Perhaps to the dismay of some, I will bring up the topic of Bobath techniques again. Nonetheless, the subject of my reflection is not exactly Bobath itself. I am merely using it as an example. I apologise if it appears I am beating about the bush.

I was searching the literature on the efficacy of Bobath techniques (AKA neurodevelopmental technique) and discovered that there is limited support for its use. A couple recent systematic reviews found nil evidence to support (or refute for that matter) its clinical value. One randomized trial found Bobath to be just as effective as motor learning based neural rehab (I think Carr and Sheppard methods), and another RCT found Bobath to be less effective. My search was by no means exhaustive. I simply typed in ‘Bobath’ under 'search' on the Pedro website. As I have mentioned in my last Blog, my neural placement is heavily Bobath based.

If Bobath is not the gold standard, why is it used as gospel? The issue that I’d like to discuss is how much of our hospital clinical experience is dogma, perpetuated by very experienced practitioners who have specialized in one philosophy of treatment? The use of the word dogma is likely too strong, but I am just trying to illustrate a point. If the clinical experience is based on one school of thought, my concern is that it prevents integration of other possibly effective neural rehabilitation techniques. Maybe the gold standard of neural patient treatment is a combination of motor learning and Bobath methods. However, if we are taught to believe one particular method of treatment is the best, where is the incentive to research new methods or a combination of methods?

I used Bobath as the example, but I think it can be with anything we are taught. It makes me appreciate Anne teaching us an integrated approach. Just a thought!