The Bobath concept is an approach to treating mobility difficulties caused by neurological conditions like cerebral palsy and strokes. It was developed over 50 years ago by Bertha and Karel Bobath based on clinical experience and the neuroscience of the time. The Bobath approach uses specialized handling techniques to reduce abnormal tone and facilitate normal movements. Through positioning and handling, stiffness can be reduced and muscle control and movement improved. The overall aim is to enable better functioning in daily life.
This presentation is detail about Volta therapy which is commonly used in paediatric neurological conditions and also for adults. this presentation explains what are the various techniques, methods of application of Volta therapy, indications, contraindications, etc.
NDT, BOBATH TECHNIQUE, BASIC IDEA OF BOBATH, CONCEPT OF BOBATH, NEUROPHYSIOLOGY OF NDT, ICF MODEL, PRINCIPLES OF TREATMENT OF NDT IN STROKE AND CP, AUTOMATIC AND EQUILIBRIUM REACTIONS, KEY POINTS OF CONTROL, FACILITATION, INHIBITION AND HANDLING IN NDT
Hierachical theory- says that higher centers control on lower center; but when higher center damage then this inhibitory control from the higher center is loss which leads to exageration of the movt.
In normal individual, these occur a smooth, rhythmic movt. Because there is a presence of control from higher center on lower center.
At the end of the lecture, the students should be able to:
Discuss the theoretical basis of the neurodevelopmental approaches
Discuss the concepts and principles underlying the Bobath approach
Discuss the concepts and principles underlying the Brunnstrom approach
Vojta technique is neuromuscular approach deals with all the conditions of CNS and Musculoskeletal system.
Contents :
Introduction
Definition
What is REFLEX LOCOMOTION
Indication
Stimulating Points
Reflex locomotion
Reflex Rolling phase 1
Reflex Rolling phase 2
Reflex creeping
Effects of Vojta technique
This presentation is detail about Volta therapy which is commonly used in paediatric neurological conditions and also for adults. this presentation explains what are the various techniques, methods of application of Volta therapy, indications, contraindications, etc.
NDT, BOBATH TECHNIQUE, BASIC IDEA OF BOBATH, CONCEPT OF BOBATH, NEUROPHYSIOLOGY OF NDT, ICF MODEL, PRINCIPLES OF TREATMENT OF NDT IN STROKE AND CP, AUTOMATIC AND EQUILIBRIUM REACTIONS, KEY POINTS OF CONTROL, FACILITATION, INHIBITION AND HANDLING IN NDT
Hierachical theory- says that higher centers control on lower center; but when higher center damage then this inhibitory control from the higher center is loss which leads to exageration of the movt.
In normal individual, these occur a smooth, rhythmic movt. Because there is a presence of control from higher center on lower center.
At the end of the lecture, the students should be able to:
Discuss the theoretical basis of the neurodevelopmental approaches
Discuss the concepts and principles underlying the Bobath approach
Discuss the concepts and principles underlying the Brunnstrom approach
Vojta technique is neuromuscular approach deals with all the conditions of CNS and Musculoskeletal system.
Contents :
Introduction
Definition
What is REFLEX LOCOMOTION
Indication
Stimulating Points
Reflex locomotion
Reflex Rolling phase 1
Reflex Rolling phase 2
Reflex creeping
Effects of Vojta technique
This presentation give an upto date insightful information on balance/postural assessment and key domains of Occupational Therapy during assessment of balance using different scales.
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
Retraining of motor control basing on understanding of normal movement & analysis of motor dysfunction.
Emphasis of MRP is on practice of specific activities, the training of cognitive control over muscles & movt. Components of activities & conscious elimination of unnecessary muscle activity.
In rehabilitation programme involve – real life activities included.
constraint induced movement therapy.pptxibtesaam huma
Constraint induced movement therapy
Dr. Quazi Ibtesaam Huma (MPT)
Dr. Suvarna Ganvir (Phd, Prof & HOD)
Dept. of Neurophysiotherapy
DVVPF’s College of Physiotherapy
Content
Introduction
History of CIMT
Components of CIMT
Population for CIMT
Advantages of CIMT
Recent advances
Introduction
History of CIMT
CIMT is based on research by Edward Taub ,his hypothesize that the non use was a learning mechanism and calls this behavior “Learned non-use”.
