Bobath concept

Bobath 概念
  • 文章类型: Journal Article
    本范围审查旨在描述Bobath概念是如何概念化的,可操作,并在成人神经康复中进行了研究。
    采用了乔安娜·布里格斯研究所(JBI)和范围审查的首选报告项目(PRISMA-ScR)指南。在电子数据库PubMed中搜索非科学和研究文章,护理和相关健康文献累积指数(CINAHL),Scopus,WebofScience,ScienceDirect,和物理治疗证据数据库(PEDro),关键词为“Bobath”或“神经发育治疗”,以英文出版,西班牙语,葡萄牙语,2013年至2023年。
    在确定的78种出版物中,31篇文章论述了Bobath概念的概念基础(7篇理论论文,七个德尔菲/调查/混合方法研究,四项定性研究,一次范围审查,给编辑的10封信,和两个社论),包括五个主题:(a)理论原则;(b)临床原则;(c)临床推理;(d)概念化运动;和,当前(e)证据辩论。修订后的定义和Bobath临床实践模型澄清了Bobath概念的独特方面。除了促进-视觉空间动觉感知-以及Bobath专家如何概念化运动之外,还确定了一种新的临床技能,这些都是临床推理不可或缺的。
    这篇综述提供了一个更新的Bobath临床框架,收集了在设计未来干预研究时需要仔细考虑的理论基础和临床实践原则。对康复的影响这项范围审查巩固了当代Bobath实践的临床和理论原理,为临床医生提供一个清晰的框架。Bobath临床实践模型(MBCP)框架可详细记录运动分析和运动诊断,指导临床推理和干预。这篇综述确定了基本原则和实践,为未来的Bobath干预研究提供信息。确保其临床相关性。已经制定了一个有具体建议的框架来指导Bobath干预研究,加强临床实践的整合,教育,和研究。
    UNASSIGNED: This scoping review aims to describe how Bobath concept is conceptualized, operationalized, and studied in adult neurorehabilitation.
    UNASSIGNED: The Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR) guidelines were adopted. Non-scientific and research articles were searched in electronic databases PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Web of Science, ScienceDirect, and Physiotherapy Evidence Database (PEDro), with the keywords \"Bobath\" or \"Neurodevelopmental Treatment\", published in English, Spanish, and Portuguese, between 2013 and 2023.
    UNASSIGNED: Of the 78 publications identified, 31 articles addressed the conceptual underpinnings of Bobath concept (seven theoretical papers, seven Delphi/surveys/mixed methods studies, four qualitative studies, one scoping review, 10 letters to the editor, and two editorials), comprising five themes: (a) theoretical principles; (b) clinical principles; (c) clinical reasoning; (d) conceptualizing movement; and, current (e) evidence debate. The revised definition and the Model of Bobath Clinical Practice provide a clarification of the unique aspects of Bobath concept. A new clinical skill was identified beyond facilitation - visuospatial kinesthetic perception - as well as how Bobath experts conceptualize movement, which are all integral to clinical reasoning.
    UNASSIGNED: This review provides an updated Bobath clinical framework that gathers the theoretical foundations and clinical practice principles that require careful consideration in the design of future intervention studies.Implications for rehabilitationThis scoping review consolidates the clinical and theoretical principles of contemporary Bobath practice, providing a clear framework for clinicians.The Model of Bobath Clinical Practice (MBCP) framework enables detailed documentation of movement analysis and movement diagnosis, guiding clinical reasoning and interventions.This review identifies fundamental principles and practices to inform future Bobath intervention studies, ensuring their clinical relevance.A framework with specific recommendations has been developed to guide Bobath intervention studies, enhancing the integration of clinical practice, education, and research.
