Bobath

Question 1

the bobath approach is aka

Answer 1

neurodevelopmental technique (NDT)

Question 2

NDT provides emphasis on _______

Answer 2

RIP - reflex inhibitory technique

Question 3

resistance of limb to passive movement

Answer 3

tone

Question 4

what constitutes abnormal tone

Answer 4

flaccid or spastic and associated reactions

Question 5

discuss flaccidity

Answer 5

seen in acute stroke

limb is heavy or dead weight in moving through ROM

(-) placing response

Question 6

what is placing response

Answer 6

ability to hold limb at a certain pos in ROM

Question 7

discuss spasticity

Answer 7

UMN; measure through modified ashwort scale

limbs are stiff and assume abnormal pos or synergies

limb resists passive motion especially fast

Question 8

discuss abnormal associated reactions

Answer 8

non-functional and involuntary changes in limb and muscle tone

sneeze = inc spasticity

Question 9

what are the normal postural reactions

Answer 9

righting reactions

equilibrium reactions

protective extension reaction

Question 10

this refers to the pt’s ability to move the head independent to the trunk and vice versa

Answer 10

righting reactions

Question 11

ability to shift weight towards opposite side if pt becomes unbalanced

Answer 11

equilibrium reactions

Question 12

ability to extend the extremity if pt loses balance to break the fall

Answer 12

protective extension reaction

Question 13

according to bobath the following problems are seen in stroke pt’s

Answer 13

loss of autonomic postural control

abnormal coordination

abnormal functional performance

Question 14

true or false

stable posture according to bobath is not needed to perform functional skills

Answer 14

false

need stable muna

Question 15

exp how loss of autonomic postural control is a problem for stroke pts

Answer 15

poor control on hemiplegic side inc risk of fall of the pt at that side

Question 16

exp how abnormal coordination is a problem for stroke pts

Answer 16

d/t spasticity, weakness and LOM pt has abnormal timing and coordination of muscles involved in movement

Question 17

exp how abnormal functional performance is a problem for stroke pts

Answer 17

presence of hemineglect reduces function of affected side

bobath advocates to bombard affected side with stimulus

Question 18

what are the 3 stages of recovery according to bobath

Answer 18

initial flaccid

spasticity stage

relative recovery stage

Question 19

discuss bobath’s initial flaccid stage

Answer 19

pt cannot move affected side nor appreciate that side

goal: proper pos and bed mob

Question 20

discuss bobath’s stage of spasticity

Answer 20

inc tone usually seen in out patient

pt may present c limb synergies

goal: dissociate synergy patterns and develop control

Question 21

discuss bobath’s stage of relative recovery

Answer 21

pt’s who have done well in treatment or not as affected

goal: improve gait and use of affected hand

Question 22

true or false

bobath believes that midline symmetry and posture is essential to correct first

Answer 22

true

correct posture then do exercises in the correct posture

Question 23

true or false

bobath says that you can impose normal movements on abnormal tone

Answer 23

false

normalize tone first

Question 24

true or false

bobath believes on the plasticity of the brain

Answer 24

true

the brain is capable to learn and develop new neurons

hence it is important to teach and make the pt experience normal movements

Question 25

what is the flowchart of bobath in treating stroke

Answer 25

inhibit spasticity and pathologic movements - stimulate autonomic reactions - emergence of normal voluntary movements

Question 26

what are the general rule of treatment for bobath

Answer 26

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

Question 27

what are the treatment techniques used by bobath

Answer 27

handling techniques RIPs key points sensory stimulation

Question 28

discuss handling techniques

Answer 28

use of RIPs and movement to elicit righting and equilibrium response uses: - influence postural tone - regulate coordination - inhibit abnormal patterns - facilitate autonomic reactions

Question 29

discuss RIPS

Answer 29

pos the limb opposite of the synergy used to inhibit abnormal patters dec spasticity prevent shunting of sensory flow to abnormal pattern adress hemineglect

Question 30

discuss key points

Answer 30

use of proximal parts of body as cues to elicit normal movement flex head = ext leg ext thumb to open other fingers

Question 31

discuss sensory stimulation

Answer 31

used for hypotonic and weak pt never done unless in RIP local response only 1. weight bearing c pressure and resistance to elicit postural tone 2. placing and holding 3. tapping on muscle belly to inc tone