It was observed that patients with hemiparesis did not use their affected extremity .
Overcoming learned non use
Mechanisms of CIMT
Population for CIMT
Stroke
Traumatic Brain Injury
Spinal Cord Injury
Multiple Sclerosis
Cerebral Palsy
Brachial Plexus Injury
Advantages of CIMT
Overall greater improvement in function than traditional treatment.
Highly researched and credible treatment approach.
There are brain activity and observed gray matter reorganization in primary motor, cortices and hippocampus.
Increase social participation
Components Of CIMT
Types of CIMT
Restraining Tools for CIMT
Minimal Requirement of hand function for CIMT
Recent Advances
The EXCITE Trial: Retention of Improved Upper Extremity Function Among Stroke Survivors Receiving CI Movement Therapy.(2008)
The Extremity Constraint Induced Movement Therapy Evaluation (EXCITE) demonstrated that CIMT administered 3-9 months post-stroke, resulted in statistically significant and clinically relevant improvement in upper extremity function during the first year compared to those achieved by participants undergoing usual and customary care.
This study was the first randomized clinical trial to examine retention and improvements for the 24 month period following CIMT therapy in a subacute sample.
Study design - single masked cross-over design, with participants undergoing adaptive randomization to balance ,gender, prestroke dominant side, side of stroke, and level of paretic arm function across sites.
CIMT was delivered up to 6 hours per day, 5 days per week for 2 weeks.
Subsequent evaluations were made after the two week period, and at 4, 8, and 12 months.
Because the control group was crossed over to receive CIMT after one year.
Primary outcome measures – Wolf Motor Function Test
Motor Activity Log
Secondary outcome measure - Stroke Impact Scale (SIS)
were assessed at each of these time intervals, was administered only at baseline, 4, 12, 16 and 24 month evaluations.
Result :There was no observed regression from the treatment effects observed at 12 months after treatment during the next 12 months for the primary outcome measures of WMFT and MAL.
In fact, the additional changes were in the direction of increased therapeutic effect. For the strength components of the WMFT the changes were significant (P < .05) Secondary outcome variables, including the SIS, exhibited a similar pattern.
Conclusion: Mild to moderately impaired patients who are 3-9 months post-stroke demonstrate
The Bobath concept is a problem-solving approach used in the evaluation and treatment of individuals with movement and postural control disturbances due to a lesion of the central nervous system.
It is named after Berta Bobath, a physiotherapist, and her husband Karel Bobath, a psychiatrist/neuropsychiatrist, who proposed the approach for treating patients affected with Central Nervous System anomalies.
Procedure: in a “trial & error” fashion in 1948.
Concept of compensatory training.
Neglects the potential of hemiplegic side.
It is an interactive problem-solving approach that focuses on continuing reassessment with attention to individual goals, developing working hypotheses, treatment plans, and relevant objective measures to evaluate interventions.
Therapist should have:
Good posture & movement analysis skills.
PRINCIPLES
NDT THERAPY WORKS
ALWAYS TREAT THE PATIENT AS A WHOLE
WORK SIMULTANEOUSLY ON PATIENTS STRENGTHS & WEAKNESSES
INDIVIDUALIZED FOR EVERY PATIENT BASED ON ICF MODEL
GAIN THE INFORMATION FROM PAST, PRESENT & FUTURE
TEAMWORK IS CRITICAL FOR REHAB PURPOSES
UNDERSTANDING THE CONCEPT OF TYPICAL DEVELOPMENT (MOTOR CONTROL)
TRANSFERENCE OF TRAINING IN DAILY LIFE
HANDS ON INTERVENTION TO ENHANCE MOTOR LEARNING & FUNCTIONS
CIMT involves constraining the unaffected limb, along with intense therapy, in order to force the use of the affected limb with intent to improve motor function.
Brian Mulligan described novel concept of the simultaneous application of therapist applied accessory mobilizations and patient generated active movements
این ارائه توسط دکتر خیاط زاده در کارگاه رویکرد جدید بوبات در توانبخشی کودکان مبتلا به فلج مغزی ارائه گردیده است.
برای مطالعه مطالب بیشتر در این زمینه، به وب سایت فروردین مراجعه نمایید.
https://www.farvardin-group.com
Bicipital tendonitis is inflammation of long head of the biceps tendon under the bicipital groove.
