The Bobath concept: a critical review of the theoretical assumptions that guide physiotherapy practice in stroke rehabilitation
Abstract
Stroke is the third most common cause of death in the adult population and a major consumer of health care resources. Physiotherapists spend a large proportion of their time rehabilitating patients following stroke using a variety of treatment approaches. The Bobath concept has gained international acceptance as one of the leading approaches in stroke rehabilitation. The aim of physiotherapy using this concept is to re-educate normal movement by the manipulation of a variety of afferent inputs which are mainly proprioceptive. Recent papers have criticized this concept for failing to integrate new knowledge into its theoretical rationale.The aim of this paper is to review the published literature concerning physiotherapy using the Bobath concept in stroke rehabilitation. The key assumptions that guide current practice are identified: a systems theory of motor control; neuroplasticity shaped by manipulation of afferent inputs; and neurophysiological dysfunction as the primary cause of movement dysfunction. These assumptions are then discussed in relation to current understanding of how movement is controlled in both normal and brain damaged adults following stroke.
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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 [1]
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 [1]
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- Authors
- Lennon, S.
- Corresponding author
- Lennon, Sheila
- ORCID
- Lennon, Sheila
- Venue
- Physical Therapy Reviews
- Publisher
- Informa UK Limited
- Published
- 1996-09
- Volume
- 1
- Issue
- 1
- Pages
- 35-45
- ISSN
- 1083-3196 (ISSN-L)
- 1743-288X
- OpenAlex
- W2074895025
- Cited by
- 75
- References
- 27
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 2 · 2021: 1 · 2020: 1 · 2019: 1 · 2018: 1 · 2016: 2 · 2015: 1 · 2014: 5 · 2012: 2
- FWCI
- 5.35
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Physical Therapy Reviews (publishedVersion)
- Topics
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Life Sciences › Neuroscience › Cognitive Neuroscience › Motor Control and Adaptation
- Health Sciences › Medicine › Psychiatry and Mental health › Cerebral Palsy and Movement Disorders
- Keywords
- Bobath concept, stroke rehabilitation, physiotherapy, motor control, systems theory, neuroplasticity, proprioception, afferent input, movement dysfunction, theoretical assumptions
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