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Neuro Developmental Treatment (NDT) Techniques: History

Neurodevelopmental Treatment (NDT) is a technique developed by Berta and Karel Bobath to promote functional recovery through facilitation of normal movement patterns and use of sensory feedback. Key aspects of NDT include focusing on alignment, demanding use of the involved side, and taking a whole-person approach to meet individualized functional goals. For NDT to be effective, therapists must be able to distinguish normal from abnormal movement, make activities meaningful, and select optimal practice methods.

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357 views

Neuro Developmental Treatment (NDT) Techniques: History

Neurodevelopmental Treatment (NDT) is a technique developed by Berta and Karel Bobath to promote functional recovery through facilitation of normal movement patterns and use of sensory feedback. Key aspects of NDT include focusing on alignment, demanding use of the involved side, and taking a whole-person approach to meet individualized functional goals. For NDT to be effective, therapists must be able to distinguish normal from abnormal movement, make activities meaningful, and select optimal practice methods.

Uploaded by

Gafencu Sergiu
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Neuro Developmental Treatment (NDT) Techniques

History

 Developed by Berta Bobath, PT and Karel Bobath, MD for functional recover


 Main patient populations include: adult CVA/hemiplegia, and Cerebral Palsy

Theoretical Framework

NDT as a neuromuscular and functional reeducation technique now includes


neuroplasticity as a basis how the brain can change and reorganize itself and its
processes based on practice and experience

 facilitation of normal postural alignment and movement patterns


 demand should be placed on the involved side during developmental and functional
activities
 sensory feedback (manual contact, visual integration, somatosensory reinforcement)
is essential to recovering function
 treatment includes looking at the whole person and specific functional needs;
recovery vs. compensation

Outline of N
Patient: Life role, supports systems, home environment, patie
Individualized Functional Outcomes
ICF: Pathologies, abilities, limitations

Motor Control Optimize use of systems (sensory, musculoskeletal) and avail

Target the Involved Side Progressive, increased demand and functional use

Closed vs. open environment, simple vs. complex, part vs. wh


Motor Learning
 

Team-Approach Coordination with rehab team, parents/caregivers, and suppor

Essentials for Treatment Effectiveness

 therapists must be able to observe and distinguish normal from abnormal alignment
and movement patterns
 therapists must be able to make the functional retraining activities meaningful to the
patient; task specific
 therapists must be able to select the optimal practice method, feedback, and
environment for maximum function and independence
 therapists must have stable footwear, good flexibility in lumbar spine and lower
extremities for optimal body mechanics during mat activities.
Key elements to Applying NDT

http://www.stonecrestmedical.com/CPM/Neuro_Ball.jpg

Cannot impose normal


Alignment movement on malaligned
  joints
 

Inhibition, Facilitation, Key


Handling
points
 
 

Assisting patients in
Placing
achieving the appropriate
 
 

Alignment Check points - PTs and PTAs use manual contact to establish, align and assist
the patient with these key elements

 Base of support - wide, narrow, staggered, asymmetrical


 Body segment alignment - synergies, compensatory head and trunk position
 Muscle activation - pattern and timing of movement during functional activities
 Weight shift - in all planes
 

Functional Check points - PTs and PTAs will modify manual cues and feedback to the
demands of the task and the ability of the patient. Examples of functional check points
include:

1. Gravity
2. Levers
3. Time
4. Distance
5. Speed
6. Environment

http://www.mitaka-supply.com/02en_models/102m165/p2.gif

NDT Intervention Framework


Starting Posture Missing Components Manual Cues

Begin and
assess the most Observe starting posture Use hands on key
efficient posture and make comparisons to
from which to points of control to
normal facilitate normal
move (typically
upright) Review the evaluation and posture/movement
POC for PT assessment of and inhibit abnormal
Reorient to primary impairments (e.g. posture/movement
midline decreased ROM, strength, May includes manual
(head/trunk) sensation, control) stretching if PT has
Neutral Select a movement-based determined
alignment of functional intervention ROM/muscle length
body segments which progresses patient interferes with
  toward mobility goals function
 

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