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.