HandFun Meeting 2013

Bobath Concept
q Assessment and rehabilitation of persons with disorders of function,
movement and postural control.
q Current Neurophysiology.
q Science movement (motor control, motor learning).
q Biomechanics and sensory components, perceptual,
cognitive, adaptive and motor.
q Normal movement.

Where does our hand begin?

Hand as the organ that explores

and interacts with the world.
Tallis, 2008

Hand evaluation
q Psychological / Cognitive / Emotional (Physiotherapist, Occupational
Therapists, Neuropsychologist)
q Sensitive / proprioceptive and perceptive.
q Motor.
Standardized Tests:
- Rivermead
- Fugl-Meyer Scale
- Motor Activity Log (MAL)
- etc

Specific work of the hand

Individual C.

Task

Environment

Patterns of movement and behavior

Specific work of the hand

1. Individual characteristics
q Stability precedes mobility.
q Postural Control Hand
q Active participation by the patient.
q Learning organization and integration.

Specific work of the hand

2.Environment

Specific work of the hand

3.Task
The patients
participation

Motivation
Cognitive processes/Planning
Cortical organization/Learning

Movement
facilitation
by physiotherapist

Search normal patterns of movement

Task success
Reinforce feedback and help feedforward

Visual input
Somesthetic input

Parietal cortex
Premotor cortex

Primary motor
cortex

Movement

Specific work of the hand

Mayston, 1999

Motor

Biomechanical

Components to
make an

Sensitive

EFFICIENT
MOVEMENT

Perceptual

Applicability to patient's
daily life

Cognitive

ITY
L
A
N
O
I
FUNCT

Environment and contact with the space

Patient

Physiotherapist

Gives meaning to the task.

Gives the preparation of the hand (form,

size ).

CONCLUSIONS
q Its a concept, not a technique or a method.
q It kept in mind postural control and motor learning.
q Component cognitive, sensory, proprioceptive, motor and integration
into daily life.
q Three factors to consider: individual, task and environment.
q Collaboration with other professionals, therapies and approaches.
q Mirror Therapy, forced use therapy, new technologies, splints and
other assistance.

BIBLIOGRAPHY
Bobath, B.; Hemiplejia del adulto: Evaluacin y Tratamiento; 1999; Editorial Mdica Panamericana
De Diego C, Puig S, Navarro X. A sensorimotor stimulation program for rehabilitation of chronic stroke patients. Restor
Neurol Neurosci. 2013; 31(4):361-71
Majnemer, A., Bourbonnais, D., Frak, V., (2008). The role of sensation for hand function in children with cerebral palsy.
Clinics in Developmental Medicine: Improving hand function in cerebral palsy: theory, evidence and intervention . A-C
Eliasson, and P. Burtner. Eds, MacKeith Press.
Mayston M (1999) An overview of the central nervous system. Workshop, SA Neurodevelopmental therapy
Association, Johannesburg , 1999.
Ertelt D, Hemmelmann C, Dettmers C, Ziegler A, Binkofski F.; Observation and execution of upper-limb movements as
a tool for rehabilitation of motor deficits in paretic stroke patients: protocol pf a randomized clinical trial. BMC Neurology
2012, 12:42
Oujamaa L, Relave I, Froger J, Mottet D, Pelissier JY. Rehabilitation of arm function after stroke. Literature review.
Ann Phys Rehabil Med. 2009; 52(3):269-93.
Paeth, B.; Experiencias con el concepto Bobath: fundamentos, tratamiento, casos; 2006; Editorial Mdica
Panamericana
Partridge CJ.; Physiotherapy approaches to the treatment of neurological conditions - an historical perspective. In:
Edwards S, editor(s). Neurological physiotherapy. A problem-solving approach. Edinburgh: Churchill
Livingstone, 1996:3-14.

BIBLIOGRAPHY
Paci M. Physiotherapy based on the Bobath concept for adults with post-stroke hemiplegia: a review of effectiveness
studies. J Rehabil Med 2003; 35:2-7.
Scalha TB, Miyasaki E et al; Correlations between motor and sensory functions in upper limb chronic hemiparetics after
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Lippincott Williams & Wilkins; 2007Tallis, R.; The Hand; 2008
Smania N, Montagnana B, Faccioli S, Fiaschi A, et al. Rehabilitation of somatic sensation and related deficit of motor
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Wolf, S.L., Winstein, C.J., Taub, E., Uswatte, G., Morris, D., Giuliani, C., Light, K.E., and Nicholas-Larsen, D. Effect of
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 THANKS !