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Background: To facilitate improvement in participation, therapy needs to be transferred into everyday life of people with chronic stroke. Individualised, home based, self-training exercise programs should be oriented towards the potential of the person, be specific to their ability and impairment levels, avoid compensation strategies as far as possible and operate at the upper limit of the individual’s ability level. Objectives: To investigate the effectiveness of an individualised learning and exercise program based on the Bobath concept for facilitating personal goal achievement in people with chronic stroke. Method: Repeated measures design. Fifty-five people with chronic stroke were recruited from participants in Advanced Bobath training courses. During the five day course, participants learned individualised self-training programs, which they then carried out at home for three months, adapting their program according to their performance level. The primary outcome measure was the Canadian Occupational Performance Measure (COPM) - Performance domain. Secondary measures included the COPM satisfaction domain, World Health Organisation Disability Assessment Score-2 (WHO-DAS2), and Goal Attainment Score (GAS). Measurements were taken three months and immediately prior to the Bobath course and three months after the course. Results: COPM-Perfomance, COPM-Satisfaction and the WHODAS-2 showed a significant difference over the time points, with followup scores significantly greater than both baseline and preintervention (p<.001). Sixty eight percent of participants achieved their personal goals (GAS). Conclusion: The study indicates that an individualised self-training approach based on Bobath principles may enable the transfer of acquired proficiency into the personal goals of people with chronic stroke.

An Individualised Learning and Exercise Program Based on the Bobath Concept to Facilitate Goal Achievement in People with Chronic Stroke