Notes on Bobath Therapy (NDT)

Introduction to Bobath Therapy

• Also known as Neurodevelopmental Therapy (NDT).
• A problem-solving approach for assessing and treating conditions such as:
  • Cerebral palsy
  • Stroke
  • Head injury
  • Other neurological disorders

Key Principles of NDT

• Each patient is considered unique with different sets of problems.
• Therapists conduct thorough evaluations to identify specific issues.
• Strategies for problem-solving are tailored to each individual's needs.

Historical Background

• Developed by Berta Bobath (physiotherapist) and Karel Bobath (psychiatrist and neurophysiologist) in 1948.
• Initial development involved trial and error techniques to alter abnormal tone in hemiplegic/stroke patients.
• Berta Bobath demonstrated the ability to retrain normal motor movement patterns in these patients.
• Rejected compensatory training that focuses on using the unaffected side, emphasizing the potential of the affected side.

Theoretical Foundations

• Karel Bobath expanded on Berta's findings with theoretical explanations of improvement in patients.
• Contradicted the reflex hierarchical theory proposed by Charles Sherrington, which suggested that brain damage leads to abnormal tone.
• Introduced the concept of neuroplasticity, where the brain can regain control over lower centers to regulate tone and promote normal movement.

Evolution of Bobath Therapy

• Since its inception, the Bobath approach has evolved through ongoing research, leading to:
  • Modification of theories and practice models.
  • Introduction of new treatment methods.
• Currently more commonly referred to as Neurodevelopmental Therapy (NDT).

Practicing NDT Therapy

• Therapists must develop:
  • Good posture and movement analysis skills.
  • Awareness that therapy must be individualized; no one-size-fits-all treatment.

Considerations for Therapists

• Assess the current functional status of the patient:
  • How much the patient can perform using the hemiplegic side.
• Identify possible reasons for limited use of the hemiplegic side:
  • Limited range of motion
  • Lack of strength
  • Poor somatosensory awareness
  • Inadequate visual feedback
• Focus on deep analysis of these problems to devise effective treatment strategies.

Conclusion

• The series aims to make NDT more accessible to therapists globally, sharing techniques, assessment skills, and treatment methods.
• Encouragement to keep learning, sharing, and staying engaged in the topic.