In early stage, tendon becomes red and swollen, as tendonitis develops the tendon sheath can thicken.
In late stage, often become dark red in color due to inflammation.
Controlled use of sensory stimulus.
Specific Motor response
Normalization of muscle tone
Use of Developmental sequences.
Sensorimotor development = from lower to higher level.
Use of activity to demand a purposeful response.
Practice of sensory motor response is necessary for motor learning.
Neurodynamics, mobilization of nervous system, neural mobilizationSaurab Sharma
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
Spina Bifida: Physiotherapy in the management of meningomyeloceleAyobami Ayodele
Spina bifida is a treatable spinal cord malformation that occurs in varying degrees of severity. Meningomyelocele is associated with abnormal development of the cranial neural tube, which results in several characteristic CNS anomalies. About 90% of babies born with Spina Bifida now live to be adults, about 80% have normal intelligence and about 75% play sports and do other fun activities. Most do well in school, and many play in sports.
This presentation give an upto date insightful information on balance/postural assessment and key domains of Occupational Therapy during assessment of balance using different scales.
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
Retraining of motor control basing on understanding of normal movement & analysis of motor dysfunction.
Emphasis of MRP is on practice of specific activities, the training of cognitive control over muscles & movt. Components of activities & conscious elimination of unnecessary muscle activity.
In rehabilitation programme involve – real life activities included.
constraint induced movement therapy.pptxibtesaam huma
Constraint induced movement therapy
Dr. Quazi Ibtesaam Huma (MPT)
Dr. Suvarna Ganvir (Phd, Prof & HOD)
Dept. of Neurophysiotherapy
DVVPF’s College of Physiotherapy
Content
Introduction
History of CIMT
Components of CIMT
Population for CIMT
Advantages of CIMT
Recent advances
Introduction
History of CIMT
CIMT is based on research by Edward Taub ,his hypothesize that the non use was a learning mechanism and calls this behavior “Learned non-use”.
It was observed that patients with hemiparesis did not use their affected extremity .
Overcoming learned non use
Mechanisms of CIMT
Population for CIMT
Stroke
Traumatic Brain Injury
Spinal Cord Injury
Multiple Sclerosis
Cerebral Palsy
Brachial Plexus Injury
Advantages of CIMT
Overall greater improvement in function than traditional treatment.
Highly researched and credible treatment approach.
There are brain activity and observed gray matter reorganization in primary motor, cortices and hippocampus.
Increase social participation
Components Of CIMT
Types of CIMT
Restraining Tools for CIMT
Minimal Requirement of hand function for CIMT
Recent Advances
The EXCITE Trial: Retention of Improved Upper Extremity Function Among Stroke Survivors Receiving CI Movement Therapy.(2008)
The Extremity Constraint Induced Movement Therapy Evaluation (EXCITE) demonstrated that CIMT administered 3-9 months post-stroke, resulted in statistically significant and clinically relevant improvement in upper extremity function during the first year compared to those achieved by participants undergoing usual and customary care.
This study was the first randomized clinical trial to examine retention and improvements for the 24 month period following CIMT therapy in a subacute sample.
Study design - single masked cross-over design, with participants undergoing adaptive randomization to balance ,gender, prestroke dominant side, side of stroke, and level of paretic arm function across sites.
CIMT was delivered up to 6 hours per day, 5 days per week for 2 weeks.
Subsequent evaluations were made after the two week period, and at 4, 8, and 12 months.
Because the control group was crossed over to receive CIMT after one year.
Primary outcome measures – Wolf Motor Function Test
Motor Activity Log
Secondary outcome measure - Stroke Impact Scale (SIS)
were assessed at each of these time intervals, was administered only at baseline, 4, 12, 16 and 24 month evaluations.
Result :There was no observed regression from the treatment effects observed at 12 months after treatment during the next 12 months for the primary outcome measures of WMFT and MAL.
In fact, the additional changes were in the direction of increased therapeutic effect. For the strength components of the WMFT the changes were significant (P < .05) Secondary outcome variables, including the SIS, exhibited a similar pattern.
Conclusion: Mild to moderately impaired patients who are 3-9 months post-stroke demonstrate
The Bobath concept is a problem-solving approach used in the evaluation and treatment of individuals with movement and postural control disturbances due to a lesion of the central nervous system.
