Bobath or Motor Relearning Programme? A comparison of two different approaches of physiotherapy in stroke rehabilitation: a randomized controlled study
Abstract
Objective: To examine whether two different physiotherapy regimes caused any differences in outcome in rehabilitation after acute stroke. Design: A double-blind study of patients with acute first-ever stroke. Sixty-one patients were consecutively included, block randomized into two groups, and stratified according to gender and hemiplegic site. Group 1 (33 patients) and group 2 (28 patients) had physiotherapy according to Motor Relearning Programme (MRP) and Bobath, respectively. The supplemental treatment did not differ in the two groups. Main outcome measures: The Motor Assessment Scale (MAS), the Sødring Motor Evaluation Scale (SMES), the Barthel ADL Index and the Nottingham Health Profile (NHP) were used. The following parameters were also registered: length of stay in the hospital, use of assistive devices for mobility, and the patient's accommodation after discharge from the hospital. Results: Patients treated according to MRP stayed fewer days in hospital than those treated according to Bobath (mean 21 days versus 34 days, p = 0.008). Both groups improved in MAS and SMES, but the improvement in motor function was significantly better in the MRP group. The two groups improved in Barthel ADL Index without significant differences between the groups. However, women treated by MRP improved more in ADL than women treated by Bobath. There were no differences between the groups in the life quality test (NHP), use of assistive devices or accommodation after discharge from the hospital. Conclusion: The present study indicates that physiotherapy treatment using the MRP is preferable to that using the Bobath programme in the acute rehabilitation of stroke patients.
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Bobath and Motor Relearning Programme differed in cost-effectiveness in terms of length of stay in hospital, with significantly shorter length of stay in favor of Motor Relearning Programme (21 versus 34 days, P=0.008).
“One study 39 compared the cost-effectiveness in terms of length of stay in the hospital of Bobath and Motor Relearning Programme and observed a significantly shorter length of stay in the hospital in favor of the Motor Relearning Programme group (21 versus 34 days, Pϭ0.008).”
From The Effectiveness of the Bobath Concept in Stroke Rehabilitation: What is the Evidence? (2009) · cites this paper as [39]
Only 7 studies in the review outlined the content of the Bobath Concept in more detail referring to specifically trained therapists who selected interventions from specifically designed treatment protocols.
“There was a lack of description of the actual content of Bobath therapy; only 7 studies outlined the content of the Bobath Concept in more detail referring to specifically trained therapists, who selected interventions from specifically designed treatment protocols.39,43,46 -48,53,55”
From The Effectiveness of the Bobath Concept in Stroke Rehabilitation: What is the Evidence? (2009) · cites this paper as [39]
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“These treatment techniques are MRP,[18,28] forced use therapy,[19] Robot therapy,[20] POWM,[21] Arm BASIS augmented exercise therapy,[22] gait training,[23] RAS,[26] Constraint‐Induced Movement Therapy,[30] meaningful task-specific training.”
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- Authors
- Langhammer, B., & Stanghelle, J. K.
- Affiliations
- Bærum Sykehus (NO)
- Sunnaas sykehus (NO)
- Venue
- Clinical Rehabilitation
- Publisher
- SAGE Publications
- Published
- 2000-08
- Volume
- 14
- Issue
- 4
- Pages
- 361-369
- ISSN
- 0269-2155 (ISSN-L)
- 1477-0873
- OpenAlex
- W2154009453
- Cited by
- 303
- References
- 22
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 7 · 2023: 7 · 2022: 6 · 2021: 5 · 2020: 9 · 2019: 10 · 2018: 8 · 2017: 5 · 2016: 14 · 2015: 13 · 2014: 18 · 2013: 14 · 2012: 14
- FWCI
- 15.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- 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 › Epidemiology › Acute Ischemic Stroke Management
- Keywords
- stroke rehabilitation, Bobath therapy, physiotherapy, acute stroke, motor recovery, activities of daily living, length of hospital stay, gender differences, quality of life, hemiplegia
- MeSH terms
- Stroke Rehabilitation, Activities of Daily Living, Adult, Aged, Aged, 80 and over, Female, Hemiplegia, Humans, Length of Stay, Male, Middle Aged, Motor Skills, Treatment Outcome, Physical Therapy Modalities
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