1. Bobath or NDT Approach to The Treatment of Adults with hemiplegia

2. Contents Introduction History Definition NDT Philosophy
Key Theoretical Statements
Assessment
NDT Principles
NDT Handling Techniques
NDT of Adults with hemiplegia
Effectiveness

3. Introduction
Karel Bobath and Berta Bobath developed Bobath or Neurodevelopment Treatment (NDT) Approach to restoring normal movements and eliminating abnormal movements in children with cerebral palsy and adults with acquired hemiplegia.

4. History 1940 – They began to develop NDT approach.
Berta Bobath discovered NDT Approach.
Karel Bobath presented scientific rationale in hypothetical terms of NDT.
They died in 1990.
NDTA in US and organizations of other countries have been working to update the theoretical basis for NDT.

5. Definition
The Bobath concept is a problem solving approach to the treatment and assessment of individuals with disturbance of function, movement and postural control due to lesion of the CNS.

6. NDT Philosophy Living concept. Problem solving approach.
Involves the assessment and treatment of movement dysfunction in individuals with CNS pathophysiology.
Goal of assessment and treatment is the enhencement of individuals capacity to function.

7. Key Theoretical Statements
Organization of motor behavior.
Motor control.
Movement dysfunction.
Neural plasticity.

8. Assessment Identify abilities and functional capabilities.
Identify functional limitations.
Determine what problems interfere with movement control and functional performance.
Establish functional goals and treatment goals.

9. NDT Principles Treatment should
Avoid movements and activities that increase abnormal muscle tone in the involved side.
Be directed towards the development of normal patterns of posture and movement.
Increase functional use of the hemiplegic side.
Produce a change in the quality of movement and functional performance of the hemiplegic side.

10. NDT Handling Techniques
Uses of inhibition techniques.
Uses of facilitation techniques.

11. NDT of Adults with Hemiplegia
Flaccid stage.
Spastic stage.
Recovery stage.

12. Effectiveness
Though it’s a familiar approach but theoretical explanation given by K Bobath is now in debate.
Results of recent research (Done in 2004) show that NDT approach was not found effective in the care of stroke patients in the hospital setting.