Evidence reviewed as of before 01-01-2021 Author(s): Ogourtsova, T. (PhD OT); Steven, E. (MSc App OT); Iliopoulos, G. (MSc App OT); & Majnemer, A. (PhD, OT, FCAHS)

Introduction

Neurofacilitation of Developmental Reaction (NFDR) approach is a therapeutic intervention developed for neuro-pediatrics. It attempts to produce adaptive postural responses. The approach is divided into two phases: 1) preparatory and variability phase, and 2) modulation phase.

The preparatory phase aims to normalize muscle tone, increase passive and active movement of the body, and encourage symmetry and alignment using inhibitory techniques and positioning. The variability component works on static and dynamic postural responses. The therapist provides neurofacilitatory orientation (of the body segments with reference to the trunk) and positioning of the limbs to improve postural stability, normalize tone and encourage normal motor behavior.

The modulation phase helps to modulate muscle tone and primitive reflexes in more complex scenarios. Movements at varying degrees, angles and intensities are used with neuro-facilitatory contact points, vestibular, proprioceptive and kinesthetic inputs as well as recruitment of the trunk musculature and integration of developmental reflexes to encourage motor development.

Parent & Family Information

Clinician Information

Children with spastic CP (mild/moderate spasticity)

CP level N/A

References

  • Batra, M., Sharma, V. P., Batra, V., Malik, G. K., & Pandey, R. M. (2012). Neurofacilitation of Developmental Reaction (NFDR) approach: a practice framework for integration / modification of early motor behavior (Primitive Reflexes) in Cerebral Palsy. Indian journal of pediatrics79(5), 659–663. https://doi.org/10.1007/s12098-011-0545-3

Definitions

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