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J Neurol Neurosurg Psychiatry 2005;76:503-508 doi:10.1136/jnnp.2004.040436
  • Paper

Comparison of Bobath based and movement science based treatment for stroke: a randomised controlled trial

  1. P M van Vliet1,
  2. N B Lincoln2,
  3. A Foxall3
  1. 1Division of Stroke Medicine, University of Nottingham, Nottingham, UK
  2. 2School of Psychology, University of Nottingham, Nottingham, UK
  3. 3Division of Stroke Medicine, University of Nottingham, Nottingham, UK
  1. Correspondence to:
 Dr Paulette M van Vliet
 Division of Rehabilitation and Ageing, School of Community Health Sciences, University of Nottingham B Floor, Medical School, Queen’s Medical Centre, Nottingham NG7 2UH, UK; paulette.vanvlietntlworld.com
  • Received 1 March 2004
  • Accepted 10 September 2004
  • Revised 12 July 2004

Abstract

Objectives: Bobath based (BB) and movement science based (MSB) physiotherapy interventions are widely used for patients after stroke. There is little evidence to suggest which is most effective. This single-blind randomised controlled trial evaluated the effect of these treatments on movement abilities and functional independence.

Methods: A total of 120 patients admitted to a stroke rehabilitation ward were randomised into two treatment groups to receive either BB or MSB treatment. Primary outcome measures were the Rivermead Motor Assessment and the Motor Assessment Scale. Secondary measures assessed functional independence, walking speed, arm function, muscle tone, and sensation. Measures were performed by a blinded assessor at baseline, and then at 1, 3, and 6 months after baseline. Analysis of serial measurements was performed to compare outcomes between the groups by calculating the area under the curve (AUC) and inserting AUC values into Mann-Whitney U tests.

Results: Comparison between groups showed no significant difference for any outcome measures. Significance values for the Rivermead Motor Assessment ranged from p = 0.23 to p = 0.97 and for the Motor Assessment Scale from p = 0.29 to p = 0.87.

Conclusions: There were no significant differences in movement abilities or functional independence between patients receiving a BB or an MSB intervention. Therefore the study did not show that one approach was more effective than the other in the treatment of stroke patients.

Footnotes

  • See Editorial Commentary, p 465

  • This study was funded by the Stroke Association, UK

  • Competing interests: none declared

Responses to this article

  • Authors' reply
    • Paulette M van Vliet,
    • Nadina B. Lincoln, Andrew Foxall
    J Neurol Neurosurg Psychiatry published online May 16, 2005
  • Response to van Vliet et al.
    • Roberta B Shepherd,
    • Janet H Carr
    J Neurol Neurosurg Psychiatry published online April 19, 2005

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