Outcomes of the Bobath concept on upper limb recovery following stroke
Abstract
Objective: To determine the effectiveness of the Bobath concept at reducing upper limb impairments, activity limitations and participation restrictions after stroke. Methods: Electronic databases were searched to identify relevant trials published between 1966 and 2003. Two reviewers independently assessed articles for the following inclusion criteria: population of adults with upper limb disability after stroke; stated use of the Bobath concept aimed at improving upper limb disability in isolation from other approaches; outcomes reflecting changes in upper limb impairment, activity limitation or participation restriction. Results: Of the 688 articles initially identified, eight met the inclusion criteria. Five were randomized controlled trials, one used a single-group crossover design and two were single-case design studies. Five studies measured impairments including shoulder pain, tone, muscle strength and motor control. The Bobath concept was found to reduce shoulder pain better than cryotherapy, and to reduce tone compared to no intervention and compared to proprioceptive neuromuscular facilitation (PNF). However, no difference was detected for changes in tone between the Bobath concept and a functional approach. Differences did not reach significance for measures of muscle strength and motor control. Six studies measured activity limitations, none of these found the Bobath concept was superior to other therapy approaches. Two studies measured changes in participation restriction and both found equivocal results. Conclusions: Comparisons of the Bobath concept with other approaches do not demonstrate superiority of one approach over the other at improving upper limb impairment, activity or participation. However, study limitations relating to methodological quality, the outcome measures used and contextual factors investigated limit the ability to draw conclusions. Future research should use sensitive upper limb measures, trained Bobath therapists and homogeneous samples to identify the influence of patient factors on the response to therapy approaches.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Two systematic reviews have specifically examined the effectiveness of Bobath-based therapy reviewing papers up to 2001 and 2003.
“Although 2 systematic reviews have specifically examined the effectiveness of Bobath-based therapy reviewing papers up to 2001 18 and 2003, 16”
From The Effectiveness of the Bobath Concept in Stroke Rehabilitation: What is the Evidence? (2009) · cites this paper as [16]
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 [16]
Cites
Statistical Methods for Psychology.
Gudgeon, A. C., & Howell, D. C. (1994) · Journal of the Royal Statistical Society Series D (The Statistician) · doi:10.2307/2348956 · Cited by 8,364 · see citing works
Technique to improve chronic motor deficit after stroke.
Taub, E., Miller, N. E., Novack, T. A., Cook, E. W., Fleming, W. C., Nepomuceno, C., Connell, J., & Crago, J. E. (1993) · PubMed · Cited by 1,557 · see citing works
Adult hemiplegia: Evaluation and treatment
Bobath, B. (1978) · Medical Entomology and Zoology · Cited by 975 · see citing works
Bütefisch, C. M., Hummelsheim, H., Denzler, P., & Mauritz, K.-H. (1995) · Journal of the Neurological Sciences · doi:10.1016/0022-510x(95)00003-k · Cited by 841 · see citing works
van der Lee, J. H., Wagenaar, R. C., Lankhorst, G. J., Vogelaar, T. W., Devillé, W. L., & Bouter, L. M. (1999) · Stroke · doi:10.1161/01.str.30.11.2369 · Cited by 745 · see citing works
Adult Hemiplegia: Evaluation and treatment
Atkinson, H. W. (1991) · Physiotherapy · doi:10.1016/s0031-9406(10)63589-4 · Cited by 575 · see citing works
Task-Related Training Improves Performance of Seated Reaching Tasks After Stroke
