Reviews of research about Bobath (NDT) Therapy have shown that receiving NDT or a combination of NDT and other intervention led to better performance than children receiving other services (Ottenbacher et al 1986) and to an immediate increase in range of movement (Butler & Darrah, 2001; Royeen & DeGangi, 1992).
Studies of children who have received Bobath (NDT) therapy, have demonstrated improvement in:
- gross motor function, self care skills and reduced caregiver assistance (Knox & Evans, 2002; DeGangi, 1994)
- improved walking demonstrated by achieving goals in improving stride length, gaining range of movement, strength, reducing spasticity and other gait parameters (Desloovere et al, 2012)
- motor progress with more intense NDT and following intermittent blocks of therapy (Tsorlakis et al, 2004; Mayo, 1991); Trahan & Malouin, 2002).
- stride, step length, heel contact and velocity of walking Adams et al 2000; Embrey et al, 1990
- reaching, hand opening and hand use (Jonsdottir et al 1997; Kluzik et al, 1993; Chakarian & Larsen 1990).
What features of the Bobath approach are supported by other research evidence?
- Bobath Centres offer a family centred approach with goals set in collaboration with parents (Knox & Menzies, 2005). Studies support a family-centred service and suggest that it is valued by parents and professionals alike (King et al, 2004). The use of specific goals has been shown to enhance effectiveness of therapy (Bower et al, 1996).
- Therapy intervention at a Bobath Centre is more intensive than typical local provision. More intensive therapy has shown correlations with increased improvement in motor skills (Tsorlakis et al, 2004; Trahan & Malouin, 2002; Bower et al, 1996 & 1992).
- Parent/carer education is considered to be essential to enable each child to maximise their functional abilities for participation in daily life, to facilitate family relationships and to improve quality of life (Law et al, 2003).
Bobath therapy also recognises that other interventions such as botulinum toxin injections or surgery may be needed.
There is no definite evidence to support one intervention for children with cerebral palsy more than another. The principles of Bobath (NDT) have brought acceptance worldwide. Like all other interventions for children with CP, more research is needed to demonstrate what works best and for whom.
How do we monitor change and progress goals in individual children?
A range of standardised Outcome Measures are used to evaluate progress before and after therapy and to adjust goals as appropriate. These include the Gross Motor Function Measure, Pediatric Evaluation of Disability Inventory, Melbourne Upper Limb Assessment, Assisting hand assessment, Canadian Occupational Performance measure and goal attainment scaling.
Research_Bibliography_April_2013
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