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Activation asymmetry of the lateral abdominal muscles in response to neurodevelopmental traction technique in children with pelvic asymmetry. BIOMEDICAL HUMAN KINETICS 2023. [DOI: 10.2478/bhk-2023-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Abstract
Study aim: The aim of the study was to evaluate asymmetry of activation of lateral abdominal muscles (LAM) in response to neurodevelopmental traction technique in children with pelvic asymmetry.
Material and methods: Measurements of LAM activation asymmetry were performed during traction with the force of 5% body weight in two experimental conditions: 1) in neutral position, 2) in 20° posterior trunk inclination. Twenty-three healthy children with pelvic asymmetry participated in the study. To evaluate LAM activation asymmetry ultrasound technology was employed (two Mindray DP660 devices (Mindray, Shenzhen, China)). Activation asymmetry indices for each individual LAM were calculated.
Results: The magnitude of LAM activation asymmetry indexes formed a gradient, with the most profound transversus abdominis (TrA) showing the greatest asymmetry, and the most superficial obliquus externus – the smallest. The inter-muscle differences were most pronounced between the TrA and the two more superficial oblique muscles. There were no correlation between the magnitude of pelvic asymmetry and LAM activation asymmetry.
Conclusions: During the neurodevelopmental traction technique there is a difference in individual LAM activation symmetry, with deeper muscles showing greater asymmetry. The activation asymmetry of the LAM does not seem to be associated with the pelvic asymmetry. Results are similar to those recorded in earlier studies in samples where no pelvic asymmetry were subjected to analysis.
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Castelli L, Giovannini S, Iacovelli C, Fusco A, Pastorino R, Marafon DP, Pozzilli C, Padua L. Training-dependent plasticity and far transfer effect enhanced by Bobath rehabilitation in Multiple Sclerosis. Mult Scler Relat Disord 2022; 68:104241. [PMID: 36274281 DOI: 10.1016/j.msard.2022.104241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/21/2022] [Accepted: 10/09/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Multiple Sclerosis (MS) is a disease that often results in motor and/or cognitive disability. Despite the increasing availability of effective drug therapies, rehabilitation is very important means of counteracting the progression of disability and improving physical function, impacting social participation and improving quality of life. Several rehabilitation approaches can be used in the context of neuro-motor rehabilitation, but there is insufficient evidence for them in the literature. OBJECTIVES This study has the twofold purpose of: (i) investigate whether rehabilitation according to Bobath Concept can improve balance and some aspects of cognitive function in MS patients; (ii) explore whether the ability to improve postural control, an indirect index of adaptive neuroplasticity, is preserved in MS patients and whether it can be improved with rehabilitation. METHOD This is an independent wait-listed study. Forty people with MS (pwMS) were enrolled: patients in the Bobath group underwent 8 weeks of rehabilitation according to the Bobath Concept. For aim 1, pwMS were assessed at baseline (T0), at the end of the 8 weeks of treatment (T1) and after 8 weeks of observation (T2) with motor and cognitive scales. For aim 2, the same 40 pwMS were matched with healthy controls and were subjected to a postural learning task using the force platform at T0, T1 and T2. RESULTS Patients in Bobath group scored better on balance and cognitive function at T1, but this improvement was not maintained at T2. All patients were less accurate than controls in the postural learning task at each assessment; however, patients also demonstrated an increase in accuracy after training, similar to that of healthy controls. The learning curve was better for patients randomized to the active group than the waitlist at T1 time, but this advantage was not maintained at the T2 assessment. CONCLUSION In light of the results, this study supports the use of rehabilitation according to Bobath Concept to improve balance control and some executive functions in MS. Despite worse baseline performance, pwMS were able to learn a postural control task on par with healthy controls. Also, supports the hypothesis that adaptive plasticity is preserved despite MS and can be promoted by rehabilitation.
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Affiliation(s)
- Letizia Castelli
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Silvia Giovannini
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; UOS Riabilitazione Post-acuzie, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
| | - Chiara Iacovelli
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Augusto Fusco
- UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Roberta Pastorino
- Department of Woman and Child Health and Public Health-Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Denise Pires Marafon
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Carlo Pozzilli
- Department of Human Neurosciences, Sapienza University, Roma, Italy
| | - Luca Padua
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
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Schimschal SE, Visentin D, Kornhaber R, Barnett T, Cleary M. Development of a Scale to Measure the Psychological Resources of Grit in Adults. Nurs Health Sci 2022; 24:752-763. [PMID: 35811301 PMCID: PMC9544496 DOI: 10.1111/nhs.12973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 05/18/2022] [Accepted: 06/26/2022] [Indexed: 11/28/2022]
Abstract
Grit, a personality trait characterized by having passion and perseverance for long‐term goals, has been linked to increased performance, retention, and well‐being in various fields. In the 15 years since the original grit scale was published, many studies have investigated factors that promote grit. However, a scale has not yet been developed measuring characteristics that can contribute to higher levels of grit. This study aimed to develop a novel scale to measure the psychological resources of grit. The Delphi technique was used to obtain consensus from a national and international panel of academics and practitioners who are experts in grit and related constructs. A total of 30 participants rated 100 scale items over three rounds of online surveys. Experts agreed that items selected for the final scale (n = 20) were essential, with 85% rating them as important or very important. The scale, called the Grit Psychological Resources Scale, has promise as a helpful tool for practitioners involved in staff development and building capabilities that contribute to goal achievement.
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Affiliation(s)
- Sarah E Schimschal
- Centre for Rural Health, School of Health Sciences, University of Tasmania, Australia
| | - Denis Visentin
- School of Health Sciences, University of Tasmania, Australia
| | | | - Tony Barnett
- Centre for Rural Health, School of Health Sciences, University of Tasmania, Australia
| | - Michelle Cleary
- School of Nursing, Midwifery & Social Sciences, CQUniversity, Australia
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Cabezas-López M, Bernabéu-Brotóns E. The effects of Bobath therapy on children with cerebral palsy: a systematic review. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2022. [DOI: 10.12968/ijtr.2021.0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims Despite its broad application in paediatric care, the effectiveness of therapy based on the Bobath concept has not been systematically researched. The aim of this review was to explore whether there is scientific evidence regarding the validity of the Bobath concept as an effective therapy for children with cerebral palsy. Methods A search was conducted between March and December 2020, of research databases (Cochrane, PEDro, PubMed, Web of Science), selecting randomised controlled trials published since 2015, which compared Bobath therapy with other therapies in terms of their effect on the gross motor functions of children with cerebral palsy. Results Applying the eligibility criteria, four randomised controlled trials were selected, three of which found Bobath therapy to be more effective than other therapies as a therapeutic method, while one found no difference between Bobath therapy and another therapy. No study that met the inclusion criteria found Bobath therapy to be less effective than another therapy. Conclusions The principal limitation of this review has been the small number of randomised controlled trials found and so the results must be interpreted with caution. Nonetheless, studies showed that therapy based on Bobath therapy improves the gross motor function of children with cerebral palsy.