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  • 文章类型: Journal Article
    躯干功能不足是平衡和移动性受损等许多问题的根本原因。尽管近年来有基于躯干的物理治疗方法,几乎所有这些方法都集中在运动问题上。本研究旨在探讨感觉训练结合以躯干为中心的Bobath练习对躯干控制和本体感觉的影响。balance,步态,和日常生活活动(ADL)。
    本研究是一项纳入27名中风患者的随机对照试验。参与者被分成两组,第1组;“感官训练结合以躯干为中心的Bobath练习”和第2组;“以躯干为中心的Bobath练习”。以躯干为中心的Bobath练习用于运动训练。感觉训练包括经皮神经电刺激和一组提供触觉和本体感觉刺激的练习。行李箱减值量表,行李箱重新定位错误,Berg平衡量表,2分钟步行测试,Barthel指数用于评估躯干控制,躯干本体感觉,balance,步态,和ADL分别。
    组内分析结果显示,树干对照,躯干本体感觉,balance,步态,两组治疗后ADL均有改善(p<0.05)。发现第1组参与者在治疗前后的躯干重新定位误差值的变化明显高于第2组(p<0.05)。
    研究结果表明,以躯干为中心的运动训练在改善躯干本体感觉和躯干控制方面是有效的,balance,步态,和ADL在中风患者中的应用。此外,感觉训练结合以躯干为中心的运动训练在改善躯干本体感觉方面比单独的运动训练更有效。
    UNASSIGNED: Inadequate trunk function is the underlying cause of many problems such as impaired balance and mobility. Although there have been trunk-based physiotherapy approaches in recent years, almost all of these approaches focus on motor problems. This study aims to investigate the effects of sensory training combined with trunk-centered Bobath exercises on trunk control and proprioception, balance, gait, and the activity of daily living (ADL).
    UNASSIGNED: This study is a randomized controlled trial included with twenty-seven stroke patients. Participants were separated into two groups, Group 1; \'sensory training combined with trunk-centered Bobath exercises\' and Group 2; \'trunk-centered Bobath exercises\'. Trunk-centered Bobath exercises were used for motor training. Sensory training included transcutaneous electric nerve stimulation and a set of exercises that provide tactile and proprioceptive stimulation. Trunk Impairment Scale, Trunk Reposition Error, Berg Balance Scale, 2-minute walk test, and Barthel Index were used to assess trunk control, trunk proprioception, balance, gait, and ADL respectively.
    UNASSIGNED: Intra-group analysis results showed that trunk control, trunk proprioception, balance, gait, and ADL improved in both groups after treatment (p < 0.05). The changes in the Trunk Reposition Error values of the participants in Group 1 before and after treatment was found to be significantly higher than Group 2 (p < 0.05).
    UNASSIGNED: The findings indicated that the application of trunk-centered motor training is effective in improving trunk proprioception and trunk control, balance, gait, and ADL in stroke patients. Also, sensory training combined with trunk-centered motor training was found more effective in improving trunk proprioception than solely motor training.
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  • 文章类型: Journal Article
    UNASSIGNED: The ability to perform routine tasks during reaching and activities of daily living (ADLs) is impaired as a result of deterioration in the postural adjustments after stroke. Trunk stability is needed to maintain balance, correct scapular position and posture while moving the upper extremity. The objective was to examine the effect of scapular exercises on the scapular stability, trunk control and ADLs.
    UNASSIGNED: Patients (50-85 years) with acute hemiparetic stroke were participated in this double blind randomized controlled study. The patients in both group were treated with the exercise program according to the Bobath concept and isometric scapular exercises were applied to the study group in addition to these exercises. The participants in both groups were taken into the physiotherapy program for 5 days and each program were taken 30 min. Patient assessment included Lateral scapular slide test (LSST), Trunk Impairment Scale (TIS), Trunk Control Test (TCT), Modified Barthel Index (MBI) and Reaching Performance Test (RPT).
    UNASSIGNED: Significant increases were observed distance in protraction, between protraction - retraction at 90° of shoulder abduction and flexion and retraction in 90° of shoulder abduction within both groups. Only the study group produced improvement in protraction of 90° of shoulder flexion (p < 0.05). While both groups achieved a significant improvement in TIS, MBI, RPT scores, TCT scores increased significantly only in study group (p < 0.05).
