The document summarizes key points from a meeting on hand rehabilitation using the Bobath concept. It discusses assessment of hand function, including psychological, sensory and motor components. Rehabilitation considers individual characteristics, tasks and environment. The goal is to improve functional movement through motor learning principles, cognitive participation, and applying skills to daily life. Collaboration across therapies is emphasized.

1. HandFun Meeting 2013

2. Bobath Concept
q Assessment and rehabilitation of persons with disorders of function,
movement and postural control.
q Current Neurophysiology.
q Science movement (motor control, motor learning).
q Biomechanics and sensory components, perceptual,
cognitive, adaptive and motor.
q Normal movement.

3. Where does our hand begin?
Hand as the organ that explores
and interacts with the world.
Tallis, 2008

4. Hand evaluation
q Psychological / Cognitive / Emotional (Physiotherapist, Occupational
Therapists, Neuropsychologist…)
q Sensitive / proprioceptive and perceptive.
q Motor.
Standardized Tests:
- Rivermead
- Fugl-Meyer Scale
- Motor Activity Log (MAL)
- …etc

5. Specific work of the hand
Patterns of movement and behavior
Individual C.
Task Environment

6. Specific work of the hand
1. Individual characteristics
q Stability precedes mobility.
q Postural Control ßà Hand
q Active participation by the patient.
q Learning organization and integration.

7. Specific work of the hand
2.Environment

8. Specific work of the hand
3.Task
Visual input
Somesthetic input
Parietal cortex
Premotor cortex
Primary motor
cortex
Movement
The patients Motivation
participation Cognitive processes/Planning
Cortical organization/Learning
Movement Search normal patterns of movement
facilitation Task success
by physiotherapist Reinforce feedback and help feedforward

9. Cognitive
Sensitive
Motor
Components to
make an
EFFICIENT
MOVEMENT
Biomechanical
Perceptual
Applicability to patient's
daily life
FUNCTIONALITY
Specific work of the hand
Mayston, 1999

10. Environment and contact with the space
Patient Gives meaning to the task.
Physiotherapist Gives the preparation of the hand (form,
size …).

11. CONCLUSIONS
q It’s a concept, not a technique or a method.
q It kept in mind postural control and motor learning.
q Component cognitive, sensory, proprioceptive, motor and integration
into daily life.
q Three factors to consider: individual, task and environment.
q Collaboration with other professionals, therapies and approaches.
q Mirror Therapy, forced use therapy, new technologies, splints and
other assistance.

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14. ¡ THANKS !