What is Bobath? A survey of UK stroke physiotherapists' perceptions of the content of the Bobath concept to treat postural control and mobility problems after stroke

Abstract

Objective. The aim of this study was to identify which interventions used to treat postural control and mobility are considered part of the Bobath concept (BC).

Design. Hospital-based UK stroke physiotherapists identified interventions which they perceived to be part of the BC from a pre-published list of interventions used to treat postural control and mobility problems. Interventions that >75% of participants felt were part of the BC were classified as ‘definitely Bobath’. Interventions that <25% felt were part of the BC were classified as ‘definitely not Bobath’. Other interventions were classified as ‘unsure’; those indentified by 50–74% of participants as part of the BC were classified as ‘probably Bobath’ and those indentified 26–49% were classified as ‘probably not Bobath’.

Results. Seventy-four physiotherapists from 33 hospitals participated. Facilitation, mobilizations and practicing components of activities were most strongly associated with the BC. Exercise and the use of equipment were identified as ‘not’ or ‘probably not Bobath’. There was uncertainty about practicing activities, teaching patients and carers and arranging independent practice.

Conclusions. UK stroke physiotherapists perceive that the BC involves interventions that focus on facilitating movement, mobilization, practicing components of activities and some whole activities. Their views about what is not part of the BC and the areas where they are uncertain contrast with British and international teachers of the BC. Consequently, it was not possible to define a ‘typical package’ of treatment for postural control and mobility that represents the BC. Future research into the BC should focus on the effectiveness of specific, well-defined interventions.

Keywords:

• Bobath Concept
• physiotherapy
• stroke
• postural control
• balance