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Farjoun N, Mayston M, Florencio LL, Fernández-De-Las-Peñas C, Palacios-Ceña D. Essence of the Bobath concept in the treatment of children with cerebral palsy. A qualitative study of the experience of Spanish therapists. Physiother Theory Pract 2022; 38:151-163. [PMID: 32043397 DOI: 10.1080/09593985.2020.1725943] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 10/09/2019] [Accepted: 01/07/2020] [Indexed: 10/25/2022]
Abstract
Objective: The aim was to explore the experiences of a group of Spanish physical therapists who apply the Bobath concept in the treatment of children with cerebral palsy, specifically to identify the components they experience as core and essential to the Bobath concept.Design: A qualitative phenomenological study.Methods: This study used purposive sampling. Non-structured interviews were carried out with 10 Spanish Bobath-trained physical therapists who treat children with cerebral palsy. Thematic analysis was applied.Results: Five themes regarding the essence of the Bobath concept emerged: 1) "normal movement" as a guide; 2) a "global" concept; 3) observation; 4) the centrality of tone; and 5) working with families. Within these themes, additional principles were reflected cross-sectionally, such as therapy being a continuous process of assessment and treatment, the application of principles of motor learning, and the importance of carryover of treatment into function.Conclusions: The results demonstrated themes traditionally identified as core to the Bobath concept, including working with families, which is also considered integral to the approach. The study participants used outdated terminology at times when discussing tone and movement. However, they reported that they no longer adhere to the theoretical perspective of pathological reflexes and reflex/tone inhibition. This study provides insight into how treatment of children with cerebral palsy based on the Bobath concept is experienced by a group of Spanish physiotherapists, who identified five main themes that they perceive as essential. The results provide grounds for further research into the application of the Bobath concept in children.
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Affiliation(s)
- Naama Farjoun
- Fundación Valenciana Para La Neurorehabilitación, Valencia, Spain
| | - Margaret Mayston
- Division of Biosciences, Neuroscience, Physiology & Pharmacology, University College London, London, UK
| | - Lidiane Lima Florencio
- Department of Physical Therapy, Occupational Therapy, Rehabilitation, and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Cesar Fernández-De-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation, and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Rehabilitation, and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
- Research Group of Humanities and Qualitative Research in Health Science, Universidad Rey Juan Carlos (Hum&qrinhs), Alcorcón, Madrid, Spain
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Kaur A, Balaji GK, Sahana A, Karthikbabu S. Impact of virtual reality game therapy and task-specific neurodevelopmental treatment on motor recovery in survivors of stroke. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2020. [DOI: 10.12968/ijtr.2019.0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims This study aimed to compare the impact of virtual reality game therapy and task-specific neurodevelopmental training on the motor recovery of upper limb and trunk control, as well as physical function, in people who have had a stroke. Methods This randomised, assessor-blinded clinical trial was conducted with 34 patients with post-stroke duration of 135 ± 23 days. Patients with first-onset cortical stroke aged 40–60 years, Mini-Mental State Examination score >20, ability to complete a nine-hole peg test within 120 seconds, ability to lift the affected arm at shoulder level and independent standing were included. Patients were excluded if they had unilateral neglect and musculoskeletal injuries of the affected limb in the past 2 months. Outcome measures used were the Fugl-Meyer Upper Extremity Scale, Action Research Arm Test, Trunk Impairment Scale and Stroke Impact Scale-16. The virtual reality game therapy group performed interactive table tennis, boxing and discus throwing games. The neurodevelopmental treatment group underwent task-specific movements of the upper limb in sitting and standing. All patients performed 45 minutes of treatment, 5 days a week for 4 weeks. Results Both groups showed improvements in all measures after training (P<0.05). There was a between-group difference of 3.47 points in Fugl-Meyer Upper Extremity Scale in favour of the virtual reality game therapy. Conclusions Both treatment regimens resulted in equal improvements in hand dexterity and trunk control after stroke. Virtual reality game therapy improved the upper limb motor recovery of stroke survivors to a greater extent than neurodevelopmental treatment.
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Affiliation(s)
- Alisha Kaur
- Chitkara School of Health Sciences, Chitkara University, Punjab, India
| | | | - A Sahana
- Chitkara School of Health Sciences, Chitkara University, Punjab, India
| | - Suruliraj Karthikbabu
- Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal Hospital, Bangalore, India
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Abstract
OBJECTIVES The implementation of advanced practice nursing (APN) programmes in sub-Saharan Africa (SSA) has been difficult due to lack of SSA-specific curriculum frameworks or benchmarks to guide institutions in developing and implementing APN programmes. A few APN programmes in SSA were benchmarked on western philosophy and materials, making local ownership and sustainability challenging. This paper presents an SSA-specific concept-based APN (Child Health Nurse Practitioner, CHNP) curriculum framework developed to guide institutions in developing relevant and responsive APN curricula in order to qualify CHNP and contribute to a decreased incidence of preventable deaths of children in the SSA region. DESIGN A sequential multimethod study design consisting of a scoping review, Delphi study, development of a framework by a curriculum team, and evaluation of the curriculum framework by faculty from 15 universities in SSA. SETTING This study included universities from East, West, Central and Southern Africa. PARTICIPANTS The study included international multidisciplinary health professionals and curriculum development experts from 15 universities in 10 SSA countries. RESULTS A concept-based Advanced CHNP curriculum framework was developed. The faculty who evaluated the curriculum framework for applicability within their institutions and the SSA context unanimously stated that the framework is detailed, evidenced-based and could be adapted for other APN specialty areas. CONCLUSION The Child Health Nurse Practitioner curriculum framework is comprehensive, context-specific and has the potential to respond to the special child healthcare needs of SSA. It is adaptable for other APN specialty programmes in SSA. Nursing leaders should lobby for funding and advocate for the introduction of the CHNP programme as a collaborative process between government, clinical services, communities and educational institutions.
