Handling - refined and magical; that’s what may come to mind when a therapist thinks of treating the child or adult with neurological impairments using an NDT/Bobath framework. When Dr. and Mrs. Bobath first started treating these individuals, the focus was very much on skillful handling. NDT/Bobath in 2015 still includes handling as a hallmark of the approach. However, what we do as therapists practicing within the NDT Practice Model* is so much more than just handling.
In addition to handling, an NDT trained clinician uses the ICF model as a guide to evaluate and develop interventions that are customized to each individual. Once we know who our client is at the Participation level of the ICF, we must determine what the most significant impairments are (at the Systems level of the ICF) by evaluating him/her through activities. We don’t assess each individual body system in the traditional way. That is, we do not lay them down and - test the strength of individual muscle groups, the range of motion at each joint, sensory awareness (light touch, proprioception, hot/cold awareness), etcetera but rather, we observe, feel with our hands, and interact with the individual while he/she moves, at the Activity level of the ICF. For example, as the child or adult is attempting to put his glasses on while seated, walk across the room to open a door, or roll over to reach for a toy, the therapist is evaluating what systems are functioning well and which are impaired.
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