EM498: IBITA Advanced Course - Management of Incomplete Spinal Cord Injury: Integrating Evidence, Technology and Clinical Reasoning

The Bobath Concept provides a contemporary framework for understanding and managing movement disorders following lesions of the central nervous system. Rather than focusing solely on task completion, it emphasises the analysis of movement quality, the interaction between posture and movement, sensorimotor integration, and the identification of the key impairments that limit functional performance. Treatment is based on an individualized, problem-solving approach that facilitates efficient movement strategies while promoting active participation and motor learning (Vaughan-Graham et al., 2019; Vaughan-Graham & Cott, 2021).

Current evidence suggests that neurological recovery after iSCI requires rehabilitation that provides sufficient intensity, repetition and task-specific practice to effectively engage the residual capacity of the nervous system. In this context, robotic technologies can be particularly valuable as a means of increasing the intensity and amount of practice that can be delivered during rehabilitation (Lin et al., 2025). However, intensity alone does not determine the quality of the sensorimotor experience. The Bobath Concept can complement technology-based interventions by providing an individualized clinical reasoning framework to identify the movement and sensorimotor impairments that constrain performance and to optimize how the individual engages in practice.

The integration of skilled movement analysis and facilitation with technologies capable of delivering high-intensity and repetitive practice may therefore provide a complementary approach: technology contributes to increasing training dose and intensity, while individualized clinical reasoning helps ensure that this practice remains meaningful, adaptable and directed towards improving movement performance and functional potential.

Learning Outcomes

At the end of the course participants will be able to:

• Understand the mechanisms underlying neurological recovery following incomplete spinal cord injury and their implications for activity-dependent neuroplasticity, functional recovery and movement quality.
• Analyse movement in individuals with incomplete spinal cord injury, identifying impairments in postural control, locomotion, and upper and lower limb function that influence functional performance and participation.
• Apply the clinical reasoning framework of the Bobath Concept to establish treatment priorities, define functional goals, and develop individualised, patient-centred rehabilitation programmesaccording to the stage of recovery, neurological level of injury, and patient-specific characteristics.
• Refine manual and environmental  facilitation and movement management skills according to the principles of the Bobath Concept, promoting efficient, adaptable and functionally relevant movement strategies.
• Design and implement individualised rehabilitation programmes that integrate the principles of the Bobath Concept with rehabilitation technologies to optimise movement quality, task-specific practice, activity-dependent neuroplasticity, functional performance, participation, and independence in everyday life.
• Critically evaluate the indications, limitations, and added value of current rehabilitation technologies, integrating them appropriately within the clinical reasoning process according to individual patient needs, goals, and stage of recovery.
• Integrate movement analysis, clinical reasoning, scientific evidence, and rehabilitation technologies within a patient-centred decision-making process aimed at maximising neuroplasticity and functional recovery.

Apply the acquired knowledge and skills in the management of complex clinical cases through practical workshops, supervised patient treatment, and interdisciplinary discussion, critically reflecting on clinical decision-making and integrating evidence-informed practice with the principles of the Bobath Concept