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Affiliation(s)
- Christmal Dela Christmals
- Department of Nursing Education, School of Therapeutic Sciences, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, Gauteng, South Africa
- SARChI Chair: Research on the Health Workforce for Equity and Quality, Centre for Health Policy, School of Public Health, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Susan J Armstrong
- Department of Nursing Education, School of Therapeutic Sciences, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, Gauteng, South Africa
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Vaughan-Graham J, Cheryl C, Holland A, Michielsen M, Magri A, Suzuki M, Brooks D. Developing a revised definition of the Bobath concept: Phase three. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2019; 25:e1832. [PMID: 31889391 DOI: 10.1002/pri.1832] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 10/17/2019] [Accepted: 12/13/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To develop a revised definition of the Bobath concept that incorporates the perspectives of members of the International Bobath Instructors Training Association (IBITA). METHODS A three-phase consensus building design utilizing (i) focus groups; (ii) survey methods; and, (iii) real-time Delphi. This paper presents the findings from the real-time Delphi, an iterative process to collect and synthesize expert opinions anonymously, provide controlled feedback, with the overall goal of achieving consensus. RESULTS One hundred and twenty-one IBITA members participated in the real-time Delphi. Over three Delphi Rounds, consensus was reached on six overarching conceptual statements and 11 statements representing unique aspects of Bobath clinical practice. One statement that aimed to describe the Bobath clinical term of "placing" was eliminated in Round One due to participant reservations that a text description was insufficient for this term. Seven statements underwent minor wording revisions in Round Two and Three to improve sentence clarity. CONCLUSION Using the real-time Delphi, we were successful in gaining consensus in an expert group on a series of statements on which a revised definition of the Bobath concept could be based.
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Affiliation(s)
- Julie Vaughan-Graham
- Department of Physical Therapy, University of Toronto, 160-500 University Avenue, Toronto, Ontario, Canada
| | - Cott Cheryl
- Department of Physical Therapy, University of Toronto, 160-500 University Avenue, Toronto, Ontario, Canada
| | - Ann Holland
- Neurorehabilitation and Therapy Services, The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK
| | | | - Alba Magri
- Studio Erre- Physiotherapy Clinic, Via della Badia, 18, Brescia-, Italy
| | - Mitsuo Suzuki
- Rokujizo Genenal Hospital, 9 Naramchi, Rokujizo Uji-shi, Kyoto, Japan
| | - Dina Brooks
- Department of Physical Therapy, University of Toronto, 160-500 University Avenue, Toronto, Ontario, Canada
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Vaughan-Graham J, Cott C, Holland A, Michielsen M, Magri A, Suzuki M, Brooks D. Developing a revised definition of the Bobath concept. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2018; 24:e1762. [PMID: 30556333 DOI: 10.1002/pri.1762] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 08/27/2018] [Accepted: 11/08/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This study was developed as a consensus-building exercise within the International Bobath Instructors Training Association (IBITA) to develop a revised definition of the Bobath concept. METHODS A three-phase design utilizing (a) focus groups, (b) survey methods, and, (c) real-time Delphi. This paper details Phase 1 and 2. RESULTS Forty IBITA members participated in five focus groups. Eight broad themes were developed from the focus groups from which the survey statements were developed. There was a high level of agreement on all nine survey statements identifying overarching constructs and on 12 of the 13 statements identifying unique aspects of Bobath clinical practice. Lower scores were attributed to lack of understanding of the term humanistic, Bobath clinical practice addressing multiple domains such as impairments, activities, and participation and limited agreement on the description of the term "placing." CONCLUSION Focus groups and a web-based survey were successful in soliciting the opinions of IBITA members on themes and statements of importance for the development of a revised Bobath definition. The results of Phase 1 and 2 will inform Phase 3, a real-time Delphi, to gain consensus within IBITA on statements on which a revised Bobath definition is to be based.
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Affiliation(s)
| | - Cheryl Cott
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Ann Holland
- Neurorehabilitation and Therapy Services, The National Hospital for Neurology and Neurosurgery, London, UK
| | | | - Alba Magri
- Physiotherapy Clinic, Studio Erre, Brescia, Italy
| | | | - Dina Brooks
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
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Gogola A, Gnat R, Zaborowska M, Dziub D, Gwóźdź M. Asymmetry of activation of lateral abdominal muscles during the neurodevelopmental traction technique. J Bodyw Mov Ther 2018; 22:46-51. [PMID: 29332756 DOI: 10.1016/j.jbmt.2017.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 03/12/2017] [Accepted: 03/27/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate the symmetry and pattern of activation of lateral abdominal muscles (LAM) in response to neurodevelopmental traction technique. DESIGN AND PARTICIPANTS Measurements of LAM thickness were performed in four experimental conditions: during traction with the force of 5% body weight (5% traction): 1) in neutral position, 2) in 20° posterior trunk inclination; during traction with the force of 15% body weight (15% traction): 3) in neutral position, 4) in 20° posterior trunk inclination. Thirty-seven healthy children participated in the study. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES To evaluate LAM activation level ultrasound technology was employed (two Mindray DP660 devices (Mindray, Shenzhen, China) with 75L38EA linear probes). An experiment with repeated measurements of the dependent variables was conducted. RESULTS Side-to-side LAM activation asymmetry showed relatively high magnitude, however, significant difference was found only in case of the obliquus externus (OE) during stronger traction (P < 0.05). The magnitude of LAM thickness change formed a gradient, with the most profound transversus abdominis (TrA) showing the smallest change, and the most superficial OE - the greatest. The inter-muscle differences were most pronounced between the OE and TrA (P < 0.001). CONCLUSIONS During the neurodevelopmental traction technique there is a difference in individual LAM activation level, with deeper muscles showing less intense activation. In statistical terms, the only signs of side-to-side asymmetry of LAM activation are visible in case of the OE, however, the magnitude of asymmetry is relatively high. The results allow to identify patterns of activation of LAM in children showing typical development that will serve as a reference in future studies in children with neurological disorder.
