Neurodevelopmental Treatment (NDT) Approach in Cerebral Palsy

NDT approach

NDT is a form of therapy used with persons who have central nervous system disorders resulting in abnormal posture & movement. Th treatment approach attempts to initiate or refine the normal stages & processes in the development of movement.Specific handling techniques as well as adaptive equipment are used to achieve inhibition of abnormal patterns, normalization of muscle tone & facilitation of more normal movement.
The main principle of NDT are :

1. The damaged central nervous system blocks normal movement.
2. Abnormal muscle tone results in abnormal patterns of posture & movement.
3. These abnormal patterns affect all function i.e. respiration, speech, feeding, perception, self-care & walking.
4. Because the basis of movement is sensation so the change requires the person to feel more normal movements.
5. Optimal Gains are achieved only with combined efforts of patient, family, physician & therapists.

The concept that movements range from least automatic to most automatic has been useful in explaining the NDT approach to therapeutic handling attempting to obtain active & automatic movements from the child which leads to voluntary purposeful movements. The child gains normal sensory motor feedback from active movements achieved without excessive efforts.

proper positioning facilitates greater trunk control

The role of NDT in Cerebral Palsy emphasizes upper body control with acquisition of hand skills for self care, academics, leisure & other community activities leading to as much independence as possible. Handling techniques are designed to normalize muscle tone & obtain postural alignment throughout the entire body & to prepare upper & lower extremities for weight bearing, weight shifting & function.

NDT has also combined with sensory integration treatment as both approaches addresses the adaptive responses of the person and use sensory input to produce the motor response. NDT focuses on motor-output & motor-control whereas sensory integration focuses on sensory processing issues

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Swavalamban Children Rehabilitation Centre

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