Physiotherapy based on the Bobath concept in stroke rehabilitation: a survey within the UK
Abstract
PURPOSE: The Bobath concept is one of the most widely used approaches in stroke rehabilitation within Europe. This survey aimed to provide an expert consensus view of the theoretical beliefs underlying current Bobath practise in the UK. METHOD: Questionnaires (with sections related to: therapist background, physiotherapy management, theoretical beliefs and gait re-education strategies used) were posted to all senior level physiotherapists working in stroke care (n = 1,022). RESULTS: The majority of respondents had more than 10 year's experience overall and at least 5 years experience in stroke care. The Bobath concept was the preferred approach (n = 67%) followed by an 'eclectic' approach (n = 31%). Despite a high level of consensus between groups, there were 13 significant differences highlighted between Bobath and 'eclectic' groups related to recovery, control of tone, the analysis and facilitation of normal movement and function. In summary. Bobath therapists considered that patients needed to have normal tone and use normal movement patterns in order to perform functional tasks. They would delay patients from performing tasks independently if abnormal tone and movement would be reinforced by task practice. They were not opposed to the use of walking aids and orthotics. CONCLUSIONS: This survey has raised several issues for debate within physiotherapy such as the automatic translation of movement into function, carry over outside therapy, and the way in which tasks should be practiced. The dominance of the Bobath concept needs to be justified by establishing that it is both effective and efficient at achieving its treatment aims of: normalizing tone, improving intrinsic recovery of the affected side and function within everyday tasks.
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Facilitation of normal movement components and task-specific practice using specific manual guidance have been identified as critical elements of the Bobath Concept.
“Facilitation of normal movement components (which includes strategies to maintain muscle and joint alignment) and task-specific practice using specific manual guidance have been identified as critical elements of the Bobath Concept.1,4,60”
From The Effectiveness of the Bobath Concept in Stroke Rehabilitation: What is the Evidence? (2009) · cites this paper as [4]
Therapy based on the Bobath Concept aims to regain motor control and function of the hemiparetic side after stroke without promoting compensation.
“Therapy based on the Bobath Concept aims to regain motor control and function of the hemiparetic side after stroke without promoting compensation.4,11,12”
From The Effectiveness of the Bobath Concept in Stroke Rehabilitation: What is the Evidence? (2009) · cites this paper as [4]
The Bobath Concept (neurodevelopmental treatment) is the most popular treatment approach used in stroke rehabilitation in the Western world.
“In the Western world, the Bobath Concept or neurodevelopmental treatment is the most popular treatment approach used in stroke rehabilitation”
From The Effectiveness of the Bobath Concept in Stroke Rehabilitation: What is the Evidence? (2009) · cites this paper as [4]
The theoretical assumptions underlying the Bobath Concept have been subject to criticism.
“In the past decade, the theoretical assumptions underlying the Bobath Concept have been subject to criticism 1,4,16”
From The Effectiveness of the Bobath Concept in Stroke Rehabilitation: What is the Evidence? (2009) · cites this paper as [4]
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- Authors
- Lennon, D. B.
- Venue
- Disability and Rehabilitation
- Publisher
- Informa UK Limited
- Published
- 2001-01
- Volume
- 23
- Issue
- 6
- Pages
- 254-262
- ISSN
- 0963-8288 (ISSN-L)
- 1464-5165
- OpenAlex
- W2104519506
- Cited by
- 134
- References
- 20
- Citations by year
- 2025: 1 · 2024: 5 · 2023: 3 · 2021: 4 · 2020: 8 · 2019: 3 · 2018: 4 · 2016: 9 · 2015: 4 · 2014: 11 · 2013: 5 · 2012: 7
- FWCI
- 4.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Disability and Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Topics
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Health Sciences › Medicine › Psychiatry and Mental health › Cerebral Palsy and Movement Disorders
- Keywords
- Bobath concept, stroke rehabilitation, physiotherapy practice, gait rehabilitation, movement patterns, walking aids, orthoses, expert consensus
- MeSH terms
- Stroke Rehabilitation, United Kingdom, Humans, Pilot Projects, Task Performance and Analysis, Physical Therapy Modalities
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