Bobath Flashcards
the bobath approach is aka
neurodevelopmental technique (NDT)
NDT provides emphasis on _______
RIP - reflex inhibitory technique
resistance of limb to passive movement
tone
what constitutes abnormal tone
flaccid or spastic and associated reactions
discuss flaccidity
seen in acute stroke
limb is heavy or dead weight in moving through ROM
(-) placing response
what is placing response
ability to hold limb at a certain pos in ROM
discuss spasticity
UMN; measure through modified ashwort scale
limbs are stiff and assume abnormal pos or synergies
limb resists passive motion especially fast
discuss abnormal associated reactions
non-functional and involuntary changes in limb and muscle tone
sneeze = inc spasticity
what are the normal postural reactions
righting reactions
equilibrium reactions
protective extension reaction
this refers to the pt’s ability to move the head independent to the trunk and vice versa
righting reactions
ability to shift weight towards opposite side if pt becomes unbalanced
equilibrium reactions
ability to extend the extremity if pt loses balance to break the fall
protective extension reaction
according to bobath the following problems are seen in stroke pt’s
loss of autonomic postural control
abnormal coordination
abnormal functional performance
true or false
stable posture according to bobath is not needed to perform functional skills
false
need stable muna
exp how loss of autonomic postural control is a problem for stroke pts
poor control on hemiplegic side inc risk of fall of the pt at that side
exp how abnormal coordination is a problem for stroke pts
d/t spasticity, weakness and LOM pt has abnormal timing and coordination of muscles involved in movement
exp how abnormal functional performance is a problem for stroke pts
presence of hemineglect reduces function of affected side
bobath advocates to bombard affected side with stimulus
what are the 3 stages of recovery according to bobath
initial flaccid
spasticity stage
relative recovery stage
discuss bobath’s initial flaccid stage
pt cannot move affected side nor appreciate that side
goal: proper pos and bed mob
discuss bobath’s stage of spasticity
inc tone usually seen in out patient
pt may present c limb synergies
goal: dissociate synergy patterns and develop control
discuss bobath’s stage of relative recovery
pt’s who have done well in treatment or not as affected
goal: improve gait and use of affected hand
true or false
bobath believes that midline symmetry and posture is essential to correct first
true
correct posture then do exercises in the correct posture
true or false
bobath says that you can impose normal movements on abnormal tone
false
normalize tone first
true or false
bobath believes on the plasticity of the brain
true
the brain is capable to learn and develop new neurons
hence it is important to teach and make the pt experience normal movements
what is the flowchart of bobath in treating stroke
inhibit spasticity and pathologic movements - stimulate autonomic reactions - emergence of normal voluntary movements
what are the general rule of treatment for bobath
avoid movements that inc spasticity or abnormal responses
should be directed towards normal patterns and function
incorporate hemiplegic side always
should improve function of involved side
what are the treatment techniques used by bobath
handling techniques
RIPs
key points
sensory stimulation
discuss handling techniques
use of RIPs and movement to elicit righting and equilibrium response
uses:
- influence postural tone
- regulate coordination
- inhibit abnormal patterns
- facilitate autonomic reactions
discuss RIPS
pos the limb opposite of the synergy
used to inhibit abnormal patters
dec spasticity
prevent shunting of sensory flow to abnormal pattern
adress hemineglect
discuss key points
use of proximal parts of body as cues to elicit normal movement
flex head = ext leg
ext thumb to open other fingers
discuss sensory stimulation
used for hypotonic and weak pt
never done unless in RIP
local response only
- weight bearing c pressure and resistance to elicit postural tone
- placing and holding
- tapping on muscle belly to inc tone
