Neural Developmental Therapy and its importance in Neuro Rehabilitation

                               Neurodevelopmental treatment (NDT) is a hands-on treatment approach used by physical therapists, occupational therapists, and speech-language pathologists. ... Without NDT interventions, the patient likely will develop a limited set of movement patterns that he or she will apply to nearly all tasks.

                               Before one hundred years before, If someone having delayed milestone , cerebral palsy, or some other neuro-anomalies kids, they were thinking that there is no other chance to rehabilitate them in a  correct way. But this century, we developed in many ways in rehabilitation approach too,along with other scientific growth. One of the most important Therapy to rehabilitate these children is NDT, we can apply this approach to stroke patient also to get speedy recovery.

                              Neuro developmental therapy is a non-invasive programme of movements which aims to promote development of the nervous system and the inhibition of primitive reflexes.  By incorporating movements which are used naturally by a baby and a young child, the nervous system is gently encouraged to mature and become more open to learning.  

                              During the Therapy, your child will have a set of specific movements which are performed every day for approximately 5-10 minutes.  Each programme is specifically designed for the needs of each child and will evolve as the programme progresses.  Both you and your child are guided by your therapist through the full programme and she/he will review progress with you both at regular intervals. 

CONCEPT OF NDT:

                             NDT is an approach to neurological physio rehabilitation that is applied in patient assessment and treatment (such as with adults after cerebrovascular accident (stroke), or children with  cerebral palsy ). The goal of applying the Bobath concept is to promote motor learning for efficient motor control in various environments, thereby improving participation and function. This is done through specific patient handling skills to guide patients through initiation and completion of intended tasks.This approach to neurological rehabilitation is multidisciplinary, primarily involving physiotherapists, occupational therapists and speech and language therapists. In the United States, the Bobath concept is also known as 'neuro-developmental treatment' (NDT).

Types of NDT:

1. Bobath approach is a problem-solving neurodevelopmental(NDT) approach for assessment and treatment of individuals with cerebral palsy and other allied neurological conditions.It is named after Berta Bobath, a physiotherapist, and her husband Karel, a psychiatrist/neurophysiologist. 

2. The Brunnstrom approach is a type of physiotherapy treatment used with patients with movement problems following damage to the brain and spinal cord, (central nervous system/ CNS).

3. The Rood Approach for the treatment of central nervous system disorders was developed by Margaret Rood in the 1950s. Rood's technique can be categorized as one of facilitation and inhibition of movement.

4. Vojta Therapy. According to Vojta, reflex locomotion is activated from the three main positions: prone, supine and side lying. To stimulate the patterns of movement, there are—as described by Vojta—ten available zones on the body and on the arms and legs.

Physiotherapists focuses while applying NDT are,

                            Firstly physiotherapists focuses on Short and long term goal settings as well as give activities to do daily activities ( bathing, carrying , sleeping positions etc). Physiotherapists are assisting to reach the milestones( rolling, sitting etc). Some activities should be functional and aim to maintain optimal muscle length, improve muscle . They are focusing as well on strength and coordination, assist with balance, stability as well as mobility.

Assistive devices such as walking aids, foot or hand orthoses, may assist with gaining independence.