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

Published by GajananBhalerao

DR. GAJANAN BHALERAO (PT) MPTh Neuro, NDT Adult (USA), Motor relearning (Australia), Aquatic therapist (Switzerland). Associate professor at Sancheti Institute College of physiotherapy, Shivajinagar, Pune. Founder Director of "School of neuro rehab and aquatic therapy" , speciality centre for neuro rehabilitation of stroke, brain and spinal cord injury. Mobile : 9822623701 Email:Gajanan_bhalerao@yahoo.com, gajanan.neurophysio@gmail.com

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