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Bobath versus task-oriented training after stroke: an assessor-blind randomized controlled trial
Sutcu G, Ozcakar L, Yalcin AI, Kilinc M
Brain Injury 2023;37(7):581-587
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: To evaluate/compare the effects of the Bobath concept and task-oriented training on motor function, muscle thickness, balance, gait, and perception of goal achievement in patients with stroke. METHODS: Thirty-two patients were randomly divided into Bobath and task-oriented groups. Exercises were applied for one hour a day, three days a week, for eight weeks. Clinical (Trunk Impairment Scale (TIS), Stroke Rehabilitation Assessment of Movement (STREAM), Goal Attainment Scale (GAS), balance, gait)) and trunk muscle thickness assessments (with ultrasound) were performed. RESULTS: Thirty patients completed the study. TIS, STREAM, and GAS scores were increased in both groups (all p < 0.05). Bilateral rectus abdominis thickness was found to have increased in the Bobath group whereby this increase was better when compared with the task-oriented group (p < 0.05). The limits of stability increased in both groups (p < 0.05). Postural sway was decreased in the anteroposterior (normal stability eyes open) in the Bobath group and the anteroposterior (perturbated stability eyes closed) in the task-oriented group. Velocity, step length, and functional ambulation profile scores increased, and double support of the paretic side decreased in the task-oriented group (all p < 0.05). CONCLUSIONS: The Bobath concept appears to be superior to task-oriented training in increasing the thickness of rectus abdominis in patients with stroke. Although the task-oriented training provided significant improvement, especially in terms of gait, no superiority was found between the two rehabilitation approaches in terms of functional ability.

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