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Bobath Approach in cerebral palsy

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Summary

This on-demand teaching session provides in-depth understanding on a sensorimotor approach to treatment, particularly focusing on progressive neuromotor facilitation techniques. Medically relevant and promising, this course provides a theoretical understanding of various therapeutic models, aiding the treatment of stroke and cerebral palsy patients. Learn about open and closed-loop systems and their applications, the hierarchy of motor controls, and delve into the fascinating area of neurodevelopmental models. Knowledge from this course is instrumental in understanding brain damage, abnormal reflexes, and the process of restoring normal movement. Better balance, normal postures and improved motor control can be achieved through techniques taught here which align with the neurodevelopmental approach. Furthermore, key principles of treatment for adult stroke patients will be discussed. Medical professionals can use this knowledge in their practice to enhance their patients' outcomes and speed up their recovery process.
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Description

The Bobath Approach, developed by Berta and Karel Bobath, is a widely recognized therapeutic approach used in the treatment of individuals with neurological conditions such as cerebral palsy. It focuses on facilitating normal movement patterns and promoting functional independence through a holistic understanding of motor control and sensory processing.

During this workshop, participants will have the opportunity to:

  1. Gain insights into the theoretical foundations of the Bobath Concept.
  2. Learn practical techniques for assessment and treatment planning in cerebral palsy.
  3. Explore hands-on demonstrations and case studies illustrating the application of the Bobath Approach in clinical practice.
  4. Discuss interdisciplinary collaboration and integration of the Bobath principles into a comprehensive treatment plan.

Our esteemed facilitators, who are experienced clinicians specializing in neurorehabilitation, will guide you through interactive sessions aimed at enhancing your clinical skills and decision-making abilities in managing individuals with cerebral palsy.

Whether you are a physiotherapist, occupational therapist, speech-language pathologist, or other healthcare professional working with individuals with cerebral palsy, this workshop offers valuable insights and practical strategies to optimize outcomes and improve quality of life for your patients.

We look forward to your active participation and meaningful engagement in this enriching learning experience.

