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Technical Janet M Howell "Neurodevelopmental Treatment Approach: Theoretical Foundations & Principles of Clinical Practice" (2002)
Posted on 2010-08-03
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More Neurodevelopmental Treatment Approach: Theoretical Foundations & Principles of Clinical Practice This book was written for members of the Neuro-Developmental Treatment Association (NDTA) and for the scientific and therapeutic communities. Its primary purpose is to describe the current state of neurodevelopmental treatment (NDT), because the approach has been criticized over the years for a lack of research published in evidence-based sources. This book attempts to remedy that criticism and also attempts to define how the approach has changed since the deaths of the Bobaths, the original developers. The book contains 5 chapters. Chapter 1, "Current Theoretical Foundations," describes original assumptions to the approach as well as 10 additional assumptions that are currently being promoted by the Neuro-Developmental Treatment Association. Text boxes titled "NDT Focus," which discuss a variety of topics such as beliefs/philosophy, interventions, examination principles, and treatment approaches, are used before current research and evidence-based concepts are presented to support that topic. Theories and research used to support the approach include systems theory, dynamic systems theory, neuronal group selection theory, and general motor programs (ie, schema theory). Assumptions concerning motor development, postural control, and sensory system organization are supported by literature on postural control, reaching development, and sensory integration. A section on motor learning and its application to NDT completes the chapter. Chapter 2, "Movement Dysfunction," begins with a description of the NDT Enablement Model of Health and Disability, which is based on the World Health Organization's International Classification of Impairments, Disabilities, and Handicaps (ICIDH ICIDH - International Classification of Impairments, Disability and Handicaps-2). The chapter continues with a discussion of the diagnoses of cerebral palsy (CP) and cerebrovascular accident cerebrovascular accident. See stroke. (CVA), including pathology and classification of diagnostic patterns. Impairments and their relationships to functional limitations are described in detail for the musculoskeletal, neuromuscular, sensory processing, respiratory, perception/cognition, arousal/regulatory, cardiopulmonary, and gastrointestinal systems. Multisystem impairments also are discussed and include pain, edema, and impaired motor planning. Motor function and dysfunction from the NDT perspective are described next. The discussion includes the hallmarks of the approach--linking functional limitations with system impairments through an in-depth analysis of alignment, weight-bearing, muscle reflex activity, balance/postural control, coordination, and the kinesiological/ biomechanical components of movement. A clinical example is applied to the NDT Enablement Model to clarify the previous content. The chapter ends with a review of recovery and compensation following a neurological insult and a review of the available evidence of NDT-based studies using Sackett's levels of evidence. Chapter 3, "Principles and Process of Examination," clarifies how the NDTA uses the terminology in APTA's Guide to Physical Therapist Practice, Second Edition. A model of examination and evaluation is presented with descriptions of each area that are based on the NDT model. This process now includes using objective, norm-referenced, criterion-based, self-referenced (ie, patients are their own control subjects) tests to supplement the clinician's examination. The chapter concludes with 2 case examinations: a child with CP and an adult with a CVA. A guide for organizing an NDT exam is also provided. Chapter 4, "Principles and Process of NDT Intervention," describes 23 intervention principles, which include additional hallmarks of the approach: therapeutic handling, key points of control, facilitation of active movement, and inhibition of undesired movement. All the principles are integrated into both a pediatric case study and an adult case study. This chapter uses a different pediatric case to illustrate the interventions based on the evaluation; however, it continues the adult case presented in chapter 3. Photographs with extensive descriptions are provided. Chapter 5, "Development of the Bobath Approach," is a review of the personal history of the Bobaths and the historical literature of neurophysiological principles. It illustrates how the Bobaths redeveloped their ideas over time as the literature evolved. The chapter concludes with a table illustrating how the approach has changed between the 1950s and the 2000s. Preview: Download Link: Part I - Part II - Part III - Part IV - Part V - Join the parts with HJ Split:
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