Effect of Bobath,s Therapeutic Approach on Spasticity and Quality of Movement Patterns in Hemiplegic Patients

Hemiplegia is a complication that results from upper motor neuron lesions and is usually associated with spasticity and movement disorders.To control spasticity and accomplish functional activities, several approaches have been presented such as Neurodevelopment treatment (NDT) according to Bobath,s assumptions. Whereas lower limb spastic hemiplegia is common and its management is time consuming, in this study we are intended to examine the effectiveness of this therapeutic approach on spasticity management and quality of lower limb movement patterns. Fifteen hemiplegic patients (age ranged 44-75) participated in this study. Baseline assessments before and after treatment included: spasticity measurement of plantar flexor muscles of ankle according to Original Ashworth Scale (OAS), measuring active and passive range of motion of ankle dorsiflexion and defining the quality of lower limb movement patterns according to" Standing test" of Bobath,s approach. following intervention (20 sessions), there was a significant decrease in spasticity and a significant increase in active and passive range of motion and quality of movement patterns. According to the obtained results, by modification of excitation – inhibition in CNS and transmitting it to peripheral region (muscles), Bobath,s approach can reduce the spasticity of plantar flexor muscles, subsequentl, the dorsiflexion range of motion increases. Indeed, this therapeutic approach increases coordination in movement patterns and improves quality of movement patterns by retraining balance in various positions. Results of this study can be used extensively in managing patients with upper motor neuron lesion referred to rehabilitation departments.