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Affiliation(s)
- Anna Gogola
- Department of Physiotherapy, The Jerzy Kukuczka University of Physical Education, Katowice, Poland.
| | - Rafał Gnat
- Department of Physiotherapy, The Jerzy Kukuczka University of Physical Education, Katowice, Poland; Motion Analysis Laboratory, The Jerzy Kukuczka University of Physical Education, Katowice, Poland
| | - Małgorzata Zaborowska
- Faculty of Physiotherapy, The Jerzy Kukuczka University of Physical Education, Katowice, Poland
| | - Dorota Dziub
- Faculty of Physiotherapy, The Jerzy Kukuczka University of Physical Education, Katowice, Poland
| | - Michalina Gwóźdź
- Faculty of Physiotherapy, The Jerzy Kukuczka University of Physical Education, Katowice, Poland
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Michielsen M, Vaughan-Graham J, Holland A, Magri A, Suzuki M. The Bobath concept - a model to illustrate clinical practice. Disabil Rehabil 2017; 41:2080-2092. [PMID: 29250987 DOI: 10.1080/09638288.2017.1417496] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background and purpose: The model of Bobath clinical practice provides a framework identifying the unique aspects of the Bobath concept in terms of contemporary neurological rehabilitation. The utilisation of a framework to illustrate the clinical application of the Bobath concept provides the basis for a common understanding with respect to Bobath clinical practice, education, and research. The development process culminating in the model of Bobath clinical practice is described. Case description: The use of the model in clinical practice is illustrated using two cases: a client with a chronic incomplete spinal cord injury and a client with a stroke. Discussion: This article describes the clinical application of the Bobath concept in terms of the integration of posture and movement with respect to the quality of task performance, applying the Model of Bobath Clinical Practice. Facilitation, a key aspect of Bobath clinical practice, was utilised to positively affect motor control and perception in two clients with impairment-related movement problems due to neurological pathology and associated activity limitations and participation restrictions - the outcome measures used to reflect the individual clinical presentation. Implications for Rehabilitation The model of Bobath clinical practice provides a framework identifying the unique aspects of the Bobath-concept. The model of Bobath clinical practice provides the basis for a common understanding with respect to Bobath clinical practice, education, and research. The clinical application of the Bobath-concept highlights the integration of posture and movement with respect to the quality of task performance. Facilitation, a key aspect of Bobath clinical practice, positively affects motor control, and perception.
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Affiliation(s)
| | | | - Ann Holland
- c Neurorehabilitation and Therapy Services , University College London Hospitals (UCLH) NHS Foundation Trust , London , UK
| | - Alba Magri
- d Studio Erre - Physiotherapy Clinic , Brescia , Italy
| | - Mitsuo Suzuki
- e Department of Rehabilitation , Bobath Memorial Hospital , Osaka , Japan
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Vaughan-Graham J, Cott C. Author response to "Letter to Editor by Roger Mepsted". J Eval Clin Pract 2017; 23:1125-1126. [PMID: 28418187 DOI: 10.1111/jep.12751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 03/06/2017] [Indexed: 12/31/2022]
Affiliation(s)
| | - Cheryl Cott
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.,Rehabilitation Science Institute, University of Toronto, Toronto, ON, Canada
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Salhab G, Sarraj AR, Saleh S. Mirror therapy combined with functional electrical stimulation for rehabilitation of stroke survivors' ankle dorsiflexion. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2016:4699-4702. [PMID: 28325013 DOI: 10.1109/embc.2016.7591776] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study investigates the effect of combining both mirror therapy with Electrical Stimulation (ES) on improvement of the function of lower extremity compared to conventional therapy. 18 stroke survivors (sub acute stage) were recruited, 9 of them were randomly assigned to receive conventional treatment and another 9 started the mirror therapy combined with ES treatment. Duration of each session in both interventions was 50 minutes, done 4 times per week over two weeks. After 2 weeks, subjects took one week rest before switching they type of treatment; those started with conventional therapy continued with mirror therapy combined with ES, and vice versa. The duration of this phase was 2 weeks with same schedule as the 1st one. Ankle dorsi-flexion range of motion, lower extremity sensory-motor function, and walking duration were measured at baseline, after 1st 2 weeks, and immediately after the last two weeks, and 4 weeks after end of training (retention test). Repeated Measures ANCOVA was done to compare outcome measures scores in both groups and between all testing days, and paired T-test was used measure the difference between groups. Significant increase in all outcome measures was found after the (MT+ES) training, which is higher than conventional therapy training (p<;0.0001). In conclusion, the results suggest that combination of mirror therapy and ES is more effective than conventional therapy in improving lower limb motor function after stroke.
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Ashford S, Jackson D, Turner-Stokes L. Development of a measure of therapy provision for spasticity management in the paretic lower limb - the Leg Therapy recording Schedule (LegTS). Disabil Rehabil 2016; 40:479-485. [PMID: 27927020 DOI: 10.1080/09638288.2016.1258435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE In rehabilitation studies, it is critical to understand the constituents of interventions. First, to enable replication of the work and second, to identify what treatments work best. The development of a tool to describe and quantify therapy interventions in the context of focal spasticity management is presented. METHODS Potential intervention categories were identified from: (a) retrospective analysis of prospectively collected data from a cohort of patients (n = 62) receiving physical interventions in the context of botulinum toxin (BoNT) injection for leg spasticity and (b) cognitive de-briefing with Patient and Carer Advisory Group (PCAG) of patient and carer dyads (n = 8). Item reduction was achieved through consultation with a purposively-selected group of physiotherapists and occupational therapists (n = 16) in a two-round Delphi process. This was followed by review of findings by PCAG members. RESULTS A list of 24 possible therapy categories were identified and then reduced, resulting in a tool with two domains: (1) postural management; four categories and (2) exercise and retraining; four categories. The Leg Therapy recording Schedule (LegTS) wording and presentation were refined for clinical and research use. CONCLUSIONS The LegTS is designed to record therapy interventions for the paretic lower limb in the context of spasticity intervention. Content and face validity have initially been addressed within the development process. Implications for Rehabilitation Clinicians need to understand intervention effectiveness, and to do so, it is critical to capture all the components of a complex intervention. In clinical practice or research, patient experience measures are required to capture the complexity of intervention provided and monitor intervention effectiveness on a case by case basis. Clinicians involved in rehabilitation and management of focal spasticity in the leg can use the Leg Therapy recording Schedule (LegTS) to enable an understanding of the entirety of the intervention package provided.
