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Since 1991

(408) 268-3691

 

 

Tier-I
Introduction

Part I
Introduction to NDT:
Achieving Functional Outcomes

Part II
Getting Results Faster:
Managing the Hemiplegic UE From an NDT Perspective

Part II
Getting Results Faster:
Using NDT to Increase Challenge of the LE's and to Improve Gait

Tier-A
Advanced Training

 

Part III
Applying the RPSF:
A Step-by-Step Framework for Assessing Potential and Individualizing Functional Outcomes Using the Principles of NDT

Part IV
Applying the RPSF:
Manual Cues for Accessing Missing Components of Movement with Intensive Focus on the Trunk Using the Principles of NDT

Part V
Applying the RPSF:
Manual Cues for Accessing Missing Components of Movement with Intensive Focus on the UE and on Gait Using the Principles of NDT

Tier-C
RPSF Certification

Part VI
Applying the RPSF:
Implementing Client Interventions Using the Principles of NDT

NDTA Approved
Certificate Course

NDT/Bobath Certificate Course in the Management and Treatment of Adults with Hemiplegia

 

All courses
apply toward
NDTA re-certification

 


"Awesome class, awesome instructors! I learned so much. This is the first continuing ed course I have taken where I walk away and feel the money was worth spending. Thank you for the info and energy."

"I felt the material presented was the perfect amount for me. It helped me see the big picture with normal movement and how to help achieve it. The course challenged me without overwhelming me. I loved this course! Your warm personality made it easier to learn."

"Very well organized, instructive and interactive. This course has helped me gain a better knowledge of how to implement NDT when working with patients who have hemiplegia."

"Yes, the instructor did a very smooth job. Other courses lost me with multiple speakers, uneven presentations, unclear objectives. You were great, inviting, motivating, moved things right along. Never a dull moment. I enjoyed your comments on goal focused treatment. Our clinic has been focusing on this for the last 5 - 6 years. The idea of not needing all those little boxes on an eval threw me. It took me a couple of hours to accept. It will be interesting to share the ideas with co-workers. I think they will agree."

"The instructor has an excellent, engaging and humorous personality. She made the material ALIVE!"

"I enjoyed this course. This sheds light on the usefulness of therapy. Looking forward to taking the three-week course. The instructors were knowledgeable and enthusiastic reminding me that I can make a difference. It's good to be reminded of that every so often."

"I feel like I have direction and meaning to take back and incorporate into treatment."

"I enjoyed this course immensely. I found that enough time was allowed for each area and I can't wait to take another course."

"Great class - good job of covering and following the course outline. Good time with lab work (demo - practice - questions) and patient treatment sessions. Great humor and rapport between instructors and among participants."

"This was an excellent course. I was only partially sold on NDT before this course and now I can't wait to take the next two courses on the UE and the three-week course."

"It gave me a good foundation for treatment of stroke patients. I now have the tools for analyzing what the patient's problems are and how I can assist with these problems. Now I have the knowledge to make my treatment plan more effective."

"I can incorporate this information to help my patients work more in midline, possibly get them independent in dressing, bathing. I can also help them get more awareness of the affected side."

"Exceeded my expectations. It tied together information I learned in school, through my internship with an NDT certified CI , and made the information and techniques applicable to my patients."

"Very valuable, wonderful instructors that focus on the positive things we are doing with patients. Very motivating. I have never been this focused and alert for five 8-hour days in a class situation. Thanks so much."

"Patient treatments were great. Loved the instructors. Great constructive feedback, not over-bearing. Would definitely recommend this course to colleagues. Thank you for making this information accessible."

"I really appreciated the hands-on and hand-over-hand demonstrations."

"The instructor was a very thorough and interesting presenter who kept my interest. I really liked watching the videos and it helped me to see how you apply the approach to patients."

"Thank you very much! The course was very beneficial; hopefully to my patients. I can't wait to try what I've learned."

"The course helped me understand the importance of facilitating "correctly" and incorporating this with functional activities thus making more sense for the patients."

"I found most beneficial the general concepts of how to use facilitation techniques and the very useful applications demonstrated and practiced. The lab practice was extremely valuable."

"The instructor did a wonderful job of keeping the course interesting, useful and fun. I also appreciated that you listened to the participants and made no question a "dumb question". Also, I feel a little less burned out in a time that is becoming challenging for therapists."

"You guys were great! Well presented material, concise; you make good use of time available - great role models for OT/PT. Fun class; you all have a wonderful sense of humor. And, especially, thanks for sharing your earlier experiences as therapists and your ongoing evolution. Thanks for helping to build a new foundation from which I too can evolve- successfully!"

"I will recognize that even as a per diem therapist, I can have influence over a person's (patient's) ability to perform a functional activity in a more normal manner."

"I will incorporate this information into my situation. Now I have more ideas of functional activities to perform during treatment. I'll use facilitation techniques I have learned to make my patient a more active participant. I will look at what is happening at the pelvis first before trying to fix distal body parts and I will write more functional and meaningful goals."

"The course was interesting and fun and the instructors were very knowledgeable. I would certainly recommend this course to my colleagues."

"I will look at our patients in a different light. I feel that I will be able to help those patients that we had given up on at our facility and be better able to serve our future CVA patients."

 

 Recovering Function
Recovering Function for Adults with Hemiplegia
Using the Principles of NDT

America's Largest Provider of Adult Hemiplegia
Neuro-Developmental Treatment (NDT) Courses
for Occupational and Physical Therapists

Please e-mail us at info@recoveringfunction.com if you have questions about courses or schedules, or if you would like to be notified when new courses are available.

Print a registration form or download a registration form PDF if you are ready to register now,
or register by phone at (408) 268-3691 from 9-6 Pacific Time.

Download the brochure PDF if you would like to view or print pages from our course brochure.




All Recovering Function Courses
Include Extensive "Hands-on"

These participants are learning from Cathy Runyan (Active, NDTA Inc. Coordinator Instructor) how to access components of movement of the trunk by handling. Cathy is providing a "hand over hand" experience for them so they can learn how to facilitate lateral lumbar flexion and lumbar extension in a medial and anterior direction. Lateral lumbar flexion is a component of movement of the trunk and is required for symmetry and for improved trunk and limb control during functional activities.

The ability to handle your patient specific to the component of movement that is missing, provides you with a very effective way to access options in movement for your patients.



Once increased control of the trunk is achieved, the limbs on the involved right side can be facilitated to actively support using a surface. These participants are now learning how to handle the right side to encourage functional use of the right upper and lower extremity in combination with improving trunk control. They are learning how to facilitate the involved right side to increase strength and range of motion, increase sustained control, increase proprioception (decreasing neglect), and increase function and balance. This ability to actively use the right side will increase their patient's independence during functional activities.

