NDT

Question 1

Goal of NDT is to work on _ _ and _.

Answer 1

Improving function and participation

Question 2

NDT is informed by _ and_ _ that emphasizes _ _ based on _ analysis for _ and _ of individuals with neurological pathophysiology

Answer 2

Informed by current and evolving research that emphasizes individualized therapeutic handling based on movement analysis for habilitation and rehabilitation of individuals with neurological pathophysiology

Question 3

NDT uses the _ _, the therapist applies a - approach to assess activity and participation

Answer 3

Uses ICF model

Therapist applies a problem-solving approach to assess activity and participation

Question 4

NDT involves an in-depth understanding of _ and _ _, and expertise in analysis of _ control, _, _, and _ throughout the lifespan

Answer 4

Understanding of typical and atypical development

Expertise in analysis of postural control, movement, activity and participation throughout the lifespan

Question 5

NDT is also known as the _ _. Developed by? _ was emphasized in the 1980’s

Answer 5

Aka: Bobath approach

Developed by Berta and Karl Bobath in the 1940’s

Function was emphasized in the 1980’s

Question 6

The contemporary NDT approach continues to _ with the emergence of new _, _, _ and information in the _ _.

Answer 6

Continues to evolve with the emergence of new theories, models, research and information in the movement sciences

Question 7

NDT: Promote efficient and effective _ and _, in order to minimize _ _ _ related to _ solutions.

Answer 7

Promote efficient and effective posture and movement

In order to minimize long term problems related to movement solutions

Question 8

NDT: uses _ _ of _ or _ (by manual contact) to guide and influence posture and movement to _ _ _.

Answer 8

Uses “key points of control” or “handling” to guid and influence posture and movement to enhance functional outcomes

Question 9

With a higher level of disability, use _ key points. With a lower level of disability, use _ key points. The _ you wish to _ also affects key points of control.

Answer 9

Higher level use= proximal key points
Lower level use= distal key points

The movements you wish to facilitate also affect key points of control that you use

Question 10

NDT handling: establish _ _ relative to task, apply principles of _ _ within task performance.

Answer 10

Establish biomechanical alignments relative to task

Apply principles of therapeutic exercise within task performance

Question 11

NDT handling: _ and _ _ to provide appropriate challenges, _ is on-going, and handling is _.

Answer 11

Grade and fade handling to provide appropriate challenges

Assessment is ongoing, and handling is modificied

Question 12

What are the 3 contemporary theories that influence NDT? _ oriented, with emphasis now on appreciating _ in _.

Answer 12

3 contemporary theories:

• Cognitive approach (Piaget)
• Information Processing
• Ecological approaches (environment)

Process oriented, with emphasis now on appreciating variability in development

Question 13

What 2 principles remain constant in NDT?

Answer 13

Movement observation and analysis are heavily relied upon to guide intervention

Handling is a critical tool used to positively influence posture and movement

Question 14

ABC’s of observation and analysis

Answer 14

Alignment of segments, Activation of muscles

Base of Support

Center of Mass, Center of Pressure

Direction of weight shift

Question 15

Task and context parameters: _ and - elements. Example: improving sitting posture

Answer 15

Essential and Non-essential elements

EX: improving sitting posture

• essential: pelvic adjustment
• non-essential: hand adjustment

Question 16

The body is _ system, look for relationships between? (2)

Answer 16

Body is a linked system

Look for relationship between:

• Limbs (UE/ LE, Left/ Right)
• Limbs and Trunk

Question 17

_ and _ must be in balance with _ and _

Answer 17

Stability and organization must be in balance with mobility and flexibility

Question 18

_ is part of normal development and postural control, and is essential for functional skill acquisition

Answer 18

Variability

Question 19

Variable and adaptable postural control facilitates _ through _, _ and _.

Answer 19

Facilitates exploration through movement, perception and action

Question 20

_ is the hallmark of normal development

Answer 20

Variability

Question 21

Efficient motor organization minimizes _ _

Answer 21

Energy expenditure

Question 22

Alignment dictates _ _

Answer 22

Synergistic activation

Question 23

3 Stages of skill acquisition in regards to degrees of freedom. Which stage is most important?

Answer 23

1degree: Freeze the degrees of freedoms (strategy used in order to compensate for lack of motor control)
2degree: Free the degrees of Freedom
3degree: Exploit passive forces to make muscular efforts more economical *most important stage

Question 24

CP is extremely variable and _.

Answer 24

Heterogenous

Question 25

_ _ are defined as the presence of behaviors that are not normally present. _ _ is the loss of normal abilities.

Answer 25

Positive symptoms- behavior that are NOT normally present Negative Symptoms- loss of normal abilities

Question 26

_ _ are the most amenable to therapy.

Answer 26

Negative symptoms

Question 27

What are the key primary impairments in cerebral palsy? (2)

Answer 27

Motor impairments Impaired postural control

Question 28

Comorbidities such as _ deficits, _ impairments and _ vary patient to patient and can influence _ function.

Answer 28

Such as sensory defecits, cognitive impairments and epilepsy vary patient to patient and can influence future function

Question 29

A _ _ is considered present at the onset of a condition. A _ _ emerges over time as a result of a _ _.

Answer 29

Primary impairment- present at the onset of a condition Secondary impairment- emerges over time as a result of primary impairment

Question 30

It is often difficult to differentiate _ and _ _ due to the complex nature of CP and _ _.

Answer 30

Difficult to differentiate primary and secondary impairments Complex nature of CP and early development

Question 31

Secondary impairments include: impaired _ and _ mobility, deformation of _, and decreased _ _ _, _ capacity, and _-_ reserve.

