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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
SPECIFIC FACILITATION TECHNIQUES USED IN TREATMENT:
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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
SPECIFIC FACILITATION TECHNIQUES USED IN TREATMENT:
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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.
Proprioceptive Facilitatory Technique
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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.
Proprioceptive Facilitatory Technique
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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
Proprioceptive Facilitatory Technique
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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