1. NDT Perspective Posture and Movement Body Systems
Functional Activities

2. Function Gross Motor Fine Motor Oral Motor ADL Communication Look For
Functional Activities
Functional Limitations.

3. Posture And Movement

4. Postural System
Alignment

5. Postural System
BOS / COM

6. Postural System BOS/COM BOS: Definition. Bigger/Smaller BOS.
COM/COG: Definition.
Normal Position.
Change of COM during movement.
Control of changing COM over the changing BOS.

7. Anticipation & Counter-balance
Postural System
Anticipation & Counter-balance
Anticipation is not cognitive, but neurological.

8. Movement System
Inertia

9. Movement Strategies
Plane of Movement
Saggital
Frontal
Transverse

10. Movement Characteristics
Range of Motion
Speed

11. Strategies used for Stability/Mobility
Muscle Synergies.
“Freeze out mobility in order to achieve stability.”

12. Integration of Posture & Movement
All the body parts have both Postural & Movement characteristics.
We need integration of posture and movement in order to achieve:
Balance
Transition
Accuracy
Efficiency

13. Individual Body Systems

14. Body Systems Regulatory System The state of arousal.
Can the child Self regulate?
Sudden or gradual change in the regulation.

15. Regulatory System
Limbic System.
Autonomic Nervous System.

16. Musculo-Skeletal System
Body Systems
Musculo-Skeletal System
Range of Motion.
Strength:
In pattern.
Isolated.
Strength is probably not the primary impairment, but it could be a profound secondary impairment.

17. Musculo-Skeletal System

18. Neuro-Muscular System
Body Systems
Neuro-Muscular System
Ability to
Sustain
Initiate
Sustain
Terminate

19. Neuro-Muscular System
Selective Recruitment of:
Postural Motor Units Vs
Movement Motor Units.

20. Neuro-Muscular System
Ability to perform:
Concentric
Isometric
Eccentric
Muscle work.
Eccentric is the 1st affected in cerebral palsy.
The role of Gamma MN/Ms Spindle.

21. Neuro-Muscular System
Recruitment of
Co-contraction Vs
Reciprocal Inhibition.
Sometimes we need co-contraction proximally & R.I. distally or vice versa.
Importance in Postural & Movt. System.
The role of M.S./GTO.

22. Neuro-Muscular System
Synergy Selectivity:
MASSED
I S O L A T E D
Isolated, fractionated movements.
Gives us disassociation.
Repertoire of Movement.
The Hallmark of Normal Movement.

23. Neuro-Muscular System
Stiffness
E.g., Spring.
Control & Co-ordination of stiffness.

24. Neuro-Muscular System
Extraneous Movements
Tremors
Clonus
Nystagmus
Chorea movements.
Damping.
Probably based on myelination of the nerves.
Probably CB/BG is also very important.

25. Body Systems Sensory Systems VISION SOMATO-SENSORY SYSTEM
VESTIBULAR SYSTEM
AUDITORY SYSTEM
TASTE & SMELL

26. Vision Primary sensory system for Postural control. Focal Vision.
Ambient Vision.
Posture & Movement both are affected by vision.
Visual System is adaptive, more so under the age of 4.

27. Somato-Sensory System
Provides awareness.
The receptors are Muscle & Joint receptors.
The joint receptors get mature & sensitive with compression of 2 bones.

29. Vestibular System Head Position, Head Movement.
Movement of body in space & in relation to gravity.
Works between the Visual & Somato-sensory systems.

30. The integration of VISION, SOMATO-SENSORY & VESTIBULAR Systems helps to get awareness of the relationship of
One body part to another,
Body with object,
Body with space, &
Body in relation to gravity.

31. Auditory System Starts functioning in utero. We may develop asymmetry.
Auditory processing.
May have associated vestibular system problems also.

32. Taste & Smell Orientation may be based on taste & smell.
Infants do early bonding through smell.
Infant as old as 10 days can identify a beaker of mother’s milk from across a room.

33. CARDIO VASCULAR SYSTEM
Body Systems
CARDIO VASCULAR SYSTEM
Blood circulation to distal parts.
Children may bite/hit self.
Thus, CV system may affect the movement.

34. Body Systems RESPIRATORY SYSTEM
How does the child breath? e.g. Post. Breathing.
Look at ribcage mobility.
Get stability by breath holding.
Freedom to breath with mobility.
Diaphragm as a postural ms to get stability rather than a respiratory ms.

35. Body Systems
Respiratory System

36. GASTRO-INTESTINAL SYSTEM
Body Systems
GASTRO-INTESTINAL SYSTEM
Issues of reflux are important- may be misunderstood as opisthotonos.
Facilitation can lead to reflux.
Issue of Constipation.

37. Body Systems
SKIN
Color
Extensibility.
Thickness.
Rashes/wounds.

38. Masoom Physiotherapy Clinic 204, 3rd Floor, Surgicare, Sardar Patel Colony, Naranpura. Ph: M: