Roods approach

Introduction Evolved from developmental neurophysiologically literature.1 motor output dependent upon sensory output.2 motor responses follow a normal developmental sequences.3 psychic , somatic , autonomic functions are interrelated.

Assumptions Appropriate sensory stimulispecific motor responses.normal ontogenetic motor development purposeful muscular responses.Muscle action can be activated , facilitated, inhibited.

TheoryNormalize muscle tone.Pre-requisite to movement.Muscles have different duties;Heavy work stabilizers.Extensors + abductors.Postural supportLight work- mobilizes . Flexors + adductorsSkilled movements

Contd voluntary motor act based on inherent reflexes.Therapy Elicit motor responses at reflexes level Incorporate with developmental sequences - to augment motor response.

Treatment begins at the developmental level of functioningCephalocaudal ruleStimulation order:FlexorsExtensors Adductors Abductors

Movement directed towards functional goalAccept the activity as a meaningful event.Develop a sub cortical program to perform a motor act .Willed Movt with intended goal better performances.

Repetition Improves coordinationRequired to formulate engrams.

Principles of treatment

TNR & TLR assist / retard the effects of sensory stimulationSide lying reduces the influences Arm and leg on the down side extensor tone .Arm and leg on the upper flexor tone.

Stimulation of specific receptors produces three major responses.Homeostatic responses- ANS Reflexive protective responses spinal and brain stem circuits.Adaptive response integration of system.

Rules of sensory inputFast brief stimulus produces large synchronous motor output.Fast repetitive sensory input produces a maintained responses.Maintained sensory input maintained responses.Slow , rhythmical repetitive sensory input deactivates body and mind.

Muscles have different dutiesStabilizersMobilizers.

Heavy work muscles integrated before light work muscles.Heavy work-light work.

Sequences of motor development

Sequential phases of motor controlReciprocal inhibitionEarly mobility patternBasic Movt pattern is primarily reflex governed by spinal and supraspinal centers .Co-contractionStability pattern

ContdHeavy workMobility superimposed on stabilitySkillHighest level of motor control.

Co-contraction Stability pattern.

Treatment techniques

Facilitation techniquesCutaneous ;-used to stimulate the exteroceptors of the skin.Responds to stimuli arising from external environment.Protective withdrawal response.Principle stimuli transmitted- pain ,temp, touch .

ContdLight moving touch Used to activate the superficial mobilizing muscles.Applied through fingertip camelhair/brush cotton swab.Frequency -2times/sec ,for 10 times.Application -3-5 strokes ,with the gap of 30 sec b/w strokes .

ContdFast brushingStimulate c fiber.Max effect 30 min after stimulation.Used before all forms of treatment.Applied over the dermatome of the same segment the muscle supplies.Application 3-5 sec ,repeated after 30 sec

Contd IcingFacilitate muscle activity & ANS.Quick icingElicits withdrawal response.Applied in 3 quick swipes.Used for hypotonic.C icingFacilitate maintained postural response.Applied in dermatome-segment mytome.

Cont.Autonomic icingInfluences glandular output.Areas of sympathetic NS

proprioceptiveStimulation gives more motor control.Facilitation of muscle spindle, golgi tendon joint receptors, vestibular apparatus.Heavy joint compression Application - > than body wt in longitudinal axis.Facilitate co- contraction around the joint.Combined with development sequences .prone on elbows, quadruped.Done manually / mechanically.

Contd.Stretch Uses principle of reciprocal innervation.Used on light work muscles.Intrinsic stretchUsed to promote stability of the scapulo humeral regions.Enhanced with Resistive gripWt on ulnar border.

CONTDSecondary ending stretchMuscle put into stretch fires secondary endings.Facilitatory flexorsInhibitory extensors.Used for integrating TNRStretch pressureApplied placing pads of thumbs and index finger on the skin over the superficial muscle.

Contd.Stretch adequate to cause deformation.Stimuli not more than 3 sec.Resistance Used in isotonic fashion in developmental sequences.Used in shortened rangeFast brushing , quick stretch , given before to maximize the responses.

ContdIntermittent resistance to desired motion.TappingDone over the muscle belly3-5 times in the muscle to be facilitated.

Vestibular stimulationStatic labyrinth promote extensor patterns of neck , trunk ,extremities.Kinetic elicits phasic cortical responsesStimulation fast, slowaccelerationDeceleration movtshorizontal vertical

Contdinversion Inversion-alter the tone.Head down maximizes the extensors tone.Upright minimizes the extensors tone.Therapeutic vibrationUsed -desensitize hypertonic muscles.For tonal changesLow frequency-50-60 cycles /secHigh frequency-100-300 cycles/sec

ContdApplied over muscle belly // to fibersOver stretched muscle Duration 1-2 minsProne position flexorsSupine position-extensorsOsteopressurePressure over bony prominences-facilitate/inhibit voluntary muscles.

inhibition techniquesNeutral warmthApplied 5-10 min Effects relaxation tone decreasedGentle shaking /rockingSlow strokingSlow rollingGeneralized inhibitory effect

Contd..Light joint compressionApplied in longitudinal axisInhibits spasticity.Tendinous pressureHas the effect on tight ,spastic muscles.Maintained stretchPositioning the extremity in elongated position.