Efficacy of reflex locomotion therapy in improving balance and walking abilities of patients with multiple sclerosis: a systematic review

Reflex locomotion therapy (RLT), also known as Vojta therapy, is a neuroproprioceptive technique that is thought to activate certain locomotion patterns that are essential for muscle activity, subsequently improving walking abilities and balance. It was initially administered to children with cerebral palsy but has recently been used in adult populations with neurological impairment such as multiple sclerosis.

This systematic review aims to review the effect of RLT on balance and walking abilities of patients with multiple sclerosis.

A systematic literature search was conducted in PubMed, Cochrane, PEDro, Web of Science, and Scopus for randomized and non-randomized clinical trials and single-arm crossover trials of patients with multiple sclerosis receiving reflex locomotion therapy. The protocol was registered on PROSPERO (CRD42022370066).

Six articles out of 310 with a total population of 353 patients met our inclusion criteria. Four studies compared RLT with motor program activating therapy (MPAT), while two studies administered conventional physical therapy to the control group. RLT showed superiority to conventional physical therapy across balance and gait parameters, while when compared to MPAT, the results either favored MPAT or showed no superiority of either intervention.

The current evidence is at its initial stages, showing limited evidence; however, adding reflex locomotion therapy to conventional physical therapy may improve balance and walking abilities in patients with multiple sclerosis more than conventional physical therapy alone. More well-structured RCTs with larger sample size are required to reach a definitive conclusion regarding the efficacy of reflex locomotion therapy.