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NDT

NDT . Mary Rose Franjoine PT, DPT, MS, PCS Margo Prim Haynes PT, DPT, MA, PCS. Reading and Resources. Required Reading : Neuro-Developmental Treatment Approach Theoretical Foundations and Principles of Clinical Practice Chapter 1 Assignment :

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NDT

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  1. NDT Mary Rose Franjoine PT, DPT, MS, PCS Margo Prim Haynes PT, DPT, MA, PCS

  2. Reading and Resources Required Reading: • Neuro-Developmental Treatment Approach Theoretical Foundations and Principles of Clinical Practice • Chapter 1 Assignment: • To be completed prior to lecture: Study Guide Learning Activity: Learning Activity 1.1.1(pp 1-2)

  3. NDT is…. • A comprehensive approach for management of patients with neuromuscular based movement disorders. • Functional and task oriented • Problem solving • Grounded in current scientific theory

  4. NDT … • Enhances function; improving the individuals quality of life • Treats individual as a Whole person

  5. NDT … • Family centered • Team approach http://www.familyconnectionsc.org/gallery

  6. NDT Intervention Process… • Begins with a comprehensive assessment of the individuals • Abilities • Needs, Wants, ….. • Dreams!

  7. NDT Intervention Process… • Includes observation analysis and identification of effective and ineffective postures and movements

  8. NDT Intervention Process… • Progressing to identification and prioritization of primary and secondary impairments critical for intervention • Continues with development of functional outcomes • Long term • Short term • Session

  9. NDT Intervention Process… • Progresses to identification of treatment strategies to enhance function • Considers the task & environment in relationship to person • Concludes with implementation of the intervention & ongoing analysis

  10. NDT is… • A “Hands On” approach • It includes the use of: • Inhibition techniques • Facilitation techniques

  11. NDT is… • Therapeutic handling is used to guide and shape movement, enhancing function • Therapeutic handling is used interdentally

  12. NDT Therapist… • Utilize typical development as a framework for treatment

  13. NDT Therapist… • Consider the multisystem effects of aging across the lifespan • Strives to optimize function while acknowledging the existence of central nervous system damage

  14. NDT Treatment Sessions should be… • Active • Dynamic • Fun • Functional

  15. NDT is a Living Approach • The NDT approach has been enhanced by advances in neural science, movement science, motor learning and motor control. • The NDT Approach will continue to evolve as our knowledge and understanding of neuromuscular-based movement disorders and neuromotor control advances.

  16. Karl and Berta Bobath

  17. Mrs. Bobath once said, it is a “living, breathing and changing” approach, and she challenged us all to grow and advance with the approach!

  18. Current Theoretical Base for NDT Mary Rose Franjoine, PT, DPT, PCS Margo Prim Haynes, MA,PT 2009

  19. Models of Motor Control • Reflex • Hierarchical Model • Program Model • Systems Models of Motor Control • Neural Group Selection

  20. Reflex • Peripheral Mode of Operation • Complex skills remerge through chaining

  21. Reflex Assumptions Underlying Motor Control for Neurologic Rehabilitation Chapter 4

  22. Hierarchical Model • Central Mode of Operation • Skill refined through a maturation process Assumptions Underlying Motor Control for Neurologic Rehabilitation Chapter 4

  23. Hierarchical Model Assumptions Underlying Motor Control for Neurologic Rehabilitation Chapter 4

  24. Program Model • Peripheral and Central Mode of Operation • Storage of Complex Motor Programs • CPG

  25. Systems Models • Function emerges from the interaction of multiple systems • Coordinative Structures (Synergies) • Degrees of Freedom

  26. Systems Models Assumptions Underlying Motor Control for Neurologic Rehabilitation Chapter 4

  27. Dynamical Systems Theory • Self Organization • Rate-limiting factor • Transition States (Chaos)

  28. Neural Group Selection Theory • Contemporary Theory • Blends our knowledge of neuro embryology and development of neuro anatomy • Plasticity

  29. Neural Group Selection Theory • Primary Neuronal Repertoires • Neonatal Optical Righting • Neonatal Kicking • Rooting • Secondary Repertories “Neural Groups” • Synergies and preferred patterns of movement • Neural Maps • Synergistic combinations activate for task performance

  30. How Theories Work for NDT? • Philosophy of NDT embraces Function for enhancing Quality of Life • NDT always considers the environment and the task. • NDT is a clinical Approach

  31. AdditionalReferences • Horak, F.B. Assumptions underlying motor control for neurological Rehabilitation. In M. Lister (Ed), Contemporary management of motor control problems. Alexandria, VA: American Physical Therapy Association. • Hadders-Algra, The neuronal group selection theory: Promising principles for understanding and treating developmental motor disorders. Developmental Medicine and Child Neurology, 2000;24; 20 (10):707-715.

  32. NDT Mary Rose Franjoine PT, DPT, MS, PCS Margo Prim Haynes PT, DPT, MA, PCS

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