It is named after Berta Bobath, a physiotherapist, and her husband Karel Bobath, a psychiatrist/neuropsychiatrist, who proposed the approach for treating patients affected with Central Nervous System anomalies.
Procedure: in a “trial & error” fashion in 1948.
Concept of compensatory training.
Neglects the potential of hemiplegic side.
It is an interactive problem-solving approach that focuses on continuing reassessment with attention to individual goals, developing working hypotheses, treatment plans, and relevant objective measures to evaluate interventions.
Therapist should have:
Good posture & movement analysis skills.
PRINCIPLES
NDT THERAPY WORKS
ALWAYS TREAT THE PATIENT AS A WHOLE
WORK SIMULTANEOUSLY ON PATIENTS STRENGTHS & WEAKNESSES
INDIVIDUALIZED FOR EVERY PATIENT BASED ON ICF MODEL
GAIN THE INFORMATION FROM PAST, PRESENT & FUTURE
TEAMWORK IS CRITICAL FOR REHAB PURPOSES
UNDERSTANDING THE CONCEPT OF TYPICAL DEVELOPMENT (MOTOR CONTROL)
TRANSFERENCE OF TRAINING IN DAILY LIFE
HANDS ON INTERVENTION TO ENHANCE MOTOR LEARNING & FUNCTIONS
CIMT involves constraining the unaffected limb, along with intense therapy, in order to force the use of the affected limb with intent to improve motor function.
Brian Mulligan described novel concept of the simultaneous application of therapist applied accessory mobilizations and patient generated active movements
این ارائه توسط دکتر خیاط زاده در کارگاه رویکرد جدید بوبات در توانبخشی کودکان مبتلا به فلج مغزی ارائه گردیده است.
برای مطالعه مطالب بیشتر در این زمینه، به وب سایت فروردین مراجعه نمایید.
https://www.farvardin-group.com
Bicipital tendonitis is inflammation of long head of the biceps tendon under the bicipital groove.
In early stage, tendon becomes red and swollen, as tendonitis develops the tendon sheath can thicken.
In late stage, often become dark red in color due to inflammation.
Controlled use of sensory stimulus.
Specific Motor response
Normalization of muscle tone
Use of Developmental sequences.
Sensorimotor development = from lower to higher level.
Use of activity to demand a purposeful response.
Practice of sensory motor response is necessary for motor learning.
Neurodynamics, mobilization of nervous system, neural mobilizationSaurab Sharma
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
Spina Bifida: Physiotherapy in the management of meningomyeloceleAyobami Ayodele
Spina bifida is a treatable spinal cord malformation that occurs in varying degrees of severity. Meningomyelocele is associated with abnormal development of the cranial neural tube, which results in several characteristic CNS anomalies. About 90% of babies born with Spina Bifida now live to be adults, about 80% have normal intelligence and about 75% play sports and do other fun activities. Most do well in school, and many play in sports.
CP-Care curriculum, training course and assessment mechanism (ECVET based)
Website: http://cpcare.eu/en/
This project (CP-CARE - 2016-1-TR01-KA202-035094) has been funded with support from the European Commission. This communication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information contained therein.
Neurodevelopemental Therapy (Bobath approach)- Principles and EvidenceSusan Jose
Here we present a widely used neurophysiotherapeutic approch - NDT, exploring its current principles and throwing a glance at the historical development and why it is being so widely practice.
does it really have that evidance base?
Find more as you click on. Give a like if I helped you learn or clear concepts. Thankyou. Love you all. Lets learn more.
Principles and application of various Neurological Approaches. Comprises of PNF, ROODS, NDT, BOBATH, SENSORY INTEGRATION, BRUNNSTORM, VOJTA, Motor Re-learning Approach , Neural Tissue Mobilization
BEHAVIOURAL THERAPY techniques,progressive relaxation and guided imagery.pptxvelveenamaran
It is a form of psychotherapy which focuses on modifying behaviour faculty rather basic changes in the personality. Instead of probing the unconscious or exploring the patient thoughts and feelings, behaviour therapist tries to eliminate the symptoms and modify ineffective or maladaptive pattern by applying basic learning techniques.
