Профессиональная медицина и вопросы здравоохранения

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Efficacy of the Bobath Concept in Improving Performance in Activities of Daily Living in Patients after Stroke: A Literature Review

Eirini Kolliopoulou

Despite its long background, since the 1940s, and its wide use, there are few studies regarding the results of Neurodevelopmental Treatment (NDT) in stroke patients. Objectives: To investigate the efficacy of the Bobath concept in the functionality and independence in activities and the use of upper limb compared to the usual treatment in the neurological rehabilitation after stroke. Design: Systematic review of randomized clinical trials, controlled trials, pilot studies, quasi-experimental studies and previous systematic reviews. Population: Adults after stroke. Materials and Methods: A systematic review of the literature on the Bobath concept from the first available publication in 2012 until December of 2022 was performed, consulting Pubmed, PEDro, Epistemonikos, CercaTot UVic, Sciencedirect and Cochrane Library databases. PEDro scale was used to determine methodological quality. Intervention: Treatment based on the Bobath concept compared to other or no interventions. Outcomes: Activities of Daily Living and upper limb motor activity. Results: Nine clinical trials and two systematic reviews were included; all but two studies compared the Bobath concept with another intervention. PEDro scale scores ranged from 3 to 7. There is limited evidence of the superiority of Bobath over other interventions, especially amplitude exercises and stretching, in producing significant changes in upper limb activity. Therapy based on Bobath concept is less effective than robotics and task-oriented training. The superiority of Bobath concept or any other therapeutic approach cannot be concluded regarding Activities of Daily Living and quality of life of stroke patients. Conclusions: No solid documentation was found describing the superiority of neurodevelopmental treatment, nor of any other advanced intervention, to consider it recommended for the improvement of functionality and quality of life after stroke. Methodological aspects of the selected studies are presented for future research. It is strongly recommended that future clinical trials analyze the functional benefits of the Bobath concept.