BOBATH TECHNIQUE

-Samrth Pareta
 Content

1. Introduction
2. History
3. Principles
4. Benefits
5. Compensatory Strategies
6. Focus of Therapy
7. Sensory control
8. Motor control
9. Assessment
10. Drawback
 Introduction

• Bobath is a type of physiotherapy treatment which aims to improve

movement and mobility in patients with damage to their central nervous
system (brain and spinal cord). Many physiotherapists use Bobath in the
rehabilitation of patients with neurological conditions to promote the
sensory and motor pathways and facilitate normal movement and motor
control.(1)
 Introduction Cont…

● The contemporary Bobath Concept is based on a systems model of motor

control, the concept of plasticity, principles of motor learning, and an
understanding and application of functional human movement. An in-depth
understanding of human movement is crucial to the clinical reasoning
process. Mrs Bobath made a distinction between ‘rehabilitation concepts’,
which were concerned with quantitatively assessing whether or not a patient
can perform a function, and the Bobath Concept, which is concerned with
quality of function (Bobath 1990).(3)
History

● Berta Bobath, MBE (December 5, 1907 – January

20, 1991) was a German physiotherapist who created
a method of rehabilitation and therapy known as the
Bobath concept in 1948.
 Principles

❏ Principles of Bobath
➔ Bobath is based around the brain's ability to adapt to change and reorganise
and recover after neurological damage.
The Bobath approach rests on a number of principles that include:
● Encouragement of normal movement patterns.
● Focusing on quality of movement.
● Normalisation of tone to facilitate active movement.
● Positioning and posture in lying, sitting and standing.
 Principles Cont…

● Discouragement of compensatory movements.

● Discouragement of muscle strength training.
● Promotion of maximum functional recovery to
improve quality of independence.
Handling techniques are used so that a person does not
move with over-exertion and to provide sensory
feedback.
 Benefits

➢ Benefits of Bobath
● Normalise tone.
● Regain motor control.
● Make movements easier to achieve that are
precise and goal directed.
● Improve posture.
● Lengthen tight muscles to help decrease
spasticity and reduce contractures.
 Benefits Cont…

● Improve ability with everyday activities.

● Increase independence.
● Achieve maximum potential.
The Bobath approach also emphasises the importance
of early rehabilitation, consistency of practise and a
stimulating environment in order to promote recovery
 Compensatory Strategies

Compensatory strategies

• Movement speed.
• Movement variability.
• Movement segmentation.
• Spatial and temporal coordination.
 Focus of Therapy

Therapy focuses on the following:

● Neuro-muscular system, spinal cord and higher centres to change motor

performance.
● Neuroplasticity, an interactive nervous system, and individual expression of
movement.
● Overcoming weakness of neural drive after a UMN lesion through selective
activation of cutaneous and muscle receptors.
 Sensory Control

● Sensory Systems:-)
The
contribution of sensory inputs to motor learning and shaping motor output is a
key concept in the Bobath approach. Patients with partial or complete sensory
loss make movements that lack precision and coordination.

Bobath therapists shape movement with sensory inputs in the form of:

● Tactile information from the hands.

● Removing manual guidance once patients are capable of self-generated
movement.
 Motor Control

• Motor Control :-)

• Bobath Concept concerns sensory, perception and adaptive behaviour along
with the motor problem that involves the whole patient. It is a goal-oriented
and task-specific approach, aiming to organise the internal (proprioceptive)
and external (exteroceptive) environment of the nervous system for
efficient functioning of the individual. It is an interactive process between
patients and therapists.
 Motor Control Cont…

• Therapists work on tone to improve movement, not to normalise tone. Tone

can be reduced by:
1. Mobilisation of muscles and stiff joints.
2. Muscle stretch.
3. Practice of more normal movement patterns.
4. Through a more efficient, less effortful performance of functional tasks.
5. Weight-bearing.
 Conditions

• The Neuro-Developmental Treatment (NDT/Bobath) approach was

developed for the treatment of individuals with Pathophysiology of the
central nervous system (CNS), primarily children with cerebral palsy
(CP) and adults with cerebral vascular accidents (CVA). Individuals with
CNS Pathophysiology have dysfunction in posture and movement and
subsequent functional activity limitations.
 Assessment

• The Bobath Concept seeks to explore the full potential for improvement
within the patient’s movement control as a basis for enhanced function.

• It is recognised that the nature of the patient’s current movement

strategies may have a positive or a negative impact upon the fulfilment of
optimal functional potential. This involves the quality of movement as
well as the quantity.
 Assessment Cont…

• Assessment and treatment are integrated with a continuous interaction

between the two. This demands responsiveness on the part of the therapist
and clinical reasoning ‘in action’ in order to determine critical movement
interferences and evaluate them further.
• The assessment process is systematic but flexible as it does not follow the
same sequence for each patient. The starting point for assessment will vary
as will the progression, with both being determined in response to the
individual’s clinical presentation.
 Drawback of Bobath

1. Limited Evidence Base.

2. Complexity: The Bobath technique requires highly
specialized training for therapists.
3. Lack of Standardization.
4. Overemphasis on Inhibition.
5. Cost and Time Intensive.
 References

1. https://www.ahajournals.org/doi/full/10.1161/STROKEAHA.108.533828
2. https://pdf.sciencedirectassets.com/280586/1-s2.0-S0004951414X61957/1-s2.0-S0004951414611223/main.pdf?X-Amz-Security-
Token=IQoJb3JpZ2luX2VjEBwaCXVzL
3. https://www.cerebralnaparaliza.com/images/dokumenta/Bobath_Concept_-_Theory_Clinical_Practice_in_Neurological_Rehabilitation-1.pdf
4. org/w/index.php?title=Bobath_concept&oldid=233811831
Thank you