Keywords
hemiparesis
neurorehabilitation
stroke
locomotion
How to Cite
Abstract
This case study describes the evaluation and treatment of a 60-year-old homemaker who suffered an ischemic stroke in 2018, resulting in right hemiparesis and aphasia. Her rehabilitation was approached using the Bobath Concept, with an emphasis on postural control, alignment, locomotion, and selective movement, within a context of specific functional goals and active patient participation. After 7 sessions in 3 weeks, the patient showed functional improvement: she went from 14 to 20 points on the Tinetti Scale and decreased the time of the Get Up and Go test from 39 to 33 seconds.
References
Feigin VL, Stark BA, Johnson CO, Roth GA, Bisignano C, Abady GG, et al. Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol[Internet]. 2021;20(10):795–820. doi: 10.1016/S1474-4422(21)00252-0
Langhorne P, Bernhardt J, Kwakkel G. Stroke rehabilitation. Lancet [Internet]. 2011;377(9778):1693–1702. doi: 10.1016/S0140-6736(11)60325-5
Michielsen M, Vaughan-Graham J, Holland A, Magri A, Suzuki M. The Bobath concept – a model to illustrate clinical practice. Disabil Rehabil [Internet]. 2017; 41(17):2080-2092. doi:10.1080/09638288.2017.1417496.
Vaughan-Graham J, Cott C, Holland A, Michielsen M, Magri A, Suzuki M, et al. Developing a revised definition of the Bobath concept: Phase three. Physiother Res Int [Internet]. 2020;25(3):e1832. doi:10.1002/pri.1832.
Marques S, Vaughan-Graham J, Costa R, Figueiredo D. The Bobath concept (NDT) in adult neurorehabilitation: a scoping review of conceptual literature. Disabil Rehabil [Internet]. 2025;47(6):1379-1390. doi:10.1080/09638288.2024.2375054.
Cagna-Castillo D, Salcedo-Carrillo L, Carrillo-Larco R, Bernabé-Ortiz A. Prevalence and incidence of stroke in Latin America and the Caribbean: a systematic review and meta‑analysis. Sci Rep [Internet]. 2023;13(1):6809. doi: 10.1038/s41598-023-33182-3
Pabón‑Páramo C. Actualización en la prevalencia y carga de la enfermedad cerebrovascular en Costa Rica en el período comprendido entre 2009 y 2019. Rev Med Cos Cen [Internet]. 2020;86(630):6-15. Disponible en: https://www.medigraphic.com/pdfs/revmedcoscen/rmc-2020/rmc20630c.pdf
Longridge T, Mallinson A. A new perspective to interpret how the vestibular efferent system correlates the complexity of routine balance maintenance with management of emergency fall prevention strategies. Audiol Res [Internet]. 2024;14(3):518-544.
Duysens J, Clarac F, Cruse H. Load-regulating mechanisms in gait and posture: comparative aspects. Physiol Rev [Internet]. 2000;80(1):83133. doi: 10.1152/physrev.2000.80.1.83
Rossignol S, Dubuc R, Gossard JP. Dynamic sensorimotor interactions in locomotion. Physiol Rev [Internet]. 2006;86(1):89-154. doi: 10.1152/physrev.00028.2005
Allen JL, McKay JL, Sawers A, Hackney ME, Ting LH. Increased neuromuscular consistency in gait and balance after partnered, dance-based rehabilitation in Parkinson’s disease. J Neurophysiol [Internet]. 2017;118(1): 363-373. doi: 10.1152/jn.00813.2016
Bent LR, McFadyen BJ, Inglis JT. Visual-vestibular interactions in postural control during the execution of a dynamic task. Exp Brain Res [Internet]. 2002;146(4): 490-500. Doi: 10.1007/s00221-002-1204-8
Carvalho Z, Coelho J, Ramos R, De Oliveira D, Machado W, Maniva S, et al. Use of the Tinetti Index to assess fall risk in patients with sequelae of stroke. J Biomed Scienc Eng [Internet]. 2014;7:1088–1094. doi: 10.4236/jbise.2014.714106
Abdollahi M, Rashedi E, Jahangiri S, et al. Fall risk assessment in stroke survivors: a machine learning model using detailed motion data from common clinical tests and motor‑cognitive dual‑tasking. Sensors (Basel). 2024;24(3):812.
Trotman MM, Ha CH. The effects of plantar surface stimulation on neuromuscular responses during standing balance and gait. J Electromyogr Kinesiol. 2025;82:103007. doi:10.1016/j.jelekin.2024.103007
Gjelsvik B, Syre L. The Bobath Concept in Adult Neurology. Alemania: Thieme; 2016.
