Written by Keegan Bow
This Sunday the 18th of February 2018, the Australian Bobath Tutors Association (ABTA) will be hosting the inaugural Bobath Conference at St Vincent’s Hospital in Melbourne. This oversubscribed event has attracted a lot of buzz nationally, as it ties in with Mary Lynch-Ellerington’s last visit to Australia. Mary is a senior Bobath instructor from the UK, who teaches widely internationally and has applied and taught the Bobath concept to an exceptionally high standard.
What is the Bobath Concept?
The Bobath concept is a problem solving approach used to treat adults and children with neurological problems. It was an approach that was created by a physiotherapist Berta Bobath since the 1940s, after she discovered that she could change the way people moved after stroke. Back then, there was little understanding of the neuroscience of recovery, and people were told to use their less affected side only to compensate for their paralysis.
The Bobath concept is an evolving one – new research into the brain, motor control and recovery are incorporated to guide the applied theory and reasoning process.
For example, research shows that before limb movement, the trunk is dynamically stable to adjust to weight and forces of the moving limb. Bobath trained therapists understand that this is part of normal movement and hence work towards seeking and building on this form of dynamic stability.
The International Bobath Instructors Training Association, of which I am a member, have interpreted the concept in diagrammatic form as below:
Image credit to Vaughan-Graham and Cott (2017)
The Bobath concept provides an interaction between assessment and treatment; how the patient responds to the treatment forms part of the assessment and this helps inform the next part of the treatment. If the person responds well, the treatment is adjusted to reinforce the change or to build on it, and if they don’t respond well, the treatment is adjusted to make the task easier or to create a more positive response instead.
In that respect, the Bobath concept is response-based and supported by hypotheses that are either confirmed or rejected based on the response. This allows faster pattern recognition and understanding of that particular patient’s movement potential, than if a pre-determined protocol of treatment is used.
Thoughtfully, the therapist and patient are also constantly communicating and adapting with each other in verbal and non-verbal ways. Together with skilled handling and manipulation of the environment (known as facilitation), the Bobath therapist can strongly influence the way in which the patient can move differently within each treatment session.
Call us on 1300 503 866 or email email@example.com to find out more about how the Bobath concept can make a difference to you.
International Bobath Instructors Training Association, www.ibita.org
Vaughan‐Graham, J., & Cott, C. (2017). Phronesis: practical wisdom the role of professional practice knowledge in the clinical reasoning of Bobath instructors. Journal of evaluation in clinical practice, 23(5), 935-948.