ROOD’S TECHNIQUE

►a.k.a. “Sensorimotor Approach”

LIGHT WORK PATTERNS: HEAVY WORK PATTERNS:
►developed by Margaret Rood,OTR,RPT
Facilitated by: Facilitated by:
►based on neurophysiological principles & involves dermatomal sensory
1. Quick stretch 1. Quick stretch
stimulation to elicit a motor response
2. Unpleasant stimuli 2. Joint compression in correct
►sensori input = motor input
3. Potentially harmful alignment
►may be used in children & adult
4. Specific receptors sites on lips, 3. Pressure on wt. bearing surfaces,
tongue, soles of feet, palms of hand distal end fix
GOAL:
5. Input from semicircular canal 4. Resistance distally to ext. or abd.
►activate movement & posture responses at an automatic level while following
of proximal limb joint
normal developmental sequence
5. Input from utricle & saccule
PRINCIPLES:
1. ONTOGENIC PLAN OF MOTOR DEVELOPMENT: SEQUENCE OF MOTOR DEVELOPMENT:
►The development of Homo Sapiens proceeds normally from the control of the LEVEL 1. Mobility
head, trunk to the rest of the body. LEVEL 2. Stability
LEVEL 3. Controlled mobility
2. LAW OF RECIPROCAL INNERVATION: LEVEL 4. Skill
►the antagonistic ms groups coordinate with each other in that as 1 group of ms
operate, the antagonistic groups are inhibited 1. MOBILITY:
►ability to initiate movement & move through range
3. TEMPORAL SUMMATION: ►phasic (MOBILITY, NONPOSTURAL, FG FIBERS) reciprocal shortening &
►the varying stimuli applied to a common point & hence an accumulation of lengthening contractions of ms
stimuli, intensifies a response ►activities:
1. supine withdrawal or supine flexion
TREATMENT STRATEGIES: 2. roll over
3. pivot prone or prone extension
1. PROPRIOCEPTIVE: 2. EXTEROCEPTIVE: 3. INTEROCEPTIVE:
Vital: inspiration & expiration
►stretch ►visual ►vestibular
►resistance ►auditory
2. STABILITY:
►jt approximation ►tactile
►ability to maintain a steady position in a wt bearing antigravity posture
►jt traction pressure
►a.k.a. “static equilibrium or static postural control”
►vibration

2a. TONIC HOLDING: 2b. Co-contraction:

ONTOGENIC PLAN OF MOTOR DEVELOPMENT:
►stability control of postural ►stability control achieved by the
►motor development follows a cephalo- caudal/proximodistal pattern
extensor ms holding in the shortened contraction of antagonistic ms
►e.q. ►e.q. UE: ►e.q. LE: ROM around a jt; provides stabilization
1. Head 1. scapula 1. pelvis during wt bearing activities
2. neck 2. shoulder 2. hip
3. face 3. elbow 3. knee
►activities (STABILITY):
4. upper trunk 4. Hand 4. ankle ar
4. pivot prone
5. lower trunk
5. neck co-contraction
► A movement response is first evoked reflexively using specific & appropriate 6. prone on elbows
sensory stimulus then the obtained responses are used in developmental 7. quadruped
patterns & then the pt uses the response purposefully to gain control over it. 8. sitting
► In the development of motor responses flexion precedes extension; adduction 9. kneeling
precedes abduction; ulnar patterns before radial patterns & rotation develops 10. standing
last. 11. vital: phonation & sucking
► Motor control progresses through the ff: stage: reflex mass patterns;
automatic/spontaneous rhythmical movement; through full range; in both ►criteria for adequate stability & control
directions; voluntary selective movement. 1. ability to hold the posture without support
2. ability to sustain posture for an adequate time
ONTOGENIC MOTOR PATTERNS OR 8 KEY DEVELOPMENTAL PATTERNS: 3. ability to control the posture as evidenced by a minimal amount of postural
sway
1. supine withdrawal or supine 5. prone on elbows
flexion 6. quadruped 3. CONTROLLED MOBILITY:
2. roll over 7. standing ►ability to maintain postural control during weight shifting & movement
3. pivot prone or prone extension 8. walking ►mobility superimposed on stability
4. neck co-contraction ►distal segment is fixed while the proximal segments move
►a.k.a. “dynamic equilibrium or dynamic postural control”
USE OF LIGHT WORK & HEAVY WORK MS IN PARTICULAR
DEVELOPMENTAL PATTERNS: 3a. STATIC DYNAMIC CONTROL:
►ability to shift wt on 1 side & free the opposite limb for non-WB dynamic
LIGHT MS WORK: HEAVY MUSCLE WORK: activities
►Mobilizers ►Stabilizers
►Phasic/fast movement ►Tonic co-contraction ►activities (Controlled mobility):
►FG motor units (pale) ►SO motor units (dark) 1. neck co-contraction (orient head in space)
►Superficial; usually arthrodial ►Deep; monoarthrodial 2. prone on elbows (shift from side to side, push backward & pull forward,
►Lateral; tendinous origin ►medial; fibrous origin unilateral WB)
►Fusiform or strap; small ►Pennate; large area of attachment 3. quadruped (rocking, shifting, unilateral wt bearing)
►Great increase in bld if active ►Rich in blood supply at all times 4. standing (wt. shifting, unilateral WB)
►High metabolic cost; rapidly fatigue ►Low metabolic cost; slow to fatigue 5. vital: swallowing solids & liquids, chewing
►Flexors & adductors ►Extensors & abductors