"Cathy, after one day back at work, all I can say is “WOW!”  Katherine and I returned to a nearly exclusive CVA caseload, which is very uncommon in our facility, but perfect timing!  We were absolutely stunned at the results we were able to accomplish in an hour with each of our patients today using the techniques taught to us this past weekend!  It was so exciting to see patients activating trunk muscles and triceps, etc., that were previously inactive and to see their faces light up with their new found muscle activity. We worked with one 89 year old woman today who has had an occipital stroke and is currently weaning off the ventilator.  Upon initially sitting her at the edge of the bed she was in such posterior pelvic tilt that she couldn’t reach forward at all.  After 50 minutes, she was able to achieve an anterior pelvic tilt and weight shift forward sufficiently to reach her hairbrush when placed 25 inches away – UNBELIEVABLE!  Two other patients achieved a neutral pelvic tilt and went from max assist for balance at the edge of the bed to contact guard assist by the end of the treatment while maintaining weight bearing and tricep activation on the affected arm!  You have made believers of us and we are so grateful for the new found knowledge and ability to individualize treatment plans for our patients and help maximize their potential during their time at our facility.  Thank you, thank you, thank you!"


Built upon the core principles of NDT
the RPSF™ is a step by step framework
of problem-solving strategies and manual cues
for assessing potential and individualizing functional outcomes
when implementing interventions for adult clients with hemiplegia

Recovering Function Tiered NDT Curriculum

Recovering Function’s tiered Neuro-Developmental Treatment (NDT) curriculum allows you to develop skills at your own pace by progressively alternating each tier’s course work with the application of learned skills on the job. In addition, by registering therapists for specific tiers, your rehabilitation team can achieve its target skills profile of introductory, advanced, and certified skills and establish a peer mentoring structure that is both effective and cost efficient. You can choose either pay as you go or package discount registration, and you can manage travel costs by choosing course locations from a list of nationwide offerings.

Individuals

Teams

To support the demonstration of competency required for clinical ladders, occupational and physical therapists who have completed Tier-C and passed Recovering Function’s certification examination for therapists will receive a certificate from Recovering Function bearing RPSFCCM in NDT (RPSF certified in Neuro-Developmental Treatment).

Occupational and physical therapist assistants who have completed Tier-C and passed Recovering Function’s certification examination for assistants will receive a certificate from Recovering Function bearing RPSFCACM in NDT (RPSF certified assistant in Neuro-Developmental Treatment).

Rehabilitation teams applying for stroke certification can request a certificate from Recovering Function that authenticates the team’s Tier-I, Tier-A, and Tier-C course completions for both therapists and therapist assistants.

Recovering Function recommends a target team skills profile of at least 50/30/20 % (Tier-I, Tier-A, Tier-C) for both therapists and therapist assistants on rehabilitation teams working with adult clients with hemiplegia to maintain an effective peer mentoring structure.

Frequently Asked Questions

Q.

How did Recovering Function's tiered NDT curriculum evolve?

A. Recovering Function has offered a full range of NDT courses since 1991. Therapists and therapist assistants attending these courses requested test of competency and credentialing from Recovering Function to help them demonstrate their competency for clinical ladders. Similarly, team leaders requested team credentialing from Recovering Function to help them demonstrate team competency whey applying for stroke certification. They also requested a curriculum architecture that would allow them to achieve their team's target skills profile of introductory, advanced, and certified skills; to establish an effective and cost efficient peer mentoring structure; and to complete course work at their own pace. Recovering Function's tiered NDT curriculum addresses these requests.

Q.

Can I attend each part of each tier anytime/anywhere it is offered, and can I register and pay for each part as I go?

A. Yes. Each part must be completed in prerequisite order. Each part has individual pricing.

Q.

Are there discounts if I register for multiple parts, or if my facility registers multiple therapists for the same parts?

A. Yes. You must register for the parts at the same time, but may choose any course dates/locations; see package discounts.

Q.

Must I complete both Part II's before taking Part III?

A. No. Either Part II satisfies the prerequisite for Part III.

Q.

Which part results in RPSFC or RPSFCA?

A. RPSFC and RPSFCA are specifically associated with the successful completion of Tier-C and its certification exam.

Q.

If I complete Recovering Function's NDTA approved course, can I also pursue RPSFC?

A. Yes. The NDTA approved course satisfies the prerequisites for Part III (therapists who successfully complete Recovering Function's NDTA approved course receive a certificate from the NDTA. Tier-I, Tier-A, and Tier-C courses issue certificates from Recovering Function and are not affiliated with the NDTA. However, Tier-I, Tier-A, and Tier-C courses are taught by active, NDTA instructors and therefore also apply toward NDTA re-certification).

Q.

Is there a difference in expectations for therapists and therapist assistants when being evaluated for RPSFC and RPSFCA?

A. Yes. Consistent with professional roles, therapists carry higher requirements for assessment.

Q.

After receiving my RPSFC or RPSFCA, how can I stay current?

A. The instructors continuously update the curriculum by integrating new research from the neurosciences, bio-kinesiology, motor learning, and motor control into each course. Recovering Function recommends 30 hours of Tier course work each three years to stay current and to experience new client interventions.

Course Schedule

Introduction to NDT (Part I): Achieving Functional Outcomes for Adults with Hemiplegia Using the Principles of NDT
Cathy Runyan, OTR/L, Active, Certified NDTA Inc. OT Coordinator Instructor

and

Getting Results Faster (Part II): Managing the Hemiplegic UE from an NDT Perspective
Cathy Runyan, OTR/L, Active Certified NDTA Inc. Coordinator Instructor

offered simultaneously with
(choose one)

Getting Results Faster (Part II): Using NDT to Increase Challenge of the LE's and to Improve Gait
Peggy Miller, PT,  or Bonnie Jenkins-Close, PT Active Certified NDTA Inc. Instructors

 

Register for Part I and either Part II (UE or LE)
of this four day course at the same time to receive the listed package price
( Part II is a continuation of Part I, and has Part I as its prerequisite )

Recovering Function certificates for Part I and Part II
are 15 contact hours each (30 for the two part package)

Be sure to also see the facility group packages available for these courses!

 

San Antonio, TX
Baptist Hospital
March 12 -13, 2010 (Part I)  $375
March 14 -15, 2010 (Part II) $375  (prerequisite Part I)

Part I and II package price: $650

Marriott room rate $85 guaranteed until 2/18/10 (210) 614-7100
Register now.
 
Paramus, NJ
Care One at the Cupola
March 20 -21, 2010 (Part I)  $375
March 22 -23, 2010 (Part II) $375  (prerequisite Part I)

Part I and II package price: $650

Crowne Plaza room rate $129 guaranteed until 3/5/10 (201) 262-6900
Register now.
 