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Affiliation(s)
- Stephen Ashford
- a Regional Hyper-Acute Rehabilitation Unit , Northwick Park Hospital, London North West Healthcare NHS Trust , London , UK.,b Faculty of Life Sciences & Medicine, Department of Palliative Care, Policy and Rehabilitation , King's College London , London , UK
| | - Diana Jackson
- b Faculty of Life Sciences & Medicine, Department of Palliative Care, Policy and Rehabilitation , King's College London , London , UK
| | - Lynne Turner-Stokes
- a Regional Hyper-Acute Rehabilitation Unit , Northwick Park Hospital, London North West Healthcare NHS Trust , London , UK.,b Faculty of Life Sciences & Medicine, Department of Palliative Care, Policy and Rehabilitation , King's College London , London , UK
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Vaughan-Graham J, Cott C. Defining a Bobath clinical framework – A modified e-Delphi study. Physiother Theory Pract 2016; 32:612-627. [DOI: 10.1080/09593985.2016.1228722] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Julie Vaughan-Graham
- Department of Physical Therapy, Rehabilitation Science Institute, University of Toronto, Toronto, ON, Canada
| | - Cheryl Cott
- Department of Physical Therapy, Rehabilitation Science Institute, University of Toronto, Toronto, ON, Canada
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16
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Gogola A, Gnat R, Dziub D, Gwóźdź M, Zaborowska M. The impact of the neurodevelopmental traction technique on activation of lateral abdominal muscles in children aged 11-13 years. NeuroRehabilitation 2016; 39:183-90. [PMID: 27372355 DOI: 10.3233/nre-161350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The aim of the study was to evaluate the activation of lateral abdominal muscles (LAM) in response to neurodevelopmental traction technique as assessed by ultrasounds as well as to compare the effects of different traction forces. OBJECTIVE An experiment with repeated measurements of the dependent variables was conducted. Thirty-seven children (22 girls) participated. METHODS Measurements of LAM thickness (indicating LAM activation) were performed bilaterally during traction of 5% body weight: 1) in neutral position, 2) in 20° posterior trunk inclination; during traction of 15% body weight: 3) in neutral position, 4) in 20° posterior trunk inclination. The ultrasound technology was employed. RESULTS When applying the lighter traction the superficial LAM (external and internal oblique muscles) showed significant changes. The mean thickness of both muscles during traction increased (both p < 0.001). The deepest transversus abdominis showed no response (p > 0.05). Stronger traction elicited smaller changes. External and internal oblique muscles showed significant increases (p < 0.001, p < 0.01, respectively). Transversus abdominis became less thick during stronger traction (p < 0.01). CONCUSIONS The neurodevelopmental traction technique elicits the changes in LAM thickness in children with typical development. The superficial LAM show more distinct responses than the profound LAM. Stronger traction induces smaller LAM thickness changes than lighter traction.
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Affiliation(s)
- Anna Gogola
- Department of Kinesiotherapy and Special Methods of Physiotherapy, The Jerzy Kukuczka University of Physical Education, Katowice, Poland
| | - Rafał Gnat
- Department of Kinesiotherapy and Special Methods of Physiotherapy, The Jerzy Kukuczka University of Physical Education, Katowice, Poland.,Motion Analysis Laboratory, The Jerzy Kukuczka University of Physical Education, Katowice, Poland
| | - Dorota Dziub
- MSc Student, Faculty of Physiotherapy, The Jerzy Kukuczka University of Physical Education, Katowice, Poland
| | - Michalina Gwóźdź
- MSc Student, Faculty of Physiotherapy, The Jerzy Kukuczka University of Physical Education, Katowice, Poland
| | - Małgorzata Zaborowska
- MSc Student, Faculty of Physiotherapy, The Jerzy Kukuczka University of Physical Education, Katowice, Poland
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Ashford S, Jackson D, Mahaffey P, Vanderstay R, Turner-Stokes L. Conceptualization and Development of the Leg Activity Measure (LegA) for Patient and Carer Reported Assessment of Activity in the Paretic Leg. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2016; 22. [DOI: 10.1002/pri.1660] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 10/07/2015] [Accepted: 11/24/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Stephen Ashford
- Regional Hyper-acute Rehabilitation Unit; Northwick Park Hospital; London UK
- King's College London, Faculty of Life Science and Medicine; Department of Palliative Care, Policy and Rehabilitation; London UK
| | - Diana Jackson
- King's College London, Faculty of Life Science and Medicine; Department of Palliative Care, Policy and Rehabilitation; London UK
| | - Patrick Mahaffey
- Regional Hyper-acute Rehabilitation Unit; Northwick Park Hospital; London UK
| | - Roxana Vanderstay
- King's College London, Faculty of Life Science and Medicine; Department of Palliative Care, Policy and Rehabilitation; London UK
| | - Lynne Turner-Stokes
- Regional Hyper-acute Rehabilitation Unit; Northwick Park Hospital; London UK
- King's College London, Faculty of Life Science and Medicine; Department of Palliative Care, Policy and Rehabilitation; London UK
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18
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Zanon MA, Porfírio GJM, Riera R, Martimbianco ALC. Neurodevelopmental treatment approaches for children with cerebral palsy. Hippokratia 2015. [DOI: 10.1002/14651858.cd011937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Márcia A Zanon
- UNCISAL; Faculdade Estácio de Alagoas; Maternal, Child and Adolescent Health Program; Rua Dr. Jorge de Lima, 113 - Trapiche da Barra Maceió Alagoas Brazil 57010 300
| | - Gustavo JM Porfírio
- Centro de Estudos de Saúde Baseada em Evidências e Avaliação Tecnológica em Saúde; Cochrane Brazil; Rua Borges Lagoa, 564 cj 63 São Paulo SP Brazil 04038-000
| | - Rachel Riera
- Centro de Estudos de Saúde Baseada em Evidências e Avaliação Tecnológica em Saúde; Cochrane Brazil; Rua Borges Lagoa, 564 cj 63 São Paulo SP Brazil 04038-000
| | - Ana Luiza C Martimbianco
- Centro de Estudos de Saúde Baseada em Evidências e Avaliação Tecnológica em Saúde; Cochrane Brazil; Rua Borges Lagoa, 564 cj 63 São Paulo SP Brazil 04038-000
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Graham JV, Eustace C, Brock K, Swain E, Irwin-Carruthers S. The Bobath Concept in Contemporary Clinical Practice. Top Stroke Rehabil 2015; 16:57-68. [DOI: 10.1310/tsr1601-57] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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20
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Hill J, Hodsdon W, Schor J, McKinney N, Rubin D, Seely D, Parmar G, Birdsall T, Alschuler L, Lamson D, Birdsall S, Zwickey H. Naturopathic Oncology Modified Delphi Panel. Integr Cancer Ther 2015. [PMID: 26209468 DOI: 10.1177/1534735415589983] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED Naturopathic oncology is a relatively new and emerging field capable of providing professional integrative or alternative services to cancer patients. Foundational research is critical to identify topics in the clinical and research development of naturopathic oncology for future growth of the field. STUDY DESIGN This study implements a modified Delphi protocol to develop expert consensus regarding ethics, philosophy, and research development in naturopathic oncology. METHODS The modified protocol implements a nomination process to select a panel of 8 physicians and to assist in question formulation. The protocol includes an in-person discussion of 6 questions with multiple iterations to maintain the concept of the Delphi methodology as well as a postdiscussion consensus survey. RESULTS The protocol identified, ranked, and established consensus for numerous themes per question. Underlying key topics include integration with conventional medicine, evidence-based medicine, patient education, patient safety, and additional training requirements for naturopathic oncologists. CONCLUSIONS The systematic nomination and questioning of a panel of experts provides a foundational and educational resource to assist in clarification of clinical ethics, philosophy, and research development in the emerging field of naturopathic oncology.