    UNASSIGNED: The adding isometric scapular exercises to the rehabilitation program significantly increased the effectivity of neurorehabilitation on increasing trunk control, independence during ADLs, reaching performance and reducing trunk impairment.
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  • 文章类型: Journal Article
    多发性硬化症(MS)是一种进行性疾病,其病程波动且不可预测,目前尚无治愈性治疗。它的主要特征之一是各种体征和症状,在疾病发展过程中出现平衡和步态改变的患者比例很高,肌肉力量下降,痉挛,或减少pimax。康复治疗,尤其是物理治疗,是使用反射运动和Bobath概念作为激活中枢神经系统预组织回路的运动疗法形式来治疗这些改变的主要过程。
    本研究的目的是评估反射运动和Bobath概念对平衡的影响,痉挛,反应时间,呼吸参数,和泪腺生物分子标记。
    这是一项在萨拉曼卡大学进行的关于两种神经康复技术在多发性硬化症患者中的有效性的随机对照试验。这项研究将在护理和物理治疗学院进行,萨拉曼卡大学。该研究将于2023年6月至2024年6月进行。反射运动组将接受单独的治疗(n=27),并且Bobath概念组(n=27)将接收相同数量的会话。两组都将在12个月内每周接受两次会议。测量变量将是伯格平衡量表,Tardieu量表,Cognitfit计划,最大吸气压力,和泪腺生物标志物。
    该研究已于2023年3月获得萨拉曼卡大学伦理委员会的批准(参考:896)。
    这项研究的主要限制是患者的选择和数量,在最初计划的时间段内实施治疗的延迟,样本收集不足,样品处理不足。
    ClinicalTrials.gov;标识符:NCT05558683。
    UNASSIGNED: Multiple sclerosis (MS) is a progressive disease with a fluctuating and unpredictable course that has no curative treatment at present. One of its main characteristics is the variety of signs and symptoms that produce a high percentage of patients who present alterations in balance and gait during the development of the disease, decreased muscle strength, spasticity, or decreased pimax. Rehabilitative therapy, especially physiotherapy, is the main course of the treatment of these alterations using reflex locomotion and the Bobath concept as a form of kinesitherapy that activates the preorganized circuits of the central nervous system.
    UNASSIGNED: The objective of this study is to evaluate the reflex locomotion and Bobath concept effects on balance, spasticity, reaction time, respiratory parameters, and lacrimal biomolecular markers.
    UNASSIGNED: This is a randomized controlled trial on the effectiveness of two neurorehabilitation techniques in patients with multiple sclerosis conducted at the University of Salamanca. The research will take place at the Faculty of Nursing and Physiotherapy, University of Salamanca. The study will be conducted from June 2023 to June 2024. The reflex locomotion group will receive individual sessions of therapy (n = 27), and the Bobath concept group (n = 27) will receive the same number of sessions. Both groups will receive two sessions per week for 12 months. The measurement variables will be the Berg Balance Scale, the Tardieu Scale, the Cognitfit Program, Maximum Inspiratory Pressure, and Lacrimal Biomarkers.
    UNASSIGNED: This study has been approved by the Ethics Committee of the University of Salamanca on March 2023 (ref: 896).
    UNASSIGNED: The main limitations of this study are the selection and number of patients, the delay in implementing the therapy within the initially scheduled period, inadequate sample collection, and inadequate sample processing.
    UNASSIGNED: ClinicalTrials.gov; identifier: NCT05558683.
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  • 文章类型: Randomized Controlled Trial
    背景:多发性硬化(MS)是一种通常导致运动和/或认知障碍的疾病。尽管有效的药物治疗越来越多,康复是抵消残疾进展和改善身体功能的非常重要的手段,影响社会参与和提高生活质量。在神经运动康复的背景下可以使用几种康复方法,但文献中证据不足.
