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Questions and Answers
What is the primary focus of a problem-solving approach in therapy?
Which principle is NOT associated with motor learning?
How does the NDT approach address postural control?
Which statement best describes the role of sensory inputs in motor control according to the Bobath concept?
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What aspect of the ICF model is specifically targeted in therapy?
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What is an important consideration for functional training in the NDT approach?
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Which technique involves the use of righting and equilibrium reactions?
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What is the goal of targeting the involved side in therapy?
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What is the primary focus of the Bobath approach in treatment?
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Which of the following conditions is NOT typically treated using the NDT approach?
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Who were the developers of the Bobath approach?
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What differentiates the NDT approach from previous management methods like braces and surgery?
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What is the significance of the International Bobath Instructor Training Association (IBITA)?
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What role do key points of control play in the Bobath approach?
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How does the NDT approach view the treatment of neuro-motor dysfunctions?
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What kind of interventions does the Bobath approach aim to inhibit?
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What is the goal of using Reflex-inhibiting pattern (RIP) in treatment?
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Which statement correctly reflects the principles of treatment in motor learning?
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How does NDT approach the treatment of individuals with motor dysfunction?
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Which key element of NDT ensures that normal postural alignment and movement patterns are facilitated?
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What is the focus of NDT in relation to motor responses?
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How can motor learning be optimized?
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What role does sensory feedback play in treatment?
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Which of the following aspects does not contribute directly to alignment in treatment?
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What role does handling play in early phases of motor learning?
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Which method can effectively assist learners in reducing movement errors?
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What is a key factor that enhances the chances of skills becoming part of a client's movement repertoire?
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Which of the following is NOT an essential skill for therapists using NDT?
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What is a critique regarding NDT's effectiveness according to Novak et al (2013)?
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Why is practice of novel skills with increasing challenges important?
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What evidence exists regarding NDT's effectiveness on tone reduction?
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What is a noted limitation of NDT concerning treatment resources?
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Study Notes
Neurodevelopmental Treatment (NDT)
- NDT is a hands-on treatment approach used by physical therapists, occupational therapists, and speech-language therapists.
- NDT-trained therapists work collaboratively with patients, their families, and caregivers, as well as other members of the rehabilitation team.
- The Bobath approach is the most common name in Europe, and NDT is more widely used in North America.
NDT Approach in Neurology
- NDT is used for neurological patients who have difficulty controlling movement, especially after cerebral palsy, traumatic brain injury (in children), stroke, or head injury.
Bobath (NDT) Therapist
- NDT therapists must complete a basic course, two advanced courses, and an instructor training at the Bobath Centre in London.
- The focus is on early intervention services and consultations for pediatric patients.
Bobath Concept
- Developed in the late 1940s by Berta Bobath, a physiotherapist, and Karel Bobath, a psychiatrist and neuropsychiatrist.
- Based on the theory that higher level cortical centres control movement, while lower centers control primitive reflexes.
- They observed that children with cerebral palsy struggled with postural control and movement against gravity.
- The initial focus was on inhibiting reflexes by holding children in fixed postures.
Bobath Approach Evolution
- Many concepts have remained unchanged, but others have evolved with new scientific knowledge.
- The focus is now on individualized therapeutic handling based on movement analysis.
What is NDT Today?
- An interactive problem-solving approach that focuses on continuous reassessment and individual goals.
- Therapists use the ICF model in a problem-solving approach and utilize objective measures to evaluate interventions.
- Goal-oriented and task-specific approach, aiming to organize the internal (proprioceptive) and external (exteroceptive) environment of the nervous system for efficient functioning.
- Interactive process between therapists and patients.
Cerebral Palsy - Postural Control
- Normal postural reflex mechanisms include righting and equilibrium reactions, reciprocal innervation, and coordination patterns.
- Abnormal tone and tonic reflexes in cerebral palsy interfere with the development of righting and equilibrium reactions.
NDT Expertise
- In-depth knowledge of the human movement system and motor control.
- Principles of motor learning.
- Understanding of typical and atypical development.
- Expertise in analyzing postural control, movement, activity, and participation as defined by the ICF.
Principles of Motor Learning
- Repetition of movements is crucial.
