ROOD’S TECHNIQUE

1. ROOD’S TECHNIQUE John Christopher A. de Luna, PTRP

6. SENSORY ORGANIZATION ANTERIOR SPINOTHALAMIC TRACT & LATERAL SPINOTHALAMIC TRACT LEMNISCAL / DORSAL COLUMNS PROPIOCEPTIVE TRACTS

7. 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

8. 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

9. 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

10. 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 skin’s surface Related to sense of tickle and pleasurable touch sensation

11. 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

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

15. 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

16. Stages of Motor Control Mobility Stability Controlled Mobility Skill

17. 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

18. 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

20. 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

21. 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

22. 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

23. NECK CONTRACTION First real stability pattern Activates both flexors & tonic neck extensor muscles RECOMMENDED: Patients needs neck stability & extraocular control

24. 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

25. QUADRUPED STANDING A skill of upper trunk because it frees upper extremity for manipulation INTEGRATION: righting reaction & equilibrium reaction

26. WALKING Sophisticated process requiring coordinated movement patterns of various parts of body “support the body weight, maintain balance, & execute the stepping motion” - Murray

30. ROOD’S 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

33. 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 developmental stages

37. 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

39. FAST BRUSHING

40. SPECIFIC FACILITATION TECHNIQUES USED IN TREATMENT:

41. ICING A Icing a.k.a. QUICK ICING Patients hypotonia Are in state of relaxation Alerts the mental processes

42. C Icing Promotes RECIPROCAL PATTERN between diaphragm & abdominal muscles Increase breating patterns, voice production and general vitality ICING

43. Proprioceptive Facilitatory Technique

45. Proprioceptive Facilitatory Technique

48. VIBRATION

52. GENTLE SHAKING OR ROCKING

54. SLOW ROLLING

56. Special Senses for Facilitation pleasant odors unpleasant odors noxious substance warm liquids sweet foods/sweet taste

57. Cases:

58. SOURCES: TROMBLY, OCCUPATIONAL THERAPY PEREDENTTI, OCCUPATIONAL THERAPY REHABILITATION SPECIALIST

59. 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 ROOD’S TECHNIQUE USING PLAY THERAPY