BOBATH APPROACH
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MOTOR LEARNING PROGRAMM
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Model of motor control
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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.
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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.
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Theories of motor development
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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.
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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.
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Assumption of therapeutic approaches
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- 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.
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- 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
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Evaluation
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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. |
