Bobat-therapy: training, exercises, effectiveness and feedback

Parents who have children with congenital malformations, put all their strength and give all the time to overcome the problems facing the family. Even without the hope for the complete disposal of the offspring of defects, they seek to facilitate his life and give a chance, at least for partial rehabilitation. Many children have the opportunity to begin to lead a more or less full life by giving Bobat therapy. However, in order for them to take advantage of this chance, parents should at least find out what it is.

History of origin

Bobat-therapy received the name (and became known under it) by the name of its developers, the London couple - physiotherapist Bertha Bobat and her husband, neurophysiologist Karl Bobat. In the 40s of the last century, Bertha proposed a cardinally new, unexpected approach to the problem of restoring patients whose disease is accompanied by spastic lesions of the musculature. It was based on many years of observations and personal experience of the physiotherapist. The main idea was the interaction of the psyche with the body, due to which the treatment was not a separate organ, but the body as a whole. The pursued goal is the development of controlled, expedient and conscious movements with a parallel decrease in muscle spasms and tension.

An invaluable practical experience was later systematized, summarized and grounded theoretically by the husband of Bertha. The high efficiency of the methodology contributed to its rapid and wide spread throughout the world. In medical circles, Bobat therapy is known as neurodynamic rehabilitation.

Scope of the methodology

The most widely and successfully used Bobat therapy in cerebral palsy, with any severity, both with affecting higher nervous activity, and only with impaired motor functions. However, it is effective in other diseases. These include:

1. Various kinds of defects that occurred during the development of the spinal canal.
2. Scoliosis of different severity.
3. Disorders of motor development: spasticity, coordination problems, hyperkinesia, impaired motor control.
4. Congenital and acquired at an early age dislocations of the hip.
5. The consequences of injuries (in particular postpartum), surgeries or illnesses, which led to the loss of the child's control of the body. This includes strokes and side effects of brain inflammation.

Of course, the Bobat-therapy can not always fully help; The results, however, it gives much more successful than many of the preceding methods.

Who should not use Bobat-therapy?

Restrictions on the use of neurodynamic recovery are few, but they are.

1. Categorically prohibited by Bobat therapy for the treatment of schizophrenics.
2. Very neatly it can be used for epilepsy. In a mild or latent form of flowing, constant monitoring and a milder style of practice are mandatory; In heavy - Bobat-therapy should be excluded from the list of allowable medical measures.
3. Convulsive readiness in the expressed form: certain actions of a technique can provoke cramps.

It is also recommended to suspend occupations if chronic diseases are in an acute stage.

Directions of impact

All the actions of Bobat-therapy are focused on achieving one of three goals.

1. Prohibiting retention. In this case, the therapist (or parents) inhibits convulsive, pathological, involuntary movements of the child. This stage is called inhibition.
2. Directional movements. They are preceded by a variety of stretch marks designed to relieve muscle tension and remove its fixation (physical memory of the body). Then the therapist moves the individual limbs of the child in the right, right rhythm and direction. The body must remember the correct movement, so that in the future, in a similar situation, it will be used automatically. This phase was called facilitation.
3. Stimulation of the child to achieve the desired result. Usually, all activities include the usual and favorite games for the child or the elements of the service, which eventually become self-service.

All activities should be conducted in a team-based manner, involving not only the therapist and the child, but also with the involvement of parents who will eventually replace the instructor-doctor, and under the supervision of a number of narrow specialists - from ENT and speech therapist to neurologist with orthopedist. In this case, treatment is primarily focused on adapting the baby to normal life.

Basic provisions of Bobat therapy

First of all, neurodynamic rehabilitation should not follow any exact schemes and dogmatic approaches. For each patient, Bobat therapy forms an individual approach. At the heart of the technique is motion therapy, called kinesitherapy. The specialist controls the movements of the child while controlling his reactions on three levels: the head - the shoulder belt - the pelvic girdle. When one of these zones passively moves (by the therapist's hands), rectification reactions, equilibria or so-called labyrinth reactions are activated. Under normal development, these reflexes are laid and fixed between the first six and eight months of life, and the simplest ones - and at all from one month. Bobat therapy helps the child to master all the positions that are natural, without pathological, wrong movements. Constant repetition poslozhnie, stand on all fours, sitting or squatting - fixes the correct movements and simplifies the stabilization of the vertical position.

Over time, correct positions begin to prevail, replacing pathological ones and passing to the level of unconditioned reflexes.

Initiation of therapy

To begin the course of neurodynamic rehabilitation can be at any age, from infants to adulthood. But, like any other treatment, the sooner you start - the more successful is Bobat-therapy. Reviews say that many movements by three years are so strongly prescribed in the child's subcortex that it is very difficult to get rid of pathologies and convulsive strains.

At the first visit the therapist should determine with what movements the baby has the greatest difficulties, which are given to him more easily and require only adjustments. From this will depend on a set of stretch marks, exercises and positions, which need to be given maximum attention.

It is equally important for the therapist to be able to determine how much parents will be persistent in therapy and be able to teach them the initial minimum required. Each Bobat-specialist should have good pedagogical qualities and have a good understanding of psychology.

Basic movements

We have already mentioned the individual approach on which Bobat therapy is based. Exercises are developed based on the level of development of the child and the degree of damage to his body. However, we will list the most commonly used motions later.

1. Extension of the extremities and neck in the supine position.
2. In the prone position on the abdomen with bent hands (all joints are involved) - lifting the head, pushing forward the hands with their preliminary shaking and shaking. A roller is placed under the breast.
3. Stimulation of overturning: segmental rotation of legs, pelvis and trunk as a whole.
4. Crawling on all fours: moving hands and feet in the right order, without intermediate excess movements, with correcting the setting of hands and controlling the hardness of the stop.
5. The development of the correct fit: the roller between the hips, holding the child by the hands with the correctness of planting and laying (without stalling on the side).
6. Working off the transition from the sitting (on the couch) to standing position.

Over time, more complex exercises are introduced, aimed at strengthening the vertical firmness and the right movements when walking. The latter is a rather complex physiological complex of movements, so that a constant control of the correctness of the position of all the components of the body, from the legs to the head, is required.

Positive results and benefits

Despite the painstakingness and duration that Bobat therapy requires, it is used with enthusiasm throughout the world, as it has a number of undeniable advantages.

1. Stability of the achieved. All the motor skills developed during the therapy are irreversible and are built directly into the personality of the patient.
2. Safety of the technique: risks of injury or infection are excluded.
3. Absence of any medicamentous load on the body.
4. Absence of any side effects.

An additional advantage is the game form, in which the therapy is conducted: the child willingly takes part in it, not perceiving as treatment.

Bobat-therapy and cerebral palsy: reviews of moms

Neurodynamic rehabilitation, according to the parents, can not be called a course of treatment. Rather, it becomes a way of life - daily and year-round. You need to pay attention to it constantly, and the more, the better. However, most mothers and fathers are very willing to do this, because the first results are visible within a month or two of regular classes. And these results are so impressive that the enthusiasm of parents increases at times.

If you are interested in Bobat therapy, a book called "Bobat-concept", compiled by experienced experts in this field, Sue Rein, Lynzi Meadows and Mary Lynch-Ellington, published in 2013 in Russian, can give you a detailed idea of the fundamental principles and Approaches of treatment. However, experts say that it is hardly possible to master it independently: the basic skills and deep understanding can be mastered only by observing the actions of a professional therapist and listening to his recommendations. However, when Bobat-therapy is involved, the teaching of the parents to her techniques is part of the therapist's task.