Biomechanical Frame of Reference

Neuro-Developmental Treatment Frame of Reference

The Neuro-Developmental Treatment (NDT) frame of reference is used to analyze and treat posture and movement impairments based on kinesiology and biomechanics. To identify difficulties and plan for intervention, the following concepts are to be considered in NDT, including planes of movement, alignment, range of motion, base of support, muscle strength, postural control, weight shifts, and mobility. NDT assumes that posture and movement impairments are changeable. Thus, it utilizes movement analysis to identify missing or atypical elements.

The Biomechanical frame of reference for positioning children for function is applied to individuals who are unable to maintain posture from appropriate automatic muscle activity caused by neuromuscular or musculoskeletal dysfunction. The goals of this frame of reference are (1) to enhance development of postural reactions, which can be done by reducing the demands of gravity and aligning the body, and (2) to improve functional performance by providing external support for proximal stability to improve distal function.

The Conceptual Model for Performance in Handwriting views that handwriting is important for one’s work and/or education domains of occupations. It considers the performance components, performance areas (functional performance), performance contexts, and the interactive relationship among them. Prerequisites to handwriting include performance components in sensory, perceptual, motor cognitive, and language functions, as well as integrations of these components.

The Framework of Occupational Gradation (FOG) focuses on one’s active movements with the more involved upper extremity. There are two versions of FOG, one for young children (C-FOG) and one for older children and adults (A-FOG). Both aim to provide occupational ideas in preventing learned non-use of the more involved upper extremity for clients with neurological impairment. These ideas can be incorporated into daily lives to increase use of the extremity. Appropriateness of task for each client is determined by hand dominance and perceived meaningfulness.

Rehabilitative frame of reference (FOR) considers rehabilitation as the process of facilitating patients in fulfilling daily activities and social roles with competence. This FOR is used with clients whose underlying impairments are unlikely to remediate and be considerable permanent, or the clients who lack motivation to participate in remediation. The theoretical basis of this FOR is that the client must focus on the remaining abilities, despite of any disabilities, to attain his/her highest level of functioning in the desired occupational performance.