BALANCE
BALANCE SYSTEM
TYPES OF BALANCE
MECHANISM
CORRELATION
BALANCE TRAINING
MANAGEMENT
STRATEGIES
PHYSIOTHERAPY INTERVENTION
BALANCE TRAINING IN ELDERLY
OUTCOME MEASURES
Detailed explanation about balance and balance training.
Balance refers to an individuals ability to maintain their line of gravity within their Base of support (BOS). It can also be described as the ability to maintain equilibrium, where equilibrium can be defined as any condition in which all acting forces are cancelled by each other resulting in a stable balanced system.
BALANCE SYSTEMS:
The following systems provides input regarding the body's equilibrium and thus maintains balance.
Somatosensory / Proprioceptive System
Vestibular System
Visual System
The Central Nervous System receives feedback about the body orientation from these three main sensory systems and integrates this sensory feedback and subsequently generates a corrective, stabilizing torque by selectively activating muscles. In normal condition, healthy subjects rely 70% on somatosensory information and 20% Vestibular & 10% on Vision on firm surface but change to 60% vestibular information, 30% Vision & 10% somatosensory on unstable surface.
SOMATOSENSORY SYSTEM:
Proprioceptive information from spino-cerebellar pathways, processed unconsciously in the cerebellum, are required to control postural balance. Proprioceptive information has the shortest time delays, with monosynaptic pathways that can process information as quickly as 40–50 ms and hence the major contributor for postural control in normal conditions.
VESTIBULAR SYSTEM:
The vestibular system generates compensatory responses to head motion via:
Postural responses (Vestibulo-Spinal Reflex) - keep the body upright and prevent falls when the body is unexpectedly knocked off balance.
Ocular-motor responses (Vestibulo-Ocular Reflex) - allows the eyes to remain steadily focused while the head is in motion.
Visceral responses (Vestibulo-Colic Reflex) - help keep the head and neck centred, steady, and upright on the shoulders.
VISUAL SYSTEM:
For non-impaired individuals, under normal conditions the contribution of visual system to postural control is partially redundant as the visual information has longer time delays as long as 150-200 ms.
Friedrich et al. observed that adults with visual disorders were able to adapt peripheral, vestibular, somatosensory perception and cerebellar processing to compensate for their visual information deficit and to provide good postural control.
In addition, Peterka found that adults with bilateral vestibular deficits can enhance their visual and proprioceptive information even more than healthy adults in order to reach effective postural stability.
The influence of moving visual fields on postural stability depends on the characteristics of the visual environment, and of the support surface, including the size of the base of support, its rigidity or compliance.
TYPES OF BALANCE:
Balance can be classified in to :
Static Balance:
Dynamic Balance
Behavior therapy is a treatment approach originally derived from learning theory, which seeks to solve problems and relieve symptoms by changing behavior and the environmental contingencies which control behavior.
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Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
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Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
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Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
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Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
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2. • The Bobath concept is an evolving approach
to the management and treatment of children
and adults with mobility difficulties caused by
neurological conditions such as cerebral
palsy and strokes.
This therapeutic approach was originated
over 50 years ago based upon clinical
experience using models of movement and
neuroscience available at that time.
3. The Bobath approach to the
management of children with
cerebral palsy was pioneered
and developed by Bertha
(Physiotherapist) and Karel
BOBATH (Neurologist)
Born in Berlin
First Bobath center opened in
1950
4. Bobath – concept [NDT]
Neuro : based on neuro-anatomy and neuro-
physiology
Developmental : the normal development of aging
child guides us through the rehabilitation process
Treatment : a structured and methodic approach
of the rehabilitation issues for stroke patients
Inhibition of abnormal tone & posture of released postural reflex
while facilitating specific automatic motor response (by special
technique of handling) resulting in performance of skilled
voluntary movements.
5. The Bobath approach to treatment
• The Bobath treatment aims to improve
posture and movement to enable more
realistic functioning in daily life.
• Through specialised ways of handling,
stiffness can be reduced, muscle control
against gravity increased and fluctuating
muscle activity stabilised.
• Depending on the severity of the condition,
the child may be better able to learn how to
sit up, use his/her hands, to stand up, to
stand, and to walk.
• Ideally the treatment will be an integral part of
the daily routine for that child.
6. • For example, the way the child is picked up,
carried, put down, or positioned when sitting,
will enable parents/carers to enhance the
child's ability and function.
• Treatment is tailored to clients' individual
needs and is based upon an assessment of
their abilities and analysis of their movement
disorder.
