Physical Rehabilitation of Children with Cerebral Palsy by Bobath-Therapy Method

Abstract

Purpose: The article presents the structure and content of a physical rehabilitation program incorporating Bobath therapy for 4-year-old children with spastic diplegia cerebral palsy in a specialized rehabilitation center. Material & methods: theoretical analysis and generalization of special scientific and methodological literature; pedagogical observation, interview, and experiment (ascertaining and formative); motor abilities testing (with the Motor abilities assessment chart by Karel and Berta Bobath); clinical study (neurological examination to determine the severity of motor impairment according to the Gross Motor Function Classification System (GMFCS)); statistical data analysis. The ascertaining experiment involved 36 4-year-old children with spastic diplegia cerebral palsy. Results: Assessment of motor function showed that the development of motor function was improved in the following basic starting positions: by 5.42% in supine lying, by 3.94% in prone lying, by 5.16% in sitting erect, by 9.06% in kneeling, by 4.06% in squatting, and by 7.41% in standing. Development of motor skills was improved by 6.01% for rolling to the side and by 3.21% for rolling to the prone position. Statistical analysis of the motor impairment assessment data after the completion of the physical rehabilitation program revealed an increase in the number of children with GMFCS level I (the mildest form), which was statistically significantly higher (p <0.05) compared to the subjects participated in the standard physical rehabilitation program; the analysis of the relationship between the motor function and the severity of motor impairment in children with cerebral palsy after the completion of the physical rehabilitation program shows the tendency for reduced motor function associated with a low level of motor impairment. Conclusions: The developed physical rehabilitation program incorporating Bobath therapy for 4-year-old children with spastic diplegia cerebral palsy in a specialized rehabilitation center was evaluated in the course of the formative experiment. The practical effectiveness of the proposed program was proved by the quantitative changes (at the level of p <0.05) of the studied parameters. The results of the study confirm the effectiveness of the proposed program of physical rehabilitation focused on the development of motor function and correction of motor impairments.