WORK: (HEAVY ➜ LIGHT)

►Heavy work ms should be developed first before light work muscles.
 4. SKILL: FACILITATORY TECHNIQUES:
►highly coordinated movement that allows for investigation & interaction with the
physical & social environment
1. POSITIONING: ►positions that reinforce abnormal reflexes
►the proximal segment is stabilized while the distal segment is moving
should be avoided & righting reactions
encouraged
►activities (SKILL):
1. prone on elbows (head is doing skilled movement & one hand is free for skilled
use; belly crawling) 2. FAST BRUSHING: ►use of a soft camel hairprint brush or battery-
2. quadruped (1 arm free for skilled use; creeping; trunk rotation & reciprocal powered brush
movement; crossed diagonal) ►fast brushing over the dermatomal
3. standing & walking representation of a ms or over the ms belly for
4. vital: articulation, speech approximately 5 seconds & repeated 3-5 times
►fast, repetitive stimulation is specific for
NOTE: ROOD has developed a system of treatment which is based upon exteroceptors & probably C fiber stimulation
stimulation of cutaneous & musculocutaneous receptors in the activation of ms with its resultant effect on the gamma loop
responses for either co- contraction or relaxation system
►effect is on non-specific & has a latency
RULE OF THUMB: period of 30 secs & reaches its maximum
► Slow movements ➜ relaxes 30-40 minutes after stimulation
► Fast movements ➜ facilitate contraction ►also beneficial in increasing circulation
►first manifestation of effects may be on the
INHIBITORY TECHNIQUES: opposite side of the body
►avoid fast brushing on the pinna of the ear
stimulates the vagus nerve, slows the heart,
1. SLOW STROKING: ►light finger pressure is applied to the ms constrict bronchial airways, stimulates
belly for a few minutes with continuous bronchial secretion
contact ►do not brush over post primary rami of L1-
►slow rhythmical stroking of the vertebral L2: will cause voiding; & S2: bladder retention
musculature using alternate hands is done
for 5 minutes or until the pt. relaxes 3. FAST ICING with a wrapped ►used for the flaccid types only
►USES: for hypertonic pt’s ice cube: ►rebound effects are noted approximately 30
seconds after application in which the ms
2. NEUTRAL WARMTH: ►promotes ms relaxation without danger of stimulated are temporarily inhibited
harmful rebound effects ►applied over the ms belly
►if heat greater than the body is applied, a ►C ICING: done by holding ice cube pressed
rebound effect is noted 2-3 hours after in place for 3-5 seconds facilitates C fibers
►for total body treatment: wrap pt in cotton ►A ICING: done by application of quick swipes
blanket for 10-20 minutes or immersed in to facilitate flexor withdrawal: applied to palms,
tepid water soles, dorsal webs of hands
►treatment of extremity: wrap in Turkish
towel 4. LIGHT TOUCH or STROKING ►activates low threshold A size sensory fibers
►USES: spasticity, rigidity, extreme tension of the skin: to activate the reciprocal action of the
or painful joints & ms superficial phasic or mobilizing ms

3. PRESSURE ON MS INSERTION: ►inhibition of tight ms or ms group 5. PRESSURE ON A MS BELLY: ►act through the ms spindle & other
proprioceptors
4. PLEASANT ODORS: ►calming effect
6. HEAVY JOINT ►facilitates co-contraction of the ms around a
5. SLOW ROLLING: ►for spastic or rigid ms COMPRESSION: jt
►should be repeated for several minutes ►usually an extension pattern is facilitated
►slow rocking in a rocking chair is a ►pressure should be more than the body wt &
variation should be directed at the longitudinal axis of
bone
6. LIGHT JOINT COMPRESSION or ►apply pressure that is less than the body ►e.q. to facilitate co-contraction of the
JOINT APPROXIMATION: weight to inhibit the ms crossing the jt shoulder ms; the pt may be placed in prone on
elbows
7. MAINTAINED STRETCH IN THE ►maintained stretch for a period of time ►stimulates high jt receptors
LENGTHENED POSITION: ranging from several minutes to weeks
biases the spindle to the longer position 7. JOINT TRACTION: ►will facilitate a pattern of flexion
►the lengthened ms spindles are biased
longer & will not react to stretch as briskly at
shorter ranges following this procedure 8. QUICK STRETCH: ►facilitatory for movement
►a low threshold stimuli that activates an
8. SLOW POUNDING along the immediate phasic stretch reflex of the ms
axis of the bone stretched & inhibits its antagonist
9. SLOW BRUSHING on a ms belly
9. TAPPING a tendon or ms ►elicits same response as quick stretch
10. PROLONG ICING: ►with an ice cube wrapped in a cloth & belly: ►area is percussed using the finger tips
placed on top of a tight ms

