Gait re-education based on the Bobath concept in two patients with hemiplegia following stroke

Background and Purpose. This case report describes the use of gait re-educa tion based on the Bobath concept to measure the changes that occurred in th e gait of 2 patients with hemiplegia who were undergoing outpatient physica l therapy. Case Description, One patient ("NM"), a 65-year-old woman, was r eferred for physical therapy 6 weeks following a right cerebrovascular acci dent. She attended 30 therapy sessions over a 15-week period. The other pat ient ("SA"), a 71-year-old woman, was referred for physical therapy 7 weeks following a left cerebrovascular accident. She attended 28 therapy session s over a 19-week period. Clinical indexes of impairment and disability and 3-dimensional gait data were obtained at the start of treatment and at disc harge. Therapy was based on the Bobath concept. Outcomes. At discharge, NM demonstrated improvements in her hip and knee movements, reduced tone, and improved mobility. At discharge, SA demonstrated improved mobility. During gait, both patients demonstrated more normal movement patterns at the level of the pelvis, the knee, and the ankle in the sagittal plane. SA also demo nstrated an improvement in hip extension. Discussion. These cases demonstra te that recovery of more normal movement patterns and functional ability ca n be achieved following a cardiovascular accident and provide insight into the clinical decision making of experienced practitioners using Bobath's co ncept.