The Bobath concept in stroke rehabilitation: a focus group study of the experienced physiotherapists' perspective

Sheila Lennon, A Ashburn

    Research output: Contribution to journalArticle

    78 Citations (Scopus)

    Abstract

    Purpose : The Bobath concept, usually known as neurodevelopmental treatment (NDT) in America, is one of the major approaches used to rehabilitate patients following stroke; however since the last publication of Bobath (1990), the concept has been taught via an oral tradition on postgraduate courses. This study therefore aimed to explore with experienced therapists firstly how the Bobath concept had changed since 1990, and secondly what they considered its main theoretical assumptions to be using a focus group research design. Method: Eight peer-nominated expert physiotherapists agreed to participate in two focus groups organized according to specialist interest in either neurology (group A) or elderly care (group B). Therapists were asked to discuss six topics based on a review of published literature. Data analysis involved several readings of verbatim transcriptions, from which key themes and concepts were developed. Results : All therapists agreed on the following core themes defining Bobath: analysis of normal movement, control of tone and facilitation of movement. Neuroplasticity was described as the primary rationale for treatment with therapists using afferent information to target the damaged central nervous system. In addition group A discussed motor learning, whereas group B discussed patient focused goals and relating treatment to function. Conclusions : This study highlighted changes in theory, terminology, and techniques. Tone remained a major problem in the rehabilitation management of the hemiplegic patient; however much attention was also directed towards the musculoskeletal system. Both facilitation of normal movement components and task specific practice using specific manual guidance were considered critical elements of the Bobath concept. For Bobath therapists, physiotherapy has an important impact on both the performance components of movement and functional outcomes. In view of the small numbers involved in this preliminary study, further studies are now needed to determine if these themes and concepts are congruent with the majority of physiotherapists' interpretation of the Bobath concept in stroke rehabilitation.
    LanguageEnglish
    Pages665-674
    JournalDISABILITY AND REHABILITATION
    Volume22
    Issue number15
    Publication statusPublished - Oct 2000

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    Physical Therapists
    Focus Groups
    Musculoskeletal System
    Neuronal Plasticity
    Neurology
    Terminology
    Publications
    Reading
    Research Design
    Therapeutics
    Rehabilitation
    Central Nervous System
    Stroke
    Learning
    Stroke Rehabilitation

    Cite this

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    title = "The Bobath concept in stroke rehabilitation: a focus group study of the experienced physiotherapists' perspective",
    abstract = "Purpose : The Bobath concept, usually known as neurodevelopmental treatment (NDT) in America, is one of the major approaches used to rehabilitate patients following stroke; however since the last publication of Bobath (1990), the concept has been taught via an oral tradition on postgraduate courses. This study therefore aimed to explore with experienced therapists firstly how the Bobath concept had changed since 1990, and secondly what they considered its main theoretical assumptions to be using a focus group research design. Method: Eight peer-nominated expert physiotherapists agreed to participate in two focus groups organized according to specialist interest in either neurology (group A) or elderly care (group B). Therapists were asked to discuss six topics based on a review of published literature. Data analysis involved several readings of verbatim transcriptions, from which key themes and concepts were developed. Results : All therapists agreed on the following core themes defining Bobath: analysis of normal movement, control of tone and facilitation of movement. Neuroplasticity was described as the primary rationale for treatment with therapists using afferent information to target the damaged central nervous system. In addition group A discussed motor learning, whereas group B discussed patient focused goals and relating treatment to function. Conclusions : This study highlighted changes in theory, terminology, and techniques. Tone remained a major problem in the rehabilitation management of the hemiplegic patient; however much attention was also directed towards the musculoskeletal system. Both facilitation of normal movement components and task specific practice using specific manual guidance were considered critical elements of the Bobath concept. For Bobath therapists, physiotherapy has an important impact on both the performance components of movement and functional outcomes. In view of the small numbers involved in this preliminary study, further studies are now needed to determine if these themes and concepts are congruent with the majority of physiotherapists' interpretation of the Bobath concept in stroke rehabilitation.",
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    The Bobath concept in stroke rehabilitation: a focus group study of the experienced physiotherapists' perspective. / Lennon, Sheila; Ashburn, A.

    In: DISABILITY AND REHABILITATION, Vol. 22, No. 15, 10.2000, p. 665-674.

    Research output: Contribution to journalArticle

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    AU - Ashburn, A

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    N2 - Purpose : The Bobath concept, usually known as neurodevelopmental treatment (NDT) in America, is one of the major approaches used to rehabilitate patients following stroke; however since the last publication of Bobath (1990), the concept has been taught via an oral tradition on postgraduate courses. This study therefore aimed to explore with experienced therapists firstly how the Bobath concept had changed since 1990, and secondly what they considered its main theoretical assumptions to be using a focus group research design. Method: Eight peer-nominated expert physiotherapists agreed to participate in two focus groups organized according to specialist interest in either neurology (group A) or elderly care (group B). Therapists were asked to discuss six topics based on a review of published literature. Data analysis involved several readings of verbatim transcriptions, from which key themes and concepts were developed. Results : All therapists agreed on the following core themes defining Bobath: analysis of normal movement, control of tone and facilitation of movement. Neuroplasticity was described as the primary rationale for treatment with therapists using afferent information to target the damaged central nervous system. In addition group A discussed motor learning, whereas group B discussed patient focused goals and relating treatment to function. Conclusions : This study highlighted changes in theory, terminology, and techniques. Tone remained a major problem in the rehabilitation management of the hemiplegic patient; however much attention was also directed towards the musculoskeletal system. Both facilitation of normal movement components and task specific practice using specific manual guidance were considered critical elements of the Bobath concept. For Bobath therapists, physiotherapy has an important impact on both the performance components of movement and functional outcomes. In view of the small numbers involved in this preliminary study, further studies are now needed to determine if these themes and concepts are congruent with the majority of physiotherapists' interpretation of the Bobath concept in stroke rehabilitation.

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