Bobath Therapy Research Articles

Использование нейростимуляции в коррекции звукопроизношения у детей дошкольного возраста с минимальными дизартрическими расстройствами

The article considers the mechanisms and types of neurostimulation (direct and indirect effect) that contribute to the development of the kinetic and kinesthetic basis for sound reproduction in children with minimal dysarthric disorders, used in modern speech therapy. Keywords: minimal dysarthric disorders, types of neurostimulation, kinetic and kinesthetic basis of speech, correction of sound pronunciation, direct and indirect effects, bioenergetics, kinesiotherapy, cerebellar stimulation, point massage, hydro-kinesiotherapy, Bobath therapy, taping.

The effect of the Bobath therapy programme on upper limb and hand function in chronic stroke individuals with moderate to severe deficits

Background/AimsThe Bobath concept has long been used to improve postural control and limb function post-stroke, yet its effect in patients with deficits have not been clearly demonstrated. This study aimed to investigate the effect of the latest Bobath therapy programme on upper limb functions, muscle tone and sensation in chronic stroke individuals with moderate to severe deficits.MethodsA pre–post test design was implemented. The participants were chronic stroke individuals (n=26). Home-based intervention based on the Bobath concept was administered 3 days per week for 6 weeks (20 repetitions × 3 sets per task each session). Outcome measures consisted of the Wolf Motor Function Test, Fugl-Meyer Assessment for the upper extremity, Modified Ashworth Scale, and the Revised Nottingham Sensory Assessment. Data were analysed using the Wilcoxon Signed rank test.ResultsAlmost all items of the Wolf Motor Function Test and the Fugl-Meyer Assessment for the upper extremity demonstrated statistically significant differences post-intervention. Finger flexor muscle tone and stereognosis were also significantly improved.ConclusionsThe 6-week Bobath therapy programme could improve upper limb function and impairments in chronic stroke individuals with moderate to severe deficits. Its effects were also demonstrated in improving muscle tone and cortical sensation.

Effect of traditional Chinese medicine acupuncture combined with rehabilitation training on children with cerebral palsy

Objective To evaluate the therapeutic effect of acupuncture combined with rehabilitation training on children with cerebral palsy. Methods A total of 68 children with cerebral palsy who met the inclusion criteria were randomly divided into two groups, 34 in each group. The control group was treated with Bobath therapy combined with Vojta therapy for rehabilitation training, while the observation group was treated with acupuncture on the basis of the control group. Both groups were treated for 12 weeks. Modified Ashworth method was used to assess the muscular tension of lower limbs, the gross motor function scale was used to assess the gross motor function, and the Fugl-Meyer motor function evaluation method was used to evaluate the limb motor function of children. And the serum levels of vascular endothelial growth factor and creatine kinase brain isoenzyme (CK-BB) were detected by ELISA. Results After treatment, the muscle tension score (1.3 ± 0.3 vs. 1.7 ± 0.4, t=4.108) in the observation group was significantly lower than that in the control group, while the GMFM score (55.7 ± 13.7 vs. 37.8±11.4, t=5.881) significantly higher than that in the control group (P<0.01). The serum VEGF (145.67 ± 19.78 ng/L vs. 171.35 ± 22.54 ng/L, t=4.993) in the observation group were significantly lower than those of the control group (P<0.01). The levels of CK-BB (71.46 ± 17.62 U/L vs. 95.76 ± 19.65 U/L, t=5.368) in the observation group were significantly lower than those of the control group (P<0.01). The total effective rate was 94.1% (32/34) in the observation group and 73.5% (25/34) in the control group. There were significant differences between the two groups (χ2=5.314, P=0.021). Conclusions Acupuncture combined with rehabilitation training can improve the muscle tension and gross motor function of children with cerebral palsy, reduce the levels of VEGF and CK-BB in serum of children with cerebral palsy, and improve the clinical effect. Key words: Cerebral palsy; Child; Body acupuncture; Points, scalp stimulation areas; Rehabilitation training; Limb function