11. SOFT MUSIC 10. RESISTANCE as a form of ►by resisting movement, motor units are
stretch: recruited to fire (overflow)

11. VESTIBULAR STIMULATION

12. FAST BEAT MUSIC
SPECIFIC TREATMENT TECHNIQUES:
A. HYPOTONIC PATIENTS:
►Floppy Infant Syndrome
►Flaccid paralysis
1. swinging, rolling. Spinning in all planes for labyrinthine stimulation
2. specific exteroceptive & proprioceptive stimulation for specific developmental
patterns in proper sequence

B. HYPERTONIC:
►Maintained flexor or extensor tone
1. neutral warmth for relaxation
2. exteroceptive & proprioceptive stimulation of antagonists of spastic
musculature in appropriate developmental sequence

C. RIGIDITY:
►Parkinson’s disease
1. neutral warmth for relaxation
2. slow rolling for relaxation, segmental in form
3. stimulation for reciprocal movement patterns

D. HYPERKINETIC PATIENTS (with uncontrolled movement):

►Athetoid
►Ataxia
►Hyperactive behavior
1. slow stroking down the posterior rami from the occiput to the coccyx for
relaxation
2. maintained holding patterns keeping the distal segment stabilized until control
is obtained
3. progress to movement patterns

Note: Multisensory rehabilitation page 229- Sullivan

PROPRIOCEPTIVE STIMULATION TECHNIQUES & EXTEROCEPTIVE

STIMULATION TECHNIQUES on next page!!!!
 PROPRIOCEPTIVE STIMULATION TECHNIQUES:

STIMULUS: ACTIVATES: TECHNIQUES: RESPONSE:

1. QUICK STRETCH ►ms spindle ►quick stretch to ms ►Reciprocal Innervation

►tapping over ms belly or tendon

2. PROLONG STRETCH ►ms spindle ►slowly maintained stretch esp. in ►primary inhibition
►GTO lengthened ranges ►dampens ms contraction
►Joint receptors ►inhibitory splinting; casting ►dampens ton
►RIP’s (NDT)

3.RESISTANCE ►Alpha & Gamma motor neurons ►manual resistance ►recruits motor units
►use of body weight & or gravity ►Reciprocal Innervation
►mechanical; weights ►Enhances kinesthetic awareness

4. JOINT APPROXIMATION ►joint receptors (static) ►joint compression- manual ►facilitates postural extensors /
►mechanical-weights or belts stabilizers
►bouncing & or gymnastic ball ►enhances jt awareness

5. JOINT TRACTION ►joint receptors (phasic) ►manual distraction ►facilitates flexors

►enhances movement, jt awareness

6. INHIBITORY PRESSURE ►tactile receptors ►firm pressure to long tendons ►inhibition

►ms spindle ►mechanical: firm objects (cones) in hand ►dampens ms tone
►GTO’s

7. VIBRATION: High frequency: (100-200Hz) ►ms spindle ►electric vibrators ►can suppress cutaneous sensations &
►Pacinian corpuscles pain via gate mechanism

8. Low Frequency: (5-50 Hz) ►produces a flutter response or

alarming reaction; protective withdrawal,
nausea, vertigo

EXTEROCEPTIVE STIMULATION TECHNIQUES:

STIMULUS: ACTIVATES: TECHNIQUES: RESPONSE:

1. LIGHT TOUCH: ►fast adapting skin receptors ►manually applied: Brief light stroke, brief swipe ►protective withdrawal
with ice cube, light pinch or painful stimulus ►increased arousal
►emotional reactions

2. MAINTAINED TOUCH: ►tactile receptors ►firm manual contact ►calming effect

►ANS (parasympathetic responses) ►pressure to midline abdomen, back ►generalized inhibition
►firm pressure to lips, palms, soles

3. SLOW STROKING ►ANS (parasympathetic response) ►with flat hand apply firm, alternate strokes in ►calming effect
paravertebrally for 3-5 minutes ►generalized inhibition

4. MANUAL CONTACTS ►skin receptors ►firm direct contact over contracting ms or body ►facilitates agonist ms contraction
part ►gives direction to movement
►provides support to body part

5. PROLONG ICING: ►decreases neural & or ms spindle firing ►ice chips & or ice wraps ►inhibition of ms tone
►decreases metabolic rate of tissue ►ice packs ►inhibition of pain
►immersion in cold water

6. NEUTRAL WARMTH: ►thermoreceptors ►wrapping body/body part with wraps, towels ►generalized inhibition of tone
►ANS (parasympathetic response) ►application of snug-fitting clothing, gloves, socks, ►calming effect
tights ►relaxation
►tepid baths ►decreased pain
►duration: 10-20 minutes