NDT Flashcards
What is placing response
maintain position when supported
What is a reflex inhibiting pattern
position to inhibit spasticity by lengthening shortened muscles
What kind of treatment approach is NDT
a living concept
What is the goal of decreasing spasticty
Improved control of posture and movement on the affected side
how to eliminate tone and dysfunctional movt
use manual techniques
what does NDT reject
use of compensatory techniques
approaches that encourage abnormal movt and reflex activity
What is NDT not based on
a developmental sequence
What is loss of postural control associated with
difficulty shifting weight, maintaining stable body position against gravity, maintaining equilibrium when a balance is challenged
What is loss of selective movt associated with
prevention of the use of the affected UE (learn neglect due o compensatory techniques)
What is always associated with spasticity in NDT
associated reactions
What is usually present immediately after stroke
spasticity
when does flaccidity start
develops over time
starts with trunk, arm, leg
What are the principles of NDT
- Retrain normal movt responses on affected side
- avoidance of activities and exercises that increase abnormal tone or strengthen abnormal movement
- utilization of tx activities and exercise hat encourage and strengthen normal movt
- Assisting the pt to use existing motor control on the affected side for occu. performance
- dev of compensation and adaptation that encourage the use of the affected side when adequate strength and control are absent in order to decrease abnormal posture and movts
What are specific handling tehniques
facilitation and inhibition
What do handling techniques provide
specific tactile prop kinesthetic input to help organize quality of movt
What are inhibition techniques used for
decrease abnormal mm tone.
try to restore normal alignment in trunk and exremitites by lenthening shortened mm.
What is inhibition used for
addressing spasticity
What are reflex inhibiting patterns used for
to decrease spasticity
to counteract pull of spastic mm
What are facilitation techniques used for
flaccidity
try to get mm to contract
how to do facilitation techniques
through weight bearing and non weight bearinging techniques
provide a system to relearn normal movt.
What can weight bearing be used for in NDT
facilitation and inhibition
What does NDT use occupation as end and means to do
to incorporate occupation while improving tone and movement
What is occupation as ends
pt. directly engaged in learning tasks and activities
used to help increase individuals independence in ADLs
What is occupation as means
precursory tasks
use activities therapeutically to influence impairments and provide opportunities for motor learning
What are guidelines for occupation as end
based on pt. lvl of function
intervention starts with adl and work and moves to IADLs
Example of occupation as end
actually brushing teeth
example of occupation as means
working on ROM to get toothbrush to mouth
What is the most important aspect of NDT
evaluation of motor patterns and the clients response to being moved
What does assessment begin with in NDT
observation
What to assess in NDT
movt controll
When can the placing response be done
only when there’s some active movt in the affected extremity
can hold limb in a position after moving
What are specific assessment guidelines
identify abilities and functional capabilities
identify functional limitations
determine which problems interfere w/ movt control and functional performance
What problems to look for in NDT
abnormal tone abnormal coordination loss of postural control loss of selective movt control loss of sensation
what are treatment goals based on
stages of recovery
What do you see in acute care
low tone
loss of muscle control
dependent in adls
What is the goal in acute care
increase independence in ADL
prevention of abnormal tone and movt
increase motor control on affected side
What is the goal in inpatient rehab
inhibit spasticity and abnormal tone
increase normal movt responses
improve occu performance by including affected side
increase coordination of affected side
Treatment techniques for a hemiplegic arm
Use inhibition (reflex inhibiting patterns)
use facilitation (weight bearing and scapulohumeral rhythm)
UE tx in supine (place and hold)
UE tx in sitting
Why is use of facilitation important
to make sure the humerous is in the glenoid fossa
Limitations of NDT
no strong evidence to support it over other approaches
no formal assessment not standardized
things vary from client to client
depends on skill level of therapist
What are associated reactions
involuntary and nonfunctional change in muscle tone w/ a stressful situation
