If you need to help someone who has problems associated with lesions on his central nervous system, such as with cerebral palsy or paralysis of one side the body due to a stroke, check to see whether your therapist is schooled in the Bobath method. These exercises can help a person gain functional movements, from a child with cerebral palsy acquiring the ability to sit unsupported to a stroke victim getting the ability to close his hands back.
Function
Bobath exercises aim to improve a person's movement and posture for a better ability to function in daily life. The exercises are meant to increase muscle control against gravity, stabilize fluctuating muscle activity and reduce stiffness. This, in turn, may help a person learn to sit up, stand, use her hands or walk.
Treatment
Bobath exercises are completely individualized, and are often administered by a physical therapist who manipulates and guides the patient's trunk, head and limb motions. Manipulations focus on key points of control at the head, spine, pelvic girdles, shoulder, feet and hands. These manipulations are meant to suppress abnormal postural reactions and undesirable reflexes and to encourage voluntary movements. Positioning is a key concept in Bobath treatment because proper positioning helps to improve a person's movements. Experiencing varying positions also is necessary when working to improve overall body control and posture.
Considerations
Many factors affect Bobath treatment. These include a person's motivation, age and the severity of his condition. Treatment also varies from session to session because it has to be continuously adapted to the patient's responses. This means that treatment is often unpredictable -- a set routine cannot be created prior to working with the patient.
Therapists often also teach caregivers, such as a parent or spouse, how to handle and position a patient properly at home. This additional effort helps facilitate correct movement. Also, many patients dislike therapy, so incorporating proper posturing and handling into day-to-day life can make the treatment more acceptable to patients and speed their progress.
History and Studies
The Bobath method was developed in the 1950s by a London husband and wife team, physical therapist Berta Bobath and neurologist Karel Bobath. The method has since been proven to be effective in a number of studies -- for example, it can lead to significant improvements in motor function among children with cerebral palsy, reports "Developmental Medicine and Child Neurology"; Bobath exercise is better than or equally effective as other methods for rehabilitation, such as movement-based science physiotherapy, for post-stroke paralysis rehabilitation, notes the "Journal of Neurol Neurosurg Psychiatry"; the Bobath method can improve symptoms of pain as well, notes a study published in the Italian journal "La Clinica Therapeutica."
References
- International Encyclopedia of Rehabilitation: Bobath Method of Exercise
- "Handbook of Neurological Rehabilitation"; Richard J Greenwood; 2003
- "Begin & Win Fitness and Mobility Now"; Frank W.D. R--der; 2010
- Origins of Cerebral Palsy: Treatment -- Physical Therapy
- PubMed.gov: The painful hemiplegic shoulder: effects of exercises program according to Bobath
- PubMed Central: Comparison of Bobath based and movement science based treatment for stroke...