Nashville, TN
Sumner Regional Medical Center
April 10 -11, 2010 (Part I)  $375
April 12 -13, 2010 (Part II) $375  (prerequisite Part I)

Part I and II package price: $650

Hampton Inn room rate $94 guaranteed until 3/9/10 (615) 206-9595
Register now.
 
Los Angeles, CA (Pomona)
Casa Colina Centers for Rehabilitation
April 15 -16, 2010 (Part I)  $375
April 17 -18, 2010 (Part II) $375  (prerequisite Part I)

Part I and II package price: $650

Holiday Inn room rate $125 guaranteed until 3/31/10 (909) 305-2323
Register now.
 
Eureka, CA
St. Joseph Hospital
April 2010

Call (408) 268-3691 for more information about this location or download the course flyer.

Clarion room rate $80 guaranteed until 4/9/10 (707) 442-3261
Register now.
 
Chicago, IL (Berwyn)
MacNeal Hospital
May 13 -14, 2010 (Part I)  $375
May 15 -16, 2010 (Part II) $375  (prerequisite Part I)

Part I and II package price: $650

Holiday Inn Express room rate $139 guaranteed until 4/12/10 (708) 458-0202
Register now.
 
Philadelphia, PA (Malvern)
Bryn Mawr Rehabilitation Hospital
May 20 -21, 2010 (Part I)  $375
May 22 -23, 2010 (Part II) $375  (prerequisite Part I)

Part I and II package price: $650

Holiday Inn room rate $106 guaranteed until 5/5/10 (610) 692-1900
Register now.
 
Cincinnati, OH
Bethesda North Hospital
June 26 -27, 2010 (Part I)  $375
June 28 -29, 2010 (Part II) $375  (prerequisite Part I)

Part I and II package price: $650

Crowne Plaza room rate $99 guaranteed until 6/4/10 (513) 793-4500
Register now.
 
San Jose, CA (Los Gatos)
El Camino Hospital Los Gatos
July 8 -9, 2010 (Part I)  $375
July 10 -11, 2010 (Part II) $375  (prerequisite Part I)

Part I and II package price: $650

Valley Park room rate $79 guaranteed until 6/17/10 (408) 295-5000
Register now.
 
Dallas, TX (Fort Worth)
Harris Methodist Hospital
September 9 -10, 2010 (Part I)  $375
September 11 -12, 2010 (Part II) $375  (prerequisite Part I)

Part I and II package price: $650

Holiday Inn room rate $119 guaranteed until 8/9/10 (817) 698-9595
Register now.
 
Atlanta, GA
Emory Health Care Center for Rehabilitation Medicine
September 16 -17, 2010 (Part I)  $375
September 18 -19, 2010 (Part II) $375  (prerequisite Part I)

Part I and II package price: $650

Holiday Inn room rate $109 guaranteed until 8/16/10 (404) 371-0204
Register now.
 
Detroit, MI (Royal Oak)
William Beaumont Hospital
October 1 -2, 2010 (Part I)  $375
October 3 -4, 2010 (Part II) $375  (prerequisite Part I)

Part I and II package price: $650

Holiday Inn room rate $115 guaranteed until 9/15/10 (248) 642-6200
Register now.
 

 

Additional locations to be announced soon.

 

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Applying the RPSF™ (Part III): A Step-by-Step Framework for Assessing Potential and Individualizing Functional Outcomes Using the Principles of NDT
Cathy Runyan, OTR/L, Active, Certified NDTA Inc. OT Coordinator Instructor

and

Applying the RPSF™ (Part IV): Manual Cues for Accessing Missing Components of Movement with Intensive Focus on the Trunk Using the Principles of NDT
Cathy Runyan, OTR/L, Active, Certified NDTA Inc. OT Coordinator Instructor

Register for Part III and Part IV
of this four day course at the same time to receive the listed package price
( Part IV is a continuation of Part III, and has Part III as its prerequisite )

Recovering Function certificates for Part III and Part IV
are 15 contact hours each (30 for the two part package)

Be sure to also see the facility group packages available for these courses!

 

Los Angeles, CA
Good Samaritan Hospital
July 16 - 17, 2010 (Part III)  $375  (prerequisite Part II or RF 3-week course)
July 18 - 19, 2010 (Part IV)  $375  (prerequisite Part III)

Part III and IV package price: $650

Kyoto Grand room rate $119 guaranteed until 6/24/10 (213) 629-1200
Register now.
 

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Applying the RPSF™ (Part V): Manual Cues for Accessing Missing Components of Movement with Intensive Focus on the UE and on Gait Using the Principles of NDT
Cathy Runyan, OTR/L, Peggy Miller, PT Active, Certified NDTA Inc. Instructors

Recovering Function certificates for Part V
are 30 contact hours

Be sure to also see the facility group packages available for this course!

 

San Jose, CA
Regional Medical Center
January 21 - 24, 2010 (Part V)  $650  (prerequisite Part IV)

Valley Park room rate $79 guaranteed until 1/1/10 (408) 293-5000
Register now.
 

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Applying the RPSF™ (Part VI): Implementing Client Interventions Using the Principles of NDT
Cathy Runyan, OTR/L, Peggy Miller, PT Active, Certified NDTA Inc. Instructors

Recovering Function certificates for Part VI
are 38 contact hours
 

San Jose, CA
August 15 - 19, 2010 (Part VI)  $750  (prerequisite Part V)

Valley Park room rate $79 guaranteed until 7/23/10 (408) 293-5000
Register now.
 

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NDT/Bobath Certificate Course in the Management and Treatment of Adults wityh Hemiplegia
Cathy Runyan, OTR/L, Peggy Miller, PT Active, Certified NDTA Inc. Instructors

NDTA certificates for this course
are 120 contact hours
 

San Jose, CA
July 28 - August 8, 2010 (weeks 1&2)
December 1 - 6, 2010 (week 3)

Call about our special pricing
for this course
!

Save with our lodging assistance for this course. Phone (408) 268-3691 for details.
Apply now.
 
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Course Descriptions


Introduction to NDT (Part I): Achieving Functional Outcomes for Adults with Hemiplegia Using the Principles of NDT

"Very well organized and presented, great content and very applicable, great treatment ideas. I will treat patients much more effectively thanks to this course. I also have a very different view of NDT compared to before. I will definitely take another course from you."

