Comparison of the content of two physiotherapy approaches for stroke.
OBJECTIVE
To identify similarities and differences between a Bobath-based (BB) and a movement science-based (MSB) approach.


METHODS
Direct observation by a trained observer was used to record behaviours during treatments.


METHODS
An acute stroke ward.


METHODS
Twenty-two stroke patients.


METHODS
Behaviours were recorded during 12 treatment sessions by three therapists, for each treatment approach. Physical and communication behaviours were recorded in pre-defined categories. The equipment used was recorded and a semi-structured interview conducted with the therapist after treatment to identify follow-up actions by the therapist.


METHODS
Frequency of occurrence of each category was compared between the approaches.


RESULTS
Treatment in the BB group contained more social conversation (p = 0.004), and more use of physiotherapy equipment (p = 0.02) and a physiotherapy assistant (p = 0.01). In the MSB group there was more detailed feedback given to the patient (p = 0.002) more use of everyday objects in training (p = 0.001), therapists more frequently listed specific components as the patient's main problems (p = 0.003) and relatives were involved more in positioning to stretch muscles (p = 0.03). Training walking was given more emphasis in the BB group and training of sit-to-stand in the MSB group.


CONCLUSIONS
The study indicates that there are differences in content between the Bobath-based and movement science-based approaches to treatment.
van Vliet
P M
PM
Division of Stroke Medicine, University of Nottingham, UK. p.van-vliet@nottingham.ac.uk
Lincoln
N B
NB
Robinson
E
E
D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010043:Outcome and Process Assessment, Health Care; D026741:Physical Therapy Modalities / Q000379:methods* / Q000592:standards*; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis