Bobath therapy is inferior to task-specific training and not superior to other interventions in improving lower limb activities after stroke:A systematic review
Open accessAbstract
QUESTION: In adults with stroke, does Bobath therapy improve lower limb activity performance, strength or co-ordination when compared with no intervention or another intervention? DESIGN: Systematic review of randomised trials with meta-analyses. PARTICIPANTS: Adults after stroke. INTERVENTION: Bobath therapy compared with another intervention or no intervention. OUTCOME MEASURES: Lower limb activity performance (eg, sit to stand, walking, balance), lower limb strength and lower limb co-ordination. Trial quality was assessed using the PEDro scale. RESULTS: Twenty-two trials were included in the review and 17 in the meta-analyses. The methodological quality of the trials varied, with PEDro scale scores ranging from 2 to 8 out of 10. No trials compared Bobath therapy to no intervention. Meta-analyses estimated the effect of Bobath therapy on lower limb activities compared with other interventions, including: task-specific training (nine trials), combined interventions (four trials), proprioceptive neuromuscular facilitation (one trial) and strength training (two trials). The pooled data indicated that task-specific training has a moderately greater benefit on lower limb activities than Bobath therapy (SMD 0.48), although the true magnitude of the benefit may be substantially larger or smaller than this estimate (95% CI 0.01 to 0.95). Bobath therapy did not clearly improve lower limb activities more than a combined intervention (SMD -0.06, 95% CI -0.73 to 0.61) or strength training (SMD 0.35, 95% CI -0.37 to 1.08). In one study, Bobath therapy was more effective than proprioceptive neuromuscular facilitation for improving standing balance (SMD -1.40, 95% CI -1.92 to -0.88), but these interventions did not differ on any other outcomes. Bobath therapy did not improve strength or co-ordination more than other interventions. CONCLUSIONS: Bobath therapy was inferior to task-specific training and not superior to other interventions, with the exception of proprioceptive neuromuscular facilitation. Prioritising Bobath therapy over other interventions is not supported by current evidence. REGISTRATION: PROSPERO CRD42019112451.
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Another systematic review conducted in 2020 described that Bobath therapy is inferior to task-specific training and not superior to other interventions in improving lower limb activities after stroke, with the exception of PNF technique.
“Another systematic review[36] conducted in 2020, described that Bobath therapy is inferior to task-specific training and not superior to other interventions in improving lower limb activities after stroke, with the exception of PNF technique.”
From The Bobath Concept (NDT) as rehabilitation in stroke patients: A systematic review (2021) · cites this paper as [36]
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The Bobath Concept (NDT) as rehabilitation in stroke patients: A systematic review
Pathak, A., Gyanpuri, V., Dev, P., & Dhiman, N. R. (2021) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_528_21 · Cited by 60 · see citing works
“Another systematic review[36] conducted in 2020, described that Bobath therapy is inferior to task-specific training and not superior to other interventions in improving lower limb activities after stroke, with the exception of PNF technique.”
The Bobath concept (NDT) in adult neurorehabilitation: a scoping review of conceptual literature
Marques, S., Vaughan-Graham, J., Costa, R., & Figueiredo, D. (2025) · Disability and Rehabilitation · doi:10.1080/09638288.2024.2375054 · Cited by 8 · see citing works
“The Bobath concept continues to be one of the most widely used approaches in neurorehabilitation worldwide [2,3,44,47], despite the apparent lack of evidence compared with other approaches [35,42,71,72].”
- Authors
- Scrivener, K., Dorsch, S., McCluskey, A., Schurr, K., Graham, P. L., Cao, Z., Shepherd, R., & Tyson, S.
- Affiliations
- Macquarie University (AU)
- Australian Catholic University (AU)
- The University of Sydney (AU)
- University of Manchester (GB)
- Corresponding author
- Scrivener, Katharine
- ORCID
- Venue
- Journal of Physiotherapy
- Publisher
- Elsevier BV
- Published
- 2020-10
- Volume
- 66
- Issue
- 4
- Pages
- 225-235
- ISSN
- 1836-9553 (ISSN-L)
- OpenAlex
- W3093255746
- Cited by
- 56
- References
- 47
- Citations by year
- 2026: 12 · 2025: 7 · 2024: 12 · 2023: 7 · 2022: 10 · 2021: 8
- FWCI
- 0.77
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of physiotherapy (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Macquarie University
- University of Sydney
- Topics
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Health Sciences › Medicine › Neurology › Botulinum Toxin and Related Neurological Disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Cerebral Palsy and Movement Disorders
- Keywords
- Bobath therapy, task-oriented training, stroke rehabilitation, lower limb function, proprioceptive neuromuscular facilitation, resistance training, balance, lower limb strength, motor coordination, combined intervention
- MeSH terms
- Stroke Rehabilitation, Adult, Exercise Therapy, Humans, Walking, Stroke, Lower Extremity
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