Course Description: This two day, “hands-on” course is designed for those who would benefit from a more in-depth understanding of the principles of NDT. Through the use of client videos you will be able to identify how each system influences motor control and understand the impairments in each system that impede your clients’ abilities to recover function. Your clinical reasoning will be improved through an understanding of neuroplasticity, resulting in your ability to select methodologies that match the etiology of CVA. Through self-experience labs you will learn how components of movement of the trunk influence each other, and understand how they influence the involved UE for active support and reach, the involved LE for the stance and swing phases of gait, as well as subluxation of the humerus. You will learn to provide effective interventions for your acute clients who are unable to control a symmetrical posture in sitting due to impairments causing poor head and trunk control. You will also learn what to expect and what to do when your clients attempt the transition from sit to stand. You will be provided with treatment ideas for achieving functional outcomes for your clients, including increased safety and independence. Using “hands-on”, you will learn how to access components of movement of the trunk and LE’s required for a symmetrical sit to stand, stand to sit, and for transfers. Facilitation of bed mobility will be demonstrated. You will gain an increased appreciation of the effect NDT can have on your clients’ recovery of function by watching a live client demonstration. You will also be provided with examples of documentation for achievable, reimbursable, discipline specific functional outcomes using NDT.

Learning Outcomes: Upon completion of the course, you will be able to:

  • Use the principles of NDT to provide your clients with opportunities for use of effective movement strategies to achieve functional outcomes
  • Identify how impairments in each system impede your clients’ abilities to recover function
  • Demonstrate an understanding of neuroplasticity and be able to select methodologies that match the etiology of CVA
  • Identify the components of movement of the trunk and understand how these components influence the involved UE and LE
  • Use effective interventions for your acute clients whose impairments cause poor head and trunk control in sitting
  • Use treatment ideas to achieve functional outcomes, including increased safety and independence
  • Use manual cues to access components of movement of the trunk and LE required for symmetrical sit to stand, stand to sit, and for transfers
  • Use examples to document achievable, reimbursable, discipline specific functional outcomes for use in all systems including a managed care environment, PPS and Medicare
Prerequisite  None
Intended Audience OTR's, COTA's, PT's, PTA's working with adults with hemiplegia.
Contact Hours  15
Course Hours  Registration 7:30 a.m.
Day one 8:00-5:30
Day two 8:00-5:00
Register now.

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Getting Results Faster (Part II): Managing the Hemiplegic UE from an NDT Perspective

"This was a great course which incorporated function instead of what is the OT role vs. PT role. I will definitely be attending further courses to increase my knowledge base to help facilitate those patients which I had previously felt had no potential."

Course Description: This two day, “hands-on” course with emphasis on the UE will provide you with an increased understanding of how hemiplegia alters the normal bio-mechanics of the shoulder and hand. You will learn how to use the principles of the NDT approach to increase active support and functional reach of the involved UE. Through self-experience labs you will understand how the trunk and lower extremities influence active support and reach of the UE. Using “hands-on”, you will learn how to facilitate the involved UE for active support and increase ROM of the scapula and humerus to decrease subluxation and pain of the involved shoulder. You will also learn how to manage the involved hand and be given ideas for ways to adapt a surface, increasing use of the hand in support and reach. You will learn how to increase ROM of the hand and wrist for decreased pain in weight bearing, improved fine motor control, and remediation of edema. You will also learn how to increase ROM around the pelvis and understand its relationship to the scapula. You will be provided with treatment ideas for increasing functional use of the involved UE. By watching a live client demonstration you will understand how the principles of the approach and manual cues are used to increase functional use of the involved UE. You will also be provided with examples of home exercise programs. Use of orthotics will be discussed. As a result of the clinical reasoning learned in this course, you will be able to identify the impairments causing your clients’ functional activity limitations related to the involved UE and get results faster. You will also be provided with examples of documentation for achievable, reimbursable, discipline specific functional outcomes using NDT.

Learning Outcomes: Upon completion of the course, you will be able to:

  • Understand how the normal bio-mechanics of the shoulder are altered by hemiplegia

  • Use the principles of NDT to increase active support and reach of the involved UE

  • Understand how the trunk and lower extremities influence functional use of the involved UE

  • Increase use of the involved UE for active support to achieve functional outcomes

  • Increase ROM of the scapula and humerus to decrease subluxation and pain of the involved shoulder

  • Increase ROM of the hand and wrist to increase weight bearing, improve fine motor control, and remediate edema

  • Increase ROM of the pelvis to increase functional use of the involved UE

  • Use examples of home exercise programs to increase functional use of the involved UE, and decrease pain and edema

  • Use orthotics for the hand, wrist and shoulder appropriate to the client’s potential for recovery

  • Understand how impairments resulting from hemiplegia influence the client’s functional use of the UE

  • Use examples to document achievable, reimbursable, discipline specific functional outcomes for use in all systems including a managed care environment, PPS and Medicare

Prerequisite Part I
Intended Audience OTR's, COTA's, PT's, PTA's working with adults with hemiplegia.
Contact Hours 15
Course Hours

Registration 7:30 a.m.
Day one 8:00-5:30
Day two 8:00-5:00

Register now.

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Getting Results Faster (Part II): Using NDT to Increase Challenge of the LE's and to Improve Gait

"I will look at our patients in a different light. I feel that I will be able to help those patients that we had given up on at our facility and be better able to serve our future CVA patients."

Course Description: This two day, “hands-on” course with emphasis on increasing challenge for the lower extremities to improve gait will provide you with an increased understanding of how hemiplegia interferes with the normal gait cycles of stance and swing. You will learn how to use the principles of the NDT approach to increase functional use of the involved LE for standing and ambulation. Through self-experience labs you will understand how the lower extremities are influenced by the components of movement of the trunk. Using “hands-on”, you will learn how to facilitate the trunk and involved LE for mid-stance alignment and use effective weight shift in preparation for the swing phase of gait. You will also learn how to increase ROM of the involved foot and ankle and be given concepts for use of orthotics for the involved foot during stance and swing. You will also learn how to increase ROM around the pelvis and hip. You will be provided with treatment ideas for increasing functional use of the involved LE and for incorporating use of the UE during gait. By watching a live client demonstration you will understand how the principles of the approach and manual cues are used to increase functional use of the involved LE. You will also be provided with examples of home exercise programs. As a result of the clinical reasoning learned in this course, you will be able to identify the impairments causing your clients’ functional activity limitations related to the involved LE and get results faster. You will also be provided with examples of documentation for achievable, reimbursable, discipline specific functional outcomes using NDT.

