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NDT Mary Rose Franjoine PT, DPT, MS, PCS
Margo Prim Haynes PT, DPT, MA, PCS
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2009
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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) 2009
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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 2009
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NDT … Enhances function; improving the individuals quality of life
Treats individual as a Whole person 2009
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NDT … Family centered Team approach
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NDT Intervention Process…
Begins with a comprehensive assessment of the individuals Abilities Needs, Wants, ….. Dreams! 2009
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NDT Intervention Process…
Includes observation analysis and identification of effective and ineffective postures and movements 2009
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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 2009
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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
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NDT is… A “Hands On” approach It includes the use of:
Inhibition techniques Facilitation techniques 2009
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NDT is… Therapeutic handling is used to guide and shape movement, enhancing function Therapeutic handling is used interdentally 2009
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NDT Therapist… Utilize typical development as a framework for treatment 2009
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NDT Therapist… Consider the multisystem effects of aging across the lifespan Strives to optimize function while acknowledging the existence of central nervous system damage 2009
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NDT Treatment Sessions should be…
Active Dynamic Fun Functional 2009
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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. 2009
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Karl and Berta Bobath 2009
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Mrs. Bobath once said, it is a “living, breathing and changing” approach, and she challenged us all to grow and advance with the approach! 2009
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Current Theoretical Base for NDT
Mary Rose Franjoine, PT, DPT, PCS Margo Prim Haynes, MA,PT 2009
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Models of Motor Control
Reflex Hierarchical Model Program Model Systems Models of Motor Control Neural Group Selection 2009
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Reflex Peripheral Mode of Operation
Complex skills remerge through chaining 2009
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Reflex Assumptions Underlying Motor Control for Neurologic Rehabilitation Chapter 4 2009
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Hierarchical Model Central Mode of Operation
Skill refined through a maturation process Assumptions Underlying Motor Control for Neurologic Rehabilitation Chapter 4 2009
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Hierarchical Model Assumptions Underlying Motor Control for Neurologic Rehabilitation Chapter 4 2009
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Program Model Peripheral and Central Mode of Operation
Storage of Complex Motor Programs CPG 2009
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Systems Models Function emerges from the interaction of multiple systems Coordinative Structures (Synergies) Degrees of Freedom 2009
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Systems Models Assumptions Underlying Motor Control for Neurologic Rehabilitation Chapter 4 2009
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Dynamical Systems Theory
Self Organization Rate-limiting factor Transition States (Chaos) 2009
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Neural Group Selection Theory
Contemporary Theory Blends our knowledge of neuro embryology and development of neuro anatomy Plasticity 2009
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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 2009
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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 2009
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Additional References
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): 2009
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NDT Mary Rose Franjoine PT, DPT, MS, PCS
Margo Prim Haynes PT, DPT, MA, PCS
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