CP Factsheet

Bobath Therapy
This factsheet provides a basic overview of Bobath Therapy and is mainly aimed at parents
and carers looking after a child with cerebral palsy. (Where children in particular are
concerned, you may come across the term Neurodevelopmental Therapy (NDT) being used
interchangeably with Bobath Therapy).

The Bobath concept is an evolving approach to the management and treatment of children
and adults with mobility difficulties caused by neurological conditions such as cerebral palsy
and stroke.

This therapeutic approach was originated by Berta and Karl Bobath over 50 years ago based
upon their clinical experience using models of movement and neuroscience available at that
time.

The approach has since developed following research, evaluation, client responses and the
latest knowledge on child development and neuroscience.

Health professionals using the Bobath approach include physiotherapists, speech and
language therapists, occupational therapists and doctors.

The Bobath approach to treatment

The Bobath treatment aims to improve the child’s posture and movement. Through
specialised ways of handling, stiffness can be reduced, muscle control against gravity
increased and fluctuating muscle activity stabilised. Depending on the severity of the
condition, the child is better able to learn how to sit up, use his/her hands, to stand up and to
walk.

Ideally the treatment is an integral part of the daily routine for that child. For instance, the way
the child is picked up, carried, put down, or positioned when sitting, will enable parents/carers
to enhance the child’s ability and function.

The goals of treatment are influenced by several factors such as the functional needs in
different contexts as expressed by the child and/or parents, the age of the child, severity of
their condition, and their motivation. Treatment is planned for each child following
assessment. Some of the areas that will be assessed are:

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• the postures and patterns of movement the child presents with in different situations, and
analysis of underlying causes of the postures and patterns of movement e.g. abnormal
muscle tone, associated problems etc
• age-appropriate movements that the child may not be achieving or may find difficult and
analysis of the possible reasons for the difficulties
• activities the child is currently capable of performing with or without assistance
• analysis of possible physical reasons for restrictions in terms of participation at home,
school and social contexts as expressed by the child and/or parents

Once the child has been assessed, the main problems will be identified and addressed in
therapy by using handling and positioning strategies based on Bobath therapy principles. The
Bobath approach focuses on enabling a child to function more effectively and therefore
therapy always incorporates activities relevant to the child's age and interests while
accommodating limitations.

Handling a child using key points on the body allows the therapist to manipulate the child to
use the most effective movements whilst limiting the use of unhelpful abnormal movement
patterns. Help may be given with movements like chewing, handling objects, moving about,
sitting or lying down. Even when a child is being carried, dressed or bathed, using correct
positioning and handling is considered very important, as this lets the child experience, as far
as possible, normal movement patterns.

Positioning is very important in the Bobath approach. Correct positioning helps improve
movements. Experience of different positions is necessary to improve overall body control
and reduce the risk of developing permanent deformity through poor posture over time.

Children are seen for blocks of intensive therapy which can be repeated on an annual basis if
required. The block normally consists of six weeks of therapy three times a week for an hour
at a time, totalling 18 sessions. This time period may occasionally vary depending on
individual needs and circumstances.

How parents, families and carers are involved

Like any other therapy, Bobath requires effort and practice to achieve benefits, so input from
parents and carers is essential as they spend most time handling the child. The therapist will
work with the family and/or carers to teach them how to handle and position the child properly
at home, so to encourage and facilitate correct movement.

Brothers and sisters are also encouraged to join in. In fact, anyone involved with the child can
participate in the therapy. Good communication by everyone involved with the child is
essential; this helps to ensure the child is having appropriate goals identified, and to ensure
that progress is considered satisfactory.

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Many children do not like therapy in isolation, so incorporating the movements into day-to-day
life and leisure activities enhances outcomes and is more acceptable and practical to the
whole family.

Referral procedure
The referral process differs for each of the Bobath Centres in the UK. In Scotland, the referral
should come through a child’s consultant paediatrician, who should make a referral in writing,
detailing full medical history and birth details to Bobath Scotland. Once Bobath Scotland has
confirmation that fees will be met by the NHS, parents are contacted to set up a block of
therapy for their child. If a particular health board in Scotland cannot provide financial support
for a child to attend a block of therapy, Bobath Scotland will endeavour to accommodate
children on a case-by-case basis.

Therapists at Bobath Scotland always contact the child's local therapists before or during a
block of therapy to ensure that goals are set collaboratively. The local therapists are invited to
attend one or more sessions during the child’s course of treatment.

Further information
For further information on Bobath therapy, reading material, training courses and assessment,
please contact:

Bobath Scotland
Children’s Cerebral Palsy Therapy Centre
10 High Craighall Road
Craighall Business Park
Glasgow
G4 9UD
Tel: 0141 352 5000
Fax: 0141 352 5016
Email: info@bobathscotland.org.uk
www.bobathscotland.org.uk

Further reading

Bobath Concept: Theory and Clinical Practice in Neurological Rehabilitation by Sue

Raine, Linzi Meadows and Mary LynchEllerington (2009) Wiley Blackwell (Pub) This is
available to borrow from our library partnership.

The Bobath Concept in Adult Neurology by Bente E. Bassoe Gjelsvik (2007) Thieme
Publishing Group (Pub) This can be purchased from www.amazon.co.uk

For Bobath Therapy, as with any other therapy or treatment, we advise people with
cerebral palsy, carers and parents to consult their GP, consultant or health
professional before starting or paying for any treatment.

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Due to the individual nature of cerebral palsy, some children will benefit from specific
treatments and therapies, others will not. Assessment of your child’s individual needs is very
important.

Our Advice Service

ASCS (Advice Service Capability Scotland) is a national disability advice and information
service. We specialise in information on cerebral palsy.

We offer:
• information on Capability Scotland services
• advice on cerebral palsy
• general advice on disability issues
We also have a small lending library with resources about cerebral palsy and children's books
about disability.

You can get in touch with ASCS by calling us, e-mailing, dropping in or writing a letter.

Advice Service Capability Scotland (ASCS)

11 Ellersly Road
Edinburgh
EH12 6HY
Tel: 0131 313 5510
Textphone: 0131 346 2529
Fax: 0131 346 1681
Email: ascs@capability-scotland.org.uk
Web: www.capability-scotland.org.uk

This factsheet can be made available in other formats eg: tape, large print.

ASCS acknowledges the co-operation of SCOPE and Bobath Scotland in the preparation of
this factsheet.

March 2011
Capability Scotland, Scottish Charity SCO11330