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Affiliation(s)
- Jacob Hill
- Helfgott Research Institute, National College of Natural Medicine, Portland, OR, USA
| | - Wendy Hodsdon
- Helfgott Research Institute, National College of Natural Medicine, Portland, OR, USA
| | | | - Neil McKinney
- Vital Victoria Naturopathic Clinic, Victoria, BC, Canada
| | | | - Dugald Seely
- Ottawa Integrative Cancer Center, Ottawa, ON, Canada
| | | | - Tim Birdsall
- Western Regional Medical Center, Goodyear, AZ, USA
| | | | | | | | - Heather Zwickey
- Helfgott Research Institute, National College of Natural Medicine, Portland, OR, USA
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21
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Kjaersgaard A, Nielsen LH, Sjölund BH. Factors affecting return to oral intake in inpatient rehabilitation after acquired brain injury. Brain Inj 2015; 29:1094-104. [DOI: 10.3109/02699052.2015.1022883] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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22
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Benito García M, Atín Arratibel MÁ, Terradillos Azpiroz ME. The Bobath Concept in Walking Activity in Chronic Stroke Measured Through the International Classification of Functioning, Disability and Health. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2014; 20:242-50. [DOI: 10.1002/pri.1614] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 05/21/2014] [Accepted: 08/21/2014] [Indexed: 11/06/2022]
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23
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Vaughan-Graham J, Cott C, Wright FV. The Bobath (NDT) concept in adult neurological rehabilitation: what is the state of the knowledge? A scoping review. Part II: intervention studies perspectives. Disabil Rehabil 2014; 37:1909-28. [DOI: 10.3109/09638288.2014.987880] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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24
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Vaughan-Graham J, Cott C, Wright FV. The Bobath (NDT) concept in adult neurological rehabilitation: what is the state of the knowledge? A scoping review. Part I: conceptual perspectives. Disabil Rehabil 2014; 37:1793-807. [DOI: 10.3109/09638288.2014.985802] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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25
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Westby MD, Brittain A, Backman CL. Expert Consensus on Best Practices for Post-Acute Rehabilitation After Total Hip and Knee Arthroplasty: A Canada and United States Delphi Study. Arthritis Care Res (Hoboken) 2014; 66:411-23. [DOI: 10.1002/acr.22164] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 09/03/2013] [Indexed: 12/27/2022]
Affiliation(s)
- Marie D. Westby
- University of British Columbia, Vancouver, and Arthritis Research Centre of Canada; Richmond, British Columbia Canada
| | - Asuko Brittain
- University of British Columbia, Vancouver, and Arthritis Research Centre of Canada; Richmond, British Columbia Canada
| | - Catherine L. Backman
- University of British Columbia, Vancouver, and Arthritis Research Centre of Canada; Richmond, British Columbia Canada
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26
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Bender A, Bauch S, Grill E. Efficacy of a post-acute interval inpatient neurorehabilitation programme for severe brain injury. Brain Inj 2013; 28:44-50. [DOI: 10.3109/02699052.2013.850177] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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27
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Ashford S, Slade M, Turner-Stokes L. Conceptualisation and development of the arm activity measure (ArmA) for assessment of activity in the hemiparetic arm. Disabil Rehabil 2013; 35:1513-8. [PMID: 23294435 PMCID: PMC3741014 DOI: 10.3109/09638288.2012.743602] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To develop a patient reported outcome measure of active and passive function in the hemiparetic upper limb. METHODS Potential items for inclusion were identified through (a) systematic review and analysis of existing measures and (b) analysis of the primary goals for treatment in a spasticity service. Item reduction was achieved through consultation with a small, purposively selected multi-disciplinary group of experienced rehabilitation professionals (n = 10) in a three-round Delphi process. This was followed by a confirmatory survey with a larger group of clinicians (n = 36) and patients and carers (n = 13 pairs). RESULTS From an initial shortlist of 75 items, 23 items were initially identified for inclusion in the arm activity measure (ArmA), and subsequently refined to a 20-item instrument comprising 7 passive and 13 active function. In common with the six measures identified in the systematic review, a five-point ordinal scaling structure was chosen, with ratings based on activity over the preceding 7 days. CONCLUSIONS The ArmA is designed to measure passive and active function following focal interventions for the hemiparetic upper limb. Content and face validity have initially been addressed within the development process. The next phase of development has involved formal evaluation of psychometric properties. IMPLICATIONS FOR REHABILITATION In clinical practice or research, outcome measures in rehabilitation need to have face and content validity. Following stroke or brain injury, goals for rehabilitation of the hemiparetic upper limb may be: to restore active function, if there is return of motor control or to improve passive function making it easier to care for the limb (e.g. maintain hygiene) if no motor return is possible, measurement of both constructs should be considered. This study describes the systematic development of the ArmA, a measure of active and passive function in the hemiparetic upper limb.
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Affiliation(s)
- Stephen Ashford
- Regional Rehabilitation Unit, Northwick Park Hospital, London, UK.