Learning Outcomes: Upon completion of the course, you will be able to:

  • Understand how the normal gait cycles are altered by hemiplegia

  • Use the principles of NDT to improve stance and swing of the involved LE

  • Understand how the trunk influences use of the LE’s in upright postures in sitting and standing

  • Increase use of the involved LE for mid-stance alignment and use effective weight shift in preparation for the swing phase of gait

  • Increase ROM of the involved foot and ankle for stance and swing

  • Increase ROM of the pelvis to increase functional use of the involved LE

  • Use examples of home exercise programs to increase functional use of the involved LE for standing in gait

  • Use orthotics for the foot and ankle appropriate to the client’s potential for recovery

  • Understand how impairments resulting from hemiplegia influence functional use of the LE

  • Use examples to document achievable, reimbursable, discipline specific functional outcomes for use in all systems including a managed care environment, PPS and Medicare

Prerequisite Part I
Intended Audience

PT's, PTA's, OTR's, COTA's working with adults with hemiplegia.

Contact Hours 15
Course Hours

Registration 7:30 a.m.
Day one 8:00-5:30
Day two 8:00-5:00

Register now.

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Applying the RPSF™ (Part III): A Step-By-Step Framework for Assessing Potential and Individualizing Functional Outcomes Using the Principles of NDT

Course Description: This two day, “hands-on” course provides you with a step by step framework of problem-solving strategies and manual cues for assessing potential and individualizing functional outcomes for your adult clients with hemiplegia using the principles of NDT (Runyan Problem Solving Framework™). You will learn how to use a framework for movement analysis (Runyan Movement Analysis Framework™) to assess your clients’ ineffective movement strategies, missing components of movement, and impairments for the trunk and involved extremities during functional activities. In self-experience labs you will use the RMAF™ to analyze functional activities and be able to identify the core elements of movement required for each activity. You will be provided with numerous examples of how to change features of the environment to increase your clients’ motivation and interest, increase or decrease challenge for movement, and provide feedback for encouraging use of effective movement strategies. You will also learn how to use functional activities and features of the environment to develop pretests and posttests to demonstrate your clients’ increased functional activity abilities as a result of your skilled interventions. You will learn how to develop discipline specific skilled intervention goals for your adult clients with hemiplegia. Through the use of self-experience labs you will learn the factors that influence movement and understand how they can be used to develop a logical progression of challenge designed to progress toward the skilled intervention goal. You will learn how to use the RFSF™ to develop treatment ideas and discipline specific, individualized functional outcomes to help your clients realize their potential for recovery of function. You will learn how to individualize expectations for practice in order to increase retention and carryover when instructing clients for home exercise programs. You will also learn how to document achievable, reimbursable, discipline specific, skilled intervention goals and individualized functional outcomes and correlate them to the Functional Independence Measure (FIM).

Learning Outcomes: Upon completion of the course, you will be able to:

  • Use the problem-solving strategies and manual cues of the RPSF™ to assess potential and individualize functional outcomes using the principles of NDT

  • Identify the core elements of movement of the RMAF™ and analyze their use in functional activities
  • Use features of the environment to encourage use of effective movement strategies
  • Use pretests and posttests to demonstrate your clients’ increased functional activity abilities due to your skilled interventions
  • Develop a discipline specific skilled intervention goal and a logical progression of challenge that progresses toward that goal
  • Develop treatment ideas and individualized functional outcomes to help your clients realize their potential for recovery of function
  • Individualize expectations for practice of use of components of movement in order to increase retention and carryover when instructing for a home exercise program
  • Document achievable, reimbursable, discipline specific, skilled intervention goals and individualized functional outcomes and correlate them to the FIM
Prerequisite Part II
Intended Audience

OTR's, PT's, COTA's, PTA's working with adults with hemiplegia.

Contact Hours 15
Course Hours

Registration 7:30 a.m.
Day one 8:00-5:30
Day two 8:00-5:00

Register now.

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Applying the RPSF™ (Part IV): Manual Cues for Accessing Missing Components of Movement with Intensive Focus on the Trunk Using the Principles of NDT

Course Description: This two day, “hands-on” course provides you with the manual cues required to access missing components of movement of the trunk for your adult clients with hemiplegia. In each lab you will learn how to use these manual cues to assess underlying impairments, increase use of appropriate muscle activity, and increase ROM for each body segment of the trunk (including the pelvis and lumbar spine, thoracic spine and ribs, scapula and clavicle, and the sternum and true ribs). You will also be provided with the soft tissue stretches for the components of movement of the trunk, as well as guidelines for when they should be used. You will learn how to use the RPSF™ to develop treatment ideas and achievable, reimbursable, discipline specific functional outcomes related to each component of movement of the trunk. You will learn how to use manual cues to provide opportunities for your clients to use more effective movement strategies for postural control in sitting and standing, and for the transitions of supine to sit and sit to supine, both toward the involved side and toward the less involved side. You will learn to use features of the environment related to use of components of movement of the trunk during functional activities. You will learn how to individualize expectations for practice of use of components of movement of the trunk in order to increase retention and carryover when instructing clients for home exercise programs. You will also learn how to document achievable, reimbursable, discipline specific, skilled intervention goals and individualized functional outcomes related to components of movement of the trunk and correlate them to the Functional Independence Measure (FIM).

Learning Outcomes: Upon completion of the course, you will be able to:

  • Use the RPSF™ to assess underlying impairments and access missing components of movement of the trunk, using the principles of NDT
  • Use the soft tissue stretches for the components of movement of the trunk, as well as understand when to use them
  • Use the RPSF™ to develop treatment ideas and achievable, reimbursable, discipline specific, individualized functional outcomes related to each component of movement of the trunk
  • Use manual cues to facilitate active use and increased ROM for lumbar extension, lumbar flexion and lateral lumbar flexion
  • Use manual cues to facilitate active use and increased ROM for thoracic extension, thoracic flexion, and rotation of the thoracic spine, including alignment and movement of the rib cage
  • Use manual cues to facilitate active use and increased ROM for scapular elevation, depression, abduction and adduction
  • Use manual cues to facilitate the ability to control postures in sitting and standing
  • Use manual cues to facilitate transitions of supine to sit and sit to supine, to both the involved side and less involved side
  • Use features of the environment to encourage use of effective movement strategies related to use of the components of movement of the trunk during functional activities
  • Individualize expectations for practice of use of components of movement of the trunk in order to increase retention and carryover when instructing for a home exercise program
  • Document achievable, reimbursable, discipline specific, skilled intervention goals and individualized functional outcomes related to the trunk and correlate them to the FIM
Prerequisite Part III
Intended Audience

OTR's, PT's, COTA's, PTA's working with adults with hemiplegia.

Contact Hours 15
Course Hours

Registration 7:30 a.m.
Day one 8:00-5:30
Day two 8:00-5:00

Register now.

