The Bobath concept: a critical review of the theoretical assumptions that guide physiotherapy practice in stroke rehabilitation

AbstractStroke is the third most common cause of death in the adult population and a major consumer of health care resources. Physiotherapists spend a large proportion of their time rehabilitating patients following stroke using a variety of treatment approaches. The Bobath concept has gained international acceptance as one of the leading approaches in stroke rehabilitation. The aim of physiotherapy using this concept is to re-educate normal movement by the manipulation of a variety of afferent inputs which are mainly proprioceptive. Recent papers have criticized this concept for failing to integrate new knowledge into its theoretical rationale.The aim of this paper is to review the published literature concerning physiotherapy using the Bobath concept in stroke rehabilitation. The key assumptions that guide current practice are identified: a systems theory of motor control; neuroplasticity shaped by manipulation of afferent inputs; and neurophysiological dysfunction as the primary cause of movement dysfu...

[1]  J. Massion.  Movement, posture and equilibrium: Interaction and coordination , 1992, Progress in Neurobiology.

[2]  P. Davies,et al.  Steps to Follow , 2000, Springer Berlin Heidelberg.

[3]  J. Valvano,et al.  Neurodevelopmental Treatment: A Review of the Writings of the Bobaths , 1991 .

[4]  V. Dietz.  Human neuronal control of automatic functional movements: interaction between central programs and afferent input. , 1992, Physiological reviews.

[5]  L. Bly.  A Historical and Current View of the Basis of NDT , 1991 .

[6]  E. Keshner,et al.  Reevaluating the theoretical model underlying the neurodevelopmental theory. A literature review. , 1981, Physical therapy.

[7]  V. Mathiowetz,et al.  Motor behavior research: implications for therapeutic approaches to central nervous system dysfunction. , 1994, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[8]  R. G. Lee,et al.  Mechanisms Underlying Functional Recovery Following Stroke , 1995, Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques.

[9]  M. Mayston.  The Bobath Concept - Evolution and Application1 , 1992 .

[10]  L. Ada,et al.  Spasticity: Research Findings and Implications for Intervention , 1995 .

[11]  A. Forster,et al.  Stroke rehabilitation: can we do better? , 1992, BMJ.

[12]  K. Hammell.  Spinal Cord Injury Rehabilitation , 2014, Therapy in Practice Series.

[13]  M. Dennis.  Adult hemiplegia: Evaluation and treatment, 3rd Edn. Berta Bobath. Published 1990 by Heinemann, Oxford. ISBN 0 43 300098 8, 190 pp. Price $24.95 , 1991, Neuromuscular Disorders.

[14]  Kay Stachura.  Professional Dilemmas Facing Physiotherapists , 1994 .

[15]  J. Carey,et al.  Movement dysfunction following central nervous system lesions: a problem of neurologic or muscular impairment? , 1993, Physical therapy.

[16]  Joanna Jackson.  Approaches to neurological rehabilitation by physiotherapists , 1994 .

[17]  A. Ashburn,et al.  Review article : Physiotherapy in the rehabilitation of stroke: a review , 1993 .

[18]  Glyn W. Humphreys,et al.  Stroke: Stroke Issues in Recovery and Rehabilitation , 1995 .