• 한국전문물리치료학회지
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• 제5권1호
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• pp.79-90
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• 1998

Neurodevelopmental treatment(NDT) is a widely used technique by physical and occupational therapists in the treatment of neuromuscular disorders. Childeren with cerebral palsy are frequently referred for physical and occupational therapy, yet the effectiveness of treatment has not been well-documented. More than 40 years ago, the Bobath introduced a treatment concept for individuals with central nervous system impairment. A theoretical framework for the approach was based on the common belief in the 1940s that the nervous system functions in a hierarchy. Clinical aspects of the NDT approach have grown and changed during the past 40 years. This article details the original NDT concepts and looks at the concept with regard to newer theoretical frameworks of nervous system.

• 대한한방소아과학회지
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• 제35권1호
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• pp.139-147
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• 2021

Objectives The purpose of this study is to investigate differences in brain activities when Neurodevelopmental treatment (NDT) is used alone compare to NDT is combined with intradermal acupuncture (IDA) treatment, using functional infrared spectroscopy (fNIRS) Methods Three children less than 7 year-old with cerebral palsy were participated. On their first visit, only NDT was used. After a week, they were treated with both NDT and IDA. During the treatment, fNIRS was used to measure any changes in their brain activities. Results In first patient with NDT, oxyhemoglobin level was increased during Standing exercise and Gait training compared to resting state. When the patient was treated with NDT and IDA, oxyhemoglobin level was decreased during Standing exercise and Gait training compared to resting state, and the result was significant (p<0.05). In second patient, oxyhemoglobin level was decreased in Gait training compared to resting state when NDT was used, but the level was increased when NDT and IDA were used in Gait training compared to resting state (p<0.05). In third patient, the difference in oxyhemoglobin levels between Gait training and resting state was significant (p<0.05). Conclusions Treatment involving both NDT and IDA has more potential to improve brain activities compared to that of NDT alone, and no adverse effect was reported. In order to confirm the finding, larger scale randomized controlled trials are needed.

• The Journal of Korean Physical Therapy
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• 제26권1호
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• pp.33-40
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• 2014

Purpose: The aim of this study was to identify the effects of the lower trunk stabilization exercise using neurodevelopmental technique (NDT) on muscle activity in lumbar region and balance in the patients with hemiplegia. Methods: Fifteen participants were allocated in two groups: NDT group (n=8) or control group (n=7). NDT group performed NDT exercise program, while control group conducted walking exercise. Both interventions were given for 30 minutes a day, 3 times a week, for 5 weeks. To measure the muscle activity in rectus abdominis (RA), external oblique (EO) and internal oblique (IO), electromyography (EMG) was used. And, Timed-Up and Go (TUG) test and Berg-Balance Scale (BBS) were performed to assess balance before and after intervention. Results: NDT group showed a significant improvement of muscle activity in RA and EO, while control group did not show significant changes in three muscles. Also, there was a significant difference in muscle activity of RA and EO between two groups. In BBS and TUG test, participants in two groups showed significant improvements after intervention. Especially, significant difference was observed in TUG test between two groups (p<.05). Conclusion: This study demonstrated that NDT exercise is an effective intervention to improve the muscle activity in trunk region and to increase balance in patients with stroke. Thus, we suggested that NDT exercise program would be a treatment intervention in stroke rehabilitation.

• 산업융합연구
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• 제18권4호
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• pp.51-59
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• 2020

본 연구는 만성 뇌졸중 환자를 대상으로 저항운동이 포함된 거울치료 시 tDCS(transcranial direct current stimulation)의 융합 자극을 통해 마비측 다리의 근력과 보행 능력의 개선을 알아보고자 하였다. 12명의 뇌졸중 환자는 실험군 당 6명씩 무작위로 할당하였다. 실험군I(n=6)은 NDT(neurodevelopmental treatment)와 거울치료 시 sham tDCS의 융합자극군, 실험군II는 NDT와 거울치료 시 tDCS의 융합자극군으로 나누어 각각 30분씩, 주5회, 총4주 동안 실험을 실시하였다. 모든 평가는 중재 전과 중재 4주 후에 실시하였다. 다리근력은 측정한 모든 근육에서 실험군I에 비해 실험군II에서 유의한 차이를 나타냈고(p<.05), 변화량을 통한 군 간 비교에서는 quadriceps(p<.01)와 tibialis anterior(p<.01)에서 유의한 차이를 나타냈다. 보행능력은 실험군I과 실험군II 모두에서 유의한 차이를 나타냈고(p<.05), 변화량을 통한 군 간 비교에서 유의한 차이를 나타냈다(p<.01). 거울치료와 tDCS의 융합자극은 마비측 다리 근력 및 보행능력 향상에 중첩효과를 통한 긍정적인 개선 효과를 주는 것을 알 수 있었다.

