Neurodevelopmental Technique/ Bobath Approach

Neurodevelopmental Technique/ Bobath Approach

(opposite of Brunnstrom Approach)

 Therapeutic Handling: Therapeutic handling is used to influence the quality of the motor response and is carefully matched to the patient’s abilities to use sensory information and adapt movements. It includes neuromuscular facilitation, inhibition, or frequently a combination of the two. Manual contacts are used to:

  • Direct, regulate, and organize tactile, proprioceptive and vestibular input
  • Direct the client’s initiation of movement more efficiently and with more effective muscle synergies
  • Support or change alignment of the body in relation to the BOS and with respect to the force of gravity prior to and during movement sequences
  • Decrease the amount of force the client uses to stabilize body segments
  • Guide or redirect the direction, force, speed, and timing of muscle activation for successful task completion
  • Either constrain or increase the flexibility in the degrees of freedom needed to stabilize or move body segments in a functional activity
  • Dense the response of the client to sensory input and the movement outcome and provide nonverbal feed-back for reference of correction
  • Recognize when the client can become independent of the therapist’s assistance and take over control of posture and movement
  • Direct the client’s attention to meaningful aspects of the motor task


Key Point of Control: Key points are parts of the body that the therapist chooses as optimal to control (inhibit or facilitate) postures and movement. Proximal key points include the shoulders and pelvis, which are used to influence proximal segments and trunk. Distal key points upper and lower extremities (typically the hands and feet). Key points of control are also used to provide inhibition of abnormal tone and postures. Examples include:

  • Head and trunk flexion decreases shoulder retraction, trunk and limb extension (key points of control: head and trunk).
  • Humeral external rotation and flexion to 90 degrees decreases flexion tone of the upper extremity (key point of control: humerus).
  • Thumb abduction and extension with forearm supination decreases flexion tone of the wrist and fingers (key point of control: the thumb).
  • Femoral external rotation and abduction decreases extensor/adductor tone of the lower extremity (key point of control: hip).
  • Facilitation: Components of posture and movement that are essential for successful functional task performance are facilitated through therapeutic handling and key points.
  • Inhibition: Components of posture and movement that are atypical and prevent development of desired motor patterns are inhibited. While originally this term referred strictly to the reduction of tone and abnormal reflexes, in current NDT practice it refers to reduction of any underlying impairment that interferes with functional performance. It can be used to:
    • “Prevent or redirect those components of a movement that are unnecessary and interfere with intentional, coordinated movement,
    • Constrain the degrees of freedom, to decrease the amount of force the client uses to stabilize posture
    • Balance antagonistic muscle groups
    • Reduce spasticity or excessive muscle stiffness that interferes with moving specific segments of the body.”



Resources for full article “A Detailed Outline of Neurorehabilitation Technique for Post-Stroke Symptoms”:

Corbett, A. (2012). Stroke. Brain Foundation: Headache Australia. Retrieved on December 9, 2012 from

Cuccurullo S, editor. Physical Medicine and Rehabilitation Board Review. New York: Demos Medical Publishing; 2004. Stroke Rehabilitation. Available from:

Dickstein, R., Hocherman, S., & Shaham, R. (1986). Stroke Rehabilitation: Three Exercise Therapy Approaches. Physical Therapy Journal, 66 (8).

Ernst, E. (1990). A review of stroke rehabilitation and physiotherapy. Stoke. Retrieved on December 10, 2012 from

IPNFA. (2012). What is IPNFA? Proprioceptive Neuromuscular Facilitation from facilitation to participation. Retrieved on November 25, 2012 from

Kollen, B., Lennon, S., Lyons, B., Wheatley-Smith, L., Scheper, M., Buurke, J., Halfens, J., Geurts, A., & Kwakkel, G. (2009). Stroke Rehabilitation What is the Evidence? American Heart Association Journals. Retrieved on November 25, 2012 from

Mayo Clinic Staff. (2012). Stroke. Diseases and Conditions. Retrieved on November 25, 2012 from

O’Sullivan, S. & Schmitz, T. (2007). Strategies to Improve Motor Function. Physical Rehabilitation 5th ed. Retrieved on November 25, 2012 from

Leave a Reply

Your email address will not be published. Required fields are marked *

Helping people age one to 100 live life to the fullest.