COMPARISION OF BOBATH APPRPACH & MOTOR LEARNING PROGRAME


BOBATH APPROACH

MOTOR LEARNING PROGRAMM

Model of motor control

Hierarchical

  • Movement are elicited by sensory input or controlled by central programs.
  • Open loop & closed loop control is used.
  • Feedback & feed-forward influences movements.
  • CNS is hierarchically organized, with higher centers controlling lower centers.
  • Reciprocal innervations are essential for coordinated movement.
Systemic model

  • Personal & environmental systems interact to achieve functional goals.
  • Movement emerges from the interaction of many systems.
  • Systems are dynamical, self-organizing & heterarchical.
  • Movement used for a task is the preferred for achieving a functional goal.
  • Changes in one or more  system can alter behavior.

Theories of motor development

Neuromaturational

  • Changes are due to CNS maturation.
  • Development follows a predictable sequence (e.g. cephalo-caudal, proximal to distal).
  • CNS damage leads to regression to lower levels & more stereotypical behaviors.
Systems

  • Changes due to interaction of multiple systems.
  • Progression varies because person & environmental context are unique.
  • CNS damage leads to attempts to use remaining resources to achieve functional goals.
  • CNS is hierarchically organized.
  • Sensory stimuli inhibit spasticity & abnormal movements & facilitate normal movement & postural responses.
  • Repetition of movement results in positive permanent change in CNS.
  • Recovery from CNC damage follows a predictable sequence.
  • Behavioral changes after CNS damage have a neurophysiological basis.

Assumption of therapeutic approaches

  •  CNS is hierarchically organized.
  • Sensory stimuli inhibit spasticity & abnormal movements & facilitate normal movement & postural responses.
  • Repetition of movement results in positive permanent change in CNS.
  • Recovery from CNC damage follows a predictable sequence.
  • Behavioral changes after CNS damage have a neurophysiological basis.
  • Personal and environmental systems, including CNS is heterarchically organized.
  • Functional task helps to organize behavior.
  • Occupational performance emerges from the interaction of person & their environment.
  • Experimentation with various strategies lead to optimal solution to motor problems.
  • Recovery is variable because personal characteristics & environmental context are unique.
  • Behavioral changes reflect attempts to compensate and to achieve task performance

Evaluation

Primary focus on performance components

  • Abnormal muscle tone
  • Abnormal reflexes & stereotypical patterns lead to in coordination.
  • Postural control
  • Memory & judgment
  • Stages of recovery or developmental levels.

Secondary focus on occupational performance. 

Primary focus on role & occupational performance using a client-cantered view.

  • Task analysis to determine performance components & context that limit function & to identify preferred movement patterns for specific tasks in varied contexts.
  • Variables that causes transition to new patterns.

 Secondary focus on selected occupational performance components & contexts that limit functions

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