Learning objectives

1. Understand the sensorimotor approach to treating patients with neurological disorders and demonstrate how the systems of sensory stimulation, motor response control, and organ sensory to motor response collectively function in sensory motor therapy. 2. Gain knowledge and understanding of progressive neuromuscular facilitation techniques and their application in the treatment of conditions like stroke and cerebral palsy. 3. Learn concepts of neurodevelopmental model, open and closed-loop systems, and how these methods facilitate the control of muscle movements. 4. Grasp the theories and approaches such as the reflex movement theory, hierarchical theory, and system approach in the neurodevelopmental model and understand how they contribute to improved motor control. 5. Develop comprehensive strategies for treatment and rehabilitation of patients with neurological-based movement disorders, emphasizing postural movement patterns, reflex activities, development of normal patterns of posture movement and enhancement of quality of movement.
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OK. So one of the sensor motor approaches treatment, sensory or motor system therapy approach. And then we have pro facilitation, the treatment sensory system stimulate motor response control uh and uh and organ sensory system to motor response to sensory motor approach. A treatment or motor system involved the approach facilitation, facilitation control. The is this is one of the sensorimotor approach or it may all be treatment as a one stronger root approach and progressive neuromuscular facilitation technique. II need your treatment. Uh Yes in theoretical basis and understanding your uh the neurodevelopmental model reflects the theory or system approach. So understand chemically four theories. Yeah, four approaches your models via in you understand both uh uh J the subequalum neurodevelopmental model. I change your neurodevelopmental model and motor controls and move and do two system of output. One is the open loop system and second is the closed loop system. Your upper loop system control uh isolated movement of the muscles and like the one is the control. And second is the close loop control or control, automatic control and functional activities. And these movements are in your control and motions activities and you control in key development system system or closed loop system gives me efferent feedback. It depends upon the efferent feedback, sensory feedback, you automatically work it. Mass movements and posture control. For example, to control, this is involuntary and automatically you have control, give or move, move activity control system. Next theory, theory, reflex, the movement and your basic unit of motor control reflexes, reflexes and but may into purposeful movement, movement, proficient movement when a baby is born or auto control or just a more so. Yeah. Uh or could you in so as you like most of the new, you have integrations or you have control. So control uh control reflex and three activities. Both important point, central nervous system damage, stroke, stroke, brain damage or brain cell damage to er this is called erg of the reflexes. Uh move abnormal per per training and retraining activity. Both important uh theory, hierarchical theory, hierarchical the motor control. It, it is hierarchically arranged, higher center and just cerebral cortex and middle uh center and middle segmental levels. Lower lower levels. Yes, motor control, your lower go, control your pain or lower. You have fever muscles, go, muscles get to go or uh your controller develop pain, your higher center, middle and lower inhibitory control and higher centers, lower center, inhibitory control to movement. You have a normal movement or posture, you have a normal in higher center is a problem. I agree. The middle or lower center which have control to lower your muscles and postures and or skill. Both the important and new job approach. That is the system approach or hierarchical. So system approach, there is a mutable relationship between various levels of the brain and brain get you a different level that just say higher center and middle centers and your lower center. In a mutable relationship. There is absolute control of higher center on the middle, middle brain, middle centers system approach, brain get different parts. You have a mutable relationship. Absolute control control or upper mutable control available. Uh Both important treatment or so, uh there are many treatment uh that are focused on S Moor approaches in neurodevelopmental reflex theory, hierarchical theory or system approach. So, it was developed by Doctor Carol, that was a neuropsychiatrist and uh and Missus Bertha bath and she was a physical therapist. See husband wife, he was a neuro psychiatrist. Yeah, pediatric neurologist with her or uh physical therapist in 1943 May technique. The was a physiotherapist who had initially trained in remedial gymnastics and she understood normal movement and the posture, one is the movement and second is the posture, his treatment, but stroke. So she was a ag uh gymnastics. She understood normal movement and the posture. And together with her husband Carol, who was a pediatric neurologist, pediatric neurologist, movement of in depth understanding uh has developed an approach to the treatment of cerebral palsy that would encourage uh child to move and function as normally as possible technique you develop, perform movement or normal function important but it is used for stroke and cerebral palsy. So, treatment, neurological based movement disorder, neuro your movement disorder, cerebral palsy, this is the uh disorder of movement and the posture that is caused by immature brain. So, cerebral palsy or stroke, neurological based movement disorders, caffeine or immature brain stroke. And you have a brain. Uh do you have