Current assumptions - Bobath

It`s time to pack the bags and start the next journey with The Bobath Advanced Course. Today I'm flying to Göteborg, Sweden. I'm going to meet Mary Lynch-Ellerington in Line Syre's beautiful clinic in Marstrand.  Senior instructor Mary with Advanced instructor candidate Line are going to teach us more about the Postural Control and Locomotion.

It is always a privilege to meet Mary Lynch-Ellerington and see her working with the patients. Her knowledge about neurophysiology, motor learning and neurorehabilitation is remarkable. Her facilitation skills are precise, spesific and they produce positive results.

People have often asked me about my studies and why Bobath is so special for me. I've studied a lot, but now I finally get more answers and explanations why something happens. It is also easier to explain for the patients what we are doing and what should be achieved for better locomotion.  It's not just an intervention and it's not just repetitions, but it's individualized, problem solving and living concept. The approach includes the whole ICF while treating the patients.

I'm looking forward to meet the colleagues from Finland and Sweden on Monday. I wanted to pick up something about current knowledge about neurophysiology and theories behind the Bobath concept. The text below is from British Bobath Tutor Association's website. In Britain they are working and doing lots of research about the approach and I hope we could do it more transparent also in Finland for people who are working with neurological patients.

Current assumptions (https://www.bbta.org.uk/en/current-assumptions)

The CNS is a complex organisation consisting of systems and subsystems. It uses a shifting focus of control depending on many biomechanical, neuroanatomical and environmental issues.

The CNS and neuromuscular system can adapt and change their structural organisation in response to intrinsic and extrinsic information i.e. they are plastic.

The manipulation of afferent input can directly effect a change in the structural organisation of the CNS through spatial and temporal summation and the facilitation of pre and postsynaptic inhibition.

Changes within in the structure of the CNS can be organised or disorganised producing adaptive or maladaptive sensorimotor behaviour.

Motor skill is based on reciprocal innervation and sequential recruitment within the Henneman principle, providing selectivity of movement control combining stability with mobility. this gives selectivity of movement control by combining stability with mobility.* Movement control is dependent on an integrated neurological and muscular system.

Selective movement control of the trunk and limbs, both concentric and eccentric are interdependent and interactive with a postural control mechanism.

The recovery of selective movement is a prerequisite for efficient postural control, alignment, and function.

Rehabilitation is a process of learning to regain motor control and should not be the promotion of compensation that can occur naturally as a result of a lesion and also as a result of therapy.

The cellular mechanisms underlying learning are the same mechanisms that take place during the development, refinement, and re-learning of motor control. These mechanisms can result in long or short-term learning i.e. carry-over or no carry-over.

TAB