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Margaret Rood
- Motor development- designs of movement
- -mobility,stability,controlled mobility, skill
- Sensory stimulation-facilitation or inhibition
- -phasic - pertaining to movement
- -quick stretch, light touch,tapping,traction
- -tonic-holding,stationary,stability
- -approximation,joint compression
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Neurodevelopmental Technique was developed by? (NDT)
- Berta Bobath-for tx of CP and adult hemiplegia (ATNR,STNR)
- - Release of (primitive)abnorma postural reflexes that inhibit righting and equilibrium reactions(stuck in reflex, wont have primitive)
- - Achieve a balance between muscle groups, decrease the effects of abnormal tone
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Neurodevelopment Con't
Based on development sequence (POE,tall kneeling)
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Primary tx principles
- -Change abnormal patterns of movement with dynamic reflex inhibiting patterns
- -Use key points of control- neck,spine,shoulders,pelvis,toes and ankles, fingers and wrists
- -Achieve a balance between muscle groups, decrease effects of abnormal tone
- - practice outside of abnormal synergies
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NDT Principles
- -Practice (repetition) movement out of obligatory tendencies
- -Body on limb before limb on body(prox before distal movement)
- -Tone is usaully mixed, not flaccid or spactic
- -Movement pattern versus individual muscle strenghthening
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NDT Principles Con't
- -Address alignment of trunk and limbs to promote more normal movement (can't superimpose normal movement over malaligned joints)
- - Work toward symmetrical postures in all planes to increse midline orientation
- -incorporate involved side in all activities
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Functional Outcomes
- -Control a posture (stability)
- -Postural adjustment (controlled mobility)-wt shifting
- -Transition-changing the BOS
- -Active support of the limbs (controlled mobility)
- -Use of limbs for reach (skill)
- -Hand and foot manipulation (skill)
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Brunnstrom Principles
- -Synergies-Fx movement pattern based on heirarchical model
- -Cutaneous sensory stimulation and resisted muscle contractions for overflow to recruit involved musculature
- -Encourage limb synergy early in recovery
- -Use of selected primitive postural reflexes to elicit voluntary movement
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Synergies
- -PNF- normal synergy movement
- -CNS links muscles into functional patterns, basic organizational units for movement and posture
- -motor pattern-postural or movement pattern within the CNS
- -can be normal or abnormal
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Motor Behavior
Basic limb synergies
- UE Flexion-scap retraction/elevation, ER, abd 90*, elbow flexion, supination, wrist and finger flexion
- UE Extension- protraction, IR, add, elbow ext, pronation
- LE Flexion-hip flex, abd and ER, knee flex 90*, DF, inv, toe ext
- LE Extension-pelvic retraction, hip ext, add and IR, knee ext, PF and inv, toe flex -interaction of synergies
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PNF
- -Kabat, Knott and Voss
- - based on hieratchical model
- -strengthen muscles in mass movement patterns in which they were designed to function
- (spiral and diagonal, cross midline)
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PNF techniques
- two diagonal patterns for each body part (flex/ext) including rotational movement and movement across midline
- -SR,AR,RI,HR,CR,RS
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