KHUZAIFA

BOBATH TECHNIQUE ROLL NO 31

The Bobath Technique, also
known as Neurodevelopmental
Treatment (NDT), is an approach
used in rehabilitation to facilitate
and optimize movement and
function in individuals with
neurological conditions or injuries
HISTORY OF THE BOBATH
TECHNIQUE
The Bobath Technique was developed in the 1940s by Berta Bobath, a
physiotherapist, and her husband Karel Bobath, a psychiatrist who proposed
the approach for treating patients affected with Central Nervous System
anomalies.
They developed this approach for effective management of neuro-motor
dysfunctions ;children with cerebral palsy (CP). Earlier, braces, passive
stretching, and surgery were the most common forms of interventions.
The Bobath concept provided a new reference that viewed children with CP
as having difficulty with postural control and movement against gravity.
BASIC CONCEPT
It is a problem-solving approach to the treatment of individuals
with disturbances of tone, movement, and function due to a lesion
of CNS, The goal of treatment is to optimize function by
improving postural control and selective movement through
facilitation(IBITA 1995).
The abnormal pattern must be stopped not by modifying the
sensory input but by giving back to the patient the lost or
undeveloped control over his output in developmental sequence.
The basic pattern of posture and movement are elicited by
providing the appropraite stimuli while the abnormal patterns
are inhibited.
Treatment therefore, concentrate on handling the patient in such
a way as to inhibit abnormal distribution of tone and abnormal
posture while stimulating the next level of motor control .
CLINICAL APPLICATION OF
BOBATH CONCEPT
MOTOR SYSTEM
It is an interactive process between patients and therapists.
Therapy focuses on the following:
a. neuro-muscular system, spinal cord and higher centres to change
motor performance,
b. neuroplasticity, an interactive nervous system, and individual
expression of movement.
C. overcoming weakness of neural drive after a UMN lesion through
selective activation of cutaneous and muscle receptors
PRINCIPLES OF MOTOR
LEARNING
Therapists should have the
knowledge of the principles of
motor learning
1. Active participation of
patient
2. Opportunities for practice for
learning or relearning to
occur
3. Meaningful goals.
Treatment is aimed at preventing the establishment of spasticity
and maximising residual function
Therapists work on tone to improve movement, not to normalise
tone.
Therapists can achieve tone reduction in a number of ways such as
1. Mobilisation of muscles and stiff joints.
2. Muscle stretching
3. Practice of more normal movement patterns.
 SENSORY SYSTEM

Sensory systems provide essential information about both the internal and
external environments upon which skilled movement is based and refined.
The aim is to re-educate the patient’s own internal referencing system to
provide accurate afferent input, giving the patient the best opportunity to be
efficient.
Voluntary movement is one of the most powerful forms of sensory
stimulation on which more refined movement can be built.
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. Even in the presence of visual
information, movements in deafferented patients with complete
large fibre sensory loss and no cutaneous sensation or
proprioception are imprecise and characterised by dysmetria.
When proprioceptive information is missing or altered as a result
of injury or disease, the nervous system is unable to specify the
origin point, or referent position, of the spatial frame of reference
for motoneurons to recruit, resulting in abnormal movement.
Bobath therapists commonly 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.
MUSCULAR SKELETAL
SYSTEM
As part of treatment it is important to create the appropriate length
and compliance of both muscle and soft tissues to have sufficient
joint range to achieve the required functional movement
components.
To achieve the appropriate muscle balance for function, treatment
may require selective and specifi c strength training.
Body weight and gravity can be used to strengthen muscles as well
as appropriate resisted exercises.
THANK YOU