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Benefits of the Bambach for Stroke Rehabilitation

• The Bambach can be utilised a therapeutic tool during ward based rehabilitation following stroke or as a means of continued long term rehabilitation in the home environment to assist with activities of daily living.
• Unilateral neglect is counteracted as the contours of the seat centre the body, and the saddle sitting position, with both feet in full plantar contact, maximises sensory input from the affected side.
• A clear midline assists maintenance of balance and symmetry. Midline positioning can be reinforced using visual as well as sensory feedback. This assists in activating the muscles of postural control in a balanced way which allows the development of a symmetrical posture, trunk control and improved sitting balance.
• The hips are at an angle of 45-degree flexion in external rotation and abduction. In this position, the individual can be balanced and secure with dynamic postural control allowing him or her to move in all planes easily.
• In this sitting position the hip joint is in its position of maximal joint surface contact (closed pack position) where there is maximum contact of the head of femur with the acetabulum (ball and socket joint of the hip) . This is the position of most comfort and stability.
• This position places the limbs in a mid range position which is beneficial in maintaining muscle length and normal tone.
• By providing secure pelvic control. The Bambach Saddle Seat can be finely adjusted so the pelvis is stabilised in its upright, neutral position. It then follows, as the spine responds to the correct pelvic angle that it can be active in its natural upright curves.
• The individual sitting upright is an active posture rather than a passive collapsed position. Conventional seating will cause a stroke patient with low tone or decreased trunk control and sitting balance to slump forward. This leads to the development of poor postural habits which if unaddressed can lead to secondary musculoskeletal problems.
• Greater control of sensory inputs which can trigger unwanted motor responses.
• Partial weight bearing can be encouraged through to standing from a half-sitting position, which stimulates lower limb proprioception (sensory feedback), mobilizes the joint and improves muscle tone. This also facilitates transfers from sitting to standing and reduces the reliance on family/carers.
• Facilitation of independence in sitting and other motor activities. This will increase confidence and encourage active participation in rehabilitation.
• Trunk and head control are easier in the natural position so that functional activities, such as swallowing and speech are improved.
• Thoracic, abdominal and pelvic spaces are maximized resulting in improved lung and internal organ function and circulation.
• With the upper body stable and free to move in this upright posture, eye contact, communication and social interaction are a great deal easier. This can lead to improved self-esteem through improved relationships with family and peers. So not just functional performance but also psycho-social interaction improves simply as a result of sitting in correct posture.
• Retraction of the shoulder girdle into the neutral position means that upper limb tasks and fine motor activities are facilitated meaning that self care activities, such as meals, washing and dressing, and writing, computer work and hobbies are more easily performed.
• Correct positioning of the shoulder girdle may also improve muscle tone of the musculature of the shoulder and reduce the risk of the development of shoulder pain common following stroke.