Neuro-developmental treatment: a guide to NDT clinical practice

578 Pages·2016·21.43 MB·English

by  Bierman

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Neuro-Developmental Treatment
A Guide to NDT Clinical Practice
Judith C. Bierman, PT, DPT, C/NDT Cathy M. Hazzard, BSc, MBA, PT, C/NDT
Clinical Director and Physical Therapist Physiotherapist
NDT Programs, Inc. Bowser, British Columbia, Canada
Adjunct Instructor NDTA Coordinator Instructor
Augusta University Neuro-Developmental Treatment
Augusta, Georgia, USA Association (NDTA)
NDTA Coordinator Instructor Laguna Beach, California, USA
Neuro-Developmental Treatment
Association (NDTA)
Janet M. Howle, PT, MACT, C/NDT
Laguna Beach, California, USA
Physical Therapist-Pediatrics
Chapel Hill, North Carolina, USA
Mary Rose Franjoine, PT, DPT, MS, PCS, C/NDT
Physical Therapist-Pediatric Clinical Specialist
Marcia Stamer, PT, MH, C/NDT
Associate Professor
Physical Therapist
Department of Physical Therapy
Adjunct Instructor
Daemen College
Stark State College
Amherst, New York, USA
North Canton, Ohio, USA
NDTA Coordinator Instructor
Editor of NDTA Network
Neuro-Developmental Treatment
Neuro-Developmental Treatment
Association (NDTA)
Association (NDTA)
Laguna Beach, California, USA
Laguna Beach, California, USA
287 illustrations
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Contents
Media Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvi
Special Acknowledgment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvii
Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xviii
Unit I: Neuro-Developmental Treatment Philosophy, Theoretical Assumptions, and Models
Supporting Clinical Practice
Introduction (by Judith C. Bierman) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
1 Neuro-Developmental Treatment: Defi nitions and Philosophical Foundations . . . . . . . . . . 4
Judith C. Bierman
1.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 1.3.1 Summary of Philosophical Tenets . . . . . . . . . . . . 5
1.2 NDT Defi ned . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 1.4 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
1.3 Philosophical Tenets of NDT . . . . . . . . . . . . . . . 4
2 Neuro-Developmental Treatment Practice Theory Assumptions and Principles:
An Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Judith C. Bierman
2.1 O rganizing Problem 2.2 NDT Practice Theory . . . . . . . . . . . . . . . . . . . . . 18
Solving for Clinical Practice . . . . . . . . . . . . . . . 17 2.2.1 How Do People Function? . . . . . . . . . . . . . . . . . . 18
2.1.1 Shaping Clinical Practice through Hypothesis 2.2.2 What Goes Wrong? . . . . . . . . . . . . . . . . . . . . . . . 23
Generation, Theories, Assumptions, 2.2.3 How Can We Provide Eff ective Intervention? . . . 24
and Principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 2.3 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
3 Neuro-Developmental Treatment Practice and the ICF Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Judith C. Bierman
3.1 The ICF Model of Health and Disability . . . . . . 27 3.2 The ICF Model from an NDT Perspective . . . . 32
3.1.1 Social Function (Participation and Participation 3.2.1 The Social and Individual Functioning Domains
Restriction) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 from an NDT Perspective . . . . . . . . . . . . . . . . . . . 33
3.1.2 Individual Function (Activities and Activity 3.2.2 The Role of Body Structure and Function from
Limitations) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 an NDT Perspective . . . . . . . . . . . . . . . . . . . . . . . 33
3.1.3 Body Function and Structures (Integrities and 3.2.3 The Role of Contextual Factors from an NDT
Impairments) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
3.1.4 Contextual Factors . . . . . . . . . . . . . . . . . . . . . . . . 32 3.2.4 The Role of NDT Practice . . . . . . . . . . . . . . . . . . . 36
3.1.5 Interaction of Concepts . . . . . . . . . . . . . . . . . . . . 32 3.3 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
4 Application of a Posture and Movement Model in Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Shirley A. Stockmeyer
4.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 4.3 F ormulating Therapeutic Principles from
4.2 A Posture and Movement Model . . . . . . . . . . . 39 Basic Information . . . . . . . . . . . . . . . . . . . . . . . . 47
4.2.1 General Concepts . . . . . . . . . . . . . . . . . . . . . . . . . 39 4.3.1 Summary of Therapeutic Principles That Guide
4.2.2 Distinct Roles of Subsystems . . . . . . . . . . . . . . . . 39 the Initial Intervention for Postural
4.2.3 The Anatomical Basis for the Posture and System Weakness . . . . . . . . . . . . . . . . . . . . . . . . . 47
Movement Model . . . . . . . . . . . . . . . . . . . . . . . . . 40
