Steps to follow : a guide to the treatment of adult hemiplegia : based on the concept of K. and B. Bobath

The treatment and reintegration of adults with brain damage sustained as a result of illness or accident is one of the most important and challenging tasks in the field of rehabilitation. This is not only due to the complexity of the lost functions, but also because stroke is the most frequent cause of severe disability in our society. Approx­ imately 25% of all severely disabled persons are hemiplegics (Nichols 1976). Brain damage caused by vascular disease is a tremendous problem for any population and civilization. Causes and effects, with the resulting symptoms, vary so widely that the problems are only gradually being recognized, and then perhaps not fully, even by the most committed research workers, doctors and therapists. The function­ al disturbances that arise as a result of cerebro-vascular accident, that is following stroke, in young and old do not differ fundamentally for the different age groups. Treatment and rehabilitation do however become more difficult with increasing age due mainly to the frequent presence of multiple disease, multiple sites, the diffuse spread of the vascular disease and the brain damage itself, the decreasing plasticity of the central nervous system and the frequent absence of a partner, of relatives and friends in later years. Deep down inside everyone knows that a stroke is one of the most devastating traumas to the whole personality, that it is a dreadful blow to the person directly af­ fected and to his family and friends as well.