Julia Rei Ilagan - incorporated the Nagi Disablement Model

into its conceptual framework of physical

BSPT III
therapy practice
The role of the Physical Therapist
Topic 1: Introduction to
Neurodevelopmental Techniques Physical Therapy - "provide services to
patients/clients who have impairments,
functional limitations, disabilities, or changes
The practice of physical therapy in in physical function and health status
the United States continues to change to resulting from injury, disease, or other
meet the increase demands placed on causes"
service provision by managed care and
-Resposible for examining the pt. and
federal regulations
developing a plan of care that meets the
goals and functional expectations of the pt.
(Sullivan)
Saad Nagi- sociologist; developed a model
of health status that is used to describe the Roles:
relationship between health and function
 Diagnosis
4 components: o Interpret evaluation
examination data
 Disease - defined as a pathologic o Organize data into defined
state manifested by the presence of clusters, syndromes, or
signs and symptoms that disrupt an categories
individual's homeostasis or internal o Determine prognosis and
balance plan of care
 Impairments – alterations in o Plan the most appropriate
anatomic, physiologic, or psychologic intervention strategies
structures or functions  Prognosis
 functional limitations - occur as a o Determine level of optimal
result of impairments and become improvement expected from
evident when an individual is unable interventions
to perform everyday activities that are o Assess amount of time
considered part of the person's daily required to reach optimal
routine improvement level
 disability – results when functional o Document plan of café
limitations become so great that the specifying the interventions to
person is unable to meet age-specific be used, timing and fx
expectations within the social or  Intervention
physical environment o Apply purposeful and skilled
interaction w the pt./clients
and if appropriate with other
Guide to Physical Therapist Practice individuls involved in the pt./
clients care
o Reexamine pt/client status to
determine changes in statsus
Reference:
Braddom, Randall, Physical Medicine and Rehabilitation,
DeLisa, Joel, Physical Medicine and Rehabilitation
O’Sullivan, Susan and Schmitz, Thomas, Physical Rehabilitation
 and to modify or direct
intervention
 Outcomes
o Results of pt/client
managemenr, which include
the impact of physical therapy
interventions in the ff domains
 Examination
o Obtain a history
o Perform a systems review
o Identify problems that require
consultation w or referral to
another provide
 Evaluation
o Utilize this dynamic process
to male clinical judgements
based on data gathered
during the pt/client
examination
Neurodevelopmental treatment approach
Karl and Berta Bobath (1940’s)
-common intervention for hemiplegia
-also work w CP
-children had gross and fine motor
delays, abnormal tone and
movement, and primitive reflexes
-they nproposed that the children’s
movements were elicited stimulu
and primitive reflexes that resulted in
their abnormal movement patterns
-goal was to inhibit abnormal postural reflex
activity and movements and to facilitate
normal motor patterns including head and
trunk control, UE support and balance
reaction
Motor control and learning
Reference:
Braddom, Randall, Physical Medicine and Rehabilitation,
DeLisa, Joel, Physical Medicine and Rehabilitation
O’Sullivan, Susan and Schmitz, Thomas, Physical Rehabilitation
-motor abilities and skills acquired during the
process of motor dev thru motor control and
motor learning
-once a basic pattern of movement is
established
-Motor development is the result of the
interaction of the innate or built-in species
blueprint for postire and movement and the
person’s expi w moving afforded by the
environment
-sensory input is needed for the move to
learn about moving and the result of moving
- it is also the combination of of the nature
of the mover and the nurture of the
environment
MOTOR CONTROL
-the ability to maintain and change posture
and movement
-the result of a complex set of neurologic and
mechanical processes (motor, cognitive and
perceptual development)
-allows the NS to direct what ms should be
used in what order and how quickly, to solve
a movement problem
-infant’s first movement problem relates to
overcoming the effect of gravity
-second related problem is how large the
head as compared to smaller body
-movement problems are related to
controlling the interaction between stability
and mobility of the head trunks and limbs
- control of task-specific movements such as
stringing beads or riding a tric depends on
cognitive and perceptual abilities
Hierarchic theory
-top-down perspective
-brain is seen as the highest level of control
with all subcortical structures taking orders
from it
ROOD’S APPROACH
-using appropriate sensory stimuli for
evocating the desired muscular response is
the basic principle of Rood approach
2. Ontogenic development sequence
-rood recommended the use of ontogenic
development sequence; sensory motor
control is developmentally based, so that
during treatment therapist must assess
current level of development and then try to
reach next higher levels of control

Margaret Rood (1940) – neurophysiological 3. Purposeful movement –used purposeful

approach who developed Rood’s approach activities which can help to get the desired
movement pattern from the patient
-it deals with the activation or de-activation
of sensory receptors, w/c us concerned with 4. Repetition of movement – encouraged to
the interaction of somatic, autonomic and use repetitive movement for motor learning
psychic factors and their role in the
regulation of motor behavior
-neurophysiological approach was designed
for the pt w motor control problem
-motor fx ad sensory mechanisms are
interrelated
-based on reflex/hierarchical model of the
central nervous system, movt is facilitated or
inhibited for rehab purpose
-motor patterns are developed from
primitive reflexes thru proper sensory
stimuli to the appropriate sensory receptors
-exploited the normal sequential dec to get
motor responses and establilsh proper
motor engrams
Principles
Basic principles of ROOD APPROACH:
1. Normalization of tone

Reference:
Braddom, Randall, Physical Medicine and Rehabilitation,
DeLisa, Joel, Physical Medicine and Rehabilitation
O’Sullivan, Susan and Schmitz, Thomas, Physical Rehabilitation
Reference:
Braddom, Randall, Physical Medicine and Rehabilitation,
DeLisa, Joel, Physical Medicine and Rehabilitation
O’Sullivan, Susan and Schmitz, Thomas, Physical Rehabilitation