4.2.4 Physiological Basis for the Posture and
Movement Model . . . . . . . . . . . . . . . . . . . . . . . . . 45
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Contents
4.3.2 Summary of Therapeutic Principles for 4.3.4 Summary of Therapeutic Principles for
Progression of Strengthening in the Postural Progression of Strengthening in the
System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 Movement System . . . . . . . . . . . . . . . . . . . . . . . . 50
4.3.3 Summary of Therapeutic Principles That Guide 4.3.5 Summary of Therapeutic Principles for Activities
the Initial Intervention for Weakness in the Requiring the Integration of the Posture and
Movement System . . . . . . . . . . . . . . . . . . . . . . . . 49 Movement Systems . . . . . . . . . . . . . . . . . . . . . . . 51
4.4 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Unit II: Clinical Practice Using the Neuro-Developmental Treatment Practice Model
Introduction (by Marcia Stamer) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
5 Neuro-Developmental Treatment Practice Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Marcia Stamer
5.1 What Is a Practice Model? . . . . . . . . . . . . . . . . 56 5.4.1 The NDT Practice Model: Overview . . . . . . . . . . 58
5.2 The NDT Practice Model and Theories That 5.4.2 The NDT Practice Model: Information Gathering . 58
Support It . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 5.4.3 The NDT Practice Model: Examination . . . . . . . . 59
5.4.4 The NDT Practice Model: Evaluation . . . . . . . . . . 61
5.3 Current Descriptive Knowledge Used in
5.4.5 The NDT Practice Model: Intervention . . . . . . . . 66
NDT Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
5.5 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
5.4 Procedural Knowledge Used in NDT Practice . . . 58
6 Information Gathering . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Marcia Stamer
6.1 Information Gathering U sing the NDT 6.1.7 Knowledge and Experience Health Conditions . . 72
Practice Model . . . . . . . . . . . . . . . . . . . . . . . . . . 69 6.1.8 Knowledge of Life Span Skill Development . . . . 72
6.1.1 Building Trust . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 6.1.9 Knowledge of Family and Societal Infl uences . . 72
6.1.2 Establishing Communication . . . . . . . . . . . . . . . 70 6.1.10 Knowledge of Human Behavior . . . . . . . . . . . . . . 72
6.1.3 A Typical Day . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 6.1.11 Knowledge of Learning Styles . . . . . . . . . . . . . . . 72
6.1.4 Knowledge of the NDT Philosophy . . . . . . . . . . . 71 6.1.12 Skilled Observation . . . . . . . . . . . . . . . . . . . . . . . 72
6.1.5 Knowledge of Basic and Applied Sciences . . . . . 72 6.2 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
6.1.6 Knowledge of a Model of Human Functioning . 72
7 Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
Marcia Stamer
7.1 E xamination Using the Neuro-Developmental 7.1.6 Identifying Other Multisystem Body Functions:
Treatment Practice Model . . . . . . . . . . . . . . . . . 74 The Interaction of System Integrities and
7.1.1 The Purpose of Examination . . . . . . . . . . . . . . . . 75 Impairments within the Context of Participation
7.1.2 The Roles of the Clinician and Client/Family in and Activity—Two Examples . . . . . . . . . . . . . . . . 87
Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 7.1.7 Examining Single-System Body Structures and
7.1.3 Examination: An Overview . . . . . . . . . . . . . . . . . 75 Functions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
7.1.4 How Does the NDT Clinician Examine Posture 7.2 NDT Practice Model in Action . . . . . . . . . . . . . . 112
and Movement? . . . . . . . . . . . . . . . . . . . . . . . . . . 86
7.3 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
7.1.5 Identifying Ineff ective Postures and Movements . 87
8 Evaluation and Developing the Plan of Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119
Marcia Stamer
8.1 E valuation Using the Neuro-Developmental 8.1.4 Developing the Plan of Care . . . . . . . . . . . . . . . . 132
Treatment Practice Model . . . . . . . . . . . . . . . . . 119 8.2 M entoring Students’ and Novice Clinicians’
8.1.1 Evaluation Requires a Framework . . . . . . . . . . . . 120 Problem-Solving Activities . . . . . . . . . . . . . . . . 139
8.1.2 What Do We Already Know about How Clinicians
8.3 Writing Outcomes for Clinical Practice and
Evaluate and Treat? . . . . . . . . . . . . . . . . . . . . . . . 120
Statistical Analysis . . . . . . . . . . . . . . . . . . . . . . . 145
8.1.3 A System for Evaluation Using the NDT Practice
8.4 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
Model: The Problem-Solving Process . . . . . . . . . 121
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Contents