a skilled brain? That pathophysiology make a brain. Brain is a central organ or sorry movements. You have control brain can then and your primary motor area has motor area. Individual muscles get you movements have work and yeah, the problem with the brain, the brain, you have a movement, movement, sensation, muscles, muscles, the movement based and neurological based movement disorder has cereals and stroke or asthma and problems control control here, hyper uh inhibit movements or reflex movement or normal. But normal brain has normal influences on lower center than the normal development, upper center intact. So normally inhibition will continue it or normal movement develop or upper or lower center inhibition, inhibition, stereotypical posture, primitive movements. So is uh model key. You know, key is the key. Any patient who occupies just a cerebral palsy and stroke to control automatically the neuroplasticity, uh control uh loss of uh one side moment because uh blood circulation. So a key move, right brain, you have a left uh side move, control or left brain, you have right side, movement control. But so your main problem, main problem, trauma, upper or lower movement control, muscle to control car. Ok. Abnormal. So it may have abnormal coordination of movement patterns. Any patient with movement, we have like under the control of reflex activity and brain carpal control, both come to say abnormal patterns develop abnormal postural tone problem is the muscle strength, muscle activity abnormal. Ok. So your main problem OK. Abnormal uh to have abnormal movement, abnormal reflexes, abnormal postures because of in upper motor, yeah, higher center. So this is a living concept. It is not static. This is important living may change or with the rational. This is a holistic approach. Holistic approach. It involves the whole patient system, perceptual system, adaptive behavior or motor problem as a whole. They think it's basic, you have idea understand it. Do you have a uh or do you have, do you have a treatment you have? So your basic idea, sensation of movement and learn not the movement, sensation of the sensation of movement. For example, uh this is the perception of the movement of sensation of the moment. Yeah, actually again. OK. About next one, they can basic postural movement pattern, learn which are later elaborated on to become functional skills, movement patterns. For example, patient functional activity movement. What pattern develop. What about patient functional activity, uh function skill of every skilled activity take place against a background of basic pattern of posture control writing reaction reaction. R protective reactions movement reflects activity reflex, the skilled movement with the patient. So, activity activity activity or movement. Because motor control sensory system for motor control, when brain is damaged, abnormal pattern of posture movements develop which are incompatible with the performance of normal everyday activities. The upper motor control disturb oga or incompatible movement, abnormal movements, abnormal movements will continue the whole brain training or retraining say will ever develop any abnormal develop the abnormal pattern developed because of sensation is shunted into this abnormal pattern. Normal sensation, abnormal sensation, the brain normal normal normal normal posture, abnormal movements, ski ski sensation. Do you have abnormal, the abnormal pattern must be stopped onto uh not so much by modifying the sensor input but by giving back to the patient, the are under developed control over his output in developmental sequence. Patient uh motor control, you have a normal movement or abnormal reflex activity inhibition. It is or get your normal movement will facilitate. So it may be developmental sequence. The basic pattern of posture and the movement, the writing reaction and uh responses are elicited by providing the appropriate stimulant. I'm thinking which is you have uh something react OK. Activity when a baby is born when you need reflex is optimal pain writing reactions. So the basic s activity writing reactions in this way, patient, the patient is giving the opportunity to experience normal movement. The sensory formation of correct movement is absolutely necessary for the development of improved motor control. So, sensory formation, your normal movement sensation, patient, normal motor control treatment therefore, concentrate on handling the patient in such a way as to inhibit abnormal distribution of tone and abnormal postures, thickening part handling of the patient, patient uh abnormal uh develop now to esca your word use key point control. But uh uh limb or lower limb may be key point control which areas and proximal body parts and just the head, neck trunk and some and sometimes distal parts take just the thumb and the finger and go home. Key point control, caffeine around the joint, uh your back go around the grip on it around the joint, on each eye back muscles. You comes comes stimulator, the wound areas called keypoint control to have a card attack. Uh upper motor principle erg of primitive reflexes, adult stroke, emergence of primitive reflexes, primitive reflexes go in reactions, go any reactions, reactions, reactions that stimulate normal patient go. Treatment should be developmental. Uh Treatment should be to control the patient and control point control area, weight bearing exercises. For example, weight stimulate is also a organ system to stimulate motor response or may have different positions, limb position, body part, key position to use. Ok. Controlled develop or avoidance of sensory input that affect the muscle tone, flexor muscle there, hyper hyperactive. The control of movement was thought to be dependent on normal posture reflex mechanism. You you can do a normal reflex mechanism treatment to neurodevelopmental technique. And so this is very