BOBATH vs. TASK-ORIENTED TRAINING AFTER STROKE: An assessor-blind randomized controlled trial.

Objectives: To evaluate/compare the effects of the Bobath concept and task-oriented training on motor function, muscle thickness, balance, gait, and perception of goal achievement in patients with stroke.

Methods: Thirty-two patients were randomly divided into Bobath and task-oriented groups. Exercises were applied for one hour a day, three days a week, for eight weeks. Clinical (Trunk Impairment Scale (TIS), Stroke Rehabilitation Assessment of Movement (STREAM), Goal Attainment Scale (GAS), balance, gait)) and trunk muscle thickness assessments (with ultrasound) were performed.

Results: Thirty patients completed the study. TIS, STREAM, and GAS scores were increased in both groups (all  < 0.05). Bilateral rectus abdominis thickness was found to have increased in the Bobath group whereby this increase was better when compared with the task-oriented group ( < 0.05). The limits of stability increased in both groups ( < 0.05). Postural sway was decreased in the anteroposterior (normal stability eyes open) in the Bobath group and the anteroposterior (perturbated stability eyes closed) in the task-oriented group. Velocity, step length, and functional ambulation profile scores increased, and double support of the paretic side decreased in the task-oriented group (all  < 0.05).

Conclusions: The Bobath concept appears to be superior to task-oriented training in increasing the thickness of rectus abdominis in patients with stroke. Although the task-oriented training provided significant improvement, especially in terms of gait, no superiority was found between the two rehabilitation approaches in terms of functional ability.