Table 1.
Effect of neurophysiological techniques (NDT/Bobath) on walking.
| Author, Year | Subjects | Program description | Results |
|---|---|---|---|
| Mulder et al. [56] 1986 |
N=12 Had completed rehabilitation Lacked dorsiflexion function |
5 weeks, 3X/week Group 1 (n=6) NDT/Bobath Group 2 (n=6) EMG visual feedback of tibialis anterior and peroneus longus during lying and standing. |
No group differences in gait speed. |
| Dickstein et al. [57] 1986 |
N=131 Took part and completed 6 weeks inpatient rehabilitation |
Group 1 (n=38) Bobath Group 2 (n=57) Conventional (functional activities) Group 3 (n=36) Proprioceptive neuromuscular facilitation |
No group differences in indoor ambulatory independence at 6 weeks post admission. |
| Richards et al. [58] 1993 |
N=27 Inpatient rehabilitation |
All groups received conventional rehabilitation, plus one of three physiotherapy groups: Group 1: Early and intensive therapy (treadmill, isokinetic device, tilt table, limb-load monitor) (n=10) Group 2: Early neurophysiological physiotherapy (n=8) Group 3: Neurophysiological physiotherapy (n=9) Groups 1 and 2 started mean 8 days and Group 3 started 13 days post-stroke. |
Gait speed: Intensive group had faster (but not significant) speed at 6 weeks post-stroke compared to other 2 groups. Note: percent of time on treadmill was not described. |
| Gelber et al. [59] 1995 |
N=27 < 1 month post-stroke |
Group 1: NDT (n=15): inhibition of abnormal muscle tone, emphasis on normal movement patterns with progression to functional activities Group 2 (n=12): Functional training (passive range of motion, progressive resistive exercises even in the presence of spasticity, early use of assistive device and bracing) |
Gait speed: Bobath Group lost gait speed at discharge (−5%), 6 months (−45%) and 12 months (−62%); Functional Group improved from baseline speed at discharge (+17%), 6 months (+133%) and 12 months (+133%). More than 60% missing data due to inability to walk. Number of days to walk without device was 57% longer for NDT group*. |
| Langhammer and Stranghelle [60] 2000 |
N=61 First-ever stroke |
Physiotherapy, 5X/week, minimum 40 min Interdiscplinary care (doctors, nurses, occupational therapists, etc). Group 1: Bobath (n=28) Group 2: Motor Relearning (n=33) |
At 2 weeks after the first assessment and 3 months post-stroke, there was no group difference in the trunk, balance and gait subscale of the Sodring Motor Evaluation Scale. Motor Relearning had higher Motor Assessment Scale (includes walking) at 3 months compared to Bobath Group |
| Van Vliet et al. [61] 2005 |
N=120 Stroke inpatients, < 2 week post-stroke |
Sessions were a median of 23 minutes for total of 365 min Group 1: Bobath (n=60) Group 2: Motor learning (n=60) Assessment at 1, 3, 6 months post-entry |
No group differences for any outcome including 6MWT, Rivermead Motor Asessment, Motor Asessement Scale (used area under curve analysis) at 1, 3 and 6 months after baseline. |
| Thaut et al. [62] 2007 |
N=78 < 4 weeks post-stroke Can walk 5 strides with arm support by therapist |
3 weeks, 30 min, 5X/week of gait training Group 1: Bobath/NDT (n=35) Group 2: Rhythmic auditory stimulation (n=43): metronome, cueing and music during walking and adaptive gait tasks (e.g., ramps) |
Gait speed*: Bobath +56%; Auditory Group + 145%. |
+/− % indicates percent increase or decrease from baseline.
*
indicates significant comparison reported in study.