L3 Part 2: Bobath Approach

Question 1

Overview

This technique inhibits abnormal patterns to facilitate motor function. RIMP ro perform isolated movements

Answer 1

Bobath Technique

Question 2

Overview

What are the 2 main claims of the Bobath Technique?

Answer 2

1. Reduction of Spasticity
2. Introduction of more selective (functional) movement patterns, both automatic and voluntary, in preparation of functional skills

Question 3

Shunting Rule of Magnus

At any moment during movement, the CNS mirrors what?

Answer 3

The state of elongation and contraction of the musculature

Question 4

Overview

What are the 5 Movement Components that are Prerequisites to the Performance of any Functional Task

Answer 4

1.Trunk Control and Mobility →Trunk Stability & Rotation
2.Head Control
3.Midline Orientation od Slef and Vertical Orientation of the Body to Environment → Midline Crossing & Vertical Position of Oneself
4.Weight Bearing and Weight Shifting in all directions
5.Limb Movement

Question 5

3 Prerequisites for Voluntary Functional Activity

Answer 5

1. Tone of Moderate Intensity
2. Reciprocal Innervation
3. Proximal Stability

Question 6

In the Hemiplegic patient, the main factors of abnormal postural reflex activity interfereing with movement are? (3)

Answer 6

1. Associated Reactions
2. Asymetrical Tonic Reflex Activity
3. Released positive supporting reaction

Question 7

Bobath Technique

What are the principles of development?

Answer 7

1. Usually proceeds cephalocaudally and proximodistally.
2. Proceeds from mobility to stability to controlled mobility
3. Gross motor control preceded fine motor control
4. Vetical movements are learned before horizontal movements are learned
5. Isometric control preceded isotonic control
6. Eccentric movement preceded concentric movement
7. Random unilateral skilled movments develop soon after

Question 8

Approaches to Treatment

Rehabilitation by compensation in the utilization of assistive devices to facilitate movement or to ensure stabiilty of a aprticular body part

Answer 8

Unilateral Apprach

↑ tone can lead to a distressingly obvious deformity → hinder mobility

Question 9

Approaches to Treatment

Symmetrical / Bobath’s Principle where there is segmental demonstration in order for the patient to not be dependent.

Ex. Right foot side steps, left foot side steps next

Answer 9

Bilateral Approach

Question 10

Approach to Treatment

What are Bobath’s 3 Advocacies?

Answer 10

1. Change of abnormal movment patterns
2. No to heavy resistance
3. Reflex Inhibiting Movement Patterns

Question 11

RIMP

RIMP of the UE

Ext3ER SupAb

Answer 11

1. Extension of neck and spine
2. External rotation of the shoulder
3. Elbow extension
4. Wrist extension
5. Supination and abduction of thumb

Question 12

RIMP

RIMP of the LE

AdEEDIR, AbRot

Answer 12

1. Hip abduction and external rotation
2. Hip and knee extension
3. Dorsiflexion of toes and ankles
4. Abduction of the big toe
5. Rotation of shoulder girdle against pelvis (vice versa)

Question 13

RIMP

What is the main RIMP counteracting flexor spasticity in the trunk and arm?

Answer 13

1. Extension of the neck and spine
2. External rotation of the arm and shoulder c extended elbow

Question 14

When is permanent reduction of spasticity only obtained?

Answer 14

When the pt is able to perform selective movements actively.

Question 15

This should be used to inc pisutal activity in pts c flaccidity and real weakness of musles.

Answer 15

Tactile Prorioceptive Stimulation

Question 16

Key Points of Control

Why should we use they key points of control?

Answer 16

1. Give pts as many sensations of normal muscle tone, posture, movement as possible
2. Lack of muscle power mat not be due to weakness but to the opposition of spastic antagonist.
3. Quicker and better results could be obtained if it is rehabilitated during the early stages

Question 17

Key Points of Control

To promote stability

Answer 17

Proximal Key Point (Shoulder Hip)

Question 18

Key Points of Control

To promote coordination

Answer 18

Distal Key Point (Wrist, ankle)

Question 19

Key Points of Control

Guided Movement

Answer 19

Intermediate Key Point (Elbow, Knee)