Outcome at Age Five Years or Older for Children with Perinatal Brain Injury Treated with Neurohabilitation or Neurodevelopmental Therapy

Background: To evaluate the outcome at age five years or older for children with perinatal brain injury who received Katona's neurohabilitation therapy or neurodevelopmental therapy (Bobath therapy) at birth, a blinded evaluation of the infant groups was performed by an expert neuropediatrician. Methods: Twenty-two infants with a gestational age (GA) ranging from 25 to 40 weeks were treated with neurohabilitation (n=11) or with neurodevelopmental therapy (n=11), with both procedures initiated before three months of corrected age. The groups were matched by sex and GA. Treatments were intensive, were sustained for at least 24 months, and required family participation. At birth, neuropediatric examinations and MRI were performed. Children were followed up, and at three-year-old Bayley-II scales were administered; the follow-up continued up to the present age. Findings: Abnormal MRI findings were observed in 21 (95%) infants. At three years old, among children treated with Katona's method, the Bayley-II score was slightly abnormal in one patient for both indices, another child had a lower performance on the mental index, and a third patient showed a very low psychomotor index; four patients treated with the Bobath procedure had very abnormal results on both indices. The outcome of a blind evaluation of the group showed that eight of 11 children treated with Katona had a normal evaluation, and only four of the children treated with the Bobath method were normal; the risk ratio (RR) was 37% (0*73-0*36= 0*37). Interpretation: The resulting outcomes after five years or more using Katona's neurohabilitation in newborns with perinatal brain damage were better than the outcomes for children treated with the Bobath procedure, even if the latter was initiated early and with great intensity. Funding Statement: This manuscript was partially supported by Project PAPIIT IN200917 from DGAPA, UNAM, and Project 4971 from CONACYT. Declaration of Interests: The authors state: There were no conflicts of interest. Ethics Approval Statement: The Ethics Committee of the Instituto de Neurobiologia of the Universidad Nacional Autonoma de Mexico approved this study, which also complies with the Ethical Principles for Medical Research Involving Human Subjects established by the Helsinki Declaration. Informed written parental consent for participation in this study was obtained for all subjects.

Effectiveness of Bobath therapy on balance in cerebral palsy

Purpose: Weakness on balance control is one of the most common problems for children with cerebral palsy. Present study aimed to investigate the effectiveness of 8 week-Bobath therapy on balance in children with diparetic or hemiparetic cerebral palsy.Materials and Methods: A total of 15 cerebral palsy diagnosed children (8 diparesis, 7 hemiparesis) aged 5-14 years, were included in this study. Children could walk independently or by using a walking aid. The demographic data were saved for each case. Gross Motor Function Classification System and Gross Motor Function Measure were used to determine level of motor function. 1 Minute Walking Test, 10-meter Walking Test, Pediatric Balance Scale for balance ability and Functional Independence Measure for children (WeeFIM) for assessing of independence in activities of daily living were used. Bobath therapy were applied to children one 60-minute session, 2 days a week and 8 weeks in total. All evaluations were performed before treatment and repeated after treatment program.Results: After 8-week Bobath therapy, the results showed that improvement in motor function, level of functional independence and balance scores were statistically significant. Conclusion: Bobath therapy improves functional motor ability, independence level on daily living activities, and also balance ability in children with cerebral palsy.

