New title: Therapy Wars [Welcome visitors from Mr. L.]
Sorry I don't have time to search for a visual to accompany this. [Well, maybe I will later.]
I've been requested to remove words from yesterday's post under 'copyright' constraints. I will explain why the complaint is a non sequitur at the end of the post.
Honestly, I thought linking other blogs into yours was considered a compliment! Links within posts drive more traffic to those blogs. No?
My original answer remains included in this post. I guess he did not like my answer. Befuddled me.
Because, really, I agreed 3X with the person who sent the message. That was a good thing. No?
The ONLY thing I disagreed with was, well, read on...and for my honest answer, my crediting him with his own words, for my very agreeable disagreeing and substantiated opinion, he called me a name on his blog: I am now a NDT devotee.
I even gave a plug for the treatment technique of which he so obviously is a devotee.
Current Blog-friends, I will be so sorry if you do not come back for the information I share here, now knowing, someone else does not approve of my opinions.
First Time-readers, welcome. Have a look for yourself and decide for yourself if I am a devotee of any particular named therapy technique.
Okay, so forthwith, yesterday's post is now edited to remove any reference from its source, and I have paraphrased the message.
Of all the treatment techniques I have laid bare reviewed, the one technique I have personally ascribed to is neurodevelopmental treatment or NDT.
A few weeks ago I received the following email message (paraphrased):
I thought your interesting post on NDT was way more even than others I've read.
I am interested in the use of NDT for recovery of persons who have had bleeding in the brain. I think NDT is bad for the image of OTs and PTs. I don't believe NDT changes the brain and no research proves otherwise.
What do you think?
In-Sincerely, Mr. L.
Please accept my apology, Mr. L. for the lateness of this reply. And thank you for saying my perspective is even.
As far as I know (also), you are correct that there is no research showing NDT makes neural change and better motor function. [Function is part of the paraphrase. Mr. L. hates the word function.]
My perspective on this is to suggest that few-to-none research studies resolve such comprehensive relationships. More bluntly, behavioral research is notoriously consistent for establishing minutiae over answering the big questions – like: does NDT make changes in the brain AND change motor behavior?
Humans make very poor Petri dishes and interpretation of behavioral research is fraught with subjectivity. I believe the error is in thinking that direct line relationships can be demonstrated between NDT, brain changes and motor changes, at this time.
My perspective is that NDT (like many of the ‘techniques’ used in therapy) is not amenable to classic experimental research.
From my post on NDT: “repetitive movement in alignment promotes function and prevents long term impairments”. Exercise (repetitive movement) is effective for changing motor behavior. Loads of research supports the (many different types of) effectiveness of exercise. We know also that impairments result from lack of movement.
We also know that learning is organic, or that when a new behavior is learned, it means that a concomitant structural change has occurred in the brain.
If movement = motor behavior or movement is considered behavior and learned, we could also assume that new movement (ability or behavior) means neural change has occurred. On a finer note (but I choose not to cover here) there is a distinct difference between learning and re-learning – making a difference in the neuroplastic changes available to a child versus an adult with brain damage.
I agree with you, Mr. L., on these statements from your interview at Living With Stroke:
(Where he said there is no best therapy).
I’m far less agreeable to your belief that NDT (paraphrased) "I think NDT is bad for the image of OTs and PTs." (His words were stronger. Something like, it is the end-of-the-world for OT and PT.) Were that so, the professions that use NDT would be out of business. So.not.the.case.
Virtually every pediatric and rehab PT and OT uses NDT principles someway, somehow in their practice.
Less commonly used, but with nicely performed research studies supporting it, is constraint induced therapy, CIT. I read blogs of several parents whose children are benefitting from this technique.
For my other regular readers, CIT consists of restraining the less-involved arm of a person who has had a cerebro-vascular accident – forcing the paralyzed or more-involved arm to move.
I would not broaden application of CIT to any other diagnostic category than those who have hemiplegia. Those nicely performed studies show CIT to be an effective technique, and the physiology/neurology necessary to show an effect is not suspect.
More Update
Copyright specifically restricts persons from using other's words as their own. Quoting and referencing someone's email message does not breach copyright. Especially egregious is when other words are used for profit. I've also stated previously that this blog has not so much as paid for the first year cost for the domain name.
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