Physiotherapy based on the Bobath concept in stroke rehabilitation: a survey within the UK

Citation
S. Lennon et al., Physiotherapy based on the Bobath concept in stroke rehabilitation: a survey within the UK, DISABIL REH, 23(6), 2001, pp. 254-262
Citations number
27
Categorie Soggetti
Rehabilitation
Journal title
DISABILITY AND REHABILITATION
ISSN journal
09638288 → ACNP
Volume
23
Issue
6
Year of publication
2001
Pages
254 - 262
Database
ISI
SICI code
0963-8288(200104)23:6<254:PBOTBC>2.0.ZU;2-T
Abstract
Purpose : The Bobath concept is one of the most widely used approaches in s troke rehabilitation within Europe. This survey aimed to provide an expert consensus view of the theoretical beliefs underlying current Bobath practis e in the UK. Method: Questionnaires (with sections related to: therapist background, phy siotherapy management, theoretical beliefs and gait re-education strategies used) were posted to all senior level physiotherapists working in stroke c are (n = 1022). Results : The majority of respondents had more than 10 year's experience ov erall and at least 5 years experience in stroke care. The Bobath concept wa s the preferred approach (n = 67%) followed by an 'eclectic' approach (n = 31%). Despite a high level of consensus between groups, there were 13 signi ficant differences highlighted between Bobath and 'eclectic' groups related to recovery, control of tone, the analysis and facilitation of normal move ment and function. In summary, Bobath therapists considered that patients n eeded to have normal tone and use normal movement patterns in order to perf orm functional tasks. They would delay patients from performing tasks indep endently if abnormal tone and movement would be reinforced by task practice . They were not opposed to the use of walking aids and orthotics. Conclusions : This survey has raised several issues for debate within physi otherapy such as the automatic translation of movement into function, carry over outside therapy, and the way in which tasks should be practiced. The dominance of the Bobath concept needs to be justified by establishing that it is both effective and efficient at achieving its treatment aims of : nor malizing tone, improving intrinsic recovery of the affected side and functi on within everyday tasks.