Blood flow in the brain venous blood vessels of children with cerebral palsy while using Bobath therapy

In the diagnosis of the causes of neurological disorders in children’s with cerebral palsy has attached the results of Transcranial Doppler. Bobath therapy is the most innovative and effective methods of physical rehabilitation. For the determination of brain blood flow of children of preschool age with various CNS lesions for the influence of the physical therapy using the Bobath’s method, 35 children aged 4.1 ± 1.1 years were examined. That was the main group (MG). All of 72 procedures were conducted. There was also a control group (CG), the results of the brain blood flow had been studied and analyzed in 34 children aged 3.8 ± 0.9 years who were undergoing rehabilitation using standard methods. Traditional methods of physical therapy and the methods of the Bobath therapy have a significant effect on the brain venous blood flow. At the same time, the significance of individual methods of physical therapy is not convincing. The comparison of changes in blood flow using the Bobath therapy and traditional methods allowed identifying certain differences. The influence of the Bobath methods, on the first place, concerns the more optimal effect on the blood flow in the veins of the spine and the direct venous sinus. At the same time, changes in blood flow with traditional approaches are more convincing to the effect on blood flow in the internal jugular veins and veins of Rosenthal.

Effect of warm joint needling plus rehabilitation on the balance function and quality of life of patients with spastic hemiplegia after ischemic cerebral stroke

To observe the effect of warm joint needling plus rehabilitation techniques on the balance function and quality of life (QOL) of patients with spastic hemiplegia after ischemic cerebral stroke. Ninety patients with spastic hemiplegia after ischemic cerebral stroke were randomized into a rehabilitation group, a warm joint needling group and an observation group, with 30 cases in each group. The rehabilitation group was intervened by Bobath therapy, the warm joint needling group was treated with joint needling on the affected side plus warm needling, and the observation group was given the same rehabilitation treatment as the rehabilitation group together with the same warm joint needling as the warm joint needling group. The three groups were treated once another day, 1 month as a treatment course for 6 months. Before the treatment, and respectively after 2-week, 1-month, 3-month, and 6-month treatment, the modified Ashworth scale (MAS) was used to measure the anti-spasm ability of the lower limb, the Berg balance scale (BBS) was adopted to evaluate the balance function, and the stroke-specific quality of life scale (SS-QOL) was employed to estimate the QOL. After 3-month and 6-month treatment, the lower-limb MAS scores in the observation group were significantly better than those in the rehabilitation group and the warm joint needling group (all P<0.05). After 1-month, 3-month and 6-month treatment, the BBS scores in the observation group were significantly better than those in the rehabilitation group and the warm joint needling group (all P<0.05). After 2-week, 1-month, 3-month and 6-month treatment, the SS-QOL scores in the observation group were markedly better than those in the rehabilitation group and the warm joint needling group (all P<0.05). Warm joint needling plus rehabilitation can effectively improve the lower‐limb spasticity state, balance function and QOL in patients with spastic hemiplegia after ischemic cerebral stroke.

Bobath Concept Structural Framework (BCSF): Positioning Partial Aspects Within a Holistic Therapeutic Concept

Background: The Bobath concept is a complex, holistic approach to neurorehabilitation. This complexity presents difficulties for describing Bobath therapy in a comprehensible way. The purpose of this project was to develop an external structure to promote a better understanding of how specific therapeutic procedures are categorized, how partial aspects can be organized and how their interactions can be made more obvious. Method: A scoping review of the literature was undertaken and clustered for keywords. These data were assigned to four levels of a framework model: Conceptual level (leading thoughts), Principle level (essential characteristics of the system), Method level (systematic procedures) and Technique level (the execution tools). Drafts of the framework were presented at annual conferences of the International Bobath Instructor Training Association (IBITA). Feedback from members was sought informally and in questionnaires. Results: The BCSF was supported by 75% of IBITA members (N = 107). In the Conceptual level, three aspects were established; propositional knowledge, individual client context and professional practice knowledge. Seven components are represented in the Principle level; optimizing activity and participation, problem solving, interactive - dialogue approach, client goal oriented, identification of potential, ongoing interplay of assessment and intervention and 24 hours approach. In the Methods level, three systematic procedures were identified; activation, shaping and repetition. At the Techniques level, four execution tools were described; communication, facilitation, assignment of task and environmental arrangement. Discussion: The BCSF provides a structure for further research into the Bobath concept. At a qualitative level, this structure will allow different aspects to be explored whilst still viewing a single aspect as a component of the whole. At a quantitative level, the BCSF clarifies what kind of therapy constitutes a Bobath intervention and the factors that need to be present at all levels of the framework. Conclusion: The BCSF is a useful tool where partial aspects of the Bobath concept can be categorized into a comprehensive classification system. This classification makes it possible to focus on specific items without losing the big picture and to identify partial aspects and their interactions more clearly. Specific procedures can be presented in a structured and transparent manner and well documented core elements for rehabilitation of people with CNS disorders can be demonstrated.

