BOBATH APPROACH

MOTOR LEARNING PROGRAMM

Model of motor control

• 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.

• 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

• 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.

• 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

• 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. 

• 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.