Neuro Developmental Treatment (NDT) Techniques


Theoretical Framework

NDT as a neuromuscular and functional reeducation technique now includes neuroplasticity as a basis how the brain can change and reorganize itself and its processes based on practice and experience


Outline of NDT Approach

Individualized Functional Outcomes

Patient: Life role, supports systems, home environment, patient's goals

ICF: Pathologies, abilities, limitations

Motor Control

Optimize use of systems (sensory, musculoskeletal) and available movement patterns/synergies

Target the Involved Side

Progressive, increased demand and functional use

Motor Learning

Closed vs. open environment, simple vs. complex, part vs. whole, practice and feedback/knowledge of results



Coordination with rehab team, parents/caregivers, and support staff to allow for continual practice and consistent use of facilitation strategies


Essentials for Treatment Effectiveness

Key elements to Applying NDT204L NDT kneel.jpg



Cannot impose normal movement on malaligned joints




Inhibition, Facilitation, Key points




Assisting patients in achieving the appropriate


Alignment Check points - PTs and PTAs use manual contact to establish, align and assist the patient with these key elements

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Functional Check points - PTs and PTAs will modify manual cues and feedback to the demands of the task and the ability of the patient. Examples of functional check points include:

  1. Gravity
  2. Levers
  3. Time
  4. Distance
  5. Speed
  6. Environment

NDT Intervention Framework

Starting Posture

Missing Components

Manual Cues

Begin and assess the most efficient posture from which to move (typically upright)

Reorient to midline (head/trunk)

Neutral alignment of body segments



Observe starting posture and make comparisons to normal

Review the evaluation and POC for PT assessment of primary impairments (e.g. decreased ROM, strength, sensation, control)

Select a movement-based functional intervention which progresses patient toward mobility goals

Use hands on key points of control to facilitate normal posture/movement and inhibit abnormal posture/movement

May includes manual stretching if PT has determined ROM/muscle length interferes with function


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Example of NDT Techniques

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