Clinical study of post-stroke upper limb spasmodic hemiplegia treated with jingou diaoyu needling technique and Bobath therapy

To compare the difference in the clinical efficacy on post-stroke upper limb spasmodic hemiplegia between the combined therapy of jingou diaoyu needling technique and Bobath technology and simple Bobath technology. Sixty patients were randomized into an observation group and a control group, 30 cases in each one. The usual medication of neurological internal medicine was used in the two groups. In the control group, Bobath facilitation technology was applied to the rehabilitation training. In the observation group, on the basis of the treatment as the control group, jingou diaoyu needling technique was used to stimulate Zhongfu (LU 1), Tianfu (LU 3), Chize (LU 5), Quchi (LI 11), Jianshi (PC 5) and Daling (PC 7). The treatment was given once a day; 5 treatments made one session and totally 4-week treatment was required in the two groups. The modified Ashworth scale, the modified Fugle-Meyer assessment (FMA) and the Barthel index (BI) were adopted to evaluate the muscular tension, the upper limb motor function and the activities of daily living (ADL) before and after treatment in the two groups. The clinical efficacy was compared between the two groups. Compared with those before treatment, the modified Ashworth scale, Fugl-Meyer score and BI score were all improved after treatment in the two groups (all P<0.01). The results in the observation group were better than those in the control group (all P<0.01). The total clinical effective rate was 93.3% (28/30) in the observation group and was 80.0% (24/30) in the control group. The efficacy in the observation group was better than that in the control group (P<0.05). The jingou diaoyu needling technique combined with Bobath therapy achieve the superior efficacy on post-stroke upper limb spasmodic hemiplegia as compared with the simple application Bobath therapy. This combined treatment effectively relieve spasmodic state and improve the upper limb motor function and the activities of daily living.

Comparative analysis of curative effect of bone marrow mesenchymal stem cell and bone marrow mononuclear cell transplantation for spastic cerebral palsy

BackgroundBone marrow mesenchymal stem cells (BMMSCs) and bone marrow mononuclear cells (BMMNCs) are both used to treat spastic cerebral palsy. However, the differences in therapeutic effect remain unknown.MethodsA total of 105 patients with spastic cerebral palsy were enrolled and randomly assigned to three groups: the BMMSC group, the BMMNC group and the control group. Patients in both transplantation groups received four intrathecal cell injections. Patients in the control group received Bobath therapy. The gross motor function measure (GMFM) and the fine motor function measure (FMFM) were used to evaluate the therapeutic efficacy before transplantation and 3, 6, and 12 months after transplantation.ResultsThree months after cell transplantation, scores in the A dimension of GMFM and the A and C dimensions of FMFM scores in the BMMSC group are all higher than those of the BMMNC and the control groups (P < 0.05). Six months after cell transplantation, scores in the A, B dimensions of GMFM and the A, B, C, D, and E dimensions of FMFM scores in the BMMSC group are higher than those of the BMMNC and the control groups (P < 0.05). Twelve months after cell transplantation, scores in the A, B, and C dimensions of GMFM and the A, B, C, D, and E dimensions of FMFM scores in the BMMSC group are all higher than those of the BMMNC and the control groups (P < 0.05). No obvious adverse effects were investigated during follow-up.ConclusionsBMMSC transplantation for the treatment of cerebral palsy is safe and feasible, and can improve gross motor and fine motor function significantly. In addition, compared with BMMNC, the motor function of children improved significantly in terms of gross motor and fine motor functions.

