Neurodevelopmental Therapy-Bobath Approach in The Early Term of Stroke; Safe and Effective

Gokhan Yazici

Status: Completed

Conditions: Ischemic Stroke; Stroke, Acute

Treatments: Other: Standart Rehabilitation Group (SR group); Other: Neurodevelopmental Therapy-Bobath group

Study type: Interventional

Funder types: Other

Identifiers

NCT03602326

196

Details and patient eligibility

About

Early term rehabilitation initiated after stroke should be based on motor learning principles and neural plasticity. To achieve motor learning and neural plasticity, exercises consisting of intense and repetitive training should be given according to the patients' functional level. The neurodevelopmental treatment-Bobath (NDT_B) approach is based on motor learning principles. In literature, studies that show the early term effects of NDT-B on functional recovery are inadequate. The aim of this study was to investigate the effects NDT-B applied in the early term of stroke, on postural control, functional movement, balance and activities of daily living.

Full description

When literature is examined, it can be seen that evidence is limited. Studies investigating the effects of the Bobath Approach in the early term in stroke, state that NDT-B is reliable and feasible. However none of these studies have examined the effects of NDT-B in acute term stroke on functionality and daily living. Additionally, in all of these studies it was also stated that further studies should be conducted.

Enrollment: 39 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients older than 18 years of age
• Systolic blood pressure between 120 and 220 mmHg
• Oxygen saturation >92% (with or without O2 support)
• A heart rate of 40 to 100 beats/min
• A body temperature of <38.5°C
• A disability level of ≤4 according to the Modified Rankin Scale
• Those who could respond to verbal commands

Exclusion criteria

• A history of previous stroke
• Concomitant progressive neurological disturbances
• Acute coronary disease
• Severe heart failure
• Concomitant rheumatologic diseases
• A fracture or an acute orthopedic disorder that would prevent mobilization

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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39 participants in 2 patient groups

Neurodevelopmental Therapy-Bobath group

Experimental group

Description:

Bobath Approach Principles and exercises will be performed 5 days a week with physical therapists and everyday with caregivers. Physiotherapy will be initiated as early as possible according to the principles of the method by experienced NDT-B therapists. Exercises will be implemented according to the patients' status and will be used to maintain and improve muscle strength and endurance. Both the unaffected and affected side will be included in rehabilitation. The exercises given are designed to be simple, understandable, task-oriented and repetitive, in accordance with the Bobath approach and the functional state of the patient at that time. In order to prevent motor amnesia and neglect of the affected side, correct positioning and sensory input will be provided since the first session.

Treatment:

Other: Neurodevelopmental Therapy-Bobath group

Standart Rehabilitation Group (SR group)

Active Comparator group

Description:

Patients will be included in standard rehabilitation sessions, 5 days per week. The rehabilitation sessions will be performed by standard clinical physiotherapists according to the hospital routine. The rehabilitation program will consist of in-bed joint range of motion exercises and bedside mobilization applications. The patients will be included in the rehabilitation program as early as possible and the program will continue until the patients are discharged

Treatment:

Other: Standart Rehabilitation Group (SR group)