Article

OBJECTIVE: 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. DESIGN: Randomized controlled
trial. SETTING: Two rehabilitation centres Participants:
Twenty-six participants
between four and 20 weeks post-stroke, able to walk with supervision indoors.
Interventions: 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. OUTCOME MEASURES: 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. RESULTS: 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). CONCLUSION: 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.

Langue : ANGLAIS