Journal of pediatric surgery · 2026
The effectiveness of Vojta therapy in enhancing functional outcomes in children with anorectal malformations following sphincter preserving anorectoplasty (SPARP) with anterior approach.
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Mesić Marko, Kotnik Suzana Skočilić, Čota Stjepan, Pavić Ana Močić, Mašić Mario, Divković Dalibor, Kopljar Mario, Kralik Kristina, Žakula Nenad, Sacks Marla A, Majnarić Mateja, Šoljić Hrvoje, Velček Francisca Tolete
Аннотация
BACKGROUND: The aim of this study was to define the difference in therapy response before and after Vojta therapy in children with anorectal malformations who underwent sphincter preserving anorectoplasty (SPARP) with anterior approach between January 2017 and December 2024.
PATIENTS AND METHODS: There were 12 male and 20 female patients with rectoperineal and 7 girls with rectovestibular fistula included in prospective study, together with their parents. Vojta therapy was performed three times a day for 3 months. Rintala Bowel Function Score (RBFS), high resolution anorectal manometry (HRAM), Pediatric Quality of Life Inventory 4.0. questionnaire (PedsQL 4.0) and Patient-Assessment of Constipation Quality of Life questionnaire (PAC-QOL) were assessed before and three months after undergoing Vojta therapy.
RESULTS: RBFS showed statistically significant difference regarding total score (p<0.001), good outcome (p=0.03), ability to always hold back defecation (p=0.03), decreased soiling (p=0.01), accidents in toilet trained patients (p=0.008), and increased number of not toilet trained patients with frequency of defecation every other day to twice a day (p=0.04). HRAM showed no significant improvement in resting anal pressure. PedsQL 4.0 questionnaire showed improvement in psychosocial health and statistically significant difference in total score in parents (p=0.01) and children 5-12 years of age (p=0.02). All children had improvement in physical health. PAC-QOL questionnaire showed improvement in physical and psychosocial discomfort, satisfaction, total score, and statistically significant difference in worries and concerns (p=0.04).
CONCLUSION: Vojta therapy is effective in enhancing functional outcomes following SPARP with the anterior approach in children starting from infancy. It is cost-effective and feasible for daily home-based implementation by trained parents.
PATIENTS AND METHODS: There were 12 male and 20 female patients with rectoperineal and 7 girls with rectovestibular fistula included in prospective study, together with their parents. Vojta therapy was performed three times a day for 3 months. Rintala Bowel Function Score (RBFS), high resolution anorectal manometry (HRAM), Pediatric Quality of Life Inventory 4.0. questionnaire (PedsQL 4.0) and Patient-Assessment of Constipation Quality of Life questionnaire (PAC-QOL) were assessed before and three months after undergoing Vojta therapy.
RESULTS: RBFS showed statistically significant difference regarding total score (p<0.001), good outcome (p=0.03), ability to always hold back defecation (p=0.03), decreased soiling (p=0.01), accidents in toilet trained patients (p=0.008), and increased number of not toilet trained patients with frequency of defecation every other day to twice a day (p=0.04). HRAM showed no significant improvement in resting anal pressure. PedsQL 4.0 questionnaire showed improvement in psychosocial health and statistically significant difference in total score in parents (p=0.01) and children 5-12 years of age (p=0.02). All children had improvement in physical health. PAC-QOL questionnaire showed improvement in physical and psychosocial discomfort, satisfaction, total score, and statistically significant difference in worries and concerns (p=0.04).
CONCLUSION: Vojta therapy is effective in enhancing functional outcomes following SPARP with the anterior approach in children starting from infancy. It is cost-effective and feasible for daily home-based implementation by trained parents.