Re: [xmca] Bobath method

Thank you Christine. That was indeed a very helpful contribution. A lot of
the things you mention have rung bells in what I have seen. It all adds up.
The therapists working with Vonney get their Bobath from the UK, BTW, I am
in Oz.
thank you,
Andy
At 06:01 PM 31/07/2007 -0700, you wrote:
>If it's helpful, I can clarify a bit about the Bobaths (Berta and Karel),
>their work, and how it impacts physical, occupational and speech therapy
>practices today around the world, and if it relates to Vygotsky.
>
>The quick and dirty history is that Berta, a dancer, noticed that children
>with cerebral palsy exhibited stereotypical patterned movements and talked
>about this with her husband Karel, a doctor. Based on the idea that these
>movements and patterns of high muscle tone and spasticity were due to
>primitive basic reflexes the damaged brain was unable to override, they
>devised an approach to inhibit these reflexes, thus allowing more natural
>movement.
>
>This became known as the neurodevelopmental treatment approach (NDT),
>which is what most therapists around the world today call this method. For
>quite a while the Bobaths' name was dropped altogether and not mentioned
>in conjunction with NDT other than as an historical footnote. Recently,
>however, there has been a split in the US training and practice of NDT,
>with another group developing procedures with a slightly different
>grounding, but still referring to the method by the acronym NDT. So, to
>clarify which NDT they mean, some therapists in the US have recently begun
>referring to traditional NDT as the Bobath approach.
>
>This approach is most often used today with individuals with hemiplegic
>stroke and children with cerebral palsy. What Andy noticed, the tactile
>cueing for voluntary movement, can only take place after "inappropriate"
>reflexes and postures are inhibited. The inhibiting takes place through
>careful hand placement at various points on the body (not necessary right
>at the area where the focus of treatment is taking place) and tactile
>cueing. It may or may not be apparent to the lay observer. The idea is not
>that you make the patient's limb move in a particular direction but that
>through careful posture adjustment and touch, one suppresses the reflex
>and enables the possibility of voluntary movement, and helps to develop
>motor memory of that posture and the voluntary movement.
>
>I am not NDT certified (nor are most therapists), but like most therapists
>around the world, I did learn about the general principles and approaches
>used in this method and a number of others as part of my basic training as
>an occupational therapist. So, while Mike's therapists may not refer to
>the Bobath's by name, they certainly learned at least some of the basics
>of the NDT approach in their schooling. Though it is one of the most
>accepted rehab approaches, there has not yet been enough outcomes research
>to establish NDT as a more effective method than any other approach, by
>the way.
>
>As for the Vygotsky question, I am sure that the Bobath's would have been
>aware of his work but I do not recall any mention of a direct influence in
>the history and literature on the method that I have read.
>
>Finally, a topic I can contribute on :-)
>
>Cristine Carrier PhD(C), OTR/L
>Department of Occupational Science and Occupational Therapy
>University of Southern California
>
>----- Original Message -----
>From: Mike Cole <lchcmike@gmail.com>
>Date: Tuesday, July 31, 2007 4:54 pm
>Subject: Re: [xmca] Bobath method
>To: "eXtended Mind, Culture, Activity" <xmca@weber.ucsd.edu>
>
> > Andy-- I am in Brasilia where people do not use the term bobath
> > and only some have heard of Vygotsky, but they adopt the same
> > philosophy-in-practice. (Gimple was no fool, as David ke has
> > eloquentlyreminded us).
> >
> > I hope to write about this in more detail but one brief (perhaps too
> > brief) example. I am at a rehabilitation center for (mostly) children
> > who exhibit some form of cerebral palsey ( a very hazy concept),
> > or have experienced traumatic brain injury (not so hazy, but always
> > ambiguous in detail). It is amazing for implementing at an
> > institutionallevel what I would consider a zone of proximal
> > development (being a relative
> > of Gimple~s and not nearly so wise).
> >
> > Among the many fascinating features of this place is a pathway in
> > the middle of an amazing rehabilitation center. Gorgeously
> > organized down to
> > the tiniest detail. But the pathway is not smooth. About every 3-4
> > meters it
> > changes its texture with small ruts or cobblestones. Why? Because
> > once a
> > patient has learned to move along a smooth surface (with whatever
> > prostheticdevices and what ever bobathian assistance) in the
> > future are the regular
> > sidewalks and streets of Brasilia. And, not unlike the sidewalks
> > of San
> > Diego or London or....... they are uneven and one must make constant
> > adjustments to their texture and uneveness,even if one is still
> > temporarily unimpaired.
> >
> > The sidewalk, thought of by a wizardess who works at this center,
> > is an
> > ^"actant" organizing to help people in the present to confront
> > their likely
> > if not inevitable future so that when that future crashes down on
> > them they
> > are not crushed by its weight.
> >
> > Bom Nioche, or G'day, whatever it is where you are
> > mike
> >
> >
> > On 7/31/07, Andy Blunden <ablunden@mira.net> wrote:
> > >
> > > I have spent a lot of time recently watching my partner Vonney
> > receiving> physiotherapy treatment following her stroke.
> > >
> > > I noticed that the physios used a Vygotskyist approach, in this
> > respect.> If
> > > for example, if Vonney was doing facilitated walking, and her
> > left hip was
> > > lazily trailing and needed to be activated and moved forward,
> > instead of
> > > pushing it forward from the back, which would be the common
> > sense thing to
> > > do, they would lightly touch her on the front. In my
> > interpretation, this
> > > touch creates a "psychological tool" in drawing Vonney's
> > attention to the
> > > part of her body which needs to be activated and she naturally
> > responds in
> > > that way and reacts against the light push.
> > >
> > > Yesterday I Googled the name of the method the physios used,
> > "Bobath", and
> > > found in the opening paragraph of the definition of this method the
> > > following:
> > >
> > >
> > > " the client's potential, which was
> > considered to be
> > > that task or those
> > > activities which could be performed by the
> > person with
> > > a little help,
> > > and therefore possible for that person to
> > achieve> independently where possible. "
> > >
> > > This is a straightforward definition of out beloved ZPD.
> > >
> > > Is this a case of "great minds think alike" or is there an
> > historical> connection between CHAT and Bobath?
> > >
> > > Andy
> > >
> > > _______________________________________________
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> > > xmca@weber.ucsd.edu
> > > http://dss.ucsd.edu/mailman/listinfo/xmca
> > >
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> >
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  Andy Blunden : http://home.mira.net/~andy/ tel (H) +61 3 9380 9435, AIM
identity: AndyMarxists mobile 0409 358 651

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Received on Tue Jul 31 18:21 PDT 2007