Objective: To identify similarities and differences between a Bobath-based (BB) and a movement science-based (MSB) approach.
Design: Direct observation by a trained observer was used to record behaviours during treatments.
Setting: An acute stroke ward.
Subjects: Twenty-two stroke patients.
Interventions: Behaviours were recorded during 12 treatment sessions by three therapists, for each treatment approach. Physical and communication behaviours were recorded in pre-defined categories. The equipment used was recorded and a semi-structured interview conducted with the therapist after treatment to identify follow-up actions by the therapist.
Main outcome measures: Frequency of occurrence of each category was compared between the approaches.
Results: Treatment in the BB group contained more social conversation (p = 0.004), and more use of physiotherapy equipment (p = 0.02) and a physiotherapy assistant (p = 0.01). In the MSB group there was more detailed feedback given to the patient (p = 0.002) more use of everyday objects in training (p = 0.001), therapists more frequently listed specific components as the patient's main problems (p = 0.003) and relatives were involved more in positioning to stretch muscles (p = 0.03). Training walking was given more emphasis in the BB group and training of sit-to-stand in the MSB group.
Conclusions: The study indicates that there are differences in content between the Bobath-based and movement science-based approaches to treatment.
