Comparative Effects of Vojta and Bobath Therapy on Lower Limb Spasticity and Motorcity among Hemiparetic Stroke Patients

Authors

  • Muhammad Zeeshan Faculty of Allied Health Sciences, Superior University, Lahore, Pakistan
  • Gulnaz Zaheer Faculty of Allied Health Sciences, Superior University, Lahore, Pakistan
  • Ayesha Arooj Aqsa Institute of Professional Studies, Faisalabad, Pakistan
  • Ahmad Faizan Aqsa Institute of Professional Studies, Faisalabad, Pakistan
  • Muhammad Luqman Akbar Department of Physiotherapy, Abasyn University, Islamabad, Pakistan
  • Maryam Ashraf Aqsa Institute of Professional Studies, Faisalabad, Pakistan

DOI:

https://doi.org/10.55735/6qp6st77

Keywords:

Bobath therapy , Fugl-Meyer assessment , Modified Ashworth scale , Motor function , Spasticity , Vojta therapy

Abstract

Background: Stroke is a neurological condition caused by a sudden disruption of cerebral blood flow, leading to functional impairments. Hemiplegic patients often experience motor dysfunction and spasticity, particularly in the lower limbs. Effective rehabilitation techniques are essential for improving the quality of life. Objective: To compare the effects of Vojta and Bobath therapies on lower limb spasticity and motorcity in hemiparetic stroke patients. Methodology: A single-blinded randomised clinical trial was conducted over six months at two clinical sites in Faisalabad. A total of 46 eligible participants were randomly divided into two groups: Group A received Vojta therapy, while Group B received Bobath therapy. Participants aged between 25 and 74 years, diagnosed with hemiparetic stroke within the past 1-4 months, were included in the trial. Each session involved five repetitions of pressure application to designated reflex zones, with each application lasting two minutes followed by a one-minute rest period. Group B received facilitation-based Bobath therapy, also administered three times per week. Motor function and spasticity outcomes were measured before and after the intervention period using the Fugl-Meyer assessment scale for the lower limb and the modified Ashworth scale. Descriptive statistics were used to summarise demographic data, while inferential tests were employed to compare pre- and post-intervention scores within and between the two groups. Results: No significant differences were observed at baseline for both the Fugl-Meyer assessment and the modified Ashworth scale. At two weeks, Bobath therapy demonstrated earlier motor gains, while Vojta therapy showed more noticeable reductions in spasticity, though not statistically significant. By week four, a significant improvement in motor function was observed in the Bobath group, while the Vojta group showed greater reduction in spasticity, though between-group differences remained statistically non-significant. Within-group comparisons showed significant improvement over time in both therapies for both motor function and spasticity. Conclusions: Both Vojta and Bobath therapies are effective for improving lower limb function and reducing spasticity in stroke patients. Bobath therapy offers faster motor gains, whereas Vojta therapy demonstrates greater spasticity reduction. A combined or individualized approach may enhance post-stroke rehabilitation outcomes.

 

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References

1. Dichgans M, Pulit SL, Rosand J. Stroke genetics: discovery, biology, and clinical applications. The Lancet Neurology 2019; 18(6): 587-99. DOI: https://doi.org/10.1016/S1474-4422(19)30043-2

https://doi.org/10.1016/S1474-4422(19)30043-2 DOI: https://doi.org/10.1016/S1474-4422(19)30043-2

2. Khan F, Chevidikunnan MF. Prevalence of balance impairment and factors associated with balance among patients with stroke. A cross sectional retrospective case control study. Healthcare (Basel) 2021; 9(3): 320. DOI: https://doi.org/10.3390/healthcare9030320

https://doi.org/10.3390/healthcare9030320 DOI: https://doi.org/10.3390/healthcare9030320

3. Bonita R, Beaglehole R. Recovery of motor function after stroke. Stroke 1988; 19(12): 1497-500. DOI: https://doi.org/10.1161/01.STR.19.12.1497

https://doi.org/10.1161/01.str.19.12.1497 DOI: https://doi.org/10.1161/01.STR.19.12.1497

