Neurodevelopmental Treatment (NDT)
Originated by Karel and Berta Bobath in the 1960s, NDT has since evolved to incorporate emerging theories of sensorimotor learning, and uses guided or facilitated movements as a treatment strategy to ensure correlation with input from tactile, vestibular, and somatosensory receptors within the body.
These assumptions (among others) are inherent in NDT :
Primary problems in clients with CP or stroke are impaired patterns of postural control and movement coordination.
Identifiable system impairments are changeable with intervention that addresses them in a task-specific context. Left untreated, clients select existing, maladaptive strategies that propagate impairments over time.
A working knowledge of typical adaptive motor development provides the framework for assessing functions and planning intervention.
Clinician focus on changing movement strategies as a means to achieve quality performance of age-appropriate tasks, and in preparation for future functional tasks.
Proximal stability precedes the acquisition of effective limb movement (distal mobility).
Therapeutic handling is integral to NDT, as an evaluative and a treatment tool that allows the therapist to:
Feel the client’s responses to changes in posture or movements
Facilitate postural control and movement patterns that expand the client’s options for selecting successful actions
Limit movements that distract form the treatment goal
Inhibit or constrain non-productive, potentially debilitating, or deformity-promoting motor patterns.
Active carry-over of gains made in treatment, essential for motor learning, requires practice by the client throughout the day, independently or with caregivers.
You can find evidence supporting NDT online at: http://paediatricworkshops.com.au/research-articles and at www.bobath.org.uk/content/evidence-base
For more information, read: Neuro-Developmental Treatment Approach: Theoretical Foundations and Principles of Clinical Practice, by Janet M Howle. 2002 available from www.ndta.org.
NDT & TheraTogs Are Closely Linked in Scientific Principles
NDTA practitioners have long known of the strong link between NDT principles and TheraTogs applications:
TheraTogs systems gently and comfortably support sensorimotor training objectives that are immediately recognizable to NDT clinicians:
- Cozy tactile input and compression for postural support and increased body awareness
- Improved resting alignment from which to initiate movement
- Improved functional alignment from which to experience movement
- Resistance to undesirable movement patterns, and assistance with gaining desirable movement patterns
By living in a well-designed TheraTogs system, the wearer experiences thousands of repetitions in corrected functional context – repetitions that are essential for optimum neuromotor re-education and optimum skeletal modeling in infants and young children.
Wearable Therapy: TheraTogs Embodies Key NDT Principles
Nancy Dilger, MA, PT, PCS. NDTA Network, January/February 2007
Marlenne Burt illustrated the connections in a related case study:
With an understanding of the principles of applied kinesiology and biomechanics, the current dynamic and motor learning theories, and the concepts of manual facilitation techniques inherent in NDT, therapists will find the TheraTogs orthotic and strapping system offers a live-in, dynamic, and enhancing postural and neuro-motor training modality.
A Strapping Case Study: Linking NDT with TheraTogs Strapping System and Other Orthotics
Marlenne Burt, PT, MS, MBA. NDTA Network, January/February 2007
We invite NDT practitioners to further explore how TheraTogs can embody your practice principles, increase compliance, and improve outcomes by multiplying repetitions.