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ROODS TECHNIQUE


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Motor Homunculus


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SENSORY ORGANIZATION

ANTERIOR SPINOTHALAMIC TRACT & LATERAL

SPINOTHALAMIC TRACT

LEMNISCAL / DORSAL COLUMNS

PROPIOCEPTIVE TRACTS


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RECEPTORS:

1. INTERORECEPTORS

Spinothalamic Tract, Dorsal Column Lemniscal

2. EXTERORECEPTORS

FREE NERVE ENDINGS

Located skin and viscera

non specific receptors pain, crude touch,temperature

Unmyelinated C / myelinated nerve fibers

Activated with thermal or brushing techniques

Causes state of arousal

Ice packs & rubbing alleviates acute pain

Synapse with gamma motor neuron and bias the

muscle spindle


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RECEPTORS :

HAIR END ORGANS

Type of free nerve ending wrap around the base of hair follicle

Activated by bending / displacement of hair

A delta (group III) fibers

Stimulated with light touch or stroking of the skin

Bias the muscle spindle through the fusimotor system

Primitive humanity and Goosebumps

MEISSNER CORPUSCLES

Found just beneath the epidermis in hairless skin

Thicker A beta ( group II) fibers

Responsible for fine tactile discriminination

Important digital exploration and sensory substitution skills (reading braille)

Responsive to low frequency vibration


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RECEPTORS:

PACINIAN CORPUSCLES

Located deep layers of the skin, viscera, mesenteries, ligaments, near

blood vessels, periosteum of long bones

Most rapidly adapting receptors

Respond to deep pressure but are sensitive to light touch

Stimulated by high frequency vibration

Plays a role tonic vibration reflex

Aids desensitization of hypersensitive skin in children who exhibits

tactile defensiveness Supresses pain perception at the cutaneous level

Calming effect


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RECEPTORS:

MERKEL TACTILE DISKS

Found deepest epidermis in hairless skin

Volar surface of fingers, lips and external genitalia Fast-conducting A beta (group II) fibers

Slowly adapting touch-pressure receptors

Sensitive to slow movements across the skins surface

Related to sense of tickle and pleasurable touch sensation


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PROPRIOCEPTORS

1. CONSCIOUS

KINESIOCEPTORS / JOINT RECEPTORS Transmitted to the cerebral cortex

Located joint capsule, ligaments, tendons

1. Ruffini end organs

2.GolgiMazzoni corpuscles

3. Vater-Pacini corpuscles 4. Golgi-type endings


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PROPRIOCEPTORS

2. UNCONSCIOUS

GOLGI TENDON ORGANS (GTO)

Greater sensitivity muscle

contraction

MUSCLE SPINDLE


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PREMISE

IF IT WERE POSSIBLE TO APPLY THE

PROPER SENSORY STIMULI TO THEAPPROPRIATE SENSORY RECEPTORAS

IT IS UTILIZED IN NORMAL SEQUENTIAL

DEVELOPMENT.

Rood, 1954


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Stages of Motor Control

Mobility

Stability

Controlled Mobility

Skill


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SEQUENCE OF MOTOR DEVELOPMENT

1. RECIPROCAL INHIBITION (INNERVATION)

a.k.a. MOBILITY

A reflex goverened by spinal & supraspinalcenters Subserves a protective function

Phasic and reciprocal type of movement

Contraction of agonist and antagonist

2.CO-CONTRACTION (C0-INNERVATION) a.k.a. STABILITY

Simultaneous agonist & antagonist contraction with antagonist

supreme


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SEQUENCE OF MOTOR DEVELOPMENT

3. HEAVY WORK

a.k.a. CONTROLLED MOBILITY

Stockmeyer mobility superimposed on stability creeping

4. SKILL

Crawling, walking, reaching, activities requiring the coordinated use

of hands


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SUPINE WITHDRAWAL

Total flexion response towards

vertebral level T10 Requires reciprocal innervation

with heavy work of proximalsegments

Aids in integration of TLR

RECOMMENDED:

patients with no reciprocalflexion

Patients dominated byextensor tone


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ROLLOVER TOWARD SIDE-LYING

Mobility pattern for extremities and lateral trunk muscles

RECOMMENDED:

Patients dominated by tonic reflex patterns in supine

Stimulates semicircular canals which activates the neck &

extraocular muscles


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PIVOT PRONE

Demands full range extension neck,

shoulders, trunk and lowerextremities

Position difficult to assume and

maintain

Important role in preparation for

stability of extensor muscles in

upright position

Associated with labyrinthine rightingreaction of the head

INTEGRATION: STNR & TLRs


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NECK CONTRACTION

First real stability pattern

Activates both flexors & tonic neck extensor muscles

RECOMMENDED:

Patients needs neck stability & extraocular control


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PRONE ON ELBOWS

Stretches the upper trunk

musculature

Influences stability scapular

and glenohumeral regions

Gives better visability of the

environment

Allows weight shifting from side

to side

RECOMMENDED:

Patients needs to inhibit

STNR


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QUADRUPED

STANDING

A skill of upper trunk because it

frees upper extremity for

manipulation INTEGRATION: righting

reaction & equilibrium reaction


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WALKING

Sophisticated process requiring

coordinated movement

patterns of various parts ofbody

support the body weight,

maintain balance, & execute

the stepping motion - Murray


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ROODS THEORY

1. Normalize muscle tone

2. Treatment begins at the developmental level of

functioning

3. Movement is directed towards functional goals

4. Repetition is necessary for the re-education of

muscular response


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CONTROLLED SENSORY INPUT

FACILITATORY Light moving touch

Fast brushing

Icing

Proprioceptive Facilitatory

techniques:

Heavy joint compression

Stretch

Intrinsic stretch

Secondary ending stretch Stretch pressure

Resistance

Tapping

Vestibular stimulation

Inversion

Therapeutic vibration

Osteopressure

INHIBITATORY

Gentle shaking or rocking

Slow stroking

Slow rolling Light joint compression

Tendinous pressure

Maintained stretch

Rocking in developmentalstages


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SPECIFIC FACILITATION TECHNIQUES USED IN TREATMENT:

Cutaneous

Stimuli

Mediated by Procedure Effect

Light moving

touch

A delta

sensory

fiber

Applied with a fingertip,

camel hairbrush-apply

3-5 strokes and allow

30 seconds of rest

betw strokes to prevent

over stimulation

Activates

low

threshold

hair end

organ and

free nerveendings


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LIGHT MOVING TOUCH

Sends input limbic structure

Increases corticosteroids levels in blood stream

ACTIVATES SUPERFICIAL MOBILIZING MUSCLES (lightwork group that performs skilled task)

STIMULATES A delta sensory fibers synapses with fusimotor

system reciprocal innervation ( phasic withdrawal response)

STD: camel hair, finger tip, brush, cotton swab


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Fast

brushing

C fibers Apply it over the

dermatomes of the

same segment themuscle supplies for 3

to 5 secs and repeated

after 30 seconds

Stimulates C

fibers which

sends manycollaterals in

the RAS



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FAST BRUSHING


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A icing/quick

icing

A fibers Ice is applied t the skin in

3 quick swipes and water

blotted with a towel betw

swipes

Facilitation

of muscle

activity and

ANS

response

C Icing C fibers Ice cube is pressed to the

skin serving the same

spinal segment of the

muscle to be stimulated,response may take as

long as 30 min

Facilitates a

maintained

postural

response



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ICING

A Icing

a.k.a. QUICK

ICING

Patients hypotonia

Are in state of relaxation

Alerts the mental

processes


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C Icing Promotes RECIPROCAL

PATTERN betweendiaphragm & abdominal

muscles

Increase breating patterns,

voice production and

general vitality

ICING


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Proprioceptive Facilitatory Technique

Proprioceptive

Facilitatory Technique

Procedure/Effect

Approximation Facilitates contraction of the jt combined with

developmental patterns, done manually or use of

weights and sandbags


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Vibration It can be used for tactile stimulation to desensitize by

hypersensitive skin and to produce tonal changes in muscles.