A Randomised Controlled Study to Investigate Effects of Bobath Based Trunk Control Training on Motor Function of Children with Spastic Bilateral Cerebral Palsy

Purpose: The aim of this study was to investigate the effects of trunk control on motor function, which plays an important role in the daily activities of children with Cerebral Palsy (CP) and is often observed as a deficiency in children with CP. Material and Methods: Forty children with spastic bilateral CP, ages between 3 to 10 years and with Gross Motor Function Classification System (GMFCS) level I, II, and III were included in this study. Children were divided into two groups using randomization and in training group; Bobath Therapy for trunk control in addition to classical physiotherapy programs was performed for 45 minutes, for two days a week, for 6 weeks. In control group, existing physiotherapy program, 45 minutes for two days a week, continued. Any addition was not made into the existing program of the control group. Modified Ashworth Scale (MAS), Pediatric Berg Balance Scale (PBBS), Trunk Control Measurement Scale (TCMS), 1 Minute Walking Test (1MWT), Timed Up and Go Test (TUG) were applied to both groups before and after 6 weeks. Moreover, trunk muscle strength of children was evaluated. Results: After therapy, differences were found in results of MAS and PBBS, and trunk extensor strength between the training group and the control group in favor of the training group (p < 0.05). In addition, TCMS, 1MWT, TUG test and showed significant improvement compared to the average of the pre-treatment of the trunk muscle strength (p < 0.05). In addition, after treatment, training group’s averages of TCMS, PBBS, 1MWT, YUG test and all trunk muscle strength were higher compared to the ones before treatment (p < 0.05). Conclusion: This study shows that adding exercises which aim trunk to conventional physiotherapy and exercise programs of children with CP, affects motor function positively.

Study of the burke lateropulsion scale to evaluate Pusher syndrome rehabilitation

Background: Pusher syndrome is a position-control disorder with a higher incidence in patients after stroke. Clinical studies have shown that patients with Pusher syndrome hospitalize for a long time and daily function after discharge are low, so early detection and treatment is critical to control the development of the disease; Burke lateropulsion scale (BLS) can be used to diagnose Pusher syndrome and can effectively and accurately reflect the changing aspects of patient movement, but now BLS has not been widely used in clinical work. Purpose:To study about the sensitivity ofBLSon changes ofPusher syndromeand the clinical features in the application of BLS as the evaluation tool in order to provide a theoretical basis for BLS’s clinical application. Methods: Patients were scored by BLS since the first day of admission, and in every two weeks till discharged. After admission, conventional motor function training were given, motor relearning and Bobath therapy mainly, including rollover, stand-up, sit-up, sit station transfer, balance training, walking training, etc. Each patient has been evaluated at least three times during hospitalization. Results: Of 48 patients, 56.3% were evaluated as mild of Pusher syndrome and 16.7% severe at admission. While at discharge, 47.9% were classified as mild, 43.8% were not diagnosed as Pusher syndrome and none severe. SRM was 1.27 during the whole hospitalization, 1.41 in 4 weeks and 2.18 in 6 weeks. Conclusion(s): The BLS is an appropriate tool for the evaluation of Pusher syndrome patients and is responsive to monitor progress and recovery during rehabilitation. It is significant to guide rehabilitation if used in routine clinical practice. It could be suitable to evaluate changes in future intervention studies. Implications: With the wide and routine use of BLS in patients after stroke, especially in those with Pusher syndrome, it will be a sensitive tool in monitor the progress during rehabilitation which gives an accurate feedback on therapy and helps with the treatment prescription adjustment in time.