Ruget H, Blouin JS, Coyle T, Mouchnino L. Modulation of proprioceptive inflow when initiating a step influences postural adjustments. Exp Brain Res. 2010;201(3):409–418. doi:10.1007/s00221-009-2050-z
Yiou E, Caderby T, Delafontaine A, Forucade P, Honeine JL. Balance control during gait initiation: State-of-the-art and research perspectives. World J Orthop [Internet]. 2017;8(11):815-828. doi: 10.5312/wjo.v8.i11.815
Perry J, Burnfield JM. Gait analysis: normal and pathological function. 2a ed. Estados Unidos: SLACK Incorporated; 2010.
McKeon PO, Fourchet F. Freeing the foot: Integrating the foot core system into rehabilitation for lower extremity injuries. Clin Sports Med [Internet]. 2015;34(2):347–361. doi: 10.1016/j.csm.2014.12.002
Tseng SC, Stanhope SJ, Morton SM. Impaired reactive stepping adjustments in older adults. J Gerontol A Biol Sci Med Sci [Internet]. 2009;64A(11):807-815. doi: 10.1093/gerona/glp027
Sahrmann SA. Diagnosis and treatment of movement impairment syndromes.Estados Unidos: Elsevier Mosby; 2001.
Myers JB, Guskiewicz KM, Schneider RA, Prentice WE. Proprioception and neuromuscular control of the shoulder after muscle fatigue. J Athl Train. 1999 Oct;34(4):362–367.
Fraser JJ, Feger MA, Hertel J. Midfoot and forefoot involvement in lateral ankle sprains and chronic ankle instability. Part 1: Anatomy and biomechanics. Int J Sports Phys Ther. 2016 Dec;11(6):992-1005. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC5095951/
Kouzaki M, Masani K. Reduced postural sway during quiet standing by light touch is due to finger tactile feedback but not mechanical support. Exp Brain Res [Internet]. 2008;188(1):153–158. doi: 10.1007/s00221-008-1426-5
Knox MF, Chipchase LS, Schabrun SM, Marshall PW. Anticipatory and compensatory postural adjustments in people with low back pain: a protocol for a systematic review and meta-analysis. Syst Rev. 2016 Apr 16;5:62. doi:10.1186/s13643-016-0242-4. PMCID: PMC4833897. PMID: 27084681.
Thompson C, Bélanger M, Fung J. Effects of plantar cutaneo-muscular and tendon vibration on posture and balance during quiet and perturbed stance. Human Mov Sci [Internet]. 2011;30(2):153-171. doi: 10.1016/j.humov.2010.04.002
Kennedy PM, Inglis JT. Distribution and behaviour of glabrous cutaneous receptors in the human foot sole. J Physiol [Internet]. 2002;538:995–1002. doi: 10.1013/jphysiol.2001.013087
Lacquaniti F, Ivanenko YP, Zago M. Patterned control of human locomotion. J Physiol [Internet]. 2015;593(20):2189-2199. doi: 10.1113/jphysiol.2011.215137
Chiba R, Takakusaki K, Ota J, Yozu A, Haga N. Human upright posture control models based on multisensory inputs; in fast and slow dynamics. Neurosci Res [Internet]. 2016;104:96–104. doi: 10.1016/j.neures.2015.12.002
Song HS, Park SD, Kim JY. The effects of proprioceptive neuromuscular facilitation integration pattern exercise program on fall efficacy and gait ability in the elderly with experienced fall. J Exerc Rehabil [Internet]. 2014;10(4):236-240. doi: 10.12965/jer.140141
Santos MJ, Kanekar N, Aruin AS. The role of anticipatory postural adjustments in cocompensatory control of posture: 2. Biomechanical Analysis. J Electromyogr Kinesiol [Internet]. 2010;20(3):398-405. doi: 10.1016/j.jelekin.2010.01.002
Takakusaki K. Functional neuroanatomy for posture and gait control. J Mov Disord. 2017;10(1):1–17. doi: 10.14802/jmd.16062
Tinetti ME, Williams TF, Mayewski R. Fall risk index for elderly patients based on number of chronic disabilities. Am J Med [Internet]. 1986;80(3):429–434. doi: 10.1016/0002-9343(86)90717-5
Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc [Internet]. 1991;39(2):142–148. doi: 10.1111/j.1532-5415.1991.tb01616.x
Vaughan-Graham J, Cott C. Defining a Bobath clinical framework- A modified e- Delphi study . Physiother Theory Pract [Internet]. 2016;32(8):612-627. doi: 10.1080/09593985.2016.1228722
Bernhardt J, Hayward KS, Dancause N, Lannin NA, Ward NS, Nudo RJ, et al. A stroke recovery trial development framework: Consensus-based core recommendations from the second Stroke Recovery and Rehabilitation Roundtable. Int J Stroke. 2019;14(8):792-802. doi: 10.1177/1747493019879657.
Luft AR, Macko RF, Forrester LW, Villagra F, Ivey F, Sorkin JD, et al. Treadmill exercise activates subcortical neural networks and improves walking after stroke: a randomized controlled trial. Stroke [Internet]. 2008;39(12):3341–3350. doi: 10.1161/STROKEAHA.108.527531
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Copyright (c) 2025 Pablo Campos-Díaz