4. Sharma N, Cohen LG. Recovery of motor function after stroke. Developmental Psychobiology 2012; 54(3): 254-62. DOI: https://doi.org/10.1002/dev.20508

https://doi.org/10.1002/dev.20508 DOI: https://doi.org/10.1002/dev.20508

5. Zeng H, Chen J, Guo Y, Tan S. Prevalence and risk factors for spasticity after stroke: a systematic review and meta-analysis. Frontiers in Neurology 2021; 11: 616097. DOI: https://doi.org/10.3389/fneur.2020.616097

https://doi.org/10.3389/fneur.2020.616097 DOI: https://doi.org/10.3389/fneur.2020.616097

6. Hatem SM, Saussez G, Della Faille M, et al. Rehabilitation of motor function after stroke: a multiple systematic review focused on techniques to stimulate upper extremity recovery. Frontiers in Human Neuroscience 2016; 10: 442. DOI: https://doi.org/10.3389/fnhum.2016.00442

https://doi.org/10.3389/fnhum.2016.00442 DOI: https://doi.org/10.3389/fnhum.2016.00442

7. Thibaut A, Chatelle C, Ziegler E, Bruno M-A, Laureys S, Gosseries O. Spasticity after stroke: physiology, assessment and treatment. Brain Injury 2013; 27(10): 1093-105. DOI: https://doi.org/10.3109/02699052.2013.804202

https://doi.org/10.3109/02699052.2013.804202 DOI: https://doi.org/10.3109/02699052.2013.804202

8. Biering-Sørensen F, Nielsen J, Klinge K. Spasticity-assessment: a review. Spinal Cord 2006; 44(12): 708-22. DOI: https://doi.org/10.1038/sj.sc.3101928

https://doi.org/10.1038/sj.sc.3101928 DOI: https://doi.org/10.1038/sj.sc.3101928

9. Sheean G. The pathophysiology of spasticity. European Journal of Neurology 2002; 9: 3-9. DOI: https://doi.org/10.1046/j.1468-1331.2002.0090s1003.x

https://doi.org/10.1046/j.1468-1331.2002.0090s1003.x DOI: https://doi.org/10.1046/j.1468-1331.2002.0090s1003.x

10. Kavlak E, Unal A, Tekin F, Al Sakkaf AAH. Comparison of the effectiveness of Bobath and Vojta techniques in babies with Down syndrome: Randomized controlled study. Annals of Clinical and Analytical Medicine 2022; 13(1): 35-39. DOI: https://doi.org/10.4328/ACAM.20830

https://doi.org/10.4328/ACAM.20830 DOI: https://doi.org/10.4328/ACAM.20830

11. Ha S-Y, Sung Y-H. Effects of Vojta method on trunk stability in healthy individuals. Journal of Exercise Rehabilitation 2016; 12(6): 542-547. DOI: https://doi.org/10.12965/jer.1632804.402

https://doi.org/10.12965/jer.1632804.402 DOI: https://doi.org/10.12965/jer.1632804.402

12. Sánchez-González JL, Sanz-Esteban I, Menéndez-Pardiñas M, Navarro-López V, Sanz-Mengíbar JM. Critical review of the evidence for Vojta Therapy: a systematic review and meta-analysis. Frontiers in Neurology 2024; 15: 1391448. DOI: https://doi.org/10.3389/fneur.2024.1391448

https://doi.org/10.3389/fneur.2024.1391448 DOI: https://doi.org/10.3389/fneur.2024.1391448

13. Nezhad FF, Daryabor A, Abedi M, Smith JH. Effect of dynamic neuromuscular stabilization and Vojta therapy on respiratory complications in neuromuscular diseases: a literature review. Journal of Chiropractic Medicine 2023; 22(3): 212-221. DOI: https://doi.org/10.1016/j.jcm.2023.04.002

https://doi.org/10.1016/j.jcm.2023.04.002 DOI: https://doi.org/10.1016/j.jcm.2023.04.002

