Bobath Technique: Post-Stroke Rehabilitation Therapy Explained

The Bobath concept is a problem-solving approach used in the evaluation and treatment of individuals with movement, tone, and functional impairments due to damage to their central nervous system. Named after Berta Bobath, a physiotherapist, and her husband Karl, a psychiatrist/neuropsychiatrist, the approach was originally developed to treat children with cerebral palsy. Today, it is also used in the rehabilitation of stroke patients. The Bobath concept is based on the idea that normal postural reflex mechanisms are fundamental to motor skill performance and focuses on recovery potential and motor performance. It involves specific patient handling skills to guide patients through the initiation and completion of tasks, with an emphasis on early rehabilitation, consistency of practice, and a stimulating environment. While Bobath therapy is widely used, its effectiveness compared to other treatments has been questioned.

Bobath therapy is a type of physiotherapy treatment that aims to improve movement and mobility in patients with damage to their central nervous system

The Bobath concept is an approach to neurological rehabilitation that is applied in patient assessment and treatment, such as with adults after a stroke or children with cerebral palsy. The goal is to promote motor learning for efficient motor control in various environments, thereby improving participation and function. This is done through specific patient handling skills to guide patients through the initiation and completion of intended tasks. The approach is multidisciplinary, primarily involving physiotherapists, occupational therapists, and speech and language therapists.

Bobath therapy is based on the brain's ability to adapt to change, reorganise and recover after neurological damage. It focuses on encouraging normal movement patterns, improving the quality of movement, normalising muscle tone to facilitate active movement, and optimising positioning and posture in lying, sitting and standing. It discourages compensatory movements and muscle strength training. Instead, it promotes maximum functional recovery to improve quality of independence. Handling techniques are used to prevent patients from moving with over-exertion and to provide sensory feedback.

Bobath therapy aims to prevent abnormal movement patterns and make movements easier to achieve, more precise and goal-directed. It also helps to lengthen tight muscles to reduce spasticity and contractures, improve ability with everyday activities and increase independence. The approach emphasises the importance of early rehabilitation, consistent practice and a stimulating environment to promote recovery.

Bobath therapy is non-standardised, as it responds to the individual patient and their movement control problems through clinical reasoning and the development of a clinical hypothesis. Treatment techniques are decided collaboratively with the patient and guided by the therapist through goal setting, close communication and interaction.

A review of clinical trials found that the Bobath concept is not more effective than other approaches used in post-stroke rehabilitation. There is moderate evidence that other therapeutic approaches, such as the forced use of the affected upper limb and constraint-induced movement therapy, are superior for motor control of the upper limb.

The Bobath concept is an approach to neurological rehabilitation that is applied in patient assessment and treatment

The Bobath concept is a problem-solving approach to neurological rehabilitation, developed by Berta Bobath, a physiotherapist, and her husband, Karl, a psychiatrist/neuropsychiatrist. It is applied in patient assessment and treatment and is the most used treatment approach in neurorehabilitation globally. The Bobath concept focuses on movement analysis with respect to selective movement, postural control, and the role of sensory information to develop a movement diagnosis guiding treatment and evaluation.

The Bobath concept is based on the brain's ability to adapt to change, reorganise, and recover after neurological damage. It involves a number of principles, including encouraging normal movement patterns, focusing on the quality of movement, normalising tone to facilitate active movement, positioning and posture in lying, sitting, and standing, discouraging compensatory movements and muscle strength training, and promoting maximum functional recovery to improve quality of independence. Handling techniques are used to guide patients through the initiation and completion of intended tasks and to prevent over-exertion.

Bobath therapy is interactive and involves both the patient and therapist. It is also multidisciplinary, involving physiotherapists, occupational therapists, and speech and language therapists. The approach is based on the idea that the presence of normal postural reflex mechanisms is fundamental to a motor skill's performance. Interventions are multi-dimensional, individualised, and reflective.

Bobath therapy focuses on recovery potential and motor performance. It primarily consists of facilitation, which includes therapeutic handling, environmental modification, and the use of appropriate verbal cues. Therapeutic handling combines both facilitation and inhibition approaches, with facilitation playing a central role in fostering motor learning by utilising sensory cues. Inhibition, on the other hand, entails diminishing abnormal movement or posture elements that hinder normal functioning.

The Bobath concept is applied to patients with movement, tone, and functional impairments due to a lesion of the central nervous system, such as adults after a stroke or children with cerebral palsy. The goal is to promote motor learning for efficient motor control in various environments, thereby improving participation and function.