much similar to uh not a static treatment, not a static approach mutable relationship between the various parts of the brain or system approach neurodevelopmental technique T KD. So this is the reconstruction of uh of the N DT approach is different part of the CNS influence one another T KG nervous system is capable of initiating anticipating and controlling the movement T KD is coming for that or feed forward and feedback uh mechanism of motor control system. And DT approach, neuroplasticity, neuroplasticity care, brain keying or this is neuroplasticity, sensation of movement and not movement, brain sense the movement, not muscle concentration of muscles like muscles, it may move. Is it up a paralysis of movement has skill hand e control and muscle scar po paralysis in the basic post movement pattern. Learn that are later elaborated on the become the functional skills, postural movement or posture control movement pattern control stroke, abnormal postural control, patient get disturbed with abnormal coordination, mil abnormal functional performance mil to go county. I get abnormal to to spasticity, control cabinet skills bearing exercise, inhibition, facilitation principle of treatment but improved control of involved drunk arm in the leg, retain normal functional pattern of the movement in the adult stroke. Patient to go treatment should avoid movement and activities that increase muscle tone or produce abnormal reflex pattern. In the involved side, treatment should be directed towards the development development of normal pattern of posture and the movement. Normal movement treatment should produce a change in the quality of movement and functional performance of the involved side. Patient gives you quality of movement normal reflects activity, quality of movement principle of treatment. In adult individualized functional outcomes, your concentration or give a functional activity or it may have motor control, carrying it patient active Jason or motor learning, motor learning Sao training and retraining task barbar perform practice for 24 or management to increase retention and carryover effect. So for example, patient inhibiting posture, the patient go posture 24 hours, maintain or carryover effect. Use an interdisciplinary approach to intervention, interdisciplinary approach, physiotherapy speciality, occupational therapy and as a medical treatment, your speech therapy, uh for example, positioning or movements, concentrate stage of spasticity. Both important is normal reflex, normal patterns or abnormal and abnormal patterns inhibiting postures and quality of life, functional activities, abnormal patterns not facilitate. How about that to cerebral palsy. This is very similar to adult stroke like in immature brain to abnormal development, abnormal reflexes and abnormal writing reactions and abnormal postures. You ever develop or abnormal postures don't get abnormal muscle activity or no abnormal movement or miles in child as a whole, a whole motor system hearing system system. This can have a bone density, your diet, uh swing, swing or you have I think both important again, but you uh chest infection both common. But as a whole patient who they can just give, you have uh on a basis for intervention is normal movement. They can, so they can estimate your intervention and you will have normal movement. Get these other app that training crying, a normal movement, ski jelly brain or normal movements will develop or patient may normal control develop treatment can key point control areas. The key point control, keypoint control, keypoint control. OK. So these are the parts of the body where the therapist can most effectively control and change pattern of postures at the moment area. That therapist you have a patient go most efficient way, control cuts like that or yeah, movements go yeah, good change like that proximal or distal or proximal, just the spine to always do you have a patient with spine, shoulder scapula pelvis and the hip. A key point control distal areas, jaw, elbow, wrist, knee base of the thumb, ankle, big toe or head, maybe proximal distal K PC. Keep control. You say you have a patient pain, use K PC that allow full pattern to be broken during handling, maximum patient to control and facilitation and inhibition facilitation into normal movements. And you have normal reflexes and in abnormal abnormal uh normal move, patients can develop techni this is manner of controlling the patient through tone, influencing patterns in normal pa of activity. Used to modify abnormal patterns of postures and the movements inhibiting postures in patient move, sensation, sensation, uh posture. You have normal uh position and A sensation is normal, must be active during the treatment. Voluntary control of normal responses and control treatment and evaluation. Our own evaluation B treatment is functionally oriented. Functional activities concentrate individual mus muscles. Training Q how many patients give functional activity? Go improve? ND is appropriate for person with sensory motor dysfunction regardless of age and cognition. No to the old treatment method via handling technique, reflex inhibiting postures, uh keypoint control, understand to, to head or neck position, normal different postures, understand position or prey correction, patient pelvis, uh lower weight bearing area or, and use B or A. You have a good day. OK. We bearing on upper lane therapy can around the shoulder or it could you have a motor control practice for a year. Again, they can keep fine. Only one finger and thumb is using in RR they can movement, go rolling or gripping, they can shower or pelvis and or patient you have a proper training. A rotation of the trunk is could be understand, cannot go over suggest improvement of the patient uh treatment or can you can see, OK. How is the therapist is handling the patient or control? So uh next time.