Changes in the bimanual skills of children with Unilateral Cerebral Palsy following blocks of Bobath therapy

Changes in the bimanual skills of children with Unilateral Cerebral Palsy following blocks of Bobath therapy

The effects of Bobath therapy on the bimanual hand function of children with hemiplegic cerebral palsy: a feasibility study

The effects of Bobath therapy on the bimanual hand function of children with hemiplegic cerebral palsy: a feasibility study

The effects of Neuro-Developmental (Bobath) therapy based goal directed therapy on gross motor function and functional status of children with cerebral palsy

AIM: The aim was to investigate the effects of the neurodevelopmental based goal directed therapy (GD-NDT) on the motor functions, daily living activities of children with CP. METHOD: 26 children with spastic CP, 14 males (53.8%) and 12 females (46.2%) ,mean age 9.5 ± 3.2 years were included. GMFCS levels were, I in 42.3%, II in 3.8% level, III in 15.4%, IV in 11.5% and V in 26.9%. GD-NDT was applied 3 times a week for 12 weeks. RESULTS: Positive developments after therapy were identified in the gross motor functions of the children (p 0.05). The goals identified for the children before treatment were involved self-care 15.4%, physical activity 17.9%, locomotion and transfer 37.2%, social status and living activities 29.5%. 76.9% of the goals identified were reached; 23.1% were not reached. CONCLUSION: Improvements were found in gross motor functions, independence in daily life and health related quality of life of children with CP who were taken GD-NDT.

The Effectiveness of Bobath Treatment Approach in Physiotherapy of Case with Ehlers-Danlos Syndrome

Ehlers-Danlos Syndrome (EDS) is one of the most frequent connective tissue diseases (1:5,000–1:10,000) and characterized by multiple clinical findings depending on connective tissue weakness in body system. Most of EDS patients consists of “hypermobility type (EDS-HT)” Physiotherapy program has an important place in the treatment of children with EDS-HT diagnosis and Bobath therapy aims to regulate muscle tone, provide postural alignment with special grip techniques and improve functions with the active participation of individual. The case with EDS-HT diagnosis is 5 year- old female child with 14 kg body weight, and 96.7 cm height. In 18th month, the case was directed to physiotherapy program towards hypotony and postural control problems in Private YA±ldA±z Cocuk Special Education and Rehabilitation Center. The case was evaluated three times for three years. Motor functions of the case were evaluated using Gross Motor Function Measurement (GMFM) scale, the disability level of the case was determined using Gross Motor Function Classification Scale and the functional independence level of the case was evaluated using Functional Independence Measure for Children (WeeFIM) scale. The applied physiotherapy program was designed from the exercises used in Bobath treatment approach. According to subsequent evaluations made through GMFM and weeFIM for throughout 3 years when the case received physiotherapy, a significant increase was observed in the scores of all parameters of GMFM and weeFIM, and an increase at one level in disability level was observed in GMFCS evaluation.

Interventions for improving upper limb function after stroke.

