Gjelsvik BB, Syre L. The Bobath Concept in Adult Neurology. 2nd ed. Thieme; 2016; 296 pp; 203 ill; $84.99
The Bobath Concept of Adult Neurology, published in 2016, offers a fresh new look on an established subject. The text is highly factual, accurate, and well-written. I feel the book is a great teaching tool for physical therapy students, as well as a reference for established practitioners. The subject is more than adequately covered and the text is organized to continually bring concepts back to clinical relevance, which is helpful for all clinicians. Compared to a previously written text in 2009, this text seems to more often pull in clinical examples. While a valuable text for practioners of neurological rehabilitation, its relevance for the neuroradiology audience is lacking.
The Bobath Concept of Adult Neurology begins with relevant neuroanatomy, applied physiology, and consequences of damage to these systems in the CNS to the functioning of the human suffering such damage. Subsequent chapters then attempt to put such damage into clinical context. This begins with the discussion of normal human movement and then branches to abnormal movement as a consequence of the damage discussed earlier. The next section addresses the treatment of such dysfunction and thus the crux of the Bobath concept of rehabilitation. By creating the initial framework and then introducing the Bobath techniques, the text helps readers understand why the treatment may work intuitively, even without the evidence of placebo-controlled research. The next chapter presents the outcome measures affected by these treatments. Finally, the text ends with two specific case histories where the Bobath technique proved successful. At this point, the reader does find the cases plausible based on the data presented.
Ample figures, tables, and drawings are presented within the text. These are relevant, instructive, and labeled appropriately. Numerous images of patients and models explain the visual nature of the discipline. The images are presented in black and white. Whether a negative or a non-factor to some readers, these images, with their lack of color or brightness, do give readers the impression that the text is something out of the 1970s. A review of the references presented shows an extensive list of original research, book chapters, and reviews of texts. There is a mixture of older articles from the 1990s and 2000s, as well as recent articles from 2014.
Ultimately, I do recommend this book for the appropriate audience. The mixture of basic science, organizational structure that sets up the plausibility of successful clinical examples, and numerous images, tables, and summaries allows the reader to use the text for original knowledge and also as a reference when specific clinical scenarios arise. The audience that would benefit from this text includes: physical therapists involved with patients who suffer from stroke, brain injury, incomplete spinal cord injuries, and neurodegenerative/neuro-inflammatory disorders; occupational therapists; and physicians leading the neuro-rehabilitation of patients. The physicians most likely to benefit would be physiatrists, neurologists, and neurosurgeons, along with any other physician involved in the care of inpatient rehabilitation patients.
On the other hand, neuroradiologists might find that their time is better spent elsewhere. While the text does attempt to explain and tie specific areas of CNS damage to functional outcome, it does not use imaging in any way to demonstrate the damage that results in the outcome. There is really no attempt to discuss the use of imaging as a research modality in the clinical investigation or outcome of the treatments. A discussion of functional MRI, correlates of damage seen to functional outcome and recovery, and current and past research done in this area would have been most helpful and expanded the interested audience.