Dean, C. M., & Shepherd, R. B. (1997) · Stroke · doi:10.1161/01.str.28.4.722 · Cited by 415 · see citing works
Compensation in recovery of upper extremity function after stroke: The Copenhagen Stroke Study
Nakayma, H., Jørgensen, H. S., Raaschou, H. O., & Olsen, T. S. (1994) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/0003-9993(94)90108-2 · Cited by 310 · see citing works
Langhammer, B., & Stanghelle, J. K. (2000) · Clinical Rehabilitation · doi:10.1191/0269215500cr338oa · Cited by 303 · see citing works
van der Lee, J. H., Snels, I. A. K., Beckerman, H., Lankhorst, G. J., WAGENAAR, R. C., & Bouter, L. M. (2001) · Clinical Rehabilitation · doi:10.1191/026921501677557755 · Cited by 235 · see citing works
Dickstein, R., Hocherman, S., Pillar, T., & Shaham, R. (1986) · Physical Therapy · doi:10.1093/ptj/66.8.1233 · Cited by 234 · see citing works
Single subject research designs for disability research
Su, Z., & Ottenbacher, K. J. (2001) · Disability and Rehabilitation · doi:10.1080/09638280150211202 · Cited by 212 · see citing works
Electromyographic Biofeedback Applications to the Hemiplegic Patient
Wolf, S. L., & Binder‐Macleod, S. A. (1983) · Physical Therapy · doi:10.1093/ptj/63.9.1393 · Cited by 159 · see citing works
Jv, B., Gowland, C. A., Finlayson, M. A., Hall, A. L., Swanson, L. R., Stratford, P. W., Trotter, J., & Brandstater, M. E. (1987) · PubMed · Cited by 151 · see citing works
WAGENAAR, R. C., Meijer, O. G., van Wieringen, P. C. W., Kuik, D. J., Hazenberg, G. J., Lindeboom, J., Wichers, F., & Rijswijk, H. (2020) · Journal of Rehabilitation Medicine · doi:10.2340/16501977902218 · Cited by 146 · see citing works
Physiotherapy Evidence Database
Herbert, R., Moseley, A. M., Sherrington, C., & Maher, C. G. (2000) · Physiotherapy · doi:10.1016/s0031-9406(05)61357-0 · Cited by 144 · see citing works
Paci, M. (2003) · Journal of Rehabilitation Medicine · doi:10.1080/16501970306106 · Cited by 131 · see citing works
Schwarzer, R. (1988) · Behavior Research Methods, Instruments, & Computers · doi:10.3758/bf03203853 · Cited by 129 · see citing works
Mudie, M. H., Winzeler-Mercay, U., Radwan, S., & Lee, L. (2002) · Clinical Rehabilitation · doi:10.1191/0269215502cr527oa · Cited by 113 · see citing works
Physiotherapists Working with Stroke Patients
Davidson, I., & Waters, K. R. (2000) · Physiotherapy · doi:10.1016/s0031-9406(05)61208-4 · Cited by 102 · see citing works
Physiotherapy in stroke rehabilitation: Bases for Australian physiotherapists’ choice of treatment
Carr, J., Mungovan, S. F., Shepherd, R. B., Dean, C. M., & Nordholm, L. A. (1994) · Physiotherapy Theory and Practice · doi:10.3109/09593989409036399 · Cited by 101 · see citing works
Hesse, S., Jahnke, M. T., Bertelt, C., Schreiner, C., Lücke, D., & Mauritz, K.-H. (1994) · Stroke · doi:10.1161/01.str.25.10.1999 · Cited by 99 · see citing works
Physiotherapy treatment for stroke patients: A survey of current practice
Sackley, C. M., & Lincoln, N. B. (1996) · Physiotherapy Theory and Practice · doi:10.3109/09593989609036422 · Cited by 97 · see citing works
Lennon, S. (1996) · Physical Therapy Reviews · doi:10.1179/ptr.1996.1.1.35 · Cited by 75 · see citing works
EMG feedback treatment of upper limb in hemiplegic stroke patients: a pilot study.
Basmajian, J. V., Gowland, C. A., Brandstater, M. E., Swanson, L. R., & Trotter, J. (1982) · PubMed · Cited by 72 · see citing works
Physical Therapy in Stroke Rehabilitation: Bases for Swedish Physiotherapists' Choice of Treatment
Nilsson, L. M., & Nordholm, L. A. (1992) · Physiotherapy Theory and Practice · doi:10.3109/09593989209108079 · Cited by 71 · see citing works
Gelber, D. A., Josefczyk, B., Herrman, D., Good, D. C., & Verhulst, S. J. (1995) · Neurorehabilitation and neural repair · doi:10.1177/154596839500900401 · Cited by 69 · see citing works
Electromyographic biofeedback and physical therapy of the hemiplegic upper limb.
