To the Editor,
“Bobath under fire”
Structured rehabilitation programmes are known to be effective in reducing morbidity and improving outcome following stroke (Stroke Unit Trialists' Collaboration 2007) and increased intensity of therapy positively influences outcome (Kwakkel et al 1997) however the optimal content of the ‘rehabilitation package’ remains uncertain.
Four systematic reviews (Paci 2003, Van Peppen et al 2004, Luke et al 2004, Kollen et al 2009) have attempted to address this issue and, due to a number of methodological issues, the results of best evidence synthesis of all available evidence has been inconclusive. The recent publication of a new text outlining the theory and clinical practice of the Bobath Concept (Raine et al 2009) has addressed the considerable gap in available reference publications. It is clear within this text that many aspects of therapy referred to by contributors to the Frontline article such as functional task practice, treadmill training and constraint – induced therapy are integrated within clinical practice using the Bobath Concept. The importance of measuring outcome in terms of functional recovery is fundamental to the clinical practice of the Bobath Concept and is also clearly described within this text. As acknowledged by Kollen et al (2009) BBTA deliver evidence based courses to physiotherapists and occupational therapists. These courses offer an opportunity to develop skills of movement analysis and treatment; the principles of which can be applied to the assessment and treatment of adults with a broad spectrum of neurological disorders rather than focusing on a single diagnosis.
BBTA and our international colleagues look forward to being involved in and seeing the results of high quality targeted research to investigate the efficacy of interventions. It is our professional responsibility to ensure we deliver high quality education packages to those attending our courses and effective therapy to our patients.
Catherine Cornall
Chairperson BBTA
Bobath Concept: Theory and Clinical Practice in Neurological Rehabilitation
Authored by members of the British Bobath Tutors Association, Bobath Concept: Theory and Clinical Practice in Neurological Rehabilitation is a practical illustrated guide that offers a detailed exploration of the theoretical underpinning and clinical interventions of the Bobath Concept.
This book guides the reader through general principles to more specific application of neurophysiological principles and movement re-education in the recovery of important areas, including moving between sitting and standing, locomotion and recovery of upper limb function.