Bobath Concept 評価・治療の進め方と実際 · PDF file2011/9/9 1...
Transcript of Bobath Concept 評価・治療の進め方と実際 · PDF file2011/9/9 1...
2011/9/9
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PT
Bobath Concept
IBITA,2004
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Bobath Concept
Postural control
Balance strategies
Patterns of movement
Muscle strength and endurance
Bobath Concept
UMNS
Minus Symptoms
Plus Symptoms
Biomechanicalchanges 2010 Gerlinde Haase
Upper motor neuron syndrome
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UMNS
Hughlings Jackson
Weakness, loss of dexterity, fatigueability
Spasticity, clonus, associated reactions
An important consequence of the initial loss of dynamic
stability is the development of compensatory mechanisms.
At a functional level the compensatory mechanisms may achieve the task.
If they do, they will reinforce the behaviour and may prevent the acquisition of other behaviours.
Treatment methods in the Bobath Concept for Minus - Symptoms
2010 Gerlinde Haase
Postural control
Orientation
Alignment
Body schema
Stability
Feedforward
Neuronal APAs
Muscular activitypreparation / excitation
Feedback(error adjustment)
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Postural Stability The control of the bodys center of mass within the boundaries of
space
=stability-limits
Stability limits are not fix but can be adapted and changed
Depending on the individual the task in the momentarily environmental situation
Stability is produced by feedforward control (APAs)APAs
And enhanced by sensory feedback
2010 Gerlinde Haase
Postural orientation
The ability to maintain alignment between body segments
The appropriate relationship between body and environment
Establishment of vertical orientation to counteract the force of gravity
Creates a reference frame for perception and action with respect to the external world
2010 Gerlinde Haase
Postural alignment
Arrangement of body segments to one another, as well as the position of the body with reference to gravity and the base of support.
Alignment determines the constellation of movement strategies that will be effective in controlling posture
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Body schema
Bobath Concept
BOS
Anticipatory Mechanisms
Predictive strategy
Pre-programmed muscle groups / force/
Minimizes postural displacements
Central stability
Prerequisite of selective movement
Experience
Movement / task specific/ 2010 Gerlinde Haase
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The Bobath Concept in Adult Neurology ()
Proactive / Reactive Balance
BOS Base of Support
Core Stability Core stability is the reciprocal co-activation of extensors
and flexors in the lower trunk for antigravity control.
Establish a stable alignment in body segments
It minimizes the amount of movement in the lower trunk, so that the other body parts above (upper trunk, head and upper extremities, HAT) can move more selectively.HAT
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()
The Bobath Concept in Adult Neurology ()
To make it possible
To make it necessary
Let it happen
Brooks 1986
Facilitation
Facilitation
Handling
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Motor Learning
Interaction of individual, environment and task
Intension, motivation and goal setting
Praxis and repetition
Feedback
Task variations and transfer to daily life situations
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Clinical reasoningin the Bobath Concept
ObservationAssessment
Analysis
Intervention
Assessment
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PT/OT/ST
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Bobath Concept