MODULE III Bobath Method

MODULE III BOBATH METHOD Final Capabilities: Master the techniques, principles and procedures for implementing physiotherapy practices carried out independently or in groups, in the scientific field of pediatric physiotherapy using the Bobath method. Practicum Objectives: Students will be able to manage physiotherapy interventions in pediatric cases using the Bobath method. Equipment Required 1. Mattress 2. Ball 3. Doll 4. Towel 5. Bolster Pillow 6. Towel 7. Children's educational toys 8. Pediatric Neuromuscular Physiotherapy practical logbook Brief description of Bobath therapy or Bobath therapy is a type of physiotherapy exercise which aims to improve movement and mobility in patients with central nervous system damage, such as cerebral palsy patients. Bobath therapy is often used to improve a patient's sensory and motor systems and facilitate normal movement and motor control. Bobath Physiotherapy can help improve movement and mobility by combining techniques that involve functional passive and active movements. The goal is to make it easier for patients to carry out daily tasks so that they can improve their quality of life. Objectives of the Bobath Method 1. Correct and prevent abnormal postures and movement patterns. 2. Teaches normal posture and movement patterns. Principles of Therapy and Treatment 1. Symmetrical in stance and movement 2. Be as active as possible with the affected side when doing activities. 3. Application of ADL movements in therapy. 4. Consistent during treatment (there are stages in therapy). 5. Learning is not directed at the movement, but at the feeling of the movement. 6. Therapy is carried out individually Bobath Principle Mechanical ability after experiencing a lesion or by using appropriate treatment allows it to be repaired. Lesions in the central nervous system cause overall functional disorders, but in NDT what is treated is motor. Spasticity in NDT is viewed as a disruption of normal posture and movement control. Normal muscle movements can be performed if muscle tone is normal. Normal Postural Reflex mechanisms are the basis of normal movement. Muscles lose the function of their individual movements and patterns. Movements initiated by the sensory are carried out by the motor and controlled by the sensory. This method begins by first emphasizing pathological abnormal reflexes that become obstacles to normal movements. The child must be placed in a certain posture called Reflex Inhibiting Posture (RIP) which aims to inhibit abnormal muscle tone. How to Treat and Inhibit Abnormal Muscle Tone Using the RIP Technique 1. Handling (grip) Proper patient grip is necessary to influence postural (body) tone, regulate coordination, inhibit abnormal patterns, and facilitate automatic responses. With proper handling , abnormal tone and movement patterns can be prevented as soon as the signs appear. 2. Key Point of Control (KPoC) KPoC is the point used by therapists to carry out inhibition and facilitation. KPoC must start from proximal to distal (moving from head-neck-body-feet and toes). With the help of KPoC, the inhibition pattern can be carried out on patients in the opposite way to the KPoC pattern (from distal-proximal) making it easier for the therapist to carry out inhibition. how to do key point of control. Bobath Therapy Technique: a. Inhibition of abnormal posture and dynamic muscle tone. Inhibition: an attempt to inhibit and reduce muscle tone. The technique is called Reflex Inhibitory Pattern. Changes in postural tone cause you to move more normally by inhibiting abnormal movement patterns into a normal body posture using the "Reflex Inhibitory Pattern" technique. How to Do Inhibition This is done by inhibiting abnormal posture and dynamic muscle tone. With the help of KPoC, inhibition can be carried out in the opposite way to the KPoC pattern, namely from distal to proximal. b. Facilitation of normal movement patterns Facilitation: efforts to facilitate automatic reactions and perfect motor movements with normal muscle tone. The technique is called “Key Point of Control”. Facilitation Function Facilitation functions to stimulate muscles that are hypertonic. The goal is facilitation 1) To restore normal postural tone. 2) To maintain and restore normal tone quality. 3) To facilitate intentional movements, required in activities daily. c. Stimulation Stimulation (stimulation): efforts to strengthen and increase muscle tone through proprioception and tactile means. Useful for improving reactions in children, maintaining positions and movement patterns that are influenced by gravitational forces automatically. Stimulation techniques 1) Tapping: Aimed at the antagonist muscle group of spastic muscles. 2) Placcing and Holding: Placement of the handle. 3) Placing Weight Bearing: Placing weight. How to stimulate cerebral palsy In this method, therapy is carried out by providing a stimulus consisting of two forms, in the form of verbal and non-verbal stimulation. 1) Verbal stimulation: with signals, sounds and noises 2) Non-verbal stimulation: uses tactile and proprioreceptive stimuli or perception of stimuli related to position, body posture, balance or body condition. d. Stabilization Stabilization is one of the Bobath therapy techniques which aims to establish balance in patients who experience abnormal movements. The stabilization provided includes postural stability and proximal stability. 3. Basic Stage of Bobath Training is divided into 4 stages a. Practice head and hand control Training to control the head and hands is very important as an initial stage of further training. Lifting and holding the head and body through resting the hands is useful in preparation for rolling, crawling and sitting. b. Exercise to control your body while sitting At this stage, children are taught to keep their bodies upright when they move leaning on their hands. The sitting position will enable the child to see his hands and use them. The aim of training at this stage is so that children can move in all directions when sitting, prepare themselves to squat and stand up from a sitting position, and move from a sitting to crawling position. c. Exercises to control the legs to stand and walk The goal to be achieved at this stage is that the child can prepare his legs from sitting on his knees to standing and then walking. d. Family education Education is needed to teach and inform families to train children regularly and lovingly at home so that children become independent more quickly. Movement Type (1). Approximation of the head - stimulation of the head upright (2). Approximation of the shoulders - stimulation of an upright body (3). Sweep on the hand - stimulation of the hand opening a facilitation of supporting reactions in the hands (4). Facilitate sitting from a prone position (5). Facilitate standing from a sitting position (6). Facilitation of rolling via the limbs (7). Facilitate body rotation & supporting reaction to the side (8). Facilitates upright reflex on the head & supports forward reaction (9). Facilitate extensor vertebrae & supporting reactions in the arms forward (10). Facilitation of vertebral rotation (11). Facilitate vertebral rotation & supporting reaction to the side (12). Facilitate sideways body balance reactions (13). Facilitate the body straightening to the side (14.) Facilitate sideways body balance reactions (15) . Facilitate body balance reactions to the front and back