A New Approach to Physical Rehabilitation
Most brain-injury patients are usually offered physical therapy where the treatment principles follow the Proprioceptive Neuromuscular Facilitation (PNF) theories by Bobath ( 1970). However, the Bobath concept appears to be insufficient in meeting the special cognitive, social, and emotional problems and integrating these variables into patient examination and physical rehabilitation of stroke or cranial trauma after 2 years or more. If the physical treatment and education in an intensive neuropsychological rehabilitation program takes place in "normal" surroundings, the results tend to demonstrate a greater "transfer effect" than it has been possible to achieve in an institutional environment.
Improvement of both upper and lower extremity function is one of the major objectives of stroke and cranial trauma rehabilitation because extremity function greatly affects the overall outcome in the acute and subacute states. Traditionally, physical and occupational therapists provide the retraining of ambulation and activities of daily living, respectively, sometimes so strictly defined that the physical therapists train the legs and the occupational therapists train the arms. In the hospital setting, they supervise the nursing staff in handling the patients according to the treatment principles of Bobath ( 1970).
At the time when the Bobath concept was introduced, other physical therapists developed a similar concept in which Proprioceptive Neuro-