    目的:这项研究有两个目的:(i)研究根据Bobath概念进行康复是否可以改善MS患者的平衡和认知功能的某些方面;(ii)探讨是否可以改善姿势控制能力,适应性神经可塑性的间接指标,保留在MS患者中,以及是否可以通过康复来改善。
    方法:这是一项独立的等待研究。纳入40名MS(pwMS)患者:根据Bobath概念,Bobath组的患者接受了8周的康复治疗。对于目标1,在基线(T0)评估pwMS,在治疗8周结束时(T1)和8周后(T2)用运动和认知量表进行观察。对于目标2,将相同的40pwMS与健康对照进行匹配,并在T0,T1和T2使用力平台进行姿势学习任务。
    结果:Bobath组患者在T1时的平衡和认知功能得分较好,但在T2时这种改善没有保持。在每次评估时,所有患者在姿势学习任务中的准确性均低于对照组;然而,患者在训练后还表现出准确性的提高,与健康对照相似。在T1时间随机分配到活动组的患者的学习曲线比等待列表更好,但这种优势在T2评估中并未保持.
    结论:根据结果,这项研究支持根据Bobath概念使用康复来改善MS的平衡控制和一些执行功能。尽管基线表现较差,pwMS能够与健康对照一样学习姿势控制任务。此外,支持以下假设:尽管MS仍保留了适应性可塑性,并且可以通过康复来促进。
    BACKGROUND: Multiple Sclerosis (MS) is a disease that often results in motor and/or cognitive disability. Despite the increasing availability of effective drug therapies, rehabilitation is very important means of counteracting the progression of disability and improving physical function, impacting social participation and improving quality of life. Several rehabilitation approaches can be used in the context of neuro-motor rehabilitation, but there is insufficient evidence for them in the literature.
    OBJECTIVE: This study has the twofold purpose of: (i) investigate whether rehabilitation according to Bobath Concept can improve balance and some aspects of cognitive function in MS patients; (ii) explore whether the ability to improve postural control, an indirect index of adaptive neuroplasticity, is preserved in MS patients and whether it can be improved with rehabilitation.
    METHODS: This is an independent wait-listed study. Forty people with MS (pwMS) were enrolled: patients in the Bobath group underwent 8 weeks of rehabilitation according to the Bobath Concept. For aim 1, pwMS were assessed at baseline (T0), at the end of the 8 weeks of treatment (T1) and after 8 weeks of observation (T2) with motor and cognitive scales. For aim 2, the same 40 pwMS were matched with healthy controls and were subjected to a postural learning task using the force platform at T0, T1 and T2.
    RESULTS: Patients in Bobath group scored better on balance and cognitive function at T1, but this improvement was not maintained at T2. All patients were less accurate than controls in the postural learning task at each assessment; however, patients also demonstrated an increase in accuracy after training, similar to that of healthy controls. The learning curve was better for patients randomized to the active group than the waitlist at T1 time, but this advantage was not maintained at the T2 assessment.
    CONCLUSIONS: In light of the results, this study supports the use of rehabilitation according to Bobath Concept to improve balance control and some executive functions in MS. Despite worse baseline performance, pwMS were able to learn a postural control task on par with healthy controls. Also, supports the hypothesis that adaptive plasticity is preserved despite MS and can be promoted by rehabilitation.
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  • 文章类型: Journal Article
    背景:中风后,患者感受到感觉运动损伤,平衡失调,失去选择性运动,低张力和/或高张力,和超敏反应,所有这些都会影响步态。
    目的:本研究的目的是确定Bobath治疗与其他特定软组织动员相比标准Bobath干预的有效性。
    方法:将受试者随机分为两组(S1和S2),每组20人。两组在5周内接受相同的干预(Bobath概念),而第二研究组(S2)也接受了额外的治疗,特定的软组织动员。伯格平衡量表(BBS)定时启动和启动测试(TUGT),背屈和膝关节屈伸的活动范围(AROM)用作临床变量,以评估治疗方式的疗效。使用混合模型ANOVA分析数据。
    结果:发现了组和时间的显著交互作用。实验(S2)组比对照(S1)组有更大的平衡和AROM改善。对于TUGT,一组没有明显的优势。
    结论:研究结果表明,Bobath治疗和其他特定软组织动员的组合在增加AROM以及平衡和移动性方面更有效。
    BACKGROUND: After a stroke, patients experience sensorimotor damage, balance disorders, loss of selective movement, hypotonia and/or hypertonia, and hypersensitivity, all of which affect gait.
