bobath concept theory underpinning development
- 1. The Bobath Concept: Developments and Current Theoretical Underpinning LECTURE: 1
- 2. The founders and development of the Bobath Concept Dr. Karel Bobath (1906), paediatric Berta bobath (1907), physiotherapist Mrs Bobath developed unique assessment and treatment procedure to normalize muscle tone. Dr Bobath studied and applied the available neurophysiology • Dr. Karel Bobath (1906), paediatric • Berta bobath (1907), physiotherapist • Mrs Bobath developed unique assessment and treatment procedure to normalize muscle tone. • Dr Bobath studied and applied the available neurophysiology
- 3. According to Mrs. Bobath, • Assessment and treatment of motor patterns giving to the patients’ existing potential is a key. • Best inhibition is patients own activity. • Treatment base on normalising tone and facilitating automatic movement through specific handling
- 4. • Unstructured set of exercises • 24-hour, holistic approach which involved the whole patient.
- 5. The contemporary Bobath Concept is: • a problem-solving approach to the assessment and treatment of individuals with disturbances of function movement postural control
- 6. Current theory underpinning the Bobath Concept • Systems approach to motor control is the base • Understanding of characteristics of – The movement system – The external and internal forces acting on the body, to understand motor control.(Bernstein,1967) • Many interacting systems work cooperatively control of integrated movement
- 7. • Motor behaviour is based upon a continuous interaction among Environment Task
- 8. • Plasticity Ability of any structure to modify or alter. 1. Neural plasticity 2. Muscular plasticity
- 9. Motor learning • Motor learning refers to the permanent change in an individual’s motor performance brought about as a result of practice or intervention
- 10. Variables in motor learning • Practice • Part or whole task; • Augmented feedback • Mental practice; • Modelling; • Guidance; • Attentional focus (goal attainment)
- 11. Upper motor neuron syndrome • Two broad groups of features 1. negative phenomena (motor activity reduction like weakness) 2. positive phenomena (motor activity increased like spasticity)
- 12. Clinical application of the theory underpinning the Bobath Concept Motor control Whole patient Interactive process Repetition without repetition Preventative and promotive aspects Tone reduction Control associated reactions
- 13. Sensory systems Provide essential information of internal & external environment Somatosensory referencing
- 14. • Musculoskeletal system Manage length of muscle & soft tissues & ROM Selective and specific strength training With or without therapists’ handling techniques • Adjuncts to therapy Splinting and orthoses Constraint-induced movement therapy and motor mental imagery Treadmill Maitland mobilisations
- 15. • Function Assessment and treatment of the patient’s potential For goals achievement, – the specific movement components of the task – the functional activity
- 16. Normal movement versus efficient movement • Bobath Concept aims to promote efficiency of movement to the individual’s maximum potential rather than normal movement • Qualities of high levels of efficient performance maximum certainty of goal achievement minimum energy expenditure minimum movement time
- 17. • Aspects related to production of efficient functional movement in the neurological patient Motor Sensory Cognitive Perceptual Biomechanical
- 18. Compensatory strategies • It is adaptive or maladaptive sensorimotor behaviour • Compensatory strategies may block potential recovery • E.g. Compensatory strategies employ in the trunk with an increase in motor deficit in the arm
- 19. • Parameters in order to explore strategies employed in stroke recovery. Movement speed Movement variability Movement segmentation Spatial and temporal coordination
- 20. Motor control and motor learning • The ability to regulate or direct the mechanisms essential to movement is motor control. • Motor learning is a set of processes associated with practice or experience which leads to relatively permanent changes in the capability of producing skilled action.
- 21. • Four basic rules for motor learning. 1. Input (information) is essential. 2. Input must be variable. 3. Input must be meaningful. 4. The site of training must be related to the site of application.
- 22. Postural body schema • The postural body schema consists of: 1. Alignment of body segments to each other and in relation to the environment. 2. Movement of the body segments in relation to the base of support; 3. Orientation of the body in relation to gravity (verticality).
- 23. Control of posture and movement • Postural control – Ability to orientate and stabilise the body within the force of gravity using appropriate balance mechanisms. • Balance – Ability to maintain the body’s centre of mass within a specific boundary
- 24. • Postural responses Feed-forward postural responses – Preparatory (prior to movement) – Anticipated (during movement) • Serve to counteract movement Feedback postural responses – Occur after movement – To reorganize posture and maintain balance
- 25. • Postural control is an essential foundation of efficient movement. • Key requirements of efficient movement: – Balance strategies – Patterns of movement – Strength and endurance – Speed and accuracy
- 26. Everyone has a story, be willing to hear it before you judge. .
Editor's Notes
- #6: From a biomechanical viewpoint, he considered the many degrees of freedom provided by the numerous joints within the body and the control needed to enable them to work together as a functional unit.
- #7: movement as resulting from a dynamic interplay between perception, cognition and action systems, and highlight the CNS’s ability to receive, integrate and respond to the environment to achieve a motor goal (Brooks 1986)
- #8: The capacity of the nervous system to change is demonstrated in children during the development of neural circuits, and in the adult brain, during the learning of new skills, establishment of new memories, and by responding to injury throughout life (Purves et al. 2004). The nervous system is continually undergoing modifi cation based upon its experiences, and it is these modifications which then support its role in achieving effi cient and effective functional goals in a variety of environments
- #12: Therapy is based on the assessment of the patient’s potential. A role of the therapist is to facilitate balance and selective movement as a basis for functional activity and
- #25: Mrs Bobath described patterns of movement as sequences of selective movement for function (Bobath 1990)