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Steps to Follow: Developing a Model for Individualized Self-Training Programs Based on the Bobath Concept

Objective: Therapy interventions aimed at enabling people with chronic stroke to meet their own personal goals require tailoring of interventions to the person’s individual situation. The purpose of this qualitative study was to identify key elements of self-training programs based on the Bobath concept, and how these were modified in relation to the individual requirements of the participants. Method: Qualitative study design. A self-training program was developed based on the Bobath concept to minimize the impact of body impairments and maximize activity and participation levels, in order to facilitate personal goal achievement. As a training medium, an individually devised folder with annotated photos of the participant performing the exercise was used. The folder contained information on how to perform the exercise, adaptations of the exercise and recommendations for the number of repetitions. For the qualitative evaluation, all photos and descriptions were translated into a descriptive structure. The study utilized both pre-determined comparisons, coding the exercises with reference to the Bobath Concept, and the use of “grounded theory” to gain insights into the data without anticipating the content interpretation by the researcher. Results: Fifty-five participants with chronic stroke received a total of 503 individual exercises. The therapeutic methods and techniques used in the self-training programs were clearly assigned to the Bobath concept. The self-training was demonstrated to be based on the personal goals, on the individual needs and the abilities of the participants. Key aspects of the Bobath concept were revealed and can be identified Based on the gained knowledge, a model for creation of a self-training program was developed. Conclusion: This qualitative study unpacked the therapy component provided, in order to elaborate the principles utilized to construct and individualize interventions. The model developed has potential to improve the specificity and tailoring of self-training exercises for individuals with stroke.

Bobath, Self-Exercise Program, Goals, Qualitative Research, Stroke

Gabriele Eckhardt, Kim Brock, Gerlinde Haase, Toshie Ishida. (2023). Steps to Follow: Developing a Model for Individualized Self-Training Programs Based on the Bobath Concept. American Journal of Health Research, 11(4), 118-129.

