Multimodal Rehabilitation in Spinal Cord Lesion: Comparative Outcomes of Vojta Therapy and Lokomat Training

Background and Objectives: Spinal cord lesion is a severe disorder of the central nervous system, leading to partial or complete interruption of nerve impulse transmission between the brain and the periphery and causing severe neurological and functional deficits. Conventional rehabilitation offers limited outcomes, while robotic gait training (Lokomat^®) and Vojta Therapy have shown benefits individually. Evidence on their combined effect remains scarce. To evaluate the combined effect of Vojta Therapy and Lokomat-assisted gait training on motor recovery, functional independence, and quality of life in SCL patients. Materials and Methods: A retrospective clinical study was conducted on 205 patients with traumatic and non-traumatic SCL. Patients were allocated to four groups: (F)-conventional rehabilitation; (V)-conventional + Vojta; (L)-conventional + Lokomat; (VL)-conventional + Vojta + Lokomat. Assessments included the ASIA Impairment Scale (AIS), ASIA motor/sensory scores, spasticity (Modified Ashworth Scale, MAS), functional independence (Functional Independence Measure, FIM), and health-related quality of life (EQ-5D), performed at admission and discharge. Statistical analyses comprised paired t-tests, Wilcoxon signed-rank tests, chi-square tests, Kruskal-Wallis with Dunn's post hoc corrections, and linear regression. Results: The most frequent lesion levels were C7 (21%) and L1 (20%). All groups showed improvement in FIM scores, with the greatest gains in the VL group (from 79.25 to 84.79, p < 0.05). Post hoc analysis confirmed significantly higher FIM outcomes in VL compared with L. Regression analysis identified the ASIA motor score as the strongest predictor of functional independence (β = 0.76, p < 0.001), with VL group membership adding +10.3 points (p = 0.004). EQ-5D indicated persistent deficits in mobility and self-care, especially in VL patients, consistent with higher lesion severity. Conclusions: Combining Vojta Therapy with Lokomat training provides additional functional benefits compared with Lokomat or Vojta alone. Multimodal individualized rehabilitation appears promising for patients with spinal cord lesions. Prospective randomized controlled trials with long-term follow-up are warranted.