Inglis, J., Mw, D., Tn, M., Sproule, M. K. J., & Young, M. J. (1984) · PubMed · Cited by 67 · see citing works
SIT-TO-STAND MANOEUVRE IN HEMIPARETIC PATIENTS BEFORE AND AFTER A 4-WEEK REHABILITATION PROGRAMME
Hesse, S. (1998) · Scandinavian Journal of Rehabilitation Medicine · doi:10.1080/003655098444174 · Cited by 63 · see citing works
Hesse, S., Jahnke, M. T., Schaffrin, A., Lücke, D., Reiter, F., & Konrad, M. (1998) · Electroencephalography and Clinical Neurophysiology/Electromyography and Motor Control · doi:10.1016/s1388-2457(98)00033-9 · Cited by 60 · see citing works
Hemiplegic shoulder pain: a study of two methods of physiotherapy treatment
Cj, P., Edwards, S., Mee, R., & van Langenberghe, H. V. V. K. (1990) · Clinical Rehabilitation · doi:10.1177/026921559000400108 · Cited by 42 · see citing works
Rehabilitation Effort to Improve Upper Extremity Function in Post-Stroke Patients: A Meta-Analysis
Hiraoka, K. (2001) · Journal of Physical Therapy Science · doi:10.1589/jpts.13.5 · Cited by 32 · see citing works
Introduction to Single System Designs for Neurorehabilitation Research
Ottenbacher, K. J. (1997) · Neurorehabilitation and neural repair · doi:10.1177/154596839701100401 · Cited by 7 · see citing works
Ogiwara, S. (1997) · Journal of Physical Therapy Science · doi:10.1589/jpts.9.63 · Cited by 6 · see citing works
Dickstein, R., & Pillar, T. (1983) · PubMed · Cited by 5 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Interventions for improving upper limb function after stroke
Pollock, A., Farmer, S. E., Brady, M. C., Langhorne, P., Mead, G. E., Mehrholz, J., & van Wijck, F. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010820.pub2 · Cited by 909 · see citing works
The Effectiveness of the Bobath Concept in Stroke Rehabilitation: What is the Evidence?
Kollen, B. J., Lennon, S., Lyons, B., Wheatley-Smith, L., Scheper, M., Buurke, J. H., Halfens, J., Geurts, A. C. H., & Kwakkel, G. (2009) · Stroke · doi:10.1161/strokeaha.108.533828 · Cited by 274 · see citing works
Kreisel, S. H., Hennerici, M. G., & Bäzner, H. (2007) · Cerebrovascular Diseases · doi:10.1159/000098323 · Cited by 127 · see citing works
Effectiveness of the Bobath concept in the treatment of stroke:A systematic review
Díaz-Arribas, M. J., Martín-Casas, P., Cano-de-la-Cuerda, R., & Plaza-Manzano, G. (2020) · Disability and Rehabilitation · doi:10.1080/09638288.2019.1590865 · Cited by 76 · see citing works
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
“This type of therapy incorporates improved functional control and independence.[10]”
BackgroundHuseyinsinoglu, B. E., Ozdincler, A. R., & Krespi, Y. (2012) · Clinical Rehabilitation · doi:10.1177/0269215511431903 · Cited by 51 · see citing works
Krukowska, J., Bugajski, M., Sienkiewicz, M., & Czernicki, J. (2016) · Neurologia i Neurochirurgia Polska · doi:10.1016/j.pjnns.2016.08.004 · Cited by 40 · see citing works
- Authors
- Luke, C., Dodd, K. J., & Brock, K.
- Affiliations
- La Trobe University (AU)
- St Vincent's Hospital Melbourne (AU)
- Venue
- Clinical Rehabilitation
- Publisher
- SAGE Publications
- Published
- 2004-12
- Volume
- 18
- Issue
- 8
- Pages
- 888-898
- ISSN
- 0269-2155 (ISSN-L)
- 1477-0873
- OpenAlex
- W2166987927
- Cited by
- 148
- References
- 35
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 2 · 2023: 11 · 2022: 8 · 2021: 10 · 2020: 10 · 2019: 6 · 2018: 2 · 2017: 4 · 2016: 5 · 2015: 10 · 2014: 13 · 2013: 9 · 2012: 10
- FWCI
- 2.72
- 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 › Medicine › Psychiatry and Mental health › Cerebral Palsy and Movement Disorders
- Health Sciences › Medicine › Neurology › Botulinum Toxin and Related Neurological Disorders
- Keywords
- Bobath concept, stroke, upper limb recovery, upper limb impairment, activity limitation, participation restrictions, shoulder pain, spasticity, muscle tone, muscle strength, motor control, cryotherapy, proprioceptive neuromuscular facilitation, stroke rehabilitation
- MeSH terms
- Stroke Rehabilitation, Humans, Recovery of Function, Stroke, Physical Therapy Modalities, Upper Extremity
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