Improving upper limb function is a core element of stroke rehabilitation needed to maximise patient outcomes and reduce disability. Evidence about effects of individual treatment techniques and modalities is synthesised within many reviews. For selection of effective rehabilitation treatment, the relative effectiveness of interventions must be known. However, a comprehensive overview of systematic reviews in this area is currently lacking. To carry out a Cochrane overview by synthesising systematic reviews of interventions provided to improve upper limb function after stroke. We comprehensively searched the Cochrane Database of Systematic Reviews; the Database of Reviews of Effects; and PROSPERO (an international prospective register of systematic reviews) (June 2013). We also contacted review authors in an effort to identify further relevant reviews. We included Cochrane and non-Cochrane reviews of randomised controlled trials (RCTs) of patients with stroke comparing upper limb interventions with no treatment, usual care or alternative treatments. Our primary outcome of interest was upper limb function; secondary outcomes included motor impairment and performance of activities of daily living. When we identified overlapping reviews, we systematically identified the most up-to-date and comprehensive review and excluded reviews that overlapped with this. Two overview authors independently applied the selection criteria, excluding reviews that were superseded by more up-to-date reviews including the same (or similar) studies. Two overview authors independently assessed the methodological quality of reviews (using a modified version of the AMSTAR tool) and extracted data. Quality of evidence within each comparison in each review was determined using objective criteria (based on numbers of participants, risk of bias, heterogeneity and review quality) to apply GRADE (Grades of Recommendation, Assessment, Development and Evaluation) levels of evidence. We resolved disagreements through discussion. We systematically tabulated the effects of interventions and used quality of evidence to determine implications for clinical practice and to make recommendations for future research. Our searches identified 1840 records, from which we included 40 completed reviews (19 Cochrane; 21 non-Cochrane), covering 18 individual interventions and dose and setting of interventions. The 40 reviews contain 503 studies (18,078 participants). We extracted pooled data from 31 reviews related to 127 comparisons. We judged the quality of evidence to be high for 1/127 comparisons (transcranial direct current stimulation (tDCS) demonstrating no benefit for outcomes of activities of daily living (ADLs)); moderate for 49/127 comparisons (covering seven individual interventions) and low or very low for 77/127 comparisons.Moderate-quality evidence showed a beneficial effect of constraint-induced movement therapy (CIMT), mental practice, mirror therapy, interventions for sensory impairment, virtual reality and a relatively high dose of repetitive task practice, suggesting that these may be effective interventions; moderate-quality evidence also indicated that unilateral arm training may be more effective than bilateral arm training. Information was insufficient to reveal the relative effectiveness of different interventions.Moderate-quality evidence from subgroup analyses comparing greater and lesser doses of mental practice, repetitive task training and virtual reality demonstrates a beneficial effect for the group given the greater dose, although not for the group given the smaller dose; however tests for subgroup differences do not suggest a statistically significant difference between these groups. Future research related to dose is essential.Specific recommendations for future research are derived from current evidence. These recommendations include but are not limited to adequately powered, high-quality RCTs to confirm the benefit of CIMT, mental practice, mirror therapy, virtual reality and a relatively high dose of repetitive task practice; high-quality RCTs to explore the effects of repetitive transcranial magnetic stimulation (rTMS), tDCS, hands-on therapy, music therapy, pharmacological interventions and interventions for sensory impairment; and up-to-date reviews related to biofeedback, Bobath therapy, electrical stimulation, reach-to-grasp exercise, repetitive task training, strength training and stretching and positioning. Large numbers of overlapping reviews related to interventions to improve upper limb function following stroke have been identified, and this overview serves to signpost clinicians and policy makers toward relevant systematic reviews to support clinical decisions, providing one accessible, comprehensive document, which should support clinicians and policy makers in clinical decision making for stroke rehabilitation.Currently, no high-quality evidence can be found for any interventions that are currently used as part of routine practice, and evidence is insufficient to enable comparison of the relative effectiveness of interventions. Effective collaboration is urgently needed to support large, robust RCTs of interventions currently used routinely within clinical practice. Evidence related to dose of interventions is particularly needed, as this information has widespread clinical and research implications.

BOBATH THERAPY IN CORRECTION OF PSYCHOMOTOR DEVELOPMENT OF CHILDREN WITH ORGANIC INJURIES CNS

The article represents therapy of Bobath such as one of the most effective author method which use in correction psychomotor development of children with disorders of musculoskeletal system. Bobath method is not new in the correction of movement disorders since last century and still supplementing and improving. In this work highlight topic of the effective use Bobath therapy in correction of psychomotor development in children age 3 – 6 years with organic involvement CNS. the experiment was based on evaluation of psycho physical state of experimental before and after 10 days course neurodevelopment therapy in hospital. The positive dynamics of motor activity in main position (lying, sitting, standing), learning motor skills (turn to the side on belly, standing on one leg), are proved effectiveness of applying Bobath therapy in correctional psychomotor development children aged 3-6 years with organic lesions CNS. applying Bobath therapy in correctional injuries in children with organic lesions CNS and exploring such as it included many aspects and direction: treatment position (normalization of muscle tone and effect on pathological reflexes) use physical exercises with use special extras (Bobath chair, Bobath couch with adjustable inclined surface, ball for feet, triangle and rollers to ensure the adoption of the necessary provisions), Bobath logopedics (normalization oral praxis, regulation of oral control, normalization of articulation muscles tone, learn the self-service skills, personal hygiene, feeding, changing clother.

