Bobath

Hi Folks,

how do folks here rate the Bobath approach and NDT with regards strokes ?

thx, Roland

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Ahhh @pando/ Roland been meaning to send you a message or reply to a post .

I have a hard prickly plastic ball about 2" in diameter maybe 3 in a walking sock that I use to relieve the locking up of muscles in my back - by draping the sock over my shoulder and then leaning against a wall and moving to roll the ball around & thus give some sort of tissue massage to those tight muscles .

I wondered if similar might help you address your unnamed muscle challenge in your glutes?

Bobath

Several studies have concluded that Bobath wasn’t superior or inferior to other methods https://scholar.google.co.uk/scholar_url?url=https://repository.ubn.ru.nl/bitstream/handle/2066/81271/81271.pdf&hl=en&sa=X&ei=Zvm7ZK7JIvmBy9YPyrqH4Ag&scisig=ABFrs3wNcFC4yv2bRi3fft8TSfrT&oi=scholarr

And https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8797128/

are typical - there are others that came to the same conclusion.

Yet another research paper w/ similar conclusions also included the idea that constraint induced movement therapy was marginally more effective.
Against which I would add that it might be more effective but it’s bloody hard to use - I tried a 3 week program (a large amount of the issues I put down to the therapist but its deffo that CIMT has issues).

I think perhaps phrasing the conclusions the other way around is worthwhile: compared with no insight Bobath is the equal of most other published approaches. A bit like all the TV ads that claim up to 100% efficient and no other formula is more effective. Ie the conclusion is this one isn’t any different from the others; neither better nor worse

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Thx Simon,

Now I think of it I do have exactly that, a 2" prickly ball, and your idea is great ; I will have a go. My glute is doing better, mainly thanks to some Chinese acupuncture, and my physio said when he first met me I did have spasticity, but now it’s some form of muscle spasm. Basically, he says I am demanding too much from certain muscle groups which cannot deliver. We’ll see how it continues.

Thanks for the Bobath info. I’m still researching it, and have yet to grasp what it’s all about. My Sister sent me a bunch of links to check out…

I’ve had such a busy last 3 days, mainly checking out my eye pressure at the Eye Hospital ; it’s a bit high, and my cornea is a bit thin but still okay. It’s odd, because my stroke-side eye feels so uncomfortable when I shut my eyelid. Anyway, that’s another story.

Speak soon, ciao, ciao, Roland

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Hi Roland @pando ,
As part of my routine I use one of the below to do what Simon @SimonInEdinburgh is suggesting (Got mine from Amazon for just over £10, their description is: Core Balance Foam Roller for Deep Tissue Muscle Massage, Trigger Point Grid Sports Massager, Fitness Gym Physio).

Take care

Rich C.

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I have another thought for your Roland @pando triggered by your statement that the physio says you are ask too much of muscle groups that are then protesting .

Your aim I think is to generate the best capability in the minimum amount of time. The achievement of that therefore demands the optimum balance of activity and rest or consolidation of gains. So excess activity is constraining limiting slowing capability development .

With that equation or target of balance between competing factors in mind maybe you can justify to yourself that building a program optimised on the goal rather than maximising the activity satisfies your desires or closely

I offer as a suggestion :slight_smile:

Ciao Simon

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Thx Simon,
It’s a tricky call, one which I make from day to day (based on how the muscle is feeling / working that day). Each day may be wildly different from the previous day. The physio may be right, he may be wrong ; I had already reached his conclusion myself a while ago. Anyway, lately I have been stepping down more and more, and the locked glute has already thanked me. There’s much to weigh and balance, but I am always questioning…( & learning). Maybe it is a question of “less is more”

If only it were clear how much to do each day…
Thanks, ciao, ciao, Roland

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just ordered it, thx

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If your memory is good then what I’m about to suggest won’t help; maybe a diary of symptoms and plausible triggers kept for a while and then analysed for any patterns ?

I think cause and effect often has a time span of greater than 24 hours, and any cause and effect that relies on multiple factors in combination will be easier to spot with some record keeping.