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Applying the RPSF™ (Part V): Manual Cues for Accessing Missing Components of Movement with Intensive Focus on the UE and on Gait Using the Principles of NDT

Course Description: This four day, “hands-on” course provides you with the manual cues required to access missing components of movement of the involved UE for reach, support, and fine motor control, and of the involved LE for functional gait for your adult clients with hemiplegia. You will learn how to use these manual cues to assess underlying impairments, increase use of appropriate muscle activity, and increase ROM for each body segment of the involved UE and LE. You will learn how to use the RPSF™ to develop treatment ideas and achievable, reimbursable, discipline specific functional outcomes related to each component of movement of the UE and LE. Each lab will have a discipline specific emphasis that allows the client to benefit not only from a holistic, team approach but also from the specific expertise afforded by each discipline. You will learn how to use manual cues to increase pain free shoulder flexion for anterior and up reach requiring at least 120°. You will learn how to use manual cues to increase co-activity of the trunk with the active use and strength of the hip extensors, abductors and knee extensors required for mid-stance alignment in standing and functional gait. You will learn how to use manual cues to increase pain free finger and wrist extension as well as to increase ROM for ankle dorsiflexion, promoting increased use of the involved UE and LE for active support. You will learn how to use manual cues to facilitate fine motor control, and both the stance and swing phases of gait when ascending and descending stairs, stepping, turning, and negotiating curbs. You will learn how to use features of the environment related to use of the components of movement of the UE and LE during functional activities. You will also learn how to individualize expectations for practice of use of components of movement of the UE and LE in order to increase retention and carryover when instructing clients for home exercise programs as well as to individualize the use of orthotics, and assistive devices for walking. You will also learn how to document achievable, reimbursable, discipline specific, skilled intervention goals and individualized functional outcomes related to components of movement of the UE and LE and correlate them to the Functional Independence Measure (FIM).

Learning Outcomes: Upon completion of the course, you will be able to:

  • Use the RPSF™ to assess underlying impairments and access missing components of movement of the involved UE and LE, using the principles of NDT
  • Use the RPSF™ to develop treatment ideas and achievable, reimbursable, discipline specific, individualized functional outcomes related to the involved UE and LE
  • Use manual cues to increase pain free ROM requiring at least 120° of shoulder flexion for functional anterior and up reach
  • Use manual cues to increase active use and strength of the involved LE in mid-stance alignment in standing
  • Use manual cues to increase ROM of the wrist, hand, ankle, and foot, and to facilitate fine motor control and the swing phase of gait
  • Use features of the environment to encourage use of effective movement strategies related to use of the components of movement of the UE and LE during functional activities
  • Individualize expectations for practice of use of components of movement of the UE and LE in order to increase retention and carryover when instructing for a home exercise program
  • Individualize use of orthotics and assistive walking devices for effective management of the involved UE and LE
  • Document achievable, reimbursable, discipline specific, skilled intervention goals and individualized functional outcomes related to the involved UE and LE and correlate them to the FIM
Prerequisite Part IV
Intended Audience

OTR's, PT's, COTA's, PTA's working with adults with hemiplegia.

Contact Hours 30
Course Hours

Registration 7:30 a.m.
Each day 8:00-5:30
Last day 8:00-4:30

Register now.

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Applying the RPSF™ (Part VI): Implementing Client Interventions Using the Principles of NDT

"My Husband had a stroke in February last year. For months after the stroke he was still using a wheelchair to get around. We participated in our first course with Recovering Function in July. During the course, you told him that he had potential to use his paralyzed left side. You gave him so much hope! You showed him he had movement in his left side and taught him how to better use it when transferring from the wheelchair.

In the Recovering Function course in August, you helped him walk using his left side. Since then, he has had NDT therapy on a consistent basis. I want you to know that this morning, he got up from his recliner and walked to the bathroom by himself using a cane.

We had planned to build a wheelchair accessible house because of his disability. After we saw what he could do in your courses, we changed our plans. We are going to Canada this summer and the plans to build a wheelchair accessible house are on hold, hopefully indefinitely. My husband still wants to ride his bike and to golf again. Now we have no reason to tell him he can't."

Course Description: This five day, "hands-on", client treatment course provides you with the opportunity to apply the RPSF™ during interventions with adult clients with hemiplegia using the principles of NDT. You will examine, assess, and treat each client, progressing from the initial interview to the achievement of individualized functional outcomes while receiving feedback from your instructor. You will develop pretests and posttests that allow you to verify and document the new functional activity abilities acquired by your clients as the result of your skilled intervention. You will use features of a functionally rich environment to examine your clients’ functional activity abilities and functional activity limitations according to the FIM categories from an NDT perspective. You will use manual cues to assess your clients’ underlying impairments while accessing missing components of movement to promote the use of more effective movement strategies. You will develop discipline specific, skilled intervention goals and functional activities for your clients, and use features of the environment to develop progressive ranges of challenge leading to those goals. You will use the RPSF™ to develop and document achievable, reimbursable, discipline specific, individualized functional outcomes for your clients, as well as to individualize home exercise programs that will promote retention and carryover.

Learning Outcomes: Upon successful completion you will be able to demonstrate the following when applying the RPSF™ during interventions with adult clients with hemiplegia:

  • Demonstrate the ability to design pretests and posttests that validate new functional activity abilities acquired by your clients as the result of your skilled intervention
  • Demonstrate the ability to use features of the environment to examine your clients' functional activity abilities and functional activity limitations according the the categories of the FIM from and NDT perspective
  • Demonstrate the ability to use manual cues to assess your clients' underlying impairments while accessing missing components of movement to promote the use of more effective movement strategies
  • Demonstrate the ability to develop discipline specific, skilled intervention goals and functional activities leading to those goals
  • Demonstrate the ability to use features of the environment to develop progressive ranges of challenge leading to skilled intervention goals
  • Demonstrate the ability to develop achievable, reimbursable, discipline specific, individualized functional outcomes for your clients
  • Demonstrate the ability to derive individualized, functional outcomes for your clients using the core elements of movement of the RMAF
  • Demonstrate the ability to individualize expectations for your clients when developing home exercise programs
  • Demonstrate the ability to document daily progress toward achievable, reimbursable, discipline specific, individualized functional outcomes and correlate them to the FIM from and NDT perspective
Prerequisite Part V
Intended Audience

OTR's, PT's, COTA's, PTA's working with adults with hemiplegia.

Contact Hours 38
Course Hours

Registration 7:30 a.m.
Each day 8:00-5:30
Last day 8:00-4:30

Register now.

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NDT/Bobath Certificate Course in the Management and Treatment of Adults with Hemiplegia

Note: Certificates and credentialing for Recovering Function's NDTA approved course are issued by the NDTA.

Apply now.