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28
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Brzuszkiewicz-Kuźmicka G, Kuźmicki S, Domaniecki J. Relationships between kinesiotherapy methods used in rehabilitation and the course of lost function recovery following surgical treatment of cranio-cerebral trauma. Brain Inj 2012; 26:1431-8. [PMID: 22758930 DOI: 10.3109/02699052.2012.694562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION AND AIM This paper aims to outline the relationships between kinesiotherapy methods used in rehabilitation and the recovery of the patient's ability to perform activities of daily living (ADLs), improvement of functional condition, regression of pareses and improvement of conscious state following surgical treatment of traumatic subdural haematomas. MATERIALS AND METHODS The study was conducted on 84 patients treated surgically for traumatic subdural haematomas, divided into two groups. The key differentiating factor was the kinesiotherapy method used in rehabilitation. Patients were assessed using the International Scale of Muscle Weakness (ISMW), Barthel Index and modified Rankin Scale, while their conscious state was assessed using the Glasgow Coma Scale. RESULTS A significant improvement of the assessed features was observed in all patients. However, patients treated with proprioceptive neuromuscular facilitation (PNF) and elements of the Bobath concept regained lost function significantly faster than patients treated with traditional kinesiotherapy. No significant differences were observed in the course of improvement of conscious state between the two groups. CONCLUSIONS Treatment using functional elements may significantly accelerate the return of the ability to perform ADLs, improvement in functional condition and regression of pareses in comparison with traditional kinesiotherapy.
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Affiliation(s)
- Grażyna Brzuszkiewicz-Kuźmicka
- Neurosurgery and Nervous System Trauma Clinic, Medical Center of Postgraduate Education, Bródno Hospital, Warsaw, Poland.
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Topics on HIV/AIDS for Inclusion Into a Physical Therapy Curriculum: Consensus Through a Modified Delphi Technique. ACTA ACUST UNITED AC 2012. [DOI: 10.1097/00001416-201201000-00009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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30
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Stanekzai MR, Todd CS, Orr MG, Bayan S, Rasuli MZ, Wardak SR, Strathdee SA. Baseline assessment of community knowledge and attitudes toward drug use and harm reduction in Kabul, Afghanistan. Drug Alcohol Rev 2011; 31:451-60. [PMID: 21919980 DOI: 10.1111/j.1465-3362.2011.00352.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS Problem drug use has been identified as a significant public health problem in Afghanistan. The study aim was to assess community knowledge and attitude toward drug use and harm reduction in Kabul, Afghanistan. DESIGN AND METHODS A cross-sectional convenience sample of community representatives of 10 possible professions were recruited, distributed between the 17 Kabul city districts in 2007. A questionnaire measured sociodemographic characteristics and awareness, knowledge, and attitudes toward drug use and harm reduction. Logistic regression and cluster analysis were performed to test for associations with participant attitude. RESULTS Of 210 participants, mean age was 36.7 years. Most (98.6%) were Afghan and employed (87.6%). Most (88.6%) were aware of problem drug use in Afghanistan, primarily attributed to unemployment. The majority of participants agreed that addiction is a disease (88.6%) and believed more and better treatment and vocational training facilities were needed (90.5%). Use of only punitive measures in response to drug use was favoured by few (7.1%) participants. Only 33.3% of participants could correctly identify legal consequences of drug use. DISCUSSION AND CONCLUSIONS Community acknowledgement of problem drug use and support for addiction treatment are present in Kabul, Afghanistan. However, knowledge gaps concerning drug laws and harm reduction should be addressed in efforts to introduce culturally appropriate harm reduction programming.
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Cott CA, Graham JV, Brunton K. When will the evidence catch up with clinical practice? Physiother Can 2011; 63:387-90. [PMID: 22654245 DOI: 10.3138/physio.63.3.387] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Cheryl A Cott
- Department of Physical Therapy, University of Toronto
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32
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Hansen TS, Jakobsen D. A decision-algorithm defining the rehabilitation approach: 'Facial oral tract therapy'. Disabil Rehabil 2010; 32:1447-60. [PMID: 20624108 DOI: 10.3109/09638280903556482] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM The aim of this study was to describe and define the rehabilitation approach: 'Facial Oral Tract Therapy' (F.O.T.T.). METHOD We defined the content and process of the rehabilitation approach (F.O.T.T.) in a decision-algorithm supported by a manual with supplementary material. The algorithm was developed by a research occupational therapist and an F.O.T.T. senior instructor. We used an inductive approach combining existing knowledge from: F.O.T.T. instructors, therapists trained in using the F.O.T.T. approach, and existing literature. A group of F.O.T.T. instructors and the originator of the treatment approach Mrs. Kay Coombes has given comments to and approved the algorithm. RESULT The algorithm consist of five flowcharts: 'one assessment' chart guiding the therapist in the examination of the patient and four 'treatment charts', one for each of the four areas of F.O.T.T.: swallowing and eating; oral hygiene; breathing, voice, and speech articulation; facial expression, giving guidance on interventions. The algorithm outlines all important components in the treatment that the therapist should decide to use or not to use in the intervention. The algorithm is supported by a manual with criteria of when to use which components. CONCLUSION This algorithm is designed to be a practical guideline to therapists using F.O.T.T. in clinical practice and in educational settings. The use of this algorithm may support standardization of F.O.T.T. and thereby promote and maintain the quality in the treatment. This in turn will facilitate research that addresses F.O.T.T. and outcomes.
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Affiliation(s)
- Trine S Hansen
- Brain Injury Unit, Department of Neurorehabilitation, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
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Barras S, Grimmer-Somers K, May E. Consensus on 'core/essential' and 'ideal world' criteria of a pre-discharge occupational therapy home assessment. J Eval Clin Pract 2010; 16:1295-300. [PMID: 20738478 DOI: 10.1111/j.1365-2753.2009.01331.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES There are no standard criteria for an occupational therapy (OT) home assessment for patients about to be discharged from an acute rehabilitation facility. This has implications for benchmarking, quality improvement and research. The aim of this paper is to establish 'core/essential' and 'ideal world' elements of OT home assessments for patients about to be discharged from acute rehabilitation settings. METHODS A piloted open-ended questionnaire initiated a Delphi study involving knowledgeable OTs working in Australian public and private acute rehabilitation settings. 'Core/essential' and 'ideal world' elements of OT home assessments were confirmed when 70% agreement was reached. RESULTS Of 242 facilities in two Australian states, 110 were invited to participate, and 81 OTs from 84 facilities did so. Four Delphi rounds were required to reach consensus on 30 'core/essential' and 25 'ideal world' elements. CONCLUSION Standard use of 'core/essential' pre-discharge home assessment elements should improve standards of care and the quality of discharge planning. OTs should consider including 'ideal world' criteria in pre-discharge assessments to optimize recently ill patients' community independence.