Vibratory stimuli applied over a muscle belly to activate the Iaafferent of muscle spindle, causing contraction of that muscles

and suppression of the stretch reflex. This response is called

the tonic vibration reflex and is best elicited by a high

frequency vibrator that delivers 100-300c/s. The duration of

the vibration should not exceed 1-2 min per application

because heat and friction will result. The prone position maybe best while vibrating flexor muscle groups and the supine

position may enhance the extensor muscles. It is best to have

the pt in a warm environment because the skin receptors are

at a lower threshold for firing.



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Stretch Activates the proprioceptors in selected muscles and

imply the principle of reciprocal innervation

a. intrinsicstretch It promotes stability of the scapulohumeral region,bearing more weight on the ulnar side of the hands

and promoting resistive grasp

b. Secondary

ending stretch

Combination of resistance and stretch to facilitate

ontogenic patterns. Once a muscle is put on a full

stretch ,secondary nerve endings which is facilitatory

to the flexors and inhibitory to the extensors

c. stretch

pressure

Effects both exteroreceptors and Ia afferents of the mm

spindle, pads of the thumb, index and middle finger are

given firm, downward pressure and stretching motion

is achieved if the thumb moves away from the finger.



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Resistance Rood uses heavy resistance to stimulate

both primary and secondary endings of the

muscle spindle. It is used in isotonic fashionin developmental fashion to influence the

stabilizers. When a muscle contracts

against resistance, it assumes a shortened

length that causes the muscle spindle to

contract so they readjust to the shortened

length. This is called biasing the musclespindle so it is more sensitive to stretch



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VIBRATION


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Gentle Shaking

or Rocking

Rhythmical circumduction of the head and slight

approximation is given can also be used in the

UE and LE


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GENTLE SHAKING OR ROCKING


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Slow Rolling Pt is rolled slowly from a SL

position to prone and back in a

rhythmical pattern; use on both

sides of the body.


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SLOW ROLLING


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Techniques Procedure/Effect

Neutral warmth Affects the temperature receptors in the hypothalamus and PSNS,

used for pxs with hypertonia. Px in recumbent and wrapped with a

blanket for 5-20 minutes. Pt feels relax and decreased in tone.

Slow stroking Pt prone while the therapist provides a rhythmical, moving deep

pressure over the dorsal distribution of the posterior rami of the

spine; done from occiput to coccyx and alternated and should not

exceed 3 minutes because it causes a rebound phenomenon

Tendinous Pressure Manual pressure applied to the tendon insertion of a muscle; can

be used in spastic or tight mm

Approximation Jt compression less than or equal BW to inhibit spastic mm around

the joint.

Maintained Stretch Positioning in the elongated position to cause lengthening of the

mm. Spindle to reset the afferents of the mm spindle to a longer

position so they become less sensitive to stretch

Rocking Shifting the weight forward and backward, progressing to side toside then diagonal patterns


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Special Senses for Facilitation

pleasant odors

unpleasant odors

noxious substance

warm liquids

sweet foods/sweet taste


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Cases:


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SOURCES:

TROMBLY, OCCUPATIONAL THERAPY

PEREDENTTI, OCCUPATIONAL THERAPY REHABILITATION SPECIALIST


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OBJECTIVES: LABORATORY

1. RETURN DEMONSTRATION ON PEDIATRIC

EVALUATION

2.INTEGRATION OF THE KNOWLEDGE GAINED IN

PEDIATRIC REHABILITATION IN GOAL SETTING

3. DEMONSTRATION RETURN DEMONSTRATION

OF ROODS TECHNIQUE USING PLAY THERAPY

roods approch

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