• The Journal of Korean Physical Therapy
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• 제26권3호
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• pp.209-215
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• 2014

Purpose: The purpose of this study is to examine the effects of postural control training using a horseback riding simulation on the spinal alignment of children with cerebral palsy. Methods: This study was conducted with 30 children with cerebral palsy at levels I~IV in the Gross Motor Function Classification System (GMFCS), and they were randomly divided into a control group and a hippotherapy group. Both the control group and the experimental group received NDT for 30 minutes per session, four times per week for ten weeks, while the experimental group also received hippotherapy 15 minutes per session, four times per week for ten weeks, after the neurodevelopmental treatment (NDT). The horseback riding simulators (JOBA, EU7805, Panasonic) used in this study simulated actual horse movements. Trunk imbalance, pelvic torsion, and pelvic tilt were measured in each group before the exercise and five weeks and ten weeks after the beginning of the exercise using a spinal structure analysis system (ABW Mapper). Results: The Intra-group effects on trunk imbalance, pelvic torsion, and pelvic tilt according to the exercise periods after the hippotherapy were tested, and the results showed significant interaction effects between the groups and the periods (p<0.05). Conclusion: The horseback riding simulation exercise was shown to be effective for the spinal alignment of children with cerebral palsy. Therefore, additional studies should be conducted with more children with CP divided by type.

• The Journal of Korean Physical Therapy
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• 제26권4호
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• pp.269-273
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• 2014

Purpose: The purpose of this study is to examine the effects of using a horseback riding simulation on static balance in children with cerebral palsy. Methods: This study was conducted with 30 children with cerebral palsy at levels I~IV in the Gross Motor Function Classification System (GMFCS), who were randomly divided into a control group and a hippotherapy group. Both the control group and the experimental group received NDT for 30 minutes per session, four times per week, for ten weeks, while the experimental group also received hippotherapy, 15 minutes per session, four times per week, for ten weeks, after the neurodevelopmental treatment (NDT). The horseback riding simulators JOBA (JEU7805, Panasonic, 일본) used in this study simulated actual horse movements; static balance was measured in each group before the exercise and five weeks and ten weeks after the beginning of the exercise using a pedoscan system (Diers Pedo, Germany). Results: The intergroup effects on static balance were tested, and the results showed no significant differences (p<0.05). Conclusion: The horseback riding simulation exercise was shown to be effective for the static balance of children with cerebral palsy. Therefore, additional studies should be conducted with more children with CP divided according to type.

• 대한감각통합치료학회지
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• 제14권1호
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• pp.41-49
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• 2016

목적 : 본 연구는 뇌성마비 아동에게 신경발달치료 접근법을 기초한 옷 벗기 기술 훈련에 따른 신체중심선과 보호반응에 미치는 효과를 알아보고자 하였다. 연구방법 : 연구대상은 B시에 거주하는 만 3세 5개월 남아와 만 4세 5개월 여아로 뇌성마비 진단을 받았다. 본 연구는 단일대상연구 중 AB 디자인을 사용하였고, 기초선 기간(A) 2회, 중재 기간(B) 10회로 총 12회기를 실시하였다. 중재는 신경발달치료 접근에 기초한 옷 벗기 훈련을 실시하였고, 평가로 신체중심선은 Miller Assessment for Preschoolers(MAP)의 하위 항목인 Stepping 항목을 사용하였으며, 보호반응은 Quality Upper Extremity Skill Test(QUEST) 검사의 하위 항목인 보호반응 항목을 사용하였다. 결과 : 아동의 신체중심선은 기초선 기간과 비교하여 중재기간이 2표준편차 이상으로 감소하였다. 보호반응은 오른쪽과 왼쪽 모두 중재기간 평균점수가 기초선 평균점수보다 높게 나타났다. 결론 : 뇌성마비 아동에게 신경발달치료접근법을 기초한 옷 벗기 기술 훈련이 신체중심선 향상에 효과적이었다. 앞으로 집단 연구를 통하여 그 효과를 확인하는 것이 필요할 것이다.

• The Journal of Korean Physical Therapy
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• 제25권5호
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• pp.360-365
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• 2013

Purpose: The purpose of study was to investigate effects of dance sports in virtual reality on balance, depression, and activities of daily living (ADL) in stroke patients. Methods: Subjects of the research consisted of 18 stroke patients who were randomly divided into the experimental and control groups, with nine patients each. All subjects underwent 30 minutes of Neurodevelopmental treatment (NDT) and 15 minutes of Functional electrical stimulation (FES) five days per week for a period of six weeks. Subjects in the experimental group performed an extra 30 minutes of dance sports in virtual reality each day. Balance, depression, and ADL of patients before and after the experiment were measured using Berg's balance scale (BBS), Beck depression inventory (BDI), and Modified Barthel index (MBI), respectively. For comparisone of the state before and after the experiment, wilcoxon signed ranks test was applied and for comparison of the difference between the groups, mannn-whitney U test was applied. Results: Results of this study, showed significant difference in balance, depression, and ADL between the experimental and control groups(p<0.05). As a control of the two groups, the experimental group, which performed extra dance sports in virtual reality, showed a significant difference in balance, depression, and ADL(p<0.05). Conclusion: Depending on the result, a dance sport in virtual reality was verified to enhance balance, depression, and ADL in stroke patients. Therefore, from now on, need for effective program development and application using dance sports in virtual reality will arise.