- Progressive increase in challenge during practice.
- Sensory information significantly influences motor learning.
NDT Principles
- Integrates postural control with task performance.
- Promotes selective movement control to produce coordinated movement sequences.
- Sensory input to motor control and motor learning is a vital focus.
- Emphasizes training in different real-life situations.
- Encourages active participation during treatment sessions.
- Incorporates functional training.
Sensory Stimulation
- Sensory input is an essential part of NDT, using techniques such as touch, vision, sound, and proprioception to enhance motor learning.
Outline of NDT Approach
- Individualized: Treatment is tailored to the specific patient's needs, goals, and environment.
- Functional Outcomes: Focuses on improving the patient's ability to perform everyday activities.
- Motor Control: Optimizes the use of sensory, musculoskeletal systems, and movement patterns.
- Target the Involved Side: Emphasizes the use of the affected side of the body.
- Motor Learning: Utilizes principles of motor learning, including practice, feedback, and challenging tasks.
Principles of Treatment
- Plan treatment to prepare for functional activity.
- Incorporate the child's own activity in the treatment.
- Use reflex-inhibiting patterns (RIP) for spasticity, lengthening shortened muscles to reduce spasticity.
- Give the child sensory experience of more normal movement and postures.
- Facilitate wide ranges of movement in tonus-inhibiting patterns (TIP).
- Facilitate automatic righting, equilibrium, and protective reactions.
Neuroplasticity
- NDT incorporates neuroplasticity, recognizing the brain's ability to change and reorganize based on practice and experience.
Key Elements of Applying NDT
- Alignment: Cannot impose normal movement on misaligned joints.
- Handling: Inhibition, facilitation, and use of key points of control.
- Placing: Assisting patients in achieving the appropriate posture.
Alignment
- Base of support: wide, narrow, staggered, asymmetrical.
- Body segment alignment: synergies, compensatory head and trunk positions.
- Muscle activation: pattern and timing of movement during functional activities.
- Weight shift: in all planes.
NDT Practical Application
- Treatment incorporates facilitation and inhibition using key points of control.
- Abnormal tone is always inhibited.
- Normal responses are always repeated.
- Facilitation: makes movement easier and possible.
- Inhibition: involves decreasing pathological movements and the effects of tonal dysfunctions.
- Facilitation and inhibition can be used simultaneously and throughout the session.
NDT Focus
- Focuses on the client's abilities to carry out efficient postural responses and movement patterns while avoiding abnormal patterns, with therapist help.
- Encourages using both sides of the body, bearing weight on the affected side, and managing muscle tone.
Motor Learning
- Improved with accurate instruction and feedback, verbal and nonverbal instructions, handling, and physical prompting.
- Hands-on guidance can influence motor learning, especially in the early stages.
- Physical or verbal guidance can limit movement errors and assist the learner with postural adjustments.
- Repetition is essential, incorporating task-specific activities in therapy sessions and functional settings.
- Practice with increasing degrees of challenge is important for motor learning.
NDT Treatment Effectiveness
- Therapists must be able to differentiate between normal and abnormal alignment and movement patterns.
- Therapists must be able to select and deliver functional activities meaningful to the patient.
- Therapists must be able to choose the optimal practice method, feedback, and environment for maximum function and independence.
- Therapists must have stable footwear and good flexibility in their lumbar spine and lower extremities for optimal body mechanics.
Evidence Base for NDT
- The lack of an evidence base highlights the need for more intensive research on the effectiveness of NDT.
- Studies have shown improvement in motor control for infants born prematurely.
- Critiques of NDT effectiveness and supporting evidence for alternative approaches:
- Casting shown to be superior to NDT for treating contractures.
- NDT shown to be ineffective for reducing tone, while Botulinum Toxin (BTX) has proven highly effective.
- NDT can be time-consuming and expensive, with motor learning shown to achieve better functional motor gains than NDT at equal doses.
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Description
Explore the fundamentals of Neurodevelopmental Treatment (NDT), a collaborative approach used by therapists to aid patients with movement disorders. Learn about the key principles, the Bobath concept, and the training required for NDT therapists. This quiz is essential for understanding NDT's application in neurology, especially for pediatric cases.
