Theoretical Approach “Living concept”

Where Bobath Began

·         Problem-solving approach based on reflex/hierarchical models.

·         Hierarchical model of CNS structure and function.

·         CNS viewed as the “controller”. Automatic postural control mechanism simplified the responsibility of the CNS in control of movement.

·         Sensory feedback is important for the correction of movement errors.

·         “Positive signs” including spasticity and abnormal coordination of movement are the most important aspects of sensorimotor impairments.

·         Muscle and postural tone determine the quality of the patterns of posture and movement used in functional activities.

Where NDT Is Now

·       Problem-solving approach based on a system/selectionist model.

·       Distributed model of CNS structure and function.

·       The CNS determines the pattern of neural activity based on input from multiple intrinsic systems and extrinsic variables that establish the context for movement initiation and execution.

·       Sensory feed-forward and feedback are equally important for different aspects of movement control.

·       The “negative signs’, including weakness, impaired postural control and paucity of movement are recognized as equally important as the “positive signs” in limitations of function limitations of function.

·       Task goals, experience, individual learning strategies, movement synergies, energy and interests all affect the quality of the final action.