The Bobath concept is not superior to other approaches for regaining mobility, motor control of the lower limb, and gait

The Bobath concept, also known as neurodevelopmental treatment, is a problem-solving approach used in the evaluation and treatment of individuals with movement, tone, and functional impairments due to a lesion of the central nervous system. It was developed by Berta Bobath, a physiotherapist, and her husband Karl, a psychiatrist/neuropsychiatrist, for patients affected by Central Nervous System anomalies, particularly those with cerebral palsy and stroke.

For instance, a 2009 systematic review of randomised controlled trials (RCTs) reported that Bobath therapy was not superior to other physical therapies for sensorimotor control of the upper and lower limbs, dexterity, mobility, activities of daily living, or cost-effectiveness. The review also found limited evidence favouring Bobath therapy for balance.

Similarly, a 2020 study by Lennon et al. concluded that even under ideal conditions, the Bobath approach had no effect on the quality of gait for patients with a stroke. Another study by Paci (2003) showed no evidence of the effectiveness of the Bobath concept as the optimal treatment for adults with hemiplegia following a stroke.

In addition, a 2020 review of lower limb rehabilitation following a stroke concluded that Bobath therapy was inferior to task-specific training, and prioritising it over other interventions is not supported by current evidence.

While the Bobath concept has its proponents and is widely used, particularly in stroke rehabilitation, the evidence suggests that it is not superior to other approaches for regaining mobility, motor control, and gait.

Bobath therapy focuses on recovery potential and motor performance

Bobath therapy is a problem-solving approach used in the evaluation and treatment of individuals with movement, tone, and functional impairments due to a lesion of the central nervous system. It is named after Berta Bobath, a physiotherapist, and her husband Karl, a psychiatrist/neuropsychiatrist, who proposed the approach for treating patients affected by Central Nervous System anomalies. The Bobath concept is based on the premise that the presence of normal postural reflex mechanisms is fundamental to a motor skill's performance. The approach focuses on recovery potential and motor performance.

Bobath therapy interventions are multi-dimensional, individualised, and reflective. It is a goal-oriented and task-specific approach that aims to organise the internal (proprioceptive) and external (exteroceptive) environment of the nervous system for efficient functioning of the individual. It is an interactive process between patients and therapists.

Therapy focuses on the neuro-muscular system, spinal cord, and higher centres to change motor performance, neuroplasticity, and individual expression of movement. It also addresses abnormal, stereotypical movement patterns that interfere with function, aiming to prevent the development of spasticity and improve residual function.

Bobath therapists work on improving tone to enhance movement, not to normalise it. This is achieved through mobilisation of muscles and stiff joints and the practice of more normal movement patterns. The precise application of facilitation during motor tasks involves considerations of timing, modality, intensity, and withdrawal, all of which impact the outcome of motor learning.

Bobath therapy also emphasises the importance of early rehabilitation, consistency of practice, and a stimulating environment in order to promote recovery.

Bobath therapy is based on the brains ability to adapt to change and reorganise and recover after neurological damage

Bobath therapy is a form of physiotherapy that focuses on the brain's ability to adapt and recover from neurological damage. The treatment is based on the understanding that the brain can reorganise itself and form new neural connections, promoting recovery and improved function. This approach was developed by Berta Bobath, a physiotherapist, and her husband, Karl Bobath, a psychiatrist and neuropsychiatrist, who specialised in treating patients with central nervous system anomalies, particularly children with cerebral palsy.

The Bobath concept is a problem-solving approach that targets movement, tone, and functional impairments resulting from neurological damage. It is a widely used treatment approach in neurorehabilitation, particularly for stroke patients. The therapy aims to address specific issues related to function, movement, and tone by encouraging normal movement patterns, improving movement quality, and normalising muscle tone. This is achieved through various techniques, including handling, facilitation, and activation of control points, all of which are designed to guide patients through tasks and improve their overall motor performance.

The Bobath approach recognises the importance of early rehabilitation, consistent practice, and a stimulating environment to promote recovery. It focuses on improving motor control, making movements more precise and efficient, reducing spasticity, and enhancing independence in daily activities. The treatment is tailored to each patient's needs, symptoms, and goals, as every individual with a neurological condition presents differently.

While Bobath therapy is popular among therapists, its effectiveness has been questioned. Some studies suggest that it is no more effective than other physical therapies for sensorimotor control, dexterity, mobility, and activities of daily living. However, it is important to note that the Bobath concept continues to evolve as new knowledge and research emerge, and further well-designed studies are needed to fully understand its effectiveness.

Frequently asked questions