Stroke Currently, in the U.S. there are 500,000 cases of stroke (brain attack) every year. Of this population, many are left with hemiplegia, or weakness and loss of movement in the affected arm and leg. Most stroke patients experience balance and coordination problems; difficulty moving around in various locations such as to/from the bed, car, or shower; and difficulty performing activities of daily living, such as getting dressed.  Fortunately, studies have shown that recovery is optimized and expedited with physical therapy   intervention.  Although most recovery occurs within the first 6 months,  many studies have shown significant progress can occur for months or years post stroke.

Guillain-Barre Syndrome is an inflammatory disorder of the peripheral nerves, those outside the brain and spinal chord. Symptoms include the rapid onset of weakness and often paralysis of the legs, arms breathing muscles and face. It currently affects 2 out of every 100,000 people in the U.S.

Multiple Sclerosis is a chronic disease caused by the inflammation and scarring of the myelin sheath (a fatty covering that surrounds and protects nerve fibers) and the underlying nerve. Signals from the brain to the muscles break down, and body movements become slow and uncoordinated. The arms and legs may feel numb or awry because the sensations from these extremities do not reach the brain. In the U.S, 400,000 people have MS, and every week, 200 additional people are diagnosed.

Spinal Cord Injury occurs when trauma damages the cells within the spinal cord or severs the nerve tracts that relay signals up and down the spinal cord. Damage can be complete, resulting in total loss of sensation and function below the level of the lesion, or incomplete, resulting in partial loss. Most injuries occur from motor vehicle accidents, with an annual injury rate of 11,000.

Physical Therapy is part of a rehabilitation team that usually includes occupational therapists, speech therapists, the medical doctor, nursing services, social services, psychological and neurological services. Patients usually require all these services in the acute phase of treatment, and then reduce them as needed. All therapy is directed toward functional training. Physical therapy typically involves improving bed mobility, transfers, walking and stair use, utilizing bracing and seating systems, overseeing adaptations in the home to improve handicapped accessibility and enhance patient safety, patient and family education regarding stroke, and assisting the caregivers in understanding their role for the patient.. The aims of treatment are goal orientated and influenced by the severity of the neurological condition.

Neurodevelopmental Training (NDT)
was begun by Drs. Karel and Berta Bobath, who observed the patterns exhibited in the arms and legs of hemiplegic's patients, and began to work on ways to assist these patients in their recovery. Some tenets of their approach are:

• Supression of abnormal patterns to facilitate the presence of normal movement patterns.

• Use of reflex- inhibiting patterns to inhibit abnormal postural reactions, and facilitate normal voluntary movements.

• Abnormal movement patterns are modified at key points of control.

• Avoidance of mass synergies as a method of movement and facilitating the normal patterns of movement.

Therapists utilizing NDT techniques have completed advance training in NDT and work closely with individuals with various neurological challenges (cerebral palsy, stroke, head injury) helping them to become as independent as possible. NDT-trained therapists work collaboratively with patients, their families, caregivers and physicians to develop comprehensive treatment programs based on the principles of human neurology and physiology. Individuals who have minimal or severe motor difficulties can benefit from the muscle patterns utilized in the NDT approach.