| Contemporary Bobath Concept Application Prior to Modified Constraint-Induced Movement Therapy in Chronic Post-Stroke Hemiplegic Patients: A Pilot Study. |
| Paper ID : 1005-ISCSR3 (R1) |
| Authors |
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Maram Ibrahim Ali *1, Soheir Rezkallah Samaan2 1Internship student, Faculty of physical therapy, Cairo university 2Professor of physical therapy/Basic science department/Faculty of Physical Therapy/Cairo University. |
| Abstract |
| Background: Stroke results in persistent upper limb impairment, requiring effective rehabilitation. Constraint-Induced Movement Therapy enhances neuroplasticity, while the Bobath Concept optimizes motor control. Despite their benefits, their combined potential remains underexplored. Purpose: This pilot study aims to develop and implement a treatment protocol combining the Contemporary Bobath Concept with modified CIMT to improve upper limb recovery and functional independence in post-stroke hemiplegic patients. It also examines the short-term effects of the Bobath Concept on muscle dexterity, range of motion, and functional independence before mCIMT. Methods: Six male patients with chronic post-stroke hemiplegia and significant upper limb impairment were divided into experimental (n=3) and control (n=3) groups. Inclusion criteria included ≥6 months post-stroke, with UL Impairment of (Modified Ashworth Scale ≤3), MMSE ≥24, and no significant upper limb contractures or other neurological conditions. Exclusion criteria included MMSE <24, grade 4 spasticity, severe shoulder pain or instability, ongoing upper limb rehabilitation outside the study protocol, and profound sensory deficits. The experimental group received 15 minutes of Bobath-based interventions before 1-hour daily mCIMT sessions, five days a week for three weeks. Treatment included posture correction, assisted stretching, neuromuscular training, task-specific motor learning, and a home-based Transfer Package. The control group received conventional therapy without Bobath or mCIMT components. Outcome Measures: Functional Independence Measure, Box and Block Test, and goniometric measurements. Results: A one-way mixed-design MANOVA showed no significant baseline differences (p = 0.691). Both groups improved significantly over time (p = 0.001). The experimental group showed increased shoulder ROM (23.83° to 28.27°) and wrist ROM (8.33° to 9.57°), while the control group had similar gains (shoulder: 22.13° to 26.07°, wrist: 8.27° to 9.21°). The interaction effect was not significant (p = 0.144). Conclusion: Comparable improvements in both groups suggest further research with larger samples and extended interventions to optimize this therapeutic approach. |
| Keywords |
| Contemporary Bobath Concept; Modified Constraint-Induced Movement Therapy; Chronic Stroke Rehabilitation; Post-Stroke Motor Recovery; Hemiplegic Upper Limb Rehabilitation. |
| Status: Abstract Accepted |