late 1990′s in CA, New York, FL, Chicago and England.

My programs with Pavel are currently held at Mark Verstegan’s Athletes’ Performance in Arizona. Ken Crenshaw, ATC (head trainers, Arizona Diamondbacks Major League Baseball Team) collaberates with me as we introduced the the work to ATCs & S/C coaches in baseball & other professional sports (NBA, NHL, Cirque du Soleil, PGA, NFL). The Professional Baseball Athletic Trainer’s Society (PBATS) has featured this work as well as Dr. Karel Lewit & Pr. Vladimir Janda’s in their newsletter

Alena Kobesova, Clayton Skaggs, Marcela Safarova, & Zuzana at Rehab Inst of Chicago

The Influence of Czech Manual Medicine: MLB Athletic Trainers Association.

Pavel is seen here w/ Koichi Sato ATC, S & C coach for the NBA Washington Wizards.

Koichi Sato w/ Pavel in Chicago

Other experts in the S & C field such as Mike Boyle and Eric Cressey have participated in Kolar’s programs.

w/ Mike Boyle

w/ Eric Cressey

Clare Frank, P.T., a long-time student of Pr Janda’s,  is one of the original U.S. faculty  for DNS. Jesper Andersen, DC from Denmark is the first non-Czech DNS faculty in Europe. Wayne Minter, DC & Inger Villadsen, DC are Australian faculty.

Clare Frank, PT w/ Pavel & Alena

Jesper Andersen

Inger Villadsen (left) & Wayne Minter (center)

The DNS work has been taught all over the world. Including the National University of Health Sciences (NUHS) in Lombard, IL. The DNS website provides course information about upcoming events.

In front of Joe Janse Building at NUHS – Magdalena Lepsikova PT, Alena Kobesova MD, Zuzana Holubcova PT

 

Martina Jezkova, PT providing “hands-on” instruction in Prague

Giorgio Zanesi, Ray Fowler, Pam Tunnell in Prague


All courses are “hands-on” and maintain a low faculty:participant ratio.

References:

New JOSPT paper on the diaphragm & chronic LBP

Bauer H, Appaji g, Mundt D 1992 Vojta Neurophysiologic Therapy. Indian Journal of Pediatrics (59):37-51

Kolár, P. The sensomotor nature of postural functions, Its fundamental role in Rehabilitation,  J. Orthopedic Medicine 21, 2, 1999 40-45

Kolár, P. Facilitation of agonist-antagonist co-activation by reflex stimulation methods. In Liebenson C (ed) Rehabilitation of the Spine: A Practitioner’s Manual (2nd ed). Lippincott, Philadephia, 2006.

Vojta V, Peters A 2007 Das Vojta-Prinzip Muskelspiele in Reflexfortbewegung und motorischer Ontogenese. 3rd edition. Springer Medizin Verlag, Heidelberg

DNS is founded on the principle that the stages of development of the infant from the fetal posture to being upright are stored involutionally in the CNS. We can use the positions & stimulation points of reflex locomotion (RL) to “hack” into the patient’s computer to rid it of viruses that have affected our locomotor system’s performance. Often overuse, injuries, postural habits, or stress alter our motor function. RL is a tool to “refresh” the computer screen or “reboot” the computer.

Upright posture is the goal of CNS control of posture from birth to 4 and 1/2 years of life. This is described here -DNS video from Liebenson’s Rehabilitation of the Spine (2nd ed) book/DVD. Also, shown are a # of the basic tests of the deep spinal stabilization system. There are three basic aspects to the work. Tests of the deep spinal stabilization system; reflex locomotion; & developmentally-based execises/mobilizations.

IAP Test

1. Tests of the deep spinal stabilization system

Pavel with Magdalena Lepsikova showing the IAP test.

Other tests include Diaphragm, hip flexion, neck/trunk flexion, arm overhead, quadruped, & upper thoracic extension.

Hip Flexion Test


These tests are described in detail & showed in Pavel’s chapter Rehab of the Spine (2nd ed) on pages 553-558.

The supine tests: Diaphragm, IAP, Neck/trunk flexion, & Arm Raise OH tests can be scored 0-4 as Gray Cook suggests. Here is a form DNS Tests-SD 2 you can use.

These functional tests are complementary to those taught by Pr Janda (upper & lower crossed syndromes) & Dr Lewit (faulty breathing, forward drawn posture).

Pr Janda with Dr Karel Lewit in Prague

Pr Janda – 1993 Prague

2. Reflex Locomotion

Naples, FL 2000 w/ Robert Lardner (US Faculty), Carol DeFranca, Scott Chapman, Ron LeFebvre, Pam Tunnel, and Pam Wilson

Tom Lotus, Brett Winchester, Judy Morey, Erin McGuire, Gil Chimes, Corey Campbell, Dave Juerhing – Chicago ’07

Reflex locomotion techniques can be performed prone, supine, side lying, kneeling, etc. They involve specific points of support, reflex zones of stimulation, and resisted movements specific to the position of the baby at that stage of neurodevelopment.

