Comparison of Task Oriented Approach and Bobath approach in Improving balance and Reducing Fear of Falling in adults with Stroke

To find out the effectiveness of Task Oriented Approach and Bobath approach in improving balance and reducing fear of falling in adults with Stroke.

Quantitative research design was employed across 20 subjects, each 10 in both control (bobath) group and experimental (Task Oriented Approach) group. Treatment was given, one hour per day on alternate days for 30 days in department of Occupational Therapy, Vijaya hospital & S.R.M. hospital, Chennai. Dependent variables were balance and the subject's confidence level about their fear of falling during daily activities. Berg Balance Scale (BBS) and Falls Efficacy Scale (FES) were used as outcome measures. Data analysis was done by using Mann-Whitney ‘U’ test and Wilcoxon't’ test.

Shows that significant improvement in balance, in both control (p=0.007) and experimental (p=0.005) group. Similarly, there was significant reduction in the fear of falling in both control (p=0.005) and experimental group (p=0.005). However, the improvement in experimental group [BBS (m) =49.30; FES (m) =88.50%] is more marked, when compared to the control group [BBS (m) =24.90; FES (m) =31.70%]

The more marked improvement in experimental group was attributed to the generalizing effects of Task Oriented Approach when compared to the bobath approaches. Task Oriented Approach gives emphasis on practicing the whole task rather practicing the task progression from part by part. Previous researches also stated that random practice is always better than the blocked practice. Hence, there was marked improvement in experimental group than the control group.

Task Oriented Approach may be more effective than the Bobath approach. Occupational therapists are encouraged to use task specific activities and changing the task requirement according to the environmental contexts to enhance functional performance.