The Bobath Clinical Reasoning Framework: A systems science approach to the complexity of neurodevelopmental conditions, including cerebral palsy

Abstract

Bobath is a widely used therapeutic approach for individuals with neurodevelopmental disorders such as cerebral palsy. The Bobath Clinical Reasoning Framework (BCRF) uses a systems science approach to explain current Bobath practice. A damaged central nervous system cannot be cured or fixed but can potentially be modified according to a child's experiences.

The BCRF uses knowledge from various fields to understand how physical and other aspects, for example sensory and cognitive factors, impact on daily activities. The BCRF depends on comprehensive in-depth clinical reasoning, and provides a structured way for professionals to think through and understand the relationships between various health domains, such as body functions, activities, and participation in daily life, which are unique to each individual. It provides a common understanding between physical therapists, occupational therapists, speech therapists, and families, about the key variables that could enable improved outcomes for different aspects of activity and participation. Treatment plans developed in response to the clinical reasoning ensure a holistic plan which can become a part of daily life activities, now and for the future, to achieve the ultimate goal of optimizing the individual's lived experience.

The article also considers the collaborative nature of the BCRF, which involves not only therapists who work in a transdisciplinary way, but places families centrally within the multidisciplinary team. This collaborative working is crucial for creating a supportive environment that fosters the individual's functional development throughout the lifespan.