9 Neuro-Developmental Treatment Intervention—A S ession View . . . . . . . . . . . . . . . . . . . . . . . . . 150
Judith C. Bierman, Mary Rose Franjoine, Cathy M. Hazzard, Janet M. Howle, Marcia Stamer, Jane Styer-Acevedo,
and Jan McElroy
9.1 I ntervention Using the Neuro-Developmental 9.3.2 Pediatric Considerations for Progression of
Treatment Practice Model . . . . . . . . . . . . . . . . . 150 Limb Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186
9.1.1 Components of an Intervention Session . . . . . . 150 9.3.3 Mitigating the Demands of Gravity . . . . . . . . . . 186
9.1.2 Bridges to the Next Intervention Session— 9.3.4 Ideas to Address the Variations of Weakness
Achievement or Failure to Achieve the Session Impairments in Muscles . . . . . . . . . . . . . . . . . . . . 186
Outcome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173 9.3.5 Dimensions for Modulating and Varying the
9.1.3 Additional Responsibilities in and between Level of Challenge . . . . . . . . . . . . . . . . . . . . . . . . 187
Intervention Sessions . . . . . . . . . . . . . . . . . . . . . . 173 9.3.6 Changes to the Base of Support to Increase
9.2 S ummary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180 Challenge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188
9.3 A Collection of Intervention Strategies and 9.3.7 Gaining Soft Tissue Length . . . . . . . . . . . . . . . . . 188
Frameworks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180 9.3.8 Concepts in Pediatric
9.3.1 Considerations for Progression of Limb Control Core Stability . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
in Adult Clients Post–Acquired Brain Injury . . . . 180
10 Cerebral Palsy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192
Marcia Stamer
10.1 W hat Is Cerebral Palsy? . . . . . . . . . . . . . . . . . . . 192 10.1.5 A General Description of Children with
10.1.1 Types and Timing of Pathologies That Can Dyskinetic Cerebral Palsy . . . . . . . . . . . . . . . . . . . 206
Cause Cerebral Palsy . . . . . . . . . . . . . . . . . . . . . . 193 10.1.6 A General Description of Children with Ataxic
10.1.2 Classifi cation of Cerebral Palsy by Body Cerebral Palsy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Distribution and Characteristics of Posture 10.1.7 Children with Mixed Types of Cerebral Palsy . . . 213
and Movement . . . . . . . . . . . . . . . . . . . . . . . . . . . 194 10.1.8 Neuro-D evelopmental T reatment Practice
10.1.3 Classifi cation of Cerebral P alsy for the Clinician . . 195 and Classifi cation of Cerebral Palsy . . . . . . . . . . . 214
10.1.4 A General Description of Children with Spastic 10.1.9 Cerebral Palsy across the Life Span . . . . . . . . . . . 215
Cerebral Palsy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196
11 N euro-Developmental Treatment Assumptions of Motor Dysfunction:
Stroke and Adult-Onset Hemiplegia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219
Cathy M. Hazzard and Karen Brunton
11.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219 11.2.1 Classifi cation of Stroke . . . . . . . . . . . . . . . . . . . . . 219
11.2 What Is Stroke? . . . . . . . . . . . . . . . . . . . . . . . . . . 219 11.3 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241
Unit III: Theoretical Framework for Neuro-Developmental Treatment Practice
Introduction (by Janet M. Howle) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247
12 Motor Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248
Janet M. Howle
12.1 What Is Motor Control? . . . . . . . . . . . . . . . . . . . 248 12.1.5 Developing Movement Competency . . . . . . . . . 251
12.1.1 Changing Theories of Motor Control . . . . . . . . . 248 12.1.6 Theory of Neuronal Group Selection . . . . . . . . . 251
12.1.2 How Do These Theories Relate to Clinical 12.1.7 How Does the Idea of Individual Diversity
Practice? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249 Support NDT? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251
12.1.3 Models of Motor Control That Emphasize 12.1.8 Three Tenets of the Theory of Neuronal Group
Dynamical Interplay between the Brain, Body, Selection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 252
and Environment . . . . . . . . . . . . . . . . . . . . . . . . . 250 12.1.9 Dynamic Systems Theory . . . . . . . . . . . . . . . . . . 257
12.1.4 NDT Assumptions of Motor Control . . . . . . . . . . 250 12.2 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 261
13 Motor Learning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 263
Janet M. Howle
13.1 What Is Motor Learning? . . . . . . . . . . . . . . . . . 263 13.1.3 Planning an Eff ective Motor Learning
13.1.1 Neuro-Developmental Treatment Assumptions Experience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264
in Motor Learning . . . . . . . . . . . . . . . . . . . . . . . . . 264 13.1.4 How Do These Concepts of Motor Learning