Course Description: This three-week, client treatment course is offered to Occupational and Physical Therapists and Speech Pathologists who are working with adult clients with hemiplegia. Through the use of lecture, demonstration, "hands-on" practice labs and client interventions you will gain significant skills for working with the adult client with hemiplegia using the NDT treatment approach. You will learn the principles of the approach as applied to adult clients with hemiplegia, and you will learn how to integrate the concepts of motor control and motor learning used in this approach into your client treatments. You will be provided with methodologies for assessing your clients' impairments in multiple systems and you will better understand how these impairments cause their functional limitations. You will assess impairments interfering with postural control and movement, and you will practice handling for facilitating movement during activities carried out in contexts that are meaningful to the client. You will learn to manage the adult client with hemiplegia both from a discipline specific perspective and from a team perspective. The information you learn will be applicable to all settings including the acute hospital. rehabilitation center, skilled nursing facility, outpatient clinic, and the home environment.

Learning Outcomes: Upon successful completion you will be able to demonstrate the following during interventions with adult clients with hemiplegia:

  • Demonstrate an understanding of the NDT principles as originated by Mrs. Berta Bobath.
  • Demonstrate an understanding of the concepts of motor control and motor learning as they apply to adult clients with hemiplegia
  • Demonstrate the ability to assess impairments in multiple systems that are causing functional limitations
  • Demonstrate the ability to use handling to facilitate postural control and movement during activities that are meaningful to the client
  • Demonstrate application of the NDT approach to the management of adult clients with hemiplegia both from a discipline specific perspective and a team perspective.

Participant Requirements:

  • Graduation from a four year degree curriculum.
  • A minimum of one year of clinical experience with adults clients with hemiplegia.
  • Participants should be presently working with adult clients with hemiplegia and returning to a similar caseload.

Application Process

  • Contact Recovering Function to receive an application form or print one now . Please state which course dates you prefer.
  • This course has limited enrollment and fills quickly. Qualified applicants are accepted on a first come basis. You will receive an acceptance letter if qualified and a participant agreement that must be signed and returned with your course deposit. Full tuition for the course will be due no later than two months prior to the start date of the course in which you are enrolled.
Prerequisite See participant requirements above.
Intended Audience

OTR's, PT's and Speech Pathologists

Contact Hours 120
Course Hours

Registration 8:00 a.m.
Each day 8:30-5:00
Last day 8:30-4:00

Apply now.

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Facility Group Packages


"This is the best continuing ed course I have taken in 5 years. I will be able to use this approach with my patients. Prior to this course, I felt fairly lost in working with patients with hemiplegia, but now I feel like I have many options to use. The instructor demonstrated such passion for her work which makes her so enjoyable and easy to listen to and learn from."

 

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For therapists working at the same location for the same employer and registering for both parts at the same time (therapists must register at the same time, but may choose different course dates):

Group of 3 or more: $15 additional discount each therapist (facility saves $45 or more)
Register now.

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For therapists working at the same location for the same employer and registering for both parts at the same time (therapists must register at the same time, but may choose different course dates):

Group of 3 or more: $15 additional discount each therapist (facility saves $45 or more)
Register now.

 

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For therapists working at the same location for the same employer and registering for this course at the same time (therapists must register at the same time, but may choose different course dates):

Group of 3 or more: $15 discount each therapist (facility saves $45 or more)
Register now.

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Public, On-site NDT Courses


Get free registrations for yourself and your colleagues when hosting public, on-site courses. To have someone contact you by phone to discuss on-site hosting, send a note with your name and phone number to info@recoveringfunction.com

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Private, Customized On-site NDT Courses


The instructors can customize private, on-site courses for your staff. They will work with you to select exactly the content your staff needs. Available formats include "hands-on" labs, live patient demonstrations, consultations, patient treatment, videotapes and lecture. To have someone contact you by phone to discuss private, customized on-site courses, send a note with your name and phone number to info@recoveringfunction.com

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Bay Area On-site NDT In-services


For facilities in the San Francisco Bay Area, the instructors can customize private, on-site, evening in-services for your staff. Available formats include "hands-on" labs, live patient demonstrations, consultations, patient treatment, videos and lecture. To have someone contact you by phone to discuss private, customized on-site in-services, send a note with your name and phone number to info@recoveringfunction.com

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Achieve functional outcomes for your patients who have hemiplegia.


The instructors’ successes using the NDT (Bobath) approach demonstrate that adult clients with hemiplegia have potential to use effective movement strategies to achieve individualized functional outcomes. They work diligently to incorporate new research from the neurosciences into each course so that you will better understand your clients’ potential for recovery of function. Research in the neurosciences shows that changes in the CNS occur based on what is practiced (neuroplasticity). When your clients are given the opportunity to practice the use of effective movement strategies requiring the involved side, they have the opportunity to change the lesioned side of the brain and to achieve individualized functional outcomes.

The instructors also continue to update the NDT (Bobath) approach by integrating information about advances in the field of bio-kinesiology. They will help you use bio-mechanical laws to identify the components of movement required for the use of effective movement strategies, and use manual cues for accessing them. When you access the components of movements required for effective movement strategies, your clients will achieve individualized functional outcomes.

The instructors also continually integrate information about practice and feedback from the fields of motor control and motor learning. Practice and feedback are essential for promoting retention and carryover for the use of effective movement strategies for adult clients with hemiplegia. The instructors will provide you with examples of scheduling practice and using features of the environment to increase your clients’ retention and carryover.

The instructors will improve your problem-solving strategies for examination, assessment, and treatment. They will demonstrate strategies for examining your clients’ life roles, support systems, medical condition, as well as features of the environment for accurate determination of functional activity limitations. They will demonstrate strategies for assessing your clients’ underlying impairments in each system by assessing their use of ineffective movement strategies and missing components of movement. They will demonstrate strategies for achieving skilled intervention goals and individualized functional outcomes for your clients via treatment activities implemented according to a logical progression of challenge, as well as strategies for improving retention and carryover.

The instructors will demonstrate procedures for documenting the need for skilled intervention as well as the reimbursable, individualized functional outcomes achieved, in formats understandable by all reviewers including Medicare, managed care, and private insurers.

As a result of the extensive “hands-on” practice and individual instructor feedback provided in these courses, you will know what to expect and what to do with your adult clients with hemiplegia. You will acquire practical, efficient problem-solving strategies, manual cues, and documentation procedures that you use can use immediately in any environment (including the acute hospital, rehab center, skilled nursing facility, outpatient clinic, and the home), getting results faster, and making your organization more cost effective.

The instructors have dedicated their professional careers to the NDT (Bobath) approach when working with adult clients with hemiplegia. They want to provide you with a learning experience that will help your adult clients with hemiplegia achieve their full potential for recovery.

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About Recovering Function


Recovering Function is dedicated to the education of Occupational and Physical Therapists and Speech Pathologists who are working with adult clients with hemiplegia. Recovering Function has offered NDT (Bobath) courses since 1991, providing therapists with practical treatment ideas based on the NDT approach.

Recovering Function instructors are all certified by the NDTA, Inc. and consistently provide state-of-the-art education.  The instructors are actively treating clients and are current in the advances made in the fields of neuroscience, motor control and motor learning and in the understanding of bio-mechanical laws influencing components of movement. Combined, they offer decades of experience with adult clients with hemiplegia and have worked in every setting including the acute hospital, rehab center, skilled nursing facility, outpatient clinic, and the home. They have taught courses together for many years and have worked together clinically, offering a cohesive presentation of the material. The emphasis in their teaching is on “getting results faster” for your clients while providing you with the highest quality of instruction.

The “hands-on” courses offered by Recovering Function provide you with problem-solving strategies and manual cues based on the principles of NDT for your adult clients with hemiplegia. You will also learn how to write achievable, reimbursable, discipline specific individualized functional outcomes for all systems including Medicare, managed care, and private insurers. Recovering Function’s competency courses in San Jose offer you the unique experience of working with clients in a functional, practical environment while receiving feedback from the instructors.

It is exciting when you realize the results that can be gained for your adult clients with hemiplegia through the use of problem-solving strategies and manual cues using the NDT approach! It is our hope that you will be able to join us for a great learning experience.

The Instructors...

Cathy Runyan, OTR, is an Active, Certified NDTA, Inc. Coordinator Instructor. She is recognized nationally as an expert in the treatment of adult clients with hemiplegia. Cathy is the only OT Coordinator Instructor in the United States to be qualified by the NDTA, to administer the NDT Three-Week Certificate Courses for adults with hemiplegia. She has over 25 years experience treating adult clients with hemiplegia in various settings including the acute hospital, rehab center, skilled nursing facility, outpatient clinic, and the home. She is also a guest lecturer at San Jose State University, and has authored for a university textbook. Cathy has taught many introductory and advanced courses and the NDTA, Inc. (Bobath) Approved NDT Three-Week Certificate Course throughout the United States.

Bonnie Jenkins-Close, PT, is an Active, Certified NDTA, Inc. Coordinator Instructor. She has over 25 years experience treating adult clients with hemiplegia in various settings including the acute hospital, rehab center, and outpatient clinic. Her treatment emphasis is combining the principles of NDT with orthomechanics. She is currently practicing in Northern California. Bonnie has taught numerous introductory and advanced courses and the NDTA, Inc. (Bobath) Approved NDT Three-Week Certificate Course throughout the United States.

Peggy Miller, PT, is an Active, Certified NDTA, Inc. PT Instructor. She has over 25 years experience treating adult clients with hemiplegia in various settings including the acute hospital, rehab center, outpatient clinic, and the home. She is currently practicing in Northern California. Peggy has taught many introductory and advanced courses and the NDTA, Inc. (Bobath) Approved NDT Three-Week Certificate Course throughout the United States.

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Copyright 2000-2010 Recovering Function. All rights reserved. . .


Facility group packages for therapists from the same facility registering for the same course (therapists must register at the same time, but may choose different course dates)

Get free registrations when hosting on-site courses

Schedule private, customized on-site courses for your staff

Achieve functional outcomes for your patients who have hempilegia

Learn more about Recovering Function.


Stella experienced the onset of hemiplegia on the left side one week before this treatment session. She was an independent homemaker. She drove a car and was active in the community. Stella cannot control the posture of extension for the time it takes for her to put on lipstick. This is a measurable, functional outcome understood by everyone. Cathy is working to access the components of lumbar and thoracic extension which are opposite to her tendencies in movement. Stella will have an opportunity to practice these components of trunk movement that she cannot access without Cathy's help while participating in the activity of grooming, something that is functional and meaningful to her.

If your patient could push into his/her involved side and lift off to pick up a shirt from a surface, would you be working on balance? Of course you would, right in the context of a functional activity. You would be assessing balance and having influence over it at the same time, getting to results faster. Cathy is working to increase active use of Gary's left side by handling his left leg and arm to facilitate increased extension. The objective is for Gary to actively use his left side to increase his balance, safety and independence in functional activities.

Bill experienced the onset of left hemiplegia several months before he attended this course. Prior to this course, he had been encouraged to use his strong side to compensate for lack of use of his left side. He has severe perceptual problems and pushes into his left side. Bill now has to relearn how to use his left side. Diane Pacholski, PT (NDT Instructor) is teaching the participants how to facilitate Bill’s left side for active use while ambulating. Diane is helping the participants learn that it is essential to deactivate the right side while increasing use of his left involved side. Using the environment helps Bill restructure his mid-line orientation and encourages thoracic extension. With increased thoracic extension and with the pelvis more toward neutral in all planes, the participant is now able to increase extension in Bill’s left lower extremity. Hip and knee extension of the left leg is required to achieve terminal stance, a sub-phase of gait.

Bonnie Jenkins-Close, PT (NDTA Inc. Active Certified Instructor) is working with this participant to give her more ideas for giving Joe, who has hemiplegia on the left side, a more optimal chance to use his left side. Bonnie is teaching the participant how to increase co-activity of his trunk with improved alignment of the pelvis and upper trunk. The participant is also learning how to increase weightshift forward and onto Joe's right leg, facilitating him to use more selective hip and knee flexion of his left leg in preparation for the swing phase of gait.

Bonnie is helping the participants  understand the importance of preparing the patient for increased challenge. The participants are learning how to increase demand for extension of Meem’s left leg. They are also working to make sure her left hip abductors and external rotators are actively holding to increase stability.

The participants have worked to increase active use of Meem's left leg. Now Bonnie is helping them to increase challenge for Meem by working with her on the stairs for reciprocal stair climbing.

Peggy Miller, PT (NDTA, Inc. Active Certified Instructor) is presenting the importance of increasing use of the involved side by handling while using the environment to encourage use of the desired component of movement. Peggy is helping the participants understand that if their patient lacked use of thoracic extension, they would need to have their patient sit on a higher surface to encourage the pelvis toward neutral and to encourage the legs to activate. The participants are also learning how to handle their patients for thoracic extension. Peggy wants the participants to understand that the functional activity of turning on a light can be used to encourage thoracic extension.

Diane, who is 36 years old, experienced the onset of right hemiplegia. Peggy is helping the participant facilitate Diane’ s right hand so that it stays open and pushes onto the cabinet in the kitchen. Diane’s scapula and humerus must be approximated while her triceps are facilitated to push. Once Diane is actively pushing, as a result of handling by the participant, Diane will be expected to keep her right hand on the surface, while participating in a light meal preparation activity.