    OBJECTIVE: The aim of the study was to establish the effectiveness of Bobath therapy with additional specific soft tissue mobilizations versus standard Bobath intervention.
    METHODS: Subjects were randomly divided into two groups (S1 and S2) of 20 people each. Both groups underwent the same intervention (Bobath concept) over a 5-week period, while the second study group (S2) also received additional, specific soft tissue mobilization. The Berg Balance Scale (BBS), Timed Up and Go Test (TUGT), Active Range of Motion (AROM) of dorsiflexion and knee flexion and extension were used as clinical variables to assess the efficacy of therapy modalities. Data was analysed using a mixed model ANOVA.
    RESULTS: A significant interaction of group and time was found. The experimental (S2) group had a larger improvement of balance and AROM than the control (S1) group. There was no clear advantage of one group over the other for TUGT.
    CONCLUSIONS: The findings demonstrate that a combination of Bobath treatment and additional specific soft tissue mobilizations are more effective in increasing AROM and balance and mobility.
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  • 文章类型: Journal Article
    目标:Bobath方法,也被称为神经发育治疗(NDT),是许多国家在中风偏瘫患者康复中广泛使用的概念。这项技术多年来一直在世界各地使用;然而,其有用性的有力证据仍然不存在。本综述旨在根据运动功能障碍的中风患者康复的随机对照试验来了解其有效性,并将其与其他治疗技术进行比较。
    方法:关于PubMedCentral的系统文献检索,科学直接,科克伦,Scopus,临床试验数据库,和印度临床试验注册在2021年7月31日之前的英语进行。该评价发表在前瞻性系统评价登记册(PROSPERO)上,注册号为“CRD42019125400。“物理治疗循证数据库(PEDro)评分已用于研究的质量评估。纳入了与其他康复技术相比,研究NDT/Bobath概念对中风患者运动活动结果和认知/行为的比较效果的随机临床试验。
    结果:没有强有力的文件描述这种神经发育治疗或其辅助神经发育治疗与其他先进的神经理疗技术相比的有效性,因此认为它是推荐的治疗中风后偏瘫/偏瘫。建议选择进一步研究的方法方面。
    结论:本研究在确定Bobath方法对中风患者运动康复的有效性方面尚无定论。这些结果与以前对同一主题进行的评论的结果相似。
    OBJECTIVE: The Bobath approach, also known as neurodevelopmental treatment (NDT), is a widely used concept in the rehabilitation of stroke patients with hemiparesis in many countries. This technique is being used since years all over the world; however, strong evidence of its usefulness is still not present. This review is aimed to find out its effectiveness based on the randomized controlled trials in the rehabilitation of stroke patients with motor disability and to compare it with other therapeutic techniques.
    METHODS: A systematic literature search on PubMed Central, Science-Direct, Cochrane, Scopus, Clinical Trial Database, and Indian Clinical Trial Registry in English till 31st July 2021 was undertaken. The review is published in Prospective Register of Systematic Reviews (PROSPERO) with registration number \"CRD42019125400.\" Physiotherapy Evidence-based Database (PEDro) score has been used for the quality assessment of the studies. Randomized clinical trials that studied the comparative effect of the NDT/Bobath concept on motor activity outcomes and cognition/behavior in stroke patients in comparison with other rehabilitative techniques were included.
