Does physiotherapy based on the Bobath concept, in conjunction with a task practice, achieve greater improvement in...

To compare the short-term effects of two physiotherapy approaches for improving ability to walk in different environments following stroke: (i) interventions based on the Bobath concept, in conjunction with task practice, compared to (ii) structured task practice alone.

Randomized controlled trial.

Two rehabilitation centres Participants: Twenty-six participants between four and 20 weeks post-stroke, able to walk with supervision indoors.

Both groups received six one-hour physiotherapy sessions over a two-week period. One group received physiotherapy based on the Bobath concept, including one hour of structured task practice. The other group received six hours of structured task practice.

The primary outcome was an adapted six-minute walk test, incorporating a step, ramp and uneven surface. Secondary measures were gait velocity and the Berg Balance Scale. Measures were assessed before and after the intervention period.

Following the intervention, there was no significant difference in improvement between the two groups for the adapted six-minute walk test (89.9 (standard deviation (SD) 73.1) m Bobath versus 41 (40.7) m task practice, P = 0.07). However, walking velocity showed significantly greater increases in the Bobath group (26.2 (SD 17.2) m/min versus 9.9 (SD = 12.9) m/min, P = 0.01). No significant differences between groups were recorded for the Berg Balance Scale (P = 0.2).

This pilot study indicates short-term benefit for using interventions based on the Bobath concept for improving walking velocity in people with stroke. A sample size of 32 participants per group is required for a definitive study.