Bobath Technique

What Is Bobath Technique?

Bobath technique, also known as neuro developmental therapy (NDT), is for the assessment and treatment of individuals with cerebral palsy and other allied neurological conditions. It is a treatment technology co-founded by British physiotherapist Berta Bobath and her husband Karel Bobath in practice. It is suitable for the rehabilitation of motor dysfunction caused by central nervous system injury.

The goal of applying the Bobath concept is to promote motor learning for efficient motor control in various environments, thereby improving participation and function.

What Is the Basic Theory of Bobath Technique?

Injury to the central nervous system leads to the release of primitive reflexes and the formation of abnormal postures and movement patterns.
As a result, it is necessary to use reflexive suppression to suppress abnormal postures and movement patterns by controlling key points; trigger posture reflexes and balance reactions to promote the formation of normal patterns and conduct various exercise control training.

Basic Concepts of Bobath

1. Reflex inhibition: use postures opposite to the spasm pattern to suppress spasm including reflex inhibition pattern (RIP) and tonic influenced posture (TIP).

2. Key point control: key points refer to certain specific parts of the human body, which have an important impact on the muscle tension of other parts of the body or limbs; therapists manipulate these specific parts to achieve the purpose of inhibiting spasm and abnormal postural reflex and promoting normal postural reflex.

3. Promote postural reflex: guide patients to form functional postures through certain specific activities and to learn from these functional postures to achieve therapeutic effects.

4. Sensory stimulation: use various sensations to inhibit abnormal movements or promote normal movements, and it includes excitatory and inhibitory stimulation.

What are the Principles of Bobath?

(1) Emphasize patients’ feelings of learning movement

Bobath believes that the feeling of exercise can be acquired through repeated learning and training. Repeated learning of the way of movement and movement postures can promote patients to get a sense of normal movement. To learn and master motor sensation, numerous training sessions of various motor sensations are required. Therapists should design training according to patients’ conditions and existing problems, which not only induce purposeful responses, but also fully consider whether they can provide patients with the same opportunities for motor repetition. Only repetitive stimulation and movements can promote and consolidate the learning of movements. Like any child or adult learning a new skill, patients need continuous stimulation and repetitive training opportunities to consolidate the learned movements.

(2) Emphasize learning basic postures and basic movement patterns

Each movement takes place based on basic patterns such as posture control, corrective response, balance response and other protective responses, grasping and relaxing. Bobath could suppress abnormal movement patterns according to the normal development process of human body. In addition, it could induce patients to gradually learn the normal movement pattern through the key point control, induce the high-level nervous system response, such as: corrective response, balance response and other protective reactions, so that patients could overcome abnormal movements and postures, gradually experience and achieve normal movement sensation and activity.

(3) Develop training plans according to the developmental sequence of movement

Patients’ training plans must be in accordance with their levels of development. During the measurement, patients should be evaluated from a developmental point of view and treated in the order of developmental sequence. Normal motor development is in the order from head to foot and from near-end to remote-end. The specific sequence of motor development is generally from supine position – turning over – lateral position – elbow support position – sitting – kneeling of hands and knees – kneeling of both knees – standing position.

(4) Treat patients as a whole

Bobath emphasized that patients should be trained as a whole during training. Not only to treat patients with limb motor dysfunction, but also to encourage patients to actively participate in treatment and remember the feeling of limbs during normal exercise. When training the lower limbs of hemiplegic patients, pay attention to inhibiting the appearance of upper spasm. In conclusion, to prevent other physical obstacles of patients, take patients as a whole to develop treatment and training plans.