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This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Dobkin, B.-H. (2016). Behavioral self-management strategies for practice and exercise should be included in neurologic rehabilitation trials and care. Curr Opin Neurol, S. 29: 693–699.
2. Eckhardt, G, Brock, K; Haase, G; Ishida, T; Hummelsheim, H. (2021). An Individualised Learning and Exercise Program Based on the Bobath Concept to Facilitate Goal Achievement in People with Chronic Stroke. American Journal of Health Research, 9 (1), 26.
3. Vaughan-Graham, J., Cheryl, C., Holland, A., Michielsen, M., Magri, A., Suzuki, M., & Brooks, D. (2020). Developing a revised definition of the Bobath concept: Phase three. Physiotherapy Research International, 25 (3), 1–10.
4. Michielsen, M., Vaughan-Graham, J., Holland, A., Magri, A., & Suzuki, M. (2017). The Bobath concept – a model to illustrate clinical practice. Disabil and Rehab.,
5. Vaughan-Graham, J., Patterson, K., Zabjek, K., & Cott, C. (2017). Conceptualizing movement by expert Bobath instructors in neurological rehabilitation. J Eval Clin Pract, pp. 1-11.
6. Ritter, G., Welling, A., & Eckhardt, G. (2016). Die zehn Prinzipien der Bobath Therapie. Castrop Rauxel: Vereinigung der Bobath Therapeuten e. V.
7. Broetz, D., & Birbaumer, N. (2013). Behavioural physiotherapy in post stroke rehabilitation.. NeuroRehabilitation, pp. (33 (3): 377-84.)..
8. Kitago & Krakauer. (2013). Motor learning principles for neurorehabilitation. In D. In: Barnes M. / Good, Handbook of Clinical Neurology. (pp. 93-103.). Elsevier Verlag.
9. Nelles G., Platz T., Allert N., Brinkmann S., Dettmer C., Dohle C., Engel A., Eckhardt G., Elsner B., Fheodoroff K., Guggisberg A., Jahn K., Liepert J., Pucks-Faes E., Reichl S., Renner C., Steib S., Rehabilitation sensomotorischer Störungen, S2k-Leitlinie, (2023), in: Deutsche Gesellschaft für Neurologie (Hrsg.), Leitlinien für Diagnostik und Therapie in der Neurologie. Online:
10. Eckhardt, G., Haase, G., Brock, K., & Hummelsheim, H. (2016). Interactive-dialogue in Bobath therapy: a mixed method study. International Journal of Therapy and Rehabilitation, Vol 23, No 2. 233-242.
11. Boutron, I., Altman, D., Moher, D., Schulz, K., & Ravaud, P. (2017). CONSORT Statement for Randomized Trials of Nonpharmacologic Treatments: Update and a CONSORT Extension for Nonpharmacologic Trial Abstracts. Ann Intern Med., pp. 167 (1): 40-47. doi: 10.7326/M17-0046. Epub 2017 Jun 20.
12. Greene, J., Caracelli, V., & Graham, W. (1989). Toward a Conceptual Framework for Mixed-Method Evaluation Designs. Educational Evaluation on Policy Analysis (
13. Teddlie, C., & Tashakkori, A. (2011). Mixed Methods Research: Contemporary issues in an emerging field. In L. Y. Eds. Denzin NK, Handbook of Qualitative Research (pp. Chapter 16 p285-299). Los Angeles USA: Sage Publications.
14. Duda, R., Hart, P., & Stork, D. (2001). Pattern classification. Wiley, New York 2001, ISBN 0-471-05669-3. New York: Wiley.
15. Schlobinski, P. & Dürr, M. (2006), Deskriptive Linguistik. Grundlagen und Methoden. Vandenhoeck & Ruprecht, Göttingen. p. 165 ff. ISBN 3525265182.
16. Mayring, Ph. & Fenzl, Th. (2019) Handbuch Methoden der empirischen Sozialforschung, ISBN: 978-3-658-21307-7.
17. Eckhardt, G., Brock, K., Haase, G., Puschnerus, C., Hengelmolen-greb, A., & Böhm, C. (2018). Bobath Concept Structural Framework (BCSF): Positioning Partial Aspects Within a Holistic Therapeutic Concept. 6 (4), 79–85.
18. Hengelmolen-Greb, A., & Joebges, M. (2018). Leitfaden in der Neurorehabilitation. Elsevier Verlag.
19. Kuckartz, U. (2016). Qualitative Inhaltsanalyse. Methoden, Praxis, Computerunterstützung. Juventa: Beltz.
20. Li, S., & Franscisco, G. (2015). New insights into pathophysiology of post-stroke spasticity. Front Hum Neurosci (9: 192).
21. Buxbaum, C., Ferraro, M., T, V., Farne, A., Whyte, J., Ladavas, E.,... Colett, H. (2004). Hemispatial neglect: subzypes, neuroanatomy and disability. Neurology (749-56).
22. Hengelmolen-Greb & Joebges (2018). Leitfaden in der Neurorehabilitation. Elsevier Verlag. p 97, p 343.
23. Taub, E. C. (1994). An operant approach to rehabilitation medicine: overcoming learnes nonuse by shaping.. Journal of the experimental analysis of behaviour, pp. (61): 281-293.
24. Levin, M. &. Panturin, E. (2011). Sensorimotor integration for functional recovery and the Bobath approach. Motor Control, pp. 15: 285-301.
25. Wulf, G., Höß, M., & Prinz, W. (Published online: 01 Apr 2010). Instructions for Motor learning: differential effects of internal versus external fokus of attention. Journal of Motor Behaviour (
26. Holdar, U. W. (2013). Why do we do as we do? Factors influenceing Clinical Reasoning and Decision-making among physiotherapits in an acute setting. Physiother. Res. Int., p. DOI: 10.1002/pri 1551.
27. Dean, C. (2012). Group task-specific circuit training for patients discharged home after stroke may be as effective as individualised physiotherapy in improving mobility. Journal of Physiotherapy (4), 269.
28. Richardson, M., Campbell, N., Allen, L., Meyer, M., & Teasell, R. (2016). The stroke impact scale: Performance as a quality of life measure in a community-based stroke rehabilitation setting. Disability and Rehabilitation (14), 1425–1430.
29. Dean, S. G., Poltawski, L., Forster, A., Taylor, R. S., Spencer, A., James, M., Allison, R., Stevens, S., Norris, M., Shepherd, A. I., & Calitri, R. (2016). Community-based Rehabilitation Training after stroke: Protocol of a pilot randomised controlled trial (ReTrain). BMJ Open (10).
30. Ammann, BC., Knols, RH., Baschung, P., Bie, RA., Bruin, ED. (2014). Application of principles of exercise training in sub-acute and chronic stroke survivors : a systematic review. 2014: 1-11.
31. Vloothuis, JDM, van Wegen, E., Veerbek, J., Konijnenbelt, M. V.-M., & Kwakkel, G. (2015). Caregiver-mediated exercises for improving outcomes after stroke. Cochrane Library (issue 4, No CD0110058).