    RESULTS: No strong documentation describing the effectiveness of this neuro-developmental treatment or its supporting neuro-developmental treatment in comparison with other advanced neuro-physiotherapeutic techniques has been found so as to consider it as the recommended treatment for post-stroke hemiplegia/hemiparesis. Methodological aspects of selected studies for further research are suggested.
    CONCLUSIONS: This study is inconclusive in determining the effectiveness of the Bobath approach for the movement rehabilitation of stroke patients. These results are similar to the results of previous reviews done on the same topic.
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  • 文章类型: Evaluation Study
    OBJECTIVE: To develop a revised definition of the Bobath concept that incorporates the perspectives of members of the International Bobath Instructors Training Association (IBITA).
    METHODS: A three-phase consensus building design utilizing (i) focus groups; (ii) survey methods; and, (iii) real-time Delphi. This paper presents the findings from the real-time Delphi, an iterative process to collect and synthesize expert opinions anonymously, provide controlled feedback, with the overall goal of achieving consensus.
    RESULTS: One hundred and twenty-one IBITA members participated in the real-time Delphi. Over three Delphi Rounds, consensus was reached on six overarching conceptual statements and 11 statements representing unique aspects of Bobath clinical practice. One statement that aimed to describe the Bobath clinical term of \"placing\" was eliminated in Round One due to participant reservations that a text description was insufficient for this term. Seven statements underwent minor wording revisions in Round Two and Three to improve sentence clarity.
    CONCLUSIONS: Using the real-time Delphi, we were successful in gaining consensus in an expert group on a series of statements on which a revised definition of the Bobath concept could be based.
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  • 文章类型: Journal Article
    Purpose: To evaluate the effectiveness of the Bobath concept in sensorimotor rehabilitation after stroke.Materials and methods: A systematic literature review was conducted on the Bobath concept from the first publication available to January 2018, consulting PUBMED, CENTRAL, CINAHL and PEDro databases. Fifteen clinical trials were selected in two consecutive screenings. Two independent researchers rated the studies according to the PEDro scale from which a best evidence synthesis was derived to determine the strength of the evidence.Results: The Bobath concept is not more effective than other approaches used in post-stroke rehabilitation. There is moderate evidence for the superiority of other therapeutic approaches such as forced use of the affected upper limb and constraint-induced movement therapy for motor control of the upper limb.Conclusions: The Bobath concept is not superior to other approaches for regaining mobility, motor control of the lower limb and gait, balance and activities of daily living of patients after stroke. There is moderate evidence regarding the superior results of other approaches in terms of the motor control and dexterity of the upper limb. Due to the limitations concerning the methodological quality of the studies, further well-designed studies are needed.Implications for rehabilitationThe Bobath concept is not superior to other approaches for patients after stroke.The treatments that incorporate overuse of the affected upper limb via intensive treatments with high-repetitions with or without robotic aids present greater effectiveness in the motor control of the upper limb and dexterity.
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  • 文章类型: Journal Article
    OBJECTIVE: This study was developed as a consensus-building exercise within the International Bobath Instructors Training Association (IBITA) to develop a revised definition of the Bobath concept.
    METHODS: A three-phase design utilizing (a) focus groups, (b) survey methods, and, (c) real-time Delphi. This paper details Phase 1 and 2.
    RESULTS: Forty IBITA members participated in five focus groups. Eight broad themes were developed from the focus groups from which the survey statements were developed. There was a high level of agreement on all nine survey statements identifying overarching constructs and on 12 of the 13 statements identifying unique aspects of Bobath clinical practice. Lower scores were attributed to lack of understanding of the term humanistic, Bobath clinical practice addressing multiple domains such as impairments, activities, and participation and limited agreement on the description of the term \"placing.\"
    CONCLUSIONS: Focus groups and a web-based survey were successful in soliciting the opinions of IBITA members on themes and statements of importance for the development of a revised Bobath definition. The results of Phase 1 and 2 will inform Phase 3, a real-time Delphi, to gain consensus within IBITA on statements on which a revised Bobath definition is to be based.
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