Module 3 Flashcards
(33 cards)
What NDT governed by?
The problem solving sequence, key points of control, and working within an appropriate environmental construct.
What is neuro-developmental treatment?
A manual therapy treatment philosophy directed at restoring and improving functional motor control in the human neuromuscular system.
What is the problem solving sequence?
Ask for movement Facilitate movement Passive movement assessment Mobilize and/or stretch Integrate movement
What are the key points of control?
Proximal: on moving part or muscle that moves part
Distal: away from part or muscle that moves parts.
When was NDT developed?
1940’s
Who developed NDT?
Karel Bobath and Berta Bobath
What is the NDT functional progression?
Bed mobility
Transfers
Gait
What are the nine bed mobility movements?
Hooklying Bridging Bridge and scoot Supine to sitting towards weaker side Supine to sitting towards stronger side Upright sitting Hip hiking Scooting forward Scooting backwards
What is the process for hooklying?
Ask patient to bend knees. If unable, provide least amount of facilitation required.
Determine motor control before releasing patient’s lower extremity.
What is the process for bridging?
Patient hooklying.
Ask patient to push bottom up using feet and arms. If unable, provide least amount of facilitation required.
Apply long-axis traction caudally throu distal femur with pressure down into patient’s foot; proximal hand under pelvis lifting up.
What is the process for bridge and scoot?
Patient hooklying.
Ask patient to scoot towards or away from clinician.
Once bottom clears mat, facilitate scooting by internally or externally rotating the ipsilateral distal femur and manually directing patient’s pelvis.
Ask patient to lift head off pillow while helping to scoot upper torso.
What is the process for supine to sitting towards weaker side?
Patient hooklying.
Ask patient to move UE 30 degrees away from body and log roll onto weaker side.
Ask patient to move LE’s off mat and push with arm to sit up. Clinician must be on weaker side.
What is the process for supine to sitting towards stronger side?
Patient hooklying.
Ask patient to move UE 30 degrees across body and log roll onto stronger side.
Ask patient to move LE’s off mat and push with arm to sit up.
Clinician must be on weaker side.
What is the process for upright sitting?
Patient sitting with hands on mat.
Ask patient to position feet under knees and sit up tall.
Place one hand on L/S and lift anterior and superior while other hand stabilizes upper trunk by gently pushing superior and posterior under clavicles.
What are the positions of the forefeet, patella, hands, trunk midline and head during upright sitting?
Forefeet under patella Patellas inline with acetabulum Hands on mat slightly externally rotated Trunk midline with no leaning in Sagittal or frontal plane Head looking forward
What is the process for hip hiking?
Patient in upright sitting position. Patient may position arm slightly further away from body.
Ask patient to lift one hip off mat.
Place finger pads on quadratus lumborum and lift medial and superior.
One hand may be required to stabilize upper trunk by placing anterior hand on contralateral shoulder.
What is the process for scooting forward?
Patient in upright sitting position with arms slightly away from body.
Ask patient to lift one hip off mat and scoot that hip forward.
Hike hip and draw femur forward by adducting it with hand or leg.
What is the process for scooting backwards?
Patient in upright position.
Ask patient to scoot backward.
Stabilize weaker tibia.
Place hands on mid-back and guide patient forward until weight transfers onto their feet.
Draw patient further forward until patient’s bottom comes off mat.
Shift forward to increase tibial contact and guide patient backwards.
What is the process for transfers?
Patient in upright sitting position at edge of mat.
Ask patient to turn heels towards chair and transfer into chair. Stabilize weaker tibia.
Place hands on mid-back and guide patient forward until weight transfers onto their feet.
Draw patient further forward until patient’s bottom comes off mat and move patient in direction of chair.
Patient’s COG must remain over their BOS during transfer.
What is the process for sit to stand?
Patient in upright sitting position at edge of mat.
Ask patient to stand up.
Place posterior thigh underneath patient’s thighs; anterior knee on patient’s involved superior tibia.
Posterior UE obliquely on patient’s upper and lower trunk and anterior hand under patient’s clavicle.
Guide patient forward until weight transfers onto their feet then cue patient to stand with posterior thigh.
Dynamically stabilize patient’s weaker knee with anterior knee while guiding trunk in anterior and superior direction.
Facilitate hip extension with posterior elbow.
Patient’s COG must remain over their BOS during transfer.
What is the process for stand to sit?
Patient in standing position at edge of mat and ask patient to sit down.
Place weaker knee between clinicians knees; posterior UE obliquely on patient’s upper and lower trunk and anterior hand under patient’s clavicles.
Ask patient to briefly look back at sitting surface. Knees bend first followed by hips and patient reaches back for sitting surfaces. Patient’s COG must remain over BOS.
When should a gait belt by applied?
While sitting or supine
How should a gait belt be worn?
Buckle in posterior
Snug but not too tight
Clinician typically stands postero-lateral
What are two other names for forearm crutches?
Lofstrand or Canadian crutches.
