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Is Bobath-based therapy used by physiotherapists in the care of stroke patients?

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The aim of this study was to investigate if physiotherapists had knowledge and skills in applying Bobath-based therapy
(BB), also referred to as Neurodevelopmental Treatment, in the care of stroke patients and if they generally used the
therapy in daily practice. This is because of the important emphasis placed on documenting the extent of the therapy
given to the client groups compared in outcome studies measuring the efficacy of therapeutic interventions. The study
took place as an intervention check for a large outcome study measuring the effects of BB therapy. BB therapy had been
implemented on six wards, whereas six other wards did not use this approach. The physiotherapists (n /38) knowledge
and skills in making decisions about applying the BB principles in all wards was measured in two steps. In step 1, the
physiotherapists received a questionnaire focusing on their physiotherapy strategy, and Bobath education. In step 2, they
received a case vignette describing a stroke patient and questions concerning the content of the physiotherapy provided to
this patient. An expert panel judged the therapists responses to the questions of both steps. Of the physiotherapists
working in the BB wards, 14 (74%) therapists generally used BB principles, whereas four (21%) therapists did not (one
was uncertain). Of the physiotherapists working in the non-BB wards (n /19), three (16%) did use BB therapy whereas
10 (52%) therapists did not use the therapy (six responses were missing). The study showed that within the BB wards, the
physiotherapists had followed sufficient BB education, as judged by a panel of experts, and demonstrated the knowledge
and skills in applying the BB therapy, whereas in the other wards they did not. BB wards could therefore participate in
the experimental group of the study measuring the effects of the Bobath therapy, and the non-BB wards could serve as
proper control wards.


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