Pathak Abhishek, Gyanpuri Vyom, Dev Priya, Dhiman Neetu Rani
Department of Neurology, Institute of Medical Sciences, Banaras Hindu University, Varanasi-UP, India.
Department of Orthopedics, Institute of Medical Sciences, Banaras Hindu University, Varanasi-UP, India.
J Family Med Prim Care. 2021 Nov;10(11):3983-3990. doi: 10.4103/jfmpc.jfmpc_528_21. Epub 2021 Nov 29.
The Bobath approach, also known as neurodevelopmental treatment (NDT), is a widely used concept in the rehabilitation of stroke patients with hemiparesis in many countries. This technique is being used since years all over the world; however, strong evidence of its usefulness is still not present. This review is aimed to find out its effectiveness based on the randomized controlled trials in the rehabilitation of stroke patients with motor disability and to compare it with other therapeutic techniques.
A systematic literature search on PubMed Central, Science-Direct, Cochrane, Scopus, Clinical Trial Database, and Indian Clinical Trial Registry in English till 31 July 2021 was undertaken. The review is published in Prospective Register of Systematic Reviews (PROSPERO) with registration number "CRD42019125400." Physiotherapy Evidence-based Database (PEDro) score has been used for the quality assessment of the studies. Randomized clinical trials that studied the comparative effect of the NDT/Bobath concept on motor activity outcomes and cognition/behavior in stroke patients in comparison with other rehabilitative techniques were included.
No strong documentation describing the effectiveness of this neuro-developmental treatment or its supporting neuro-developmental treatment in comparison with other advanced neuro-physiotherapeutic techniques has been found so as to consider it as the recommended treatment for post-stroke hemiplegia/hemiparesis. Methodological aspects of selected studies for further research are suggested.
This study is inconclusive in determining the effectiveness of the Bobath approach for the movement rehabilitation of stroke patients. These results are similar to the results of previous reviews done on the same topic.
Bobath疗法,也称为神经发育疗法(NDT),在许多国家是中风偏瘫患者康复中广泛应用的概念。这项技术在全球已使用多年;然而,其有效性的有力证据仍然缺乏。本综述旨在基于随机对照试验,探究其在中风运动功能障碍患者康复中的有效性,并与其他治疗技术进行比较。
截至2021年7月31日,在PubMed Central、Science-Direct、Cochrane、Scopus、临床试验数据库和印度临床试验注册中心进行了系统的英文文献检索。该综述发表于系统评价前瞻性注册库(PROSPERO),注册号为“CRD42019125400”。采用物理治疗循证数据库(PEDro)评分对研究质量进行评估。纳入了比较NDT/Bobath概念与其他康复技术对中风患者运动活动结果和认知/行为的比较效果的随机临床试验。
未发现有强有力的文献描述这种神经发育疗法或其辅助神经发育疗法与其他先进神经物理治疗技术相比的有效性,因此不能将其视为中风后偏瘫/半身不遂的推荐治疗方法。建议了进一步研究的所选研究的方法学方面。
本研究在确定Bobath疗法对中风患者运动康复的有效性方面尚无定论。这些结果与之前关于同一主题的综述结果相似。