The Bobath Concept for Cerebral Palsy and Stroke Rehabilitation

Bobath should have been shitcanned since 2003.

My best therapist supposedly used it but I really think her competence came from her knowledge of anatomy.

Physiotherapy Based on the Bobath Concept for Adults with Post-Stroke Hemiplegia: A Review of Effectiveness Studies 2003

The latest here:

 

The Bobath Concept for Cerebral Palsy and Stroke Rehabilitation

In the United States, the Bobath concept is known as Neurodevelopmental Therapy (NDT). Patients with cerebral palsy, stroke and other central nervous system diseases have postural and movement abnormalities that lead to limitations in functional activity. Bobath’s approach is individual and continues to evolve. It is based on brain neuroplasticity and is multidisciplinary, and includes physical therapy, occupational therapy, and speech and language therapy.

Rehabilitation after stroke

Systematic review from 2009 published in the journal brain attack Comparison of the efficacy of Bobath therapy with conventional therapies for stroke and no evidence was found of superiority of Bobath therapy over other stroke therapies for upper and lower extremity sensorimotor control, dexterity, mobility, ADL, HRQOL, and cost-effectiveness. It found methodological shortcomings in the studies reviewed and called for further research.

current status

The Bobath approach is widely used in stroke and cerebral palsy, although there is no good evidence for its effectiveness. The Neurodevelopmental Therapy Association (NDTA) continues to offer certification in NDT. Some European countries consider Bobath’s approach to be outdated and no longer teach it.

conclusion

Bobath’s approach looked promising, providing practical, individualized and multidisciplinary interventions to improve function in cerebral palsy and rehabilitation after stroke. But evidence from scientific studies has not proven its superiority over other treatments. More high-quality research is needed.

Harriet Hall, MD Also known as The SkepDoc, he is a retired family physician who writes about pseudoscience and questionable medical practices. She received her MBBS and MS degrees from the University of Washington, completed her Air Force training (the second woman ever to do so), and was the first graduate of an Air Force residency practice family at Eglin Air Force Base. During her long career as a medic in the Air Force, she held various positions from flight surgeon to DBMS (Director of Basic Medical Services) and did everything from delivering babies to taking control of the B-52. I retired with the rank of colonel. In 2008 she published her memoir, Women are not supposed to fly.

 

Caffeine Improves Long-Term Neurodevelopment in Premature Infants

How would this apply to stroke survivors? We also are starting over with neurodevelopment.

Should we start with caffeine right after we give patients caffeinol?

Does Coffee and Alcohol (Caffeinol) Prevent and Reduce Severity of Strokes?

The latest here:

Caffeine Improves Long-Term Neurodevelopment in Premature Infants

The prompt administration of caffeine to very premature infants is associated with improvement in their long-term neurodevelopment, researchers reported here on April 27 at the 2015 Annual Meeting of the Pediatric Academic Societies (PAS)
The prowess of caffeine as a neuroprotectant has been harnessed to lessen apnoea in premature infants. Use of the drug in very premature infants also appears to be beneficial in terms of lessening bronchopulmonary dysplasia and patent ductus arteriosus. However, the benefits of caffeine on long-term neurodevelopment are less clear.
For the current prospective study, Abhay K. Lodha, MD, University of Calgary, Calgary, Alberta, and colleagues explored the effect of caffeine therapy started within 2 days following the birth of very preterm neonates on their neurodevelopment at a correct age of 18 to 21 months.
The study involved 3,145 surviving neonates <29 weeks gestational age born in 27 hospitals nationwide in Canada between July 1, 2009 and December 31, 2011. Of these, 467 missed subsequent follow-ups and caffeine data was missing in 8. The remaining 2,670 neonates had been randomised to receive caffeine within 2 days of birth (early caffeine, n = 1941) or later than 2 days after birth (late caffeine, n = 729).
By 18 to 21 months corrected age, infants in both groups were similar in terms of the occurrence of bronchopulmonary dysplasia, patent ductus arteriosus, intraventricular haemorrhage, sepsis, and necrotizing enterocolitis.
Neurodevelopmental impairment was evident in 1,164 (60%) infants in the early caffeine group and in 474 (65%) of the late caffeine group (adjusted odds ratio = 1.0; 95% confidence interval, 0.8-1.3).
The early caffeine group showed lower incidences of definitive cerebral palsy (3.9% vs 7.8%), visual impairment (1.6% vs 2.7%), hearing impairment (6.8% vs 9.9%), and Bayley-III composite scores <85 in cognition (13.2% vs 17.5%), language (33.5% vs 38.3%), and motor composition (19.9% vs 25.5%).
“There is a significantly lower incidence of adverse neurodevelopmental outcome in newborns in the early caffeine group,” concluded Dr. Lodha.
The researchers hope that the information will spur at least the consideration of caffeine’s prowess in the neurodevelopment in very premature neonates, if not the adoption of the use of caffeine therapy early after birth in this at-risk population.
[Presentation title: Early Caffeine Administration and Long-Term Neurodevelopmental Outcomes in Premature Infants (<29 Weeks) at 18 to 24 Months Corrected Age (CA) in Canadian Neonatal Follow-Up Network (CNFUN). Abstract 3856.127]