• This is achieved through the use of
specialized handling techniques that help to
reduce spasticity and facilitate more normal
movement.
7. AIM OF TREATMENT
• To improve the quality of movement on
affected side, so that ultimately the 2 sides
work together as harmoniously as possible
within the scope of the cerebral injury.
8. In general, the results of a treatment depends
on
- measure of spasticity
- sensibility disorders
- perceptive disorders
- incontinence
- duration and deepness of coma
And not on the use of a treatment concept
!!!!!!!!!!!!!!
9. NOT
Overload of not affected body half to
compensate loss of functionality in
affected body half.
10. Two major principles:
Plasticity of the central nerval system
The brain is able to learn and from that the
brain is also able te relearn
Initiation of a normal development
The normal development (0y-3y) shows the
same major developments but we can also
notice little individual differences in
development
11. Structural Bobath thinking
1. Analysis of normal movements
2. Analysis of pathological movements
3. Analysis of rehabilitation technics and methods
12. Analysis of normal movements
After 3yrs there are recognizable, specific patterns with
little individual differences
Intentional movements
- specific
- intended
- controlled
Automatic reactions
- unconsciously
24. Conditions for a normal development
of the motor skills
Sensory-motor conditions
- muscle tone
- adaptation to postural changes
- mobility, feeling, senses, endurance
Cognition
Psychological and Social conditions
25. Control of movement
From proximal to distal
From global to selective
From reflex to reaction
From spontanuous to functional
26. Conclusions
Normal moving includes
Mechanisms of postural reflexes
Mechanisms of postural reactions
Normal muscle tonus
Reciprocal innervation/inhibition
Automatic movement patterns
28. BASIS OF PRACTICE
• It is based on the assumption that:-
• Increased tone & reflex activity emerges as the
result of lack of inhibition from damaged postural
reflex mech & movt will be abn. If it emerges
from abn tone
• Performing abn movts will reinforce more abn
movts
• Tone could be influenced by altering the position
or movt of prox jts of body
29. Bobath treatment includes facilitation of normal
movement and inhibition of pathological movement.
Facilitation starts with the normal development from rolling
to hopping.
Inhibition starts with the inhibition of synergisms,
spasticity, associated reactions.
30. KEY POINTS OF CONTROL :- facilitation
of correct movt by handling body at key
point of control- head, spine, shoulders,
pelvic girdle & feet & hands
MANUAL HANDLING:- to control postural
tone & allow normal movts to emerge
REFLEX INHIBITING POSTURES:- to
facilitate relearning of normal movts
46. ASSESSMENT
• The aims of the treatment are goal-
orientated and influenced by several
factors such as the age of the child,
severity of their condition and their
motivation.
• Treatment is planned for each child via
assessment. Some of the areas that will
be assessed are:-.
The patterns of movement the child
presents with.
47. Age-appropriate movements that the
child may not be achieving or may find
difficult.
The child's present capabilities.
Examination of the child's posture in
different situations and positions.
• Once the child has been assessed, a
prioritised 'problem-solving' list will be
formulated, and then appropriate
techniques used to address these
areas.
48. • Positioning is very important in Bobath
treatment. Correct positioning helps
improve movements. Experience of
different positions is necessary to
improve overall body control and reduce
the risk of unnecessary poor posture.
49.
50.
51. • Handling a child using key points on the
body allows the therapist to manipulate the
child to correct their movements.
• Help may be given with movements like
chewing, handling objects, moving about,
sitting or lying down.
• Even when a child is being carried, using
correct positioning and handling of 'key
points' on the child's body, is considered
very important, as this lets the child
experience, as far possible, normal
movement patterns.
52. • The main aim of treatment is to encourage
and increase the child's ability to move and
function in as normal a way as possible.
• More normal movements cannot be
obtained if the child stays in a few positions
and moves in a limited or disordered way.
• The aim of management is to help the child
to change his abnormal postures and
movements so that he or she is able to
comfortably adapt to the environment and
develop a better quality of functional skills.
![Bobath
Therapy
[NDT]
Dr. Jasjyot Kaur Sabharwal (PT)](https://image.slidesharecdn.com/bobaththerapy-230508084108-ba8e8d16/85/Bobath-therapy-ppt-1-320.jpg)
