Neurodevelopmental treatment is a certification you can get as a physical therapist that a whole lot of people use when treating stroke patients.  I don’t agree with the approach.  NDT is all about inhibiting improper movements. If you get trained in NDT, the basic premise – I think, I’m not trained in NDT so I can’t say for sure – is that if you allow the bad movements it will lead to even more bad movements.  Nope.  I think that you need to let your movements be weird and then try to gain more control over them and make them better.  If you don’t let the movements be all weird, how on earth will they get better?  Just inhibiting the weird movement from the get-go will not work.  I had a stroke – I know what I’m talking about.  I’m a physical therapist – I know what I’m talking about.

Peter G. Levine also knows what he’s talking about……


This goes for emotional crap too.  Don’t fight it, it’s ok.  Let the bad feelings be there and acknowledge them.  You’ll be shocked at how much pressure is taken off your shoulders once you say to yourself “well I feel like shit and that’s ok, I’m not gonna pretend everything is hunky-dory when it’s so, so, so, so, so, so not.  Moving all weird is ok and feeling like crap is ok.

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Categories: Brain stuff, Health, Recovery, Rehab, Stroke stuff

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9 replies

  1. Yes, sometimes the end justifies the means – if a patient wants to be on the other side of the room, why sould she care how crappy her gait is as long as she gets there? She can have a poor gait until she has a better gait.

  2. That’s the dumbest concept. Not at all realistic. I like a more practical approach: Use what you have, when u can, as much as u can. You can always tweek the smaller imperfections later.

  3. “Fake it ’til you make” is an expression I’ve heard often and it applies to this situation. To fight the tendency of my affected ankle to roll out, for years I’ve concentrated on walking on the inside edge of my affected foot, which helps bring the ankle back to perpendicular. Without walking a lot in an incorrect way, there would be no hope of someday walking in a correct way. NDT makes no sense to me.

  4. NDT has been proven in clinical trials to lead to worser outcomes

  5. My OT was using my recovery via her NDT as a case study in her work to get certified to be able to train other therapists in NDT. I actually hated the concept since it seemed more of what not to do rather than what to do. I trusted her ability to know what muscles were and were not working more than her NDT work.

  6. I agree. I do constraint-induced movement therapy research. CI therapy is very effective and does not emphasize good movement mechanics at all. Focuses more on use. Our research shows that increased use is what links to quality of life. Feel free to follow me on Twitter (DrG4Rehab), where I will post updates of this research.

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