In worldwide physiotherapy practice, Bobath Concept is referred to as the neuro-developmental technique (NDT).
The main idea is to develop, incorporating principles and techniques regarding new concepts and methods targeting for motor improvement.
Bobath approach needs active involvement of the patients which works on the different types of movement dysfunctions and so that they can develop motor control.
Physical touch for NDT is based on manual handling, which is to support the patient at specific proprioceptive points.
This can be done through joint compression and distraction, so that patients can respond actively to carry out specific functions.
There is various type of manual handling but is slowly removed to make the patient independent in motor activities. Consequently, it shows to enhance functional control and independence.
To date, Bobath Concept has evolved into its current form which explained by the International Bobath Instructors Training Association (IBITA) as a problem-solving approach to the assessment and treatment of individuals with disturbances of function, movement, and postural control due to a lesion of the central nervous system.
It is clear that Bobath Concept is more holistic to identify and analyze problems within functional activities and participation in everyday life as well as the analysis of movement components and underlying impairments.
How we help stroke patients with Bobath techniques?
As a neurorehab physiotherapist, we guide patients’ movement by modifying the sensory input to inhibit abnormal patterns and develop patient’s control on weak limb. This is done by providing appropriate stimuli with inhibition of abnormal pattern.
Thus, we re-educate normal movement pattern along the journey of rehab. Physiotherapist will apply exercise therapy at a functional level and preferably in the patient’s own environment. This is because the effects of impairment-focused training rarely generalize to activities that are not directly trained in the treatment program and also that these generated effects are context-dependent.
In other words, all treatment plan is tailored to patients’ goal so it is more targeted to progress them throughout the rehab program.
Let’s take an example of just sit to stand. When we facilitate a stroke patient with left sided body weakness, we will be standing on their left side.
Using Bobath approach, we assist with key points holding on either pelvic, shoulder or hand, see which one can mimic most activation of muscles to sound side. It may look simple to practise but hard to teach the care taker as it is a very hi-touch technique.
Without facilitation, patient still able to perform but compensatory pattern of the sound side will take place. This is why starting a proper guided neuro rehab is so important to help in their recovery.
The Bobath concept has evolved over the last 50 years, and is now based on the systems approach to motor control, with neuroplasticity as the primary mechanism for neurological recovery.
Many researchers had reported great improvement with this technique; Individually developed exercise programs based on Bobath concept had showed to improve trunk performance, balance, and walking ability in stroke patients more than conventional exercises.
It can further help to improve posture, regain more to normalise tone and better motor control in everyday activities to help patient to achieve maximum physical potential.
Prepared by Ng Su Quan
Your Physio Butterworth