Bobath Flashcards

1
Q

the bobath approach is aka

A

neurodevelopmental technique (NDT)

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2
Q

NDT provides emphasis on _______

A

RIP - reflex inhibitory technique

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3
Q

resistance of limb to passive movement

A

tone

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4
Q

what constitutes abnormal tone

A

flaccid or spastic and associated reactions

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5
Q

discuss flaccidity

A

seen in acute stroke

limb is heavy or dead weight in moving through ROM

(-) placing response

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6
Q

what is placing response

A

ability to hold limb at a certain pos in ROM

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7
Q

discuss spasticity

A

UMN; measure through modified ashwort scale

limbs are stiff and assume abnormal pos or synergies

limb resists passive motion especially fast

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8
Q

discuss abnormal associated reactions

A

non-functional and involuntary changes in limb and muscle tone

sneeze = inc spasticity

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9
Q

what are the normal postural reactions

A

righting reactions

equilibrium reactions

protective extension reaction

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10
Q

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

A

righting reactions

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11
Q

ability to shift weight towards opposite side if pt becomes unbalanced

A

equilibrium reactions

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12
Q

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

A

protective extension reaction

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13
Q

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

A

loss of autonomic postural control

abnormal coordination

abnormal functional performance

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14
Q

true or false

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

A

false

need stable muna

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15
Q

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

A

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

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16
Q

exp how abnormal coordination is a problem for stroke pts

A

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

17
Q

exp how abnormal functional performance is a problem for stroke pts

A

presence of hemineglect reduces function of affected side

bobath advocates to bombard affected side with stimulus

18
Q

what are the 3 stages of recovery according to bobath

A

initial flaccid

spasticity stage

relative recovery stage

19
Q

discuss bobath’s initial flaccid stage

A

pt cannot move affected side nor appreciate that side

goal: proper pos and bed mob

20
Q

discuss bobath’s stage of spasticity

A

inc tone usually seen in out patient

pt may present c limb synergies

goal: dissociate synergy patterns and develop control

21
Q

discuss bobath’s stage of relative recovery

A

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

goal: improve gait and use of affected hand

22
Q

true or false

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

A

true

correct posture then do exercises in the correct posture

23
Q

true or false

bobath says that you can impose normal movements on abnormal tone

A

false

normalize tone first

24
Q

true or false

bobath believes on the plasticity of the brain

A

true

the brain is capable to learn and develop new neurons

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

25
Q

what is the flowchart of bobath in treating stroke

A

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

26
Q

what are the general rule of treatment for bobath

A

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

27
Q

what are the treatment techniques used by bobath

A

handling techniques

RIPs

key points

sensory stimulation

28
Q

discuss handling techniques

A

use of RIPs and movement to elicit righting and equilibrium response

uses:
- influence postural tone
- regulate coordination
- inhibit abnormal patterns
- facilitate autonomic reactions

29
Q

discuss RIPS

A

pos the limb opposite of the synergy

used to inhibit abnormal patters

dec spasticity

prevent shunting of sensory flow to abnormal pattern

adress hemineglect

30
Q

discuss key points

A

use of proximal parts of body as cues to elicit normal movement

flex head = ext leg

ext thumb to open other fingers

31
Q

discuss sensory stimulation

A

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