Reflex locomotion stimulation can be lead to involuntary movements such as rolling over, creeping or crawling. But, the 1st goal is something far less sensational, but just as valuable – normalization of a faulty breathing pattern. Diaphragmatic breathing is easily facilitated even in chronic chest breathers who cannot breath from their abdomen on their own. This only takes seconds to facilitate and can make a lasting imprint on the patient’s nervous system.

3. Developmentally-based exercise/mobilizations:

Petra Valouchova and Craig Liebenson JBMT article showing developmentally inspired core exercise

Here is an overview article  too.


Zuzana demonstrates thoracic extension & C0-C1 centration in kneeling position w/ Dr Scott Fonda

Mobilization of upper ribs – Giorgio Zanasi & Ron LeFebvre in Naples, FL 2000

 

The Bear

Brett Winchester utilizing Tband for resistance of reflex rolling

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19 Responses to Dynamic Neuromuscular Stabilization

  1. luis says:

    Can I know famous hospital in USA is practice DNS?

    • Clare says:

      I don’t think there is a hospital in the US that practices DNS solely. DNS is not well-known in the health/rehab mainstream as it’s quite new in the US.

  2. ALI says:

    HI,
    I am a graduate Physiotherapist and post graduate student.
    Can i do my Postgraduation in this field…..
    Thank you

    • Craig Liebenson says:

      There are postgraduate training options available in Germany. That is where most of the “official” training occurs.

  3. Ali says:

    Hi,
    Thanks for response.
    I will be gratefull if you please send me the name of the Universities Offering D N S in Germany.
    Thank you very much

  4. Craig Liebenson says:

    The email for the German organization teaching the Vojta work is info@vojta.com. That will go to Fionn Bailey, she does all the English communications for the society.
    In Prague Pavel Kolar teaches his version of what he learned from Dr Vojta. His work falls under the name Dynamic Neuromuscular Stabilization (DNS) and teaches courses around the world. You can go to http://www.rehabps.com for course information.

    I will be hosting my annual program on DNS at Athletes’ Performance in Arizona this November. My good friend Clare Frank, PT hosts quite a few programs in L.A. as well as Asia

    Also, Richard Cohen, D.C. – richcohendc@hotmail.com – teaches programs in the U.S. and has one in Philadelphia this March.

  5. ALI says:

    Hi,
    Thank you very much for your kind information.
    I will be gratefull if you please send me some information about the program you are hosting on D N S.
    Thank you very much
    ALI
    PAkistan

  6. Craig Liebenson says:

    Ali,
    Feel free to email me at craigliebensondc@gmail.com. The program will be in November & a flyer which will describe the program will be available in a few months.
    Thanks,
    Craig

  7. sangary says:

    hi. how is vojta therapy working on childrens… currently i m working on that. kindly pls help me out sir. thank you.

  8. neha says:

    hello,
    I am neha, a neurodevelopmental therapist and a mother of a 1 year old dystonic baby girl(cause birth asphyxia). I am interested in doing the courses on DNS and Reflex Locomotion and want to know whether this would help in treament of my child because I dont want to leave anyleaf unturned. On your home-page, i could not find the details of the A,B,C courses and local organisers. I would want to know for which country can i apply for these courses.
    thanks a lot.
    regards..
    neha

  9. johncenanss says:

    Its really very helpful for the sports people.The sports people always face a problem in the joints. This therapy id very useful.Thanks for providing such a useful information.
    ————
    Johncenanss

  10. [...] Amazing information! Dr.Liebenson goes into detail about Dynamic Neuromuscular Stabilization (DNS), the newest manual rehabilitation technique being taught within the physical therapy [...]

  11. [...] Dr. Craig Liebenson, has a very good summary article about this whole new paradigm on his blog at http://www.craigliebenson.com/?p=666 Categories: core stability, Uncategorized Tags: core stability, DCA, deep core amnesia, deep [...]

  12. [...] you’re interested in learning more about the philosophy and development of DNS, you can read this overview from Dr. Craig [...]

  13. [...] This was a hands on where Craig took us through some the rolling, planking, and crawling progressions he uses to treat his athletes.  Craig is a “DNS guy” which is awesome.  Simply put, Dynamic Neuromuscular Stabilization (DNS) is program that uses pediatric reflex locomotion and deep spinal stabilization techniques to treat stroke victims and injured individuals.   You can learn more about it here. [...]

  14. [...] For more information on DNS,  visit Dr. Liebenson’s blog  [...]

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