13.1.2 Diff erentiating Motor Learning from Motor Impact NDT Practice? . . . . . . . . . . . . . . . . . . . . . . 266
Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264 13.1.5 Practice in Motor Learning . . . . . . . . . . . . . . . . . . 266
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13.1.6 Scheduling Practice . . . . . . . . . . . . . . . . . . . . . . . 268 13.1.9 Importance of the Environment . . . . . . . . . . . . . 271
13.1.7 Frequency and Intensity . . . . . . . . . . . . . . . . . . . 269 13.2 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273
13.1.8 Feedback . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 270
14 Motor Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277
Janet M. Howle
14.1 Motor Development as a Lifelong Process . . . 277 14.3.2 Directionality . . . . . . . . . . . . . . . . . . . . . . . . . . . . 278
14.1.1 Changes in Thinking about Motor Development . 278 14.3.3 What Supports the Progression of Motor
14.2 NDT Assumptions in M otor Development . . . 278 Development? . . . . . . . . . . . . . . . . . . . . . . . . . . . 281
14.3 C ontemporary Principles in Motor 14.4 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291
Development That Support NDT Practice . . . 278
14.3.1 Stages of Motor Development . . . . . . . . . . . . . . 278
15 Neuroplasticity and Recovery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 294
Gay L. Girolami and Takako Shiratori
15.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 294 15.4.2 Injuries to the Somatosensory System . . . . . . . . 297
15.2 How Is Plasticity Studied? . . . . . . . . . . . . . . . . . 295 15.5 Applying Concepts of Neuroplasticity to
15.3 Plasticity: Adaptive and Developmental. . . . . 295 Adults and Children . . . . . . . . . . . . . . . . . . . . . . 297
15.3.1 Adaptive Plasticity . . . . . . . . . . . . . . . . . . . . . . . . 295 15.5.1 Concepts Applied to Adults . . . . . . . . . . . . . . . . . 297
15.3.2 Developmental Plasticity . . . . . . . . . . . . . . . . . . . 296 15.5.2 Concepts Applied to Infants and Children . . . . . 300
15.4 Neurophysiology of Brain Injuries in Infants . 296 15.6 F inal Thoughts: Recovery versus
15.4.1 Injuries to the Developing Motor System— Compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . 301
Corticospinal Projections . . . . . . . . . . . . . . . . . . . 296 15.7 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 302
Unit IV: The Neuro-Developmental Treatment Team within the Practice Model:
Interdisciplinary Care
Introduction (by Cathy M. Hazzard) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307
16 T he Practice of Occupational Therapy from a N euro-Developmental Treatment
Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 308
Kim Barthel, Chris Cayo, Kris Gellert, and Beth Tarduno
16.1 The Occupational Therapy Profession . . . . . . . 308 16.2.6 Examining, Evaluating, and Intervention with
16.2 O ccupational Therapy and Neuro- Attention and Higher Cognitive Skills . . . . . . . . . 318
Developmental T reatment . . . . . . . . . . . . . . . . 308 16.2.7 Examining, Evaluating, and Intervention with
16.2.1 Task Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 310 Emotional and Social Skills . . . . . . . . . . . . . . . . . 320
16.2.2 Examining, Evaluating, and Intervention of 16.2.8 Identifying Activities of Daily Living and Their
Sensory Processing for Function . . . . . . . . . . . . . 312 Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 321
16.2.3 The Sensory Systems and Oral Skills . . . . . . . . . . 316 16.2.9 Focusing on Play, Work, and Leisure . . . . . . . . . . 322
16.2.4 Examining, Evaluating, and Intervention with 16.3 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 323
Multisystem Praxis . . . . . . . . . . . . . . . . . . . . . . . . 317
16.2.5 Examining, Evaluating, and Intervention with
Physiological Arousal . . . . . . . . . . . . . . . . . . . . . . 317
17 T he Practice of Physical Therapy from a Neuro- Developmental Treatment
Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 325
Cathy M. Hazzard and Marcia Stamer
17.1 D efi nition of Physical Therapy 17.3 E xpertise and C ontributions of Physical
(Physiotherapy) . . . . . . . . . . . . . . . . . . . . . . . . . 325 Therapists to NDT Practice . . . . . . . . . . . . . . . . 326
17.2 A Brief History of P hysical Therapy 17.4 T he Contributions of NDT to
and the O rigins of Neuro-Developmental Physical Therapy . . . . . . . . . . . . . . . . . . . . . . . . . 326
Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 325 17.4.1 Problem-Solving of the Physical Therapist
Using the NDT Practice Model: A Child with
Cerebral Palsy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327
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