Theories

Question 1

NDT

Answer 1

neurodevelopment treatment approach “bobath”

• to address postural control and movement as patients attempted anti-gravity mvmts.
• treating neurological deficiencies, esp CP and stroke
• motor function can be improved by reducing abnormal movements or reflex patterns
• once ab. normal mvmts are modified, normal automatic mvmts such as righting and equilibrium reactions can be developed.
• bobath focuses on sensory-motor relationship of not only “doing” an action, but feeling the sensation of mvmt.
• focuses on tone and how it affects movement
• looks at how to position prix body parts to influence mvmt changes distally.
• positioning is a key concept in bobath treatment because proper positing helps to improve a person;s movements.

Question 2

Brunnstrom

Answer 2

• Brunnstrom approach looks at the nervous system from a hierarchical viewpoint.
• Created to work on movement during the rehabilitation of hemiplegic patients who have suffered from a chronic or acute stroke.
• By eliciting certain movements the CNS can avert back to purposeful movements.
• Brunnstrom uses synergies to encourage combinations of movement patterns.
• The approach uses flexor synergies first and then extensor synergies to activate the muscles in rehab to encourage normal voluntary movement.

Stages of recovery for arm

1. flaccidity -no voluntary mvnt
2. synergies (reflexively)- flexion before extension; increased spasticity
3. beg. voluntary mvnt- only in synergy, increase spasticity
4. some mvnts from synergy- hand behind back, arm in forward horizontal position, pro/sup with elbow flexed in 90
5. Indep. from basic synergies- arm to side horizontal, arm over head, pro/sup with elbow extended
6. isolated joint mvtnt.

Stages for hand:

1. flaccidity
2. little or not active finger flex.
3. mass grasp or hook grasp- no voluntary finger extension or release
4. semi-voluntary finger extension - later prehension with release by thumb
5. palmar prehension- cylindrical and spherical, voluntary mass finger extension
6. all types of prehension- voluntary finger extension, individual finger mvnt.

Stages start at basic reflex activity and progress toward more complex voluntary mvnt. From there we are able to use mvnt. functionally in treatment.