2 cents
Ciao
Simon

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And that is good news, give it that couple days or week off then go back to it and give it a thorough workout and then another break. You might even notice you can get that little bit more from it or get further with it, then take another break.

That’s what I’ve been doing all along and my body has been happy with that. Whenever I’ve tried to push for more beyond what it is giving me, I’ve just got frustrated and angry with myself and it gets me absolutely nowhere. I gave up pushing myself very quickly in that first 6mths as I came to the conclusion my brain is giving back what is available, when it becomes available. You’ve got your glute but maybe there’s still a component part that is yet to be repaired/delivered/ceased to be available.

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Excellent suggestion, Simon
yes i am writing a book on my stroke in real time…
Usually update it 2x per week,
it has everything that happens to me !!
ciao, Roland

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Emerald hi,

Hopefully, I’ll learn the right formula.
It can only go so fast. Thx for adding your experience

ciao ciao, Roland

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Hi Pando, great question. I am Bobath trained, use the principle 100% but not the actual technique. I deliver a smoothie technique, where I mix different approaches to form my own treatment and it works. Without hands on, stroke treatment cannot happen, new RCP quidenlines is a sad step I feel. I hope this help. Take care, Kusal, Stroke OT

The referenced RCP guidelines are :
Overview
https://www.strokeguideline.org/

Guidelines themselves
https://www.strokeguideline.org/contents/

@Kusal which sections do you feel could be better?
How do you justify that hands-on is mandatory? Or do you just mean that if there’s a third party giving ”treatment" That can only be accomplished face-to-face?
My current understanding is that bobath is based on the idea of use in daily life so surely it’s 100% the principles for everybody? Does it have anything to do with the research by Sherrington in 19thC. then taub & Berman in '60s?

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Thx Kusal,

may I ask where you are based, Kusal ?

cheers, Roland

Dear Simon,

Thanks for your query, Bobath is based on restoration of postural symmetry through elimination of associated reactiona/compensation which involves biofeedback and after stroke it is not possible to correct posture without hands on. This is one of the key message that I have been trying to explain through my posts - as many people are receiving treatment in form of exercises only without hands on facilitation/activation. I have tried to explain in a simple way, but it is a very wide concept - not just activities of daily living. I hope that this makes sense- my view the new guideline discourages hands on treatment which I feel is a step backwards, but there are many positive sides of the new guidelines that is very helpful.

I hope that this makes sense.

Kind regards

Kusal, Stroke OT

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Hi Pando, I am based in greater London.

Kind regards

Kusal Das, Stroke OT

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Thx Kusal,

Doyou know of anyone who can help me in Bristol / or in South-West ?

ciao, Roland

Thanks for your reply, it may be a coincidence but our team physio finsihed with us on Friday to move back to Bristol. If you want I can ask her- she is Bobath trained and worked with us almost 3 years, we are sad to see her go. She is a very caring and good physio.

Please let me know your thoughts.

Kind regards, Kusal Stroke OT

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Hi, Kusal,

That sounds like a good coincidence… I have nothing to lose, and would welcome the opportunity. I see a local private physio, but only once a month, if I’m lucky. I live in BS6 7XU so let’s hope that is convenient… please do put us in contact one way or another…

As a brief intro, I’m 58 had serious stroke / bleed 10 months ago, walk with stick, but have a touch of spasticity, which bothers me. My arm is comparatively much better ; it was remapped 10 days after my stroke with the help of my Chinese Dr who does acupuncture on me x2 a week. My profession was violin teacher and luckily I can still do that, though I limit my lessons to just 2/3 per day. In fact now I’m on Summer hols. though Bristol is having a very grey and wet July. I am very active in my recovery, and try to work to a careful, balanced program. My sister recently told me about Bobath method ; I know very lttle about it.

Thanks for helping out. I can send my details via PM
ciao, Roland

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Hi Roland, Thanks for your message. I have forwarded the information to my colleague, she is on holiday, hence, I am not sure about if she has signal. I would update you as soon as I can, and then depending on her response, we can think of next steps. I would like to let you know, that normally I do not refer to anyone but because I have worked with her I have full confidence in her. Kind regards
Kusal