Answer 31

Impaired ROM and joint mobility Deformation of Bone Decreased bone mineral density, respiratory capacity and cardio-vascular reserve

Question 32

Atypical motor development: original problem- _ - _ patterns - _ and finally _. As much as possible what does PT try to prevent through interventions/ treatments?

Answer 32

``` Original problem - Compensations- Habit patterns - Deformities - Surgeries ``` We try to prevent surgeries as much as possible

Question 33

According to the systems theory motor behavior emerges dynamically due interaction between the _, the _ and the _.

Answer 33

Interaction between: | The task, the individual and the environment

Question 34

_ _ interact in order to produce _ _. Each system _ and_ at different points of time.

Answer 34

Multiple systems interact in order to produce motor behavior Each system develops and strengthens at different points of time

Question 35

Normally developing children take _ _ _, in order to _ _. Need to have an environment that _ _ and _ _

Answer 35

Normally develop children take lots of risks, in order to test limits. Need to have an environment that promotes exploration and risk taking

Question 36

3 tenets of neuronal group selection: _ development, _ and _ circuitry provides primary repertoire of _; _ and _ creates secondary repertoire of functional circuits selected and strengthened through _; _ and _ of multiple systems for movement determined by _ demands.

Answer 36

Brain development, genetics and neuronal circuitry provides primary repertoire of behaviors Experience and use create secondary repertoire of functional circuits selected and strengthened through use Interconnection and integration of multiple systems for movement determined by environmental demands

Question 37

_ _ _ is mandated for children ages 0-3 by the federal government.

Answer 37

Family focused care

Question 38

Intervention aims at improving _ _ to enhance _, capitalizes on _ and _, uses the _-_ model framework.

Answer 38

Improving functional skills to enhance participation, capitalizes on strengths and resources, uses WHO-ICF model framework

Question 39

Critical lifespan competencies accomplished during the first year of life: _ , _ posture, _, _ interaction and _ _ function, and _ care. Competency in these domains leads to?

Answer 39

Communication, upright posture, mobility, environmental interaction and upper extremity function, and self care Competency leads to greater real life function

Question 40

Intervention should focus on _ _ management.

Answer 40

Life time management

Question 41

_, _, and _ of intervention in the growing child depends on developmental _, changing life roles with _ and _. Should explain?

Answer 41

Timing, Frequency and duration of intervention in the growing child depends on: Developmental biomechanic,s, changing life roles with age and transitions. Should explain to family/ patient why treatment should end, but that they will be able to return during transitional years/ growth spurts.

Question 42

Intervention should support _ _ as early as possible, and promote _ activities with _ benefits. Examples? (2)

Answer 42

Should support inclusive opportunities as early as possible and promote leisure activities with therapeutic benefits ``` Hippo therapy (horse therapy) Aqua therapy ```

Question 43

Does every child need to crawl before they walk? Why?

Answer 43

No, walking and standing is more functional than crawling

Question 44

Dispelling myths- development doesn't always proceed: _ to _, _ to _, _ before _, and _ to _

Answer 44

Cephalo to caudal Proximal to distal Stability before mobility Gross to fine

Question 45

NDT focus on the _ and _ of participation, activation, and body function and structures.

Answer 45

Focuses on the What and How

Question 46

Developmental milestone attainment is not a _ _/ _

Answer 46

Not a functional test/ scale

Question 47

Functional goals are determined by the _ and _ _, are directed toward improving _ and reducing _ _, are _ appropriate, _ and _, are also informed by _ _ and the _.

Answer 47

Determined by client and their family Directed toward improving participation and reducing participation restrictions Are age appropriate, realistic and functional Are also informed by professional expertise and the literature

Question 48

3 parts of treatment that you can manipulate in order to meet functional goals

Answer 48

Key points of control used for handling Environmental set up Task and activity selection . . . Individual, task, and environment

Question 49

3 goals of posture and movement observation?

Answer 49

Observe and describe motor dsyfunction Identify consistencies in posture and movement Prioritize consistencies relative to functional goals/ identify those that significantly interfere with overall function/ goal attainment

Question 50

Should always establish a _-_ for each session. Includes establishing a _, assessing treatment _, assessment of _ _, measure of _ _ which influence task performance, test _ about the impairments that contribute to _ _.

Answer 50

Establish test-retest task/ measure for each session Includes: establishing a baseline, assessing treatment efficiency, assessment of motor learning, measure of qualitative changes which influence task performance, test hypothesis about the impairments that contribute to movement solutions

Question 51

Though _ is always used and is considered the gold standard it only looks at _ _ _ and has a _ _. _ is often better to assess patient.

Answer 51

GMFCS . . . Only looks at gross motor function and has a low ceiling PEDI (pediatric evaluation disability inventory) is often better to assess patient.

Question 52

Functional classification systems used for children with CP? (5) All are scaled?

Answer 52

MEG from BC - Manual ability classification system (MACS) - eating and drinking classification system (EADCS) - Gross motor function classification system (GMFCS) - bi-manual fine motor function (BMFM) - Communication function classification system (CFCS) All are scaled 1-5, most independent to least independent

Question 53

What are the 5 steps in the evidence based practice process?

Answer 53

``` Assess the patient Ask the question (PICO) Acquire the evidence Appraise the evidence (validity) and applicability (clinical usefulness) Apply to patient ```

Question 54

What does PICO stand for?

Answer 54

Patient Intervention Comparison Outcome

Question 55

What is the only functional classification system that uses a 1-6 level scale that begins with the most independent to least independent

Answer 55

Functional mobility scale