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Affiliation(s)
- Sarah Barras
- University of South Australia, Adelaide, South Australia, Australia
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Tyson SF, Connell L, Busse M, Lennon S. What do acute stroke physiotherapists do to treat postural control and mobility? An exploration of the content of therapy in the UK. Clin Rehabil 2009; 23:1051-5. [PMID: 19786419 DOI: 10.1177/0269215509334837] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate the content of acute stroke physiotherapy to treat postural control and mobility problems. DESIGN Stroke physiotherapists recorded the interventions used to treat postural control and mobility during treatment sessions. They recorded five sessions for at least five patients each. Descriptive statistics assessed the frequency with which the interventions were used. SETTING Hospital-based acute stroke care. SUBJECTS Thirty-six acute stroke physiotherapists recorded 2374 interventions in 364 treatment sessions for 76 patients. MAIN MEASURES The Stroke Physiotherapy Intervention Recording Tool. RESULTS Facilitation techniques were the most frequently used interventions (n = 1258, 53%) with exercise (n = 115, 5%), teaching others how to help the patient (n = 99, 4%) and provision of equipment (n = 63, 3%) the least frequently used. CONCLUSIONS Acute stroke physiotherapists primarily use therapist-led 'hands-on' interventions to treat postural control and mobility problems. Interventions to promote activity or practice outside the treatment session are infrequently used.
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Affiliation(s)
- Sarah F Tyson
- Centre for Rehabilitation and Human Performance Research, University of Salford, Salford.
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35
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Tyson SF, Connell LA, Lennon S, Busse ME. What treatment packages do UK physiotherapists use to treat postural control and mobility problems after stroke? Disabil Rehabil 2009; 31:1494-500. [DOI: 10.1080/09638280802627686] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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36
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Kneafsey R, Haigh C. Moving and handling rehabilitation patients: A survey of nurses' views. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2009. [DOI: 10.12968/ijtr.2009.16.8.43481] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Rosie Kneafsey
- Adult Nursing School of Nursing, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT; and
| | - Carol Haigh
- School of Nursing, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Elizabeth Gaskell Campus, Hathersage Road, Manchester, M13 OJA, UK
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Raine S. The current theoretical assumptions of the Bobath concept as determined by the members of BBTA. Physiother Theory Pract 2009; 23:137-52. [PMID: 17558878 DOI: 10.1080/09593980701209154] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The Bobath concept is a problem-solving approach to the assessment and treatment of individuals following a lesion of the central nervous system that offers therapists a framework for their clinical practice. The aim of this study was to facilitate a group of experts in determining the current theoretical assumptions underpinning the Bobath concept.A four-round Delphi study was used. The expert sample included all 15 members of the British Bobath Tutors Association. Initial statements were identified from the literature with respondents generating additional statements. Level of agreement was determined by using a five-point Likert scale. Level of consensus was set at 80%. Eighty-five statements were rated from the literature along with 115 generated by the group. Ninety-three statements were identified as representing the theoretical underpinning of the Bobath concept. The Bobath experts agreed that therapists need to be aware of the principles of motor learning such as active participation, opportunities for practice and meaningful goals. They emphasized that therapy is an interactive process between individual, therapist, and the environment and aims to promote efficiency of movement to the individual's maximum potential rather than normal movement. Treatment was identified by the experts as having "change of functional outcome" at its center.
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Affiliation(s)
- Sue Raine
- Walkergate Park for Neurorehabilitation and Neuropsychiatry, UK.
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Tyson SF, Connell LA, Busse ME, Lennon S. What is Bobath? A survey of UK stroke physiotherapists' perceptions of the content of the Bobath concept to treat postural control and mobility problems after stroke. Disabil Rehabil 2009; 31:448-57. [DOI: 10.1080/09638280802103621] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kollen BJ, Lennon S, Lyons B, Wheatley-Smith L, Scheper M, Buurke JH, Halfens J, Geurts ACH, Kwakkel G. The effectiveness of the Bobath concept in stroke rehabilitation: what is the evidence? Stroke 2009; 40:e89-97. [PMID: 19182079 DOI: 10.1161/strokeaha.108.533828] [Citation(s) in RCA: 148] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND PURPOSE In the Western world, the Bobath Concept or neurodevelopmental treatment is the most popular treatment approach used in stroke rehabilitation, yet the superiority of the Bobath Concept as the optimal type of treatment has not been established. This systematic review of randomized, controlled trials aimed to evaluate the available evidence for the effectiveness of the Bobath Concept in stroke rehabilitation. Method- A systematic literature search was conducted in the bibliographic databases MEDLINE and CENTRAL (March 2008) and by screening the references of selected publications (including reviews). Studies in which the effects of the Bobath Concept were investigated were classified into the following domains: sensorimotor control of upper and lower limb; sitting and standing, balance control, and dexterity; mobility; activities of daily living; health-related quality of life; and cost-effectiveness. Due to methodological heterogeneity within the selected studies, statistical pooling was not considered. Two independent researchers rated all retrieved literature according to the Physiotherapy Evidence Database (PEDro) scale from which a best evidence synthesis was derived to determine the strength of the evidence for both effectiveness of the Bobath Concept and for its superiority over other approaches. RESULTS The search strategy initially identified 2263 studies. After selection based on predetermined criteria, finally, 16 studies involving 813 patients with stroke were included for further analysis. There was no evidence of superiority of Bobath on sensorimotor control of upper and lower limb, dexterity, mobility, activities of daily living, health-related quality of life, and cost-effectiveness. Only limited evidence was found for balance control in favor of Bobath. Because of the limited evidence available, no best evidence synthesis was applied for the health-related quality-of-life domain and cost-effectiveness. CONCLUSIONS This systematic review confirms that overall the Bobath Concept is not superior to other approaches. Based on best evidence synthesis, no evidence is available for the superiority of any approach. This review has highlighted many methodological shortcomings in the studies reviewed; further high-quality trials need to be published. Evidence-based guidelines rather than therapist preference should serve as a framework from which therapists should derive the most effective treatment.
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Affiliation(s)
- Boudewijn J Kollen
- Research Bureau, Isala Academy, Isala klinieken site Sophia, Zwolle, The Netherlands.
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Mayston M. Bobath Concept: Bobath@50: mid-life crisis--what of the future? PHYSIOTHERAPY RESEARCH INTERNATIONAL 2009; 13:131-6. [PMID: 18752337 DOI: 10.1002/pri.413] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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