14. Kollen BJ, Lennon S, Lyons B, et al. The effectiveness of the Bobath concept in stroke rehabilitation: what is the evidence? Stroke 2009; 40(4): e89-e97. DOI: https://doi.org/10.1161/STROKEAHA.108.533828

https://doi.org/10.1161/STROKEAHA.108.533828 DOI: https://doi.org/10.1161/STROKEAHA.108.533828

15. Michielsen M, Vaughan-Graham J, Holland A, Magri A, Suzuki M. The Bobath concept-a model to illustrate clinical practice. Disability and Rehabilitation 2019; 41(17): 2080-92. DOI: https://doi.org/10.1080/09638288.2017.1417496

https://doi.org/10.1080/09638288.2017.1417496 DOI: https://doi.org/10.1080/09638288.2017.1417496

16. Parau D, Todoran AB, Barcutean L, Avram C, Balasa R. The Benefits of Combining Bobath and Vojta Therapies in Infants with Motor Development Impairment - A Pilot Study. Medicina 2023; 59(10): 1883. DOI: https://doi.org/10.3390/medicina59101883

https://doi.org/10.3390/medicina59101883 DOI: https://doi.org/10.3390/medicina59101883

17. Calle ERQ, Álvarez MMR, Ibarra OPR, Machado JDP. Análisis articular de la marcha en fase de balanceo en sujetos con secuelas neurológicas. Retos 2025; 68: 1635-43. DOI: https://doi.org/10.47197/retos.v68.116381

https://doi.org/10.47197/retos.v68.116381 DOI: https://doi.org/10.47197/retos.v68.116381

18. Huseyinsinoglu BE, Ozdincler AR, Krespi Y. Bobath Concept versus constraint-induced movement therapy to improve arm functional recovery in stroke patients: a randomized controlled trial. Clinical Rehabilitation 2012; 26(8): 705-15. DOI: https://doi.org/10.1177/0269215511431903

https://doi.org/10.1177/0269215511431903 DOI: https://doi.org/10.1177/0269215511431903

19. Kılınç M, Avcu F, Onursal O, Ayvat E, Savcun Demirci C, Aksu Yildirim S. The effects of Bobath-based trunk exercises on trunk control, functional capacity, balance, and gait: a pilot randomized controlled trial. Topics in Stroke Rehabilitation 2016; 23(1): 50-8. DOI: https://doi.org/10.1179/1945511915Y.0000000011

https://doi.org/10.1179/1945511915Y.0000000011 DOI: https://doi.org/10.1179/1945511915Y.0000000011

20. Ha S-Y, Sung Y-H. Effects of Vojta approach on diaphragm movement in children with spastic cerebral palsy. Journal of Exercise Rehabilitation 2018; 14(6): 1005-1009. DOI: https://doi.org/10.12965/jer.1836498.249

https://doi.org/10.12965/jer.1836498.249 DOI: https://doi.org/10.12965/jer.1836498.249

21. Ungureanu A, Rusu L, Rusu MR, Marin MI. Balance rehabilitation approach by Bobath and Vojta methods in cerebral palsy: a pilot study. Children (Basel) 2022; 9(10): 1481. DOI: https://doi.org/10.3390/children9101481

https://doi.org/10.3390/children9101481 DOI: https://doi.org/10.3390/children9101481

22. Menéndez-Pardiñas M, Alonso-Bidegaín M, Santonja-Medina F, Sánchez-González JL, Sanz-Mengibar JM. Effects of Vojta therapy on the motor function of children with neuromotor disorders: study protocol for a randomized controlled trial. Journal of Clinical Medicine 2023; 12(23): 7373. DOI: https://doi.org/10.3390/jcm12237373

https://doi.org/10.3390/jcm12237373 DOI: https://doi.org/10.3390/jcm12237373

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23-08-2025

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Comparative Effects of Vojta and Bobath Therapy on Lower Limb Spasticity and Motorcity among Hemiparetic Stroke Patients. HJPRS [Internet]. 2025 Aug. 23 [cited 2025 Sep. 17];5(2):413-9. Available from: https://thehealerjournal.com/index.php/templates/article/view/474

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