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The Bobath-concept - background -
The Bobath-concept was developed by Dr. Karel Bobath, neurologist
and psychiatrist (1906-1991), and Dr.h.c. Berta Bobath, physiotherapist
(1907-1991). The concepts main difference to other forms of
treatment lies in its holistic approach based on
- latest scientific findings on the development of brain
functions and
- neurophysiology.
Accordingly, the concept has been continually refined since
the beginnings in the forties. This openness for recent and
future scientific findings and empiric experience alike is exactly
the reason, why it is deliberately not labelled as being a 'method'.
Today, the Bobath-concept is applied by
- physiotherapists
- occupational therapists and
- speech therapists.
They treat clients from all age-groups with
- impaired movement functions after brain damage
- conspicuousness in movement
- neurological or neuro-muscular diseases and
- impaired cognition.
The treatment approach according to Bobath
During the course of its development, a child flexibly adapts
its innate repertoire of movements to all the varied circumstances
and requirements: out of curiosity, by trial and repetition,
it constantly acquires new movement patterns. Physical disturbance
or damage during this phase can impede the development of
movement capacity in a multitude of ways. The goal of the
Bobath approach is to provide an opportunity for 'motor learning'
by trial and repetition to patients of all age-groups.
Prerequisites for the treatment are
- a corresponding medical diagnosis and
- a complementary specialized result.
Initially, before 'motor learning' can be applied, it has
to be determined on which existing movement capacities the
treatment can be built in order
- to either improve or
- compensate for or
- at least to minimize deterioration of senso-motoric disturbances.
The basis of this analysis is formed by sophisticated knowledge
of the normal development as well as its variety and knowledge
of the pathological development with its effects on motor-learning
ability.
Treatment steps are deducted from this analysis. The patients
personality as well as his social environment has to be taken
in consideration as well.
Newly acquired skills and abilities are continually checked
against still persisting difficulties over the course of the
treatment. With the current treatment situation further demanding
a 'dialog approach', result and treatment together constitute
a momentum in their own right.
Best treatment results can be achieved when the following
requirements are met:
- specific action-tasks in everyday-situations are assigned
- the therapeutic approach matches age and development stage
of patient
- general alertness, motivation and attention are present
in all participants
The treatment is carried out as close to the 'normal' everyday
situation as possible. All areas of everyday life are integrated:
meals, communication, personal hygiene, dressing and undressing,
transportation. 'Small everyday challenges' stimulate experimentation,
exploration and trial of varied patterns of movement and promote
goal-directed motor learning. Likewise, ways are picked to
reinforce the client's own initiative.
Clients' attachment figures – with children mainly parents
– take part from the beginning and also when customized
approaches have to be considered.
The learning process is further supported through cognition
of various other stimuli. Touching and being touched,
moving and being moved are equally deliberately employed to
this end as cognition of additional acoustic, optic and taste
stimuli.
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