NDT Flashcards
NDT primary principals
- neuro involvement of CNS —> abnormal tone and retention of primary reflexes
- developmental delays in motor maturation —> delayed scattered or arrested gross and fine motor skills
NDT can be applied to
All dx
Changes are based on advances in motor learning and motor control
NDT goals
Normalize tone and give people the opportunity to experience new movement patterns
Developmental milestones
Reflect maturation of CNS
Very stereotypical responses
Problems of pts w/ neuro disorders
Abnormal tone Decreased strength Disturbed synergistic organization Impaired timing of muscle contractions Disturbed postural synergies Sensory deficits Bilateral dysfunction Altered bio mechanical alignment Comm dysfunction
Abnormal tone
Cluster of symptoms
Amount of spasticity someone has is NOT related to voluntary movement someone has
Decreased strength
True and apparent weakness from hypertonic antagonist
Loss of type II motor units, fast fibers
Difficulty generating force at high velocities
Disturbed synergistic organization
Tonic reflex, reemergence of reflexes w/ postural changes
Loss of movement patterns, loss of established linkages, ataxia, tremor
Impaired timing of muscle contractions
Loss of coordinated synergistic w/ reciprocal inhibition of antagonist
Stroke pts demonstrate the reversal of activation pattern
Disturbed postural synergies
Loss of anticipatory postural set w/ recruitment of abnormal or excessive muscle contractions to produce a movement
Sensory deficits
Movement can result from CNS/out sensory input but movement breaks down in sensory input
Bilateral dysfunction
Lack of normal interplay b/n two sides
All movement requires coordination b/n the two sides of body
Creates loss of midline
Altered bio mechanical alignment
Alters the effort required to stay upright
Changes the motor program used
Communication dysfunction
Aphasia
Neglect
Conscious memory not necessary for memory of motor skills
NDT pt management
Achieving vertical orientation in space
Handling in vertical posture
Level of alter ness
Repetition w/ quality
Concepts of normal development
Handling by parents in functional situations
Trunks as most important key point
Movement into higher level of activity as means of achieving perfection
Overlap principle
Grading sequence and control through activity
Carefully time handling sequences
All pts regain control and function this sequence
- posturing and postural control
- transitional movement patterns
- ability to be active in postures…functioning
Five components must be present for postural control
- Trunk control and movement
- Midline orientation
- Movement over the BOS w/ weight shift
- Head control on the trunk
- Limb function and control on the trunk, alignment in terms of WB and tone control
Transitional movement patterns
What we used to change position/ adjust ourselves
Need to have the same 5 components of posture present to have control in transition
Postural control w/ movement
Function (movement)
Quality of movement w/ efficiency
Involves appropriate time sequences
Speed
General principals of management and handling
“Living concept” - changing and active
Management of “life” - helping pt physically, mentally, emotionally,
Functional
Adaptable
Vs treatment (implies you are doing something to them)
Management and handling - emphasis
Movement not dx
Focus on what is biomechanically advantageous for pt
Quality of life (movement and control, how they are moving)
Treating the whole person
Management and handling - overlap in
Assessment and treatment
Inhibition and facilitation
Quality of function
AIM for HIGHEST LEVEL of function that pt can achieve
Pay close attention to starting postures, key points of control
Management and handling - sequencing
Preparation —> movement—> function **WB precedes movement** Isometric —> eccentric —> concentric Proximal to distal key points Smaller to larger ranges
Give the “feel” for the movement
NDT aim of tx
Accomplishing a task in most efficient way
Active
Ask them to solve a problem
Set it up that there is high probability that pt will chose a certain strategy
Allow pt to make mistakes (provide feedback)
Provide variety of experiences w/in a task and w/in a movement
Aim of tx - function
Part task to whole task
Individual exercises do not automatically translate to function
CNS will not recognize movement as valuable unless it is put back into a functional situation
Aim of tx - repitition
Only way to get carryover