Effects of individualized therapeutic porgram with heat-reinforcing needling in combination with Bobath therapy on gross motor dysfunction in children with cerebral palsy: a randomized controlled trial

ObjectiveTo explore the effect of heat-reinforcing acupuncture combined with Bobath rehabilitation training for the gross motor function measurement (GMFM) in children with cerebral palsy. MethodsSixty cases of cerebral palsy were randomized into a heat-reinforcing acupuncture combined with rehabilitation training group (group A) and a rehabilitation group (group B), 30 cases in each group. Rehabilitation training was applied in group B and heat-reinforcing acupuncture was added in group A. Jiāj▪ (▪ EX-B 2), Jiānyú (▪ LI 15), Qūchí (▪ LI 11), Hégŭ (▪ LI 4), Yánglíngquán (▪ GB 34), Yīnlíngquán (▪ SP 9), Xuánzhōng (▪ GB 39), Zúsānl▪ (▪ ST 36), Sānyīnjiāo (▪ SP 6), Chéngshān (▪ BL 57), Tài chōng (▪ LR 3), Tàixī (▪ KI 3) and Shénmén (▪ HT 4) were chosen in group A and the heat-reinforcing acupuncture was applied once a day. For scalp acupuncture, Băihuì (▪ GV 20), Sìshéncōng (▪ EX-HN 1), Zhìsānzhēn (▪), N▪osānzhēn (▪), Nièsānzhēn (▪) and motor area (▪) were punctured without any manipulation, once every other day, 3 months as a treatment course and 2 courses were needed. GMFM were selected to assess the children with cerebral palsy before treatment, after 3 months treatment and after 6 months treatment. ResultsThe total effective rate in group A was 70.00% (21/30), which is superior to that of 60.00% (24/30) in group B (P<0.05). In group A, the GMFM scores of decubitus position and turn-over of body, creeping and kneeling, sitting, standing, walking, running and jumping after 6 months treatment were significantly improved compared with that before treatment and after 3 months treatment (all P<0.05). In group B, above indices after 6 months treatment were significantly improved compared with those before treatment, the standing score after 6 months treatment was significantly improved compared with that after 3 months treatment (P<0.05); the GMFM scores of creeping, kneeling, sitting, standing, walking, running and jumping after 6 months treatment in group A were more significantly improved than that in group B (all P<0.05). ConclusionThe heat-reinforcing acupuncture combined with Bobath rehabilitation training has a better effect than rehabilitation training on the GMFM scores of creeping and kneeling, sitting, standing, walking, running and jumping of children with cerebral palsy. It can be shown that the combination of heat-reinforcing acupuncture and Bobath rehabilitation training can improve the gross motor function of children with cerebral palsy.

보바스 치료가 뇌졸중 환자에 균형과 보행에 미치는 효과

Purpose : The purpose of this study was to examine the effect of bobath treatment on the balance and gait in adult hemiplegia. Methods : The study was performed with patients of hemiparesis caused by cerebral stroke. The participants were based on random sampling method. The hemiplegia patient received Bobath therapy. Each rehabilitation program lasted 40 minutes a day, 5 days a week, for 6 weeks. Pertinent indicators Berg's balance scale (BBS), gait velocity, and static balance analysis were recorded before and after the programs, as well as every 2 weeks during the rehabilitation programs. Results : There was showed a significantly increase of BBS score. Static open and close showed statistically significant in interaction by time and groups. There was significant difference of gait velocity. Conclusion : These findings in this study that the Bobath therapy was effective therapy in improving dynamic balance and gait velocity.