Restoring movement and functional ability post-stroke: Now and the future

V. M. Pomeroy, R. C. Tallis

Research output: Contribution to journalArticle

25 Citations (Scopus)


There is strong evidence that all stroke patients should receive rehabilitation from a specialist multi-professional team but there is little research evidence to guide the treatment given. This is particularly important for physiotherapists, as many patients remain severely disabled after rehabilitation.

Most physiotherapists in the UK probably use the Bobath approach. However, its theoretical framework is questioned by research findings. Nevertheless it does not necessarily follow that ‘hands-on' physical therapies given within the Bobath approach are ineffective. Indeed some experimental studies have found that ‘hands-on' physiotherapy has beneficial effects on neurophysiology. Controlled trials suggest that physical therapies might have beneficial effects on movement and functional ability but it is noteworthy that many of the primary studies did not investigate Bobath-type interventions. In the search for better outcomes for patients it is important that clinical reports of benefit from Bobath interventions are not ignored.

A proposed way forward to improve the evidence base has been to unpack the ‘black box' of UK conventional physiotherapy in enough detail for specific interventions to be evaluated for their purported effects and compared with each other for effectiveness. Research findings have revealed though that this approach, because of the sheer size and complexity of conventional physiotherapy, is unlikely to deliver on the research agenda if used alone. A complementary research approach will be to identify/develop and evaluate interventions explicitly derived from emergent understanding of neurological impairment and neurological recovery and the means by which this might be promoted.

Research findings from neuroscience suggest the possibility of exploiting neuroplasticity to enhance neurorecovery and several novel therapies are now being developed. It is important that physiotherapists develop closer collaboration with basic and clinical scientists to lead physiotherapy into an exciting phase of development which should result in physical therapies becoming even more effective than they already are.
Original languageEnglish
Pages (from-to)3-17
Number of pages15
Issue number1
Publication statusPublished - 2002

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