Bobath treatment techniques
(1) Concept.
Based on the theoretical basis of neurodevelopment, postural development and motor development, it aims at the immaturity of motor development of pediatric cerebral palsy, the abnormality of motor development, the plasticity and compliance of the brain, inhibiting the fixation and development of abnormal posture and motor patterns, and promoting the establishment and development of normal posture and motor patterns to achieve the purpose of treatment and rehabilitation.
(2) Treatment goals
To prevent spasticity and establish maximum residual function
Reduction of spasticity by changing the length and range of motion of muscles, loosening of muscles and stiff joints, pulling of muscles, and more efficient and labor-saving functional activities.
(3) Basic treatment principles.
Inhibition of abnormal posture and motor patterns, especially for abnormal tension postural reflexes; facilitation of normal posture and motor patterns, especially for upright and balance reflexes. For spastic cerebral palsy, the main purpose is to relieve muscle tension and stiffness, to make the child’s trunk fully extended, to avoid the movement of spastic posture, and to induce normal movement patterns as early as possible; for involuntary cerebral palsy, the main purpose is to suppress upper trunk muscle tension, to train the stretching of short contracted muscles, to promote the stability and dynamic balance of anti-gravity posture, and to feasibly train the adjustment of the twitchy upper limbs.
(4) Basic treatment techniques.
Control of key points: The main key points are head, shoulder, elbow, wrist, trunk, pelvis, hip, knee, and foot and ankle joints.
Facilitation of postural reflexes: the most commonly used clinical techniques to facilitate the cervical erectile reflexes operated from the head, facilitation of cervical correction response: through the operation of the head, facilitate the movement of the trunk, upper limbs, lower limbs to achieve normal development of movement; upper limbs to protect the extension response facilitation; balance response facilitation: in the supine, sitting, standing and other positions to facilitate.
Stimulation of proprioceptors and body surface receptor manual techniques: compression manual techniques: in the process of applying local pressure, with resistance to weight load, to achieve the purpose of automatic regulation of movement of the trunk and limbs; placement response and hold response: a limb is passively placed in a certain position, and then it is stagnant, and the stimulation of the weight-bearing limb leads to the desired postural response, the adjustment of muscle tone, to improve the contraction of muscle groups and proprioceptive Percussion techniques: inhibitory percussion, compressive percussion, alternating percussion, sweeping percussion.
(5) Application in the clinic
Head control training: Head control movement is the earliest movement completed in motor development, and it is difficult to complete other movements if you cannot control your head. Therefore, you should inhibit head dorsiflexion, promote spinal extension, promote elbow support, promote head lifting, head movement and resistance to gravity.
Turning training: suppression of tense neck reflex and tense vagus reflex posture, promotion of hand-mouth-foot coordination, promotion of passive turning and trunk gyration movement, promotion of lateral lying single elbow support.
Sitting training: promotion of single-arm support, promotion of sitting balance and spinal extension development.
Crawl training: two-handed support training, four-crawl position and spine and pelvis separation movement training, posture change adjustment ability training, promotion of lower limb interaction movement.
Standing position training: inhibit knee hyperflexion or dorsiflexion, inhibit abnormal postures such as toe crossing, kneeling position balance response promotion, body twisting to promote trunk rotation, standing position balance response promotion.
Walking training: single-leg standing downward alternating movement training of both legs.
(6) Infants and children emphasize the importance of the 8 patterns
Stretching mode of the whole body
Head erection to resist gravity mode
Symmetrical posture pattern
Protective stretching mode
Sitting mode with extended legs
Rotation mode with torso as the axis
Various balance response modes