Deans' stroke musings: 2009 - The Effectiveness of the Bobath Concept in Stroke

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Friday, September 20, 2019

2009 - The Effectiveness of the Bobath Concept in Stroke

If Bobath is not superior why the hell would you recommend further trials? Since this was written in 2009 have your therapists discontinued using Bobath?

2009 - The Effectiveness of the Bobath Concept in Stroke

Boudewijn J. Kollen, PhD; Sheila Lennon, PhD; Bernadette Lyons, MSc; Laura Wheatley-Smith, BSc;Mark Scheper, MSc; Jaap H. Buurke, PhD; Jos Halfens;Alexander C.H. Geurts, MD, PhD; Gert Kwakkel, PhD

Purpose

In the Western world, the Bobath Concept or neurodevelopmental treatment is the most popular treatment approach used in stroke rehabilitation, yet the superiority of the Bobath Concept as the optimal type of treatment has not been established. This systematic review of randomized, controlled trials aimed to evaluate the available evidence for the effectiveness of the Bobath Concept in stroke rehabilitation.

Method

(March 2008) and by screening the references of selected publications (including reviews). Studies in which the effects of the Bobath Concept were investigated were classified into the following domains: sensorimotor control of upper and lowerlimb; sitting and standing, balance control, and dexterity; mobility; activities of daily living; health-related quality of life; and cost-effectiveness. Due to methodological heterogeneity within the selected studies, statistical pooling was not considered. Two independent researchers rated all retrieved literature according to the Physiotherapy Evidence Database(PEDro) scale from which a best evidence synthesis was derived to determine the strength of the evidence for both effectiveness of the Bobath Concept and for its superiority over other approaches.

Results

The search strategy initially identified 2263 studies. After selection based on predetermined criteria, finally, 16 studiesinvolving 813 patients with stroke were included for further analysis. There was no evidence of superiority of Bobath onsensorimotor control of upper and lower limb, dexterity, mobility, activities of daily living, health-related quality of life, and cost-effectiveness. Only limited evidence was found for balance control in favor of Bobath. Because of the limited evidenceavailable, no best evidence synthesis was applied for the health-related quality-of-life domain and cost-effectiveness.

Conclusions

This systematic review confirms that overall the Bobath Concept is not superior to other approaches. Based on best evidence synthesis, no evidence is available for the superiority of any approach. This review has highlighted many methodological shortcomings in the studies reviewed; further high-quality trials need to be published.Evidence-based guidelines rather than therapist preference should serve as a framework from which therapists should derive the most effective treatment. Stroke . 2009;40:e89-e97.)