ROODS TECHNIQUE

John Christopher A. de Luna, PTRP

Motor Homunculus
SENSORY ORGANIZATION
ANTERIOR SPINOTHALAMIC TRACT & LATERAL
SPINOTHALAMIC TRACT

LEMNISCAL / DORSAL COLUMNS

PROPIOCEPTIVE TRACTS
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
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
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
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
PROPRIOCEPTORS

1. CONSCIOUS
KINESIOCEPTORS / JOINT RECEPTORS
Transmitted to the cerebral cortex
Located joint capsule, ligaments, tendons
1. Ruffini end organs
2.Golgi Mazzoni corpuscles
3. Vater-Pacini corpuscles
4. Golgi-type endings
PROPRIOCEPTORS

2. UNCONSCIOUS
GOLGI TENDON ORGANS (GTO)
Greater sensitivity muscle
contraction

MUSCLE SPINDLE
PREMISE

IF IT WERE POSSIBLE TO APPLY THE

PROPER SENSORY STIMULI TO THE
APPROPRIATE SENSORY RECEPTOR AS
IT IS UTILIZED IN NORMAL SEQUENTIAL
DEVELOPMENT.
Rood, 1954
Stages of Motor Control

Mobility
Stability
Controlled Mobility
Skill
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
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
 SUPINE WITHDRAWAL

Total flexion response towards

vertebral level T10
Requires reciprocal innervation
with heavy work of proximal
segments
Aids in integration of TLR
RECOMMENDED:
patients with no reciprocal
flexion
Patients dominated by
extensor tone
 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
 PIVOT PRONE

Demands full range extension neck,

shoulders, trunk and lower
extremities
Position difficult to assume and
maintain
Important role in preparation for
stability of extensor muscles in
upright position
Associated with labyrinthine righting
reaction of the head
INTEGRATION: STNR & TLRs
 NECK CONTRACTION

First real stability pattern

Activates both flexors & tonic neck extensor muscles
RECOMMENDED:
Patients needs neck stability & extraocular control
 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
 QUADRUPED

STANDING
A skill of upper trunk because it
frees upper extremity for
manipulation
INTEGRATION: righting
reaction & equilibrium reaction
 WALKING
Sophisticated process requiring
coordinated movement
patterns of various parts of
body
support the body weight,
maintain balance, & execute
the stepping motion - Murray
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
CONTROLLED SENSORY INPUT

FACILITATORY INHIBITATORY
Light moving touch Gentle shaking or rocking
Fast brushing Slow stroking
Icing Slow rolling
Proprioceptive Facilitatory Light joint compression
techniques: Tendinous pressure
Heavy joint compression
Maintained stretch
Stretch
Rocking in developmental
Intrinsic stretch
stages
Secondary ending stretch
Stretch pressure
Resistance
Tapping
Vestibular stimulation
Inversion
Therapeutic vibration
Osteopressure
SPECIFIC FACILITATION TECHNIQUES USED IN TREATMENT:

Cutaneous Mediated by Procedure Effect

Stimuli

Light moving A delta Applied with a fingertip, Activates

touch sensory camel hairbrush-apply low
fiber 3-5 strokes and allow threshold
30 seconds of rest hair end
betw strokes to prevent organ and
over stimulation free nerve
endings
LIGHT MOVING TOUCH
Sends input limbic structure
Increases corticosteroids levels in blood stream
ACTIVATES SUPERFICIAL MOBILIZING MUSCLES (light
work 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
SPECIFIC FACILITATION TECHNIQUES USED IN TREATMENT:

Fast C fibers Apply it over the Stimulates C

brushing dermatomes of the fibers which
same segment the sends many
muscle supplies for 3 collaterals in
to 5 secs and repeated the RAS
after 30 seconds
FAST BRUSHING
SPECIFIC FACILITATION TECHNIQUES USED IN TREATMENT:

A icing/quick A fibers Ice is applied t the skin in Facilitation of

icing 3 quick swipes and water muscle
blotted with a towel betw activity and
swipes ANS
response
C Icing C fibers Ice cube is pressed to the Facilitates a
skin serving the same maintained
spinal segment of the postural
muscle to be stimulated, response
response may take as
long as 30 min
ICING
A Icing
a.k.a. QUICK
ICING
Patients hypotonia
Are in state of relaxation
Alerts the mental
processes
ICING

C Icing
Promotes RECIPROCAL
PATTERN between
diaphragm & abdominal
muscles
Increase breating patterns,
voice production and
general vitality
Proprioceptive Facilitatory Technique

Proprioceptive Procedure/Effect
Facilitatory Technique

Approximation Facilitates contraction of the jt combined with

developmental patterns, done manually or use of
weights and sandbags
Proprioceptive Facilitatory Technique

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 Ia
afferent 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 may be
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

Stretch Activates the proprioceptors in selected muscles and

imply the principle of reciprocal innervation
a. intrinsic It promotes stability of the scapulohumeral region,
stretch bearing more weight on the ulnar side of the hands and
promoting resistive grasp
b. Secondary Combination of resistance and stretch to facilitate
ending stretch 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 Effects both exteroreceptors and Ia afferents of the mm
pressure 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

Resistance Rood uses heavy resistance to stimulate

both primary and secondary endings of the
muscle spindle. It is used in isotonic fashion
in 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 muscle
spindle so it is more sensitive to stretch
Proprioceptive Facilitatory Technique

Tapping with the fingertips or percussed 3-5 times and may be done before or
during the time the px is voluntary contracting the muscles. This
stimulus acts on the afferent of the muscle spindles and increases the
tone of the underlying muscles.

Vestibular Stimulation Vestibular stimulation is a powerful type of proprioceptive unit. The

vestibular system is found to activate the antigravity muscles and their
antagonist muscle before the stretch reflex of the muscle spindles.
The system affects tone, balance, directionality, protective response,
cranial nerve function, bilateral integration, auditory language
development and eye pursuits. It is stimulated through linear
acceleration and deceleration in horizontal and vertical planes and
angular acceleration and deceleration such as spinning, rolling or
swinging. Fast stimulation tends to stimulate while slow rhythmical
rocking tends to relax.

Inversion In the inverted position, static vestibular system produces increased

tonicity of the muscles of the neck, midline trunk extensors and
selected extensors in the limbs. The head must be in normal
alignment with the neck.
VIBRATION
Gentle Shaking Rhythmical circumduction of the head and slight
or Rocking approximation is given can also be used in the
UE and LE
GENTLE SHAKING OR ROCKING
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.
SLOW ROLLING
 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 to
side then diagonal patterns
Special Senses for Facilitation
pleasant odors

unpleasant odors

noxious substance

warm liquids

sweet foods/sweet taste

Cases:
SOURCES:

TROMBLY, OCCUPATIONAL THERAPY

PEREDENTTI, OCCUPATIONAL THERAPY
REHABILITATION SPECIALIST
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