The Bobath Clinical Reasoning Framework: A systems science approach to the complexity of neurodevelopmental
Margaret J Mayston1, Gillian M Saloojee2, Sarah E Foley3
1Division of Biosciences, University College London, London, UK.
Insights
The Bobath Clinical Reasoning Framework (BCRF) uses systems science for a holistic view of childhood disability. This approach aids in understanding and managing conditions like cerebral palsy (CP) throughout life.
Area of Science:
- Neuroscience
- Systems Science
- Developmental Pediatrics
Background:
- Childhood-onset disabilities, such as cerebral palsy (CP), present complex challenges requiring a holistic understanding.
- Current developmental Bobath practice can be enhanced by applying systems science principles.
- The International Classification of Functioning, Disability and Health (ICF) provides domains that need to be understood in their interrelationships.
Purpose of the Study:
- To conceptualize developmental Bobath practice through the lens of systems science.
- To provide a holistic perspective on the interconnected variables in childhood-onset disability.
- To enhance the understanding and management of neurological disorders like CP.
Main Methods:
- Utilizing the Bobath Clinical Reasoning Framework (BCRF) as a transdisciplinary observational system.
- Applying a practical reasoning approach integrated with systems science.
- Considering individual and social environmental contextual factors, including the family unit.
Main Results:
- The BCRF offers a holistic understanding of complex situations associated with disorders like CP.
- It elucidates the interrelationships between typical and atypical development, pathophysiology, and neuroscience.
- It provides a basis for lifelong management and habilitation, optimizing the individual's lived experience.
Conclusions:
- Conceptualizing Bobath practice within a systems science framework (BCRF) offers a comprehensive approach to childhood disability.
- The BCRF facilitates understanding the interplay of factors influencing functioning and participation.
- This model is crucial for the lifelong management of individuals with neurological disorders, aiming to optimize their overall quality of life.
Abstract:
The current recommended developmental Bobath practice within the Bobath Clinical Reasoning Framework (BCRF) can be conceptualized using the lens of systems science, thereby providing a holistic perspective on the interrelatedness and interconnectedness of the variables associated with childhood-onset disability. The BCRF is defined as an in-depth clinical reasoning framework that can be applied to help understand the relationships between the domains of the International Classification of Functioning, Disability and Health, how those domains can be influenced, and how they impact each other. The BCRF is a transdisciplinary observational system and practical reasoning approach that results in an intervention plan. This provides a holistic understanding of the complexity of situations associated with disorders such as cerebral palsy (CP) and the basis for the lifelong management and habilitation of people living with neurological disorders. The clinical reasoning used by the BCRF draws on the important contextual factors of the individual and their social environment, primarily the family unit. It is rooted in an understanding of the interrelationships between typical and atypical development, pathophysiology (sensorimotor, cognitive, behavioural), and neuroscience, and the impact of these body structure and function constructs on activity and participation. The systems science model integral to the BCRF is a useful way forward in understanding and responding to the complexity of CP, the overarching goal being to optimize the lived experience of any individual in any context.
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