The Bobath concept in adult neurological rehabilitation

Many of us have heard about this concept but doesn’t know much about it. I collected some information about it from literature and researches and hopefully you get some idea why this is a good approach with people who have stroke, traumatic brain injury, spinal cord injury or some other neurological disorders which can cause long-term disability in adults.

The Bobath concept is an approach that provides therapists with a conceptual framework for their clinical interventions. In 1950’s the concept was conceived by Berta Bobath, a physiotherapist. At that time conventional treatment post-stroke consisted of a ”compensatory” approach focusing only on the use and strengthening of  the ”sound” side to regain functional independence. Mrs. Bobath recognized the recovery potential  of the patients affected side despite the lack of any clinical evidence of neuroplasticity at that time. She published three books with respect to adult hemiplegia and in 1984 the IBITA was founded. 

Berta Bobath

Today IBITA unites Instructors (Physiotherapists and Occupational Therapists) worldwide, representing more than 255 members in 29 countries. More about IBITA www.ibita.org

In Finland we have three Instructors (BCI) and two candidates. The trainee programme is going to change in future and also the Bobath concept is redefined.

Nowadays the Bobath concept is described as an inclusive, individualized, problem-solving, living concept based on a systems approach to motor control with particular emphasis on movement analysis and motor recovery from the perspective of integration of postural control, task performance and contribution of sensory inputs.

New knowledge with respect to ”Equilibrium-Point” theory, ”Anticipatory Postural Adjustments” and the view of the body as a ”multi-joint kinetic chain” support the assumption that posture and movement are inseparable. (The Cornerstone of the Bobath concept today)

The other key aspects of clinical practice today in Bobath concept are the role of sensory information in motor control, including the role of sensation in perception. Facilitation, including manipulation of the environment and therapeutic handling, is the use of afferent information to effect improvements in motor performance.

Bobath concept is an approach that favors motor solutions that optimize quality (/efficiency) of movement while limiting the use of motor compensations. In addition, the ultimate goal of Bobath intervention is to optimize the activity and participation thereby improving quality of life.

Bobath concept is not a treatment protocol! It is a problem-solving approach grounded in individualization and flexibility to each client.

References

Julie Vaughan-Graham, Cott C., & Wright V. The Bobath concept in adult neurological rehabilitation. Disability and Rehabilitation Volume 37, Issue 21, October 2015, pages 1909-1928.