ndt mary rose franjoine pt, dpt, ms, pcs margo prim haynes pt, dpt, ma, pcs
TRANSCRIPT
NDT
Mary Rose Franjoine PT, DPT, MS, PCS
Margo Prim Haynes PT, DPT, MA, PCS
2009 2
2009 3
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)
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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
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NDT …• Enhances function;
improving the individuals quality of life
• Treats individual as a Whole person
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NDT …
• Family centered
• Team approach
http://www.familyconnectionsc.org/gallery
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NDT Intervention Process…
• Begins with a comprehensive assessment of the individuals– Abilities– Needs, Wants, …..
–Dreams!
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NDT Intervention Process…• Includes observation analysis and
identification of effective and ineffective postures and movements
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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
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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
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NDT is…
• Therapeutic handling is used to guide and shape movement, enhancing function
• Therapeutic handling is used interdentally
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NDT Therapist…
• Utilize typical development as a framework for treatment
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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
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NDT Treatment Sessions should be…
• Active
• Dynamic
• Fun
• Functional
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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.
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Karl and Berta Bobath
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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!
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
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Reflex
• Peripheral Mode of Operation • Complex skills remerge through
chaining
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Reflex
Assumptions Underlying Motor Control for Neurologic Rehabilitation Chapter 4
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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
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Hierarchical Model
Assumptions Underlying Motor Control for Neurologic Rehabilitation Chapter 4
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Program Model
• Peripheral and Central Mode of Operation
• Storage of Complex Motor Programs
• CPG
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Systems Models
• Function emerges from the interaction of multiple systems
• Coordinative Structures (Synergies)
• Degrees of Freedom
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Systems Models
Assumptions Underlying Motor Control for Neurologic Rehabilitation Chapter 4
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Dynamical Systems Theory
• Self Organization
• Rate-limiting factor
• Transition States (Chaos)
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Neural Group Selection Theory
• Contemporary Theory
• Blends our knowledge of neuro embryology and development of neuro anatomy
• Plasticity
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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
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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
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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):707-715.
NDT
Mary Rose Franjoine PT, DPT, MS, PCS
Margo Prim Haynes PT, DPT, MA, PCS