NDT Flashcards
Goal of NDT is to work on _ _ and _.
Improving function and participation
NDT is informed by _ and_ _ that emphasizes _ _ based on _ analysis for _ and _ of individuals with neurological pathophysiology
Informed by current and evolving research that emphasizes individualized therapeutic handling based on movement analysis for habilitation and rehabilitation of individuals with neurological pathophysiology
NDT uses the _ _, the therapist applies a - approach to assess activity and participation
Uses ICF model
Therapist applies a problem-solving approach to assess activity and participation
NDT involves an in-depth understanding of _ and _ _, and expertise in analysis of _ control, _, _, and _ throughout the lifespan
Understanding of typical and atypical development
Expertise in analysis of postural control, movement, activity and participation throughout the lifespan
NDT is also known as the _ _. Developed by? _ was emphasized in the 1980’s
Aka: Bobath approach
Developed by Berta and Karl Bobath in the 1940’s
Function was emphasized in the 1980’s
The contemporary NDT approach continues to _ with the emergence of new _, _, _ and information in the _ _.
Continues to evolve with the emergence of new theories, models, research and information in the movement sciences
NDT: Promote efficient and effective _ and _, in order to minimize _ _ _ related to _ solutions.
Promote efficient and effective posture and movement
In order to minimize long term problems related to movement solutions
NDT: uses _ _ of _ or _ (by manual contact) to guide and influence posture and movement to _ _ _.
Uses “key points of control” or “handling” to guid and influence posture and movement to enhance functional outcomes
With a higher level of disability, use _ key points. With a lower level of disability, use _ key points. The _ you wish to _ also affects key points of control.
Higher level use= proximal key points
Lower level use= distal key points
The movements you wish to facilitate also affect key points of control that you use
NDT handling: establish _ _ relative to task, apply principles of _ _ within task performance.
Establish biomechanical alignments relative to task
Apply principles of therapeutic exercise within task performance
NDT handling: _ and _ _ to provide appropriate challenges, _ is on-going, and handling is _.
Grade and fade handling to provide appropriate challenges
Assessment is ongoing, and handling is modificied
What are the 3 contemporary theories that influence NDT? _ oriented, with emphasis now on appreciating _ in _.
3 contemporary theories:
- Cognitive approach (Piaget)
- Information Processing
- Ecological approaches (environment)
Process oriented, with emphasis now on appreciating variability in development
What 2 principles remain constant in NDT?
Movement observation and analysis are heavily relied upon to guide intervention
Handling is a critical tool used to positively influence posture and movement
ABC’s of observation and analysis
Alignment of segments, Activation of muscles
Base of Support
Center of Mass, Center of Pressure
Direction of weight shift
Task and context parameters: _ and - elements. Example: improving sitting posture
Essential and Non-essential elements
EX: improving sitting posture
- essential: pelvic adjustment
- non-essential: hand adjustment
The body is _ system, look for relationships between? (2)
Body is a linked system
Look for relationship between:
- Limbs (UE/ LE, Left/ Right)
- Limbs and Trunk
_ and _ must be in balance with _ and _
Stability and organization must be in balance with mobility and flexibility
_ is part of normal development and postural control, and is essential for functional skill acquisition
Variability
Variable and adaptable postural control facilitates _ through _, _ and _.
Facilitates exploration through movement, perception and action
_ is the hallmark of normal development
Variability
Efficient motor organization minimizes _ _
Energy expenditure
Alignment dictates _ _
Synergistic activation
3 Stages of skill acquisition in regards to degrees of freedom. Which stage is most important?
1degree: Freeze the degrees of freedoms (strategy used in order to compensate for lack of motor control)
2degree: Free the degrees of Freedom
3degree: Exploit passive forces to make muscular efforts more economical *most important stage
CP is extremely variable and _.
Heterogenous
_ _ are defined as the presence of behaviors that are not normally present. _ _ is the loss of normal abilities.
Positive symptoms- behavior that are NOT normally present
Negative Symptoms- loss of normal abilities
_ _ are the most amenable to therapy.
Negative symptoms
What are the key primary impairments in cerebral palsy? (2)
Motor impairments
Impaired postural control
Comorbidities such as _ deficits, _ impairments and _ vary patient to patient and can influence _ function.
Such as sensory defecits, cognitive impairments and epilepsy vary patient to patient and can influence future function
A _ _ is considered present at the onset of a condition. A _ _ emerges over time as a result of a _ _.
Primary impairment- present at the onset of a condition
Secondary impairment- emerges over time as a result of primary impairment
It is often difficult to differentiate _ and _ _ due to the complex nature of CP and _ _.
Difficult to differentiate primary and secondary impairments
Complex nature of CP and early development
Secondary impairments include: impaired _ and _ mobility, deformation of _, and decreased _ _ _, _ capacity, and - reserve.
