I'm Jenny Trott, and this video is all about Bobath therapy.
I'm here with Philip Vervaeke, one of the clinical specialist physiotherapists
here for Bobath Scotland, and we're going to be talking all about Bobath, what it is,
who it's for, what you might expect from a therapy session. Stay tuned and then
we're going to find out all about it
Hi Philip, thank you very much for joining me, and finding a space in your
therapy schedule. So we're going to be talking all about Bobath therapy. And
we're here in Scotland at Bobath Scotland. I think probably the first thing we need
to do is talk about what Bobath therapy is. So can you give me a quick idea of
what it's all about. Yeah, so Bobath therapy is in the first
instance, a family-centered approach. So it's important to find out from the
family what their expectations are particularly what their concerns are
for their child, or the person that we'll be working with. And help them
achieve goals that are important to them; functional goals in fact. So how
does it differ from any other therapy approach? Yeah, so the difference is
really it's a clinical reasoning approach; that's kind of the
framework. It's a problem-solving approach. So with clinical reasoning
being it's about observing and analyzing how the person is moving and
it's also about interaction between the therapist or the therapists, and in some
cases with the person, and actually also with anybody else that is
in session. Which is usually, or is always another parent or carer and
possibly also siblings. And then analyzing how the person is moving
and what that means for their overall functioning in daily life and
changing the way they move for it to be
functional but also more typical, and more efficient. And helping them to use
their own activity for that to stay. So it's not good
enough to change things in the session and then for them to relapse to what
happened before, in the next session. So each session we're looking for progress
and to build on that progress in the follow-up session. And very important is
that the person uses their own activity; reasoning being that cerebral palsy is a
sensory motor disorder and so we're relying on the person's feedback to
actually be aware of, not necessarily consciously,
ideally actually automatically, of changes that are happening to the body while we're
working with them so that with using their own activity then they're slowly,
gradually changing the way they're moving and that is a change that is,
stays over time. So you mentioned cerebral palsy there, so it's important that
we highlight that this is a therapy that's specifically designed for people
who have a diagnosis of cerebral palsy, is that right? Yes it's for people who have cerebral
palsy or what they would call allied neurological conditions. And particularly
what we see and what Mrs. Bobath identified was that initially she
was working with actually adults, people who'd had a stroke, and then she opened
up the approach to also include people with cerebral palsy. Bobath therapy can
help everyone who is got altered tone to bring the tone that is either
changed to below typical, or above typical or a combination of this or
fluctuation of this, to bring the tone more towards the typical range. So
interesting that it started off as a therapy for adults ; I think it's mostly
concentrated on children now, but do Bobath Scotland offer support to
adults as well? Yes we, in the last six, seven years we've now
included also therapy for adults. Which is, it's funded differently but
it's been a natural process that the children, some of the children that
we were treating, you know, grew up into adulthood so they obviously wanted to
come back because we already recognize that CP is a lifelong condition with, for
a lot of people, near normal life expectation so it's important that we
keep on supporting. I think we should touch on what to expect from a therapy
session, but before I forget it's not something that just, you come to every
week for a year. It's concentrated sessions isn't it, periods of sessions?
Yeah. One of the pieces of research that showed that intensive blocks are a very
effective way of helping people, children with cerebral palsy. So we tend to work
in blocks, in intensive therapy blocks. Children come here together with at
least one of the parents, and it's a process of working together,
communicating, interacting as I explained earlier. And both the child and the
parents, people who care for the child, learning together and
growing and actually, almost, spontaneously naturally practicing the
things that they've learned at home. And it's not practicing as in exercising,
it's about incorporating it into their daily life. Often we will use
opportunities as dressing to do it in a slightly different way, to change the way
the child is moving, and also the way the parent is doing it; the way
they're interacting together and also, particularly using play to
throughout their day. Yes, so play is quite an important part of the therapy sessions
isn't it, it's to make it fun and engaging, less like hard work.
Yes because what I said earlier about, we need to use the child's own activity in
order to make the changes. So motivation of the child is very important and also
of the parents in fact. So if we get the child on board, which is, play is
one strategy, but it's a very important and useful strategy
particularly the younger the child is. And having fun together as
a family is an important aspect of anyone's life but it means that
learning will happen, and that's, we can achieve the changes that we're
looking for. I introduced you at the beginning as a physiotherapist, but
there are lots of other therapy disciplines involved in the Bobath
team? Yes. So I'm only one part of our team
in terms of discipline, as a physio. So we also have occupational therapists
and the name says it. Occupational therapist will look at the
person's job or role in their life, which for children is very much about play.
But also about learning; school education. And also about leisure which is
very important. So all those aspects, and then we also work together with our
speech and language therapists. Which isn't just about speech and language
because that isn't always a given for people with cerebral palsy, but it's very
much about communication as well as about eating and drinking, again not
always a given that is easy from early on in life can be difficulty with
feeding and with drinking and eating. We can only speak of what happens here
in Scotland but if we're speaking to a parent or a carer of a child who would
like to access this service how do they go about getting
it paid for? The important thing to know about it, and you know the limited
things I know about it as a therapist, is that not to worry about the funding, but
contact us and and we'll take it from there. We will find a way of
helping every person in Scotland who has cerebral palsy. But important for people
watching who may be like doing fundraising, you are a charity, your
registered charity, so a lot of your funding comes from fundraising,
trusts, government support etc so important that everybody knows that too.
Bobath isn't just here, its elsewhere as well? Throughout the UK?
There's two other Bobath centres in the UK; there's the centre in London, the
actual, The Bobath Center which is where it all originated from, the Bobath approach.
And then there's also a centre in Cardiff in Wales. But Bobath happens in
many countries all over the world. Thank you very much Philip that's been
a fascinating, although a whistle-stop tour about what Bobath is I think
it's probably ticked all the boxes for those watching who don't know anything
about the therapy, and hopefully enough to encourage people to seek it out if
they think it might be helpful to them or all their children, so thank you very
much. I hope it was helpful. Thank you.
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