Impaired ROM and joint mobility
Deformation of Bone
Decreased bone mineral density, respiratory capacity and cardio-vascular reserve
Atypical motor development: original problem- _ - _ patterns - _ and finally _. As much as possible what does PT try to prevent through interventions/ treatments?
Original problem - Compensations- Habit patterns - Deformities - Surgeries
We try to prevent surgeries as much as possible
According to the systems theory motor behavior emerges dynamically due interaction between the _, the _ and the _.
Interaction between:
The task, the individual and the environment
_ _ interact in order to produce _ . Each system _ and at different points of time.
Multiple systems interact in order to produce motor behavior
Each system develops and strengthens at different points of time
Normally developing children take _ _ _, in order to _ _. Need to have an environment that _ _ and _ _
Normally develop children take lots of risks, in order to test limits.
Need to have an environment that promotes exploration and risk taking
3 tenets of neuronal group selection: _ development, _ and _ circuitry provides primary repertoire of _; _ and _ creates secondary repertoire of functional circuits selected and strengthened through _; _ and _ of multiple systems for movement determined by _ demands.
Brain development, genetics and neuronal circuitry provides primary repertoire of behaviors
Experience and use create secondary repertoire of functional circuits selected and strengthened through use
Interconnection and integration of multiple systems for movement determined by environmental demands
_ _ _ is mandated for children ages 0-3 by the federal government.
Family focused care
Intervention aims at improving _ _ to enhance _, capitalizes on _ and _, uses the - model framework.
Improving functional skills to enhance participation, capitalizes on strengths and resources, uses WHO-ICF model framework
Critical lifespan competencies accomplished during the first year of life: _ , _ posture, _, _ interaction and _ _ function, and _ care. Competency in these domains leads to?
Communication, upright posture, mobility, environmental interaction and upper extremity function, and self care
Competency leads to greater real life function
Intervention should focus on _ _ management.
Life time management
_, _, and _ of intervention in the growing child depends on developmental _, changing life roles with _ and _. Should explain?
Timing, Frequency and duration of intervention in the growing child depends on:
Developmental biomechanic,s, changing life roles with age and transitions.
Should explain to family/ patient why treatment should end, but that they will be able to return during transitional years/ growth spurts.
Intervention should support _ _ as early as possible, and promote _ activities with _ benefits. Examples? (2)
Should support inclusive opportunities as early as possible and promote leisure activities with therapeutic benefits
Hippo therapy (horse therapy) Aqua therapy
Does every child need to crawl before they walk? Why?
No, walking and standing is more functional than crawling
Dispelling myths- development doesn’t always proceed: _ to _, _ to _, _ before _, and _ to _
Cephalo to caudal
Proximal to distal
Stability before mobility
Gross to fine
NDT focus on the _ and _ of participation, activation, and body function and structures.
Focuses on the What and How
Developmental milestone attainment is not a _ _/ _
Not a functional test/ scale
Functional goals are determined by the _ and _ _, are directed toward improving _ and reducing _ _, are _ appropriate, _ and _, are also informed by _ _ and the _.
Determined by client and their family
Directed toward improving participation and reducing participation restrictions
Are age appropriate, realistic and functional
Are also informed by professional expertise and the literature
3 parts of treatment that you can manipulate in order to meet functional goals
Key points of control used for handling
Environmental set up
Task and activity selection
. . . Individual, task, and environment
3 goals of posture and movement observation?
Observe and describe motor dsyfunction
Identify consistencies in posture and movement
Prioritize consistencies relative to functional goals/ identify those that significantly interfere with overall function/ goal attainment
Should always establish a - for each session. Includes establishing a _, assessing treatment _, assessment of _ _, measure of _ _ which influence task performance, test _ about the impairments that contribute to _ _.
Establish test-retest task/ measure for each session
Includes: establishing a baseline, assessing treatment efficiency, assessment of motor learning, measure of qualitative changes which influence task performance, test hypothesis about the impairments that contribute to movement solutions
Though _ is always used and is considered the gold standard it only looks at _ _ _ and has a _ _. _ is often better to assess patient.
GMFCS . . . Only looks at gross motor function and has a low ceiling
PEDI (pediatric evaluation disability inventory) is often better to assess patient.
Functional classification systems used for children with CP? (5) All are scaled?
MEG from BC
- Manual ability classification system (MACS)
- eating and drinking classification system (EADCS)
- Gross motor function classification system (GMFCS)
- bi-manual fine motor function (BMFM)
- Communication function classification system (CFCS)
All are scaled 1-5, most independent to least independent
What are the 5 steps in the evidence based practice process?
Assess the patient Ask the question (PICO) Acquire the evidence Appraise the evidence (validity) and applicability (clinical usefulness) Apply to patient
What does PICO stand for?
Patient
Intervention
Comparison
Outcome
What is the only functional classification system that uses a 1-6 level scale that begins with the most independent to least independent
Functional mobility scale
