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11/29/08 C.B.

SENTHILKUMAR 1
ROOD APPROACH
Muscles have different duties. Most of them
are a combination, but some predominate, in
“light work” , others in “heavy work”.
 Margaret Rood, American Physical therapist, 1956.

Neurological ?

RA,OA, Soft tissue injury, Post fractures ?

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Muscle Work
Light : Heavy:

Phasic. Tonic.

Fast glycolytic. Slow oxidative.

Superficial. Deep.

Multiarthrodial. Single joint muscle.

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Fusiform or strap. Pennate.

Small area Large area


attachment. attachment.

Active↑Blood All time rich in


supply. blood.

High metabolic cost. Low metabolic cost.

Rapidly fatigue. Slow fatigue.

Flexors & Adductors. Extensors &


11/29/08 C.B.SENTHILKUMAR abductors. 4
To normalize the muscle
tone
Facilitatory technique:

--To normalize the muscle tone from a flaccid state.


--Icing, fast brushing, tapping, stroking, quick stretch.

Inhibitory technique:

--To normalize the muscle tone from hypertonic or spastic


state.
--Deep pressure, slow rolling, and slow rocking.

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Facilitation
Light Work: Heavy Work:
Quick stretch. Quick stretch.

Unpleasant stimuli. Joint compression.

Pain Pressurewt.
stimu(Nociceptors). bearing.

Lips, tongue, feet, Resistance.


palm.
Utricle &
SCC(head Saccule(Static).
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Features
 Identification of goal.

 Identification of factors  Poor function.

 Selecting the relevant need(motor activity).

 Selecting afferent stimuli.

 Timing of stimuli.

 Ensuring repetition.

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Goals
Communication.

Manipulative skills.

Gross motor function.

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Examination
Sensation.

Perception.

Postural reaction.

Quality of movement.

Muscle tone.

Circulatory defects.

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Sequences in Gross Motor
Development
A1:
 Supine.

 Withdrawal pattern.

 Total flexion.

 Tonic heavy work.

 Reciprocal innervation.

 Bilateral.

 Centered at 10th

thoracic vertebrae.

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A2:

Roll over.

Flexion top arm &


leg.

Phasic movement.

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A3:
Pivot pattern.

Total extension.

Reciprocal
innervation.

Bilateral.

Cen at 10th
vertebrae.

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B. Fixed Distal Segments
B1:
Neck Co contraction,
Vertebral extension.

For head & neck


hyperkinesia.

To stabilise eyes if


nystagmus.

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B2:
Forearm support.

Gleno humeral joint


alignment.

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B3:
All fours.

B4:
Sitting.

Pressure on knees
through to heels
Auto facilitation.

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C: D:

Movement over Skilled movement


fixed distal segment. distal end of limbs
free.
To ↑ Dynamic
stability. To ↑ mobility.

Rock side to side, Reaching , Crawling,


back and forward. Walking.

Turning movements. Objective &


Functional.
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Movement Control
Sequence
Flexion.

Extension.

Adduction.

Abduction.

Rotation.

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Receptors
Cutaneous:
Quick light brushing:

 Nerve root.
 Soft artist or decorator’s brush or electrically
powered.
 Anterior primary rami  local, superficial muscles.
 Posterior primary rami  deep back muscle.
 Face  muscles of mastication & expression( V  VII
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).
Delay upto 20 min for inhibited not used
recently.

Rapid stimulation effective over Poor


circulation.

‘Cutaneous stimulation  rapid & large ms


spindle modulation thro gamma motoneuron
reflexes’- Loeb & Hoffer (1981).
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Brief Cold Application
Quick wipe with ice cube.

Warm limb.

Immediate & most effective.

Limb Extensors.

To palm of hand  ↑ mental process.

Lips , tongue  suck, swallow, speech.

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Slow Stroking
Neck to sacrum over centre of back  ↓

chorea athetosis or excessive muscle tone.

Rhythmically for 3 minutes.

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Precautions
Brush:
Aware of effect.
3 sec in one place.
Repeated in bursts at intervals.
Do not use mechanical tools.
In flaccid infant seizures(stroking adviced).
Ear , outer 3rd forehead central inhi.Avoid in
brain stem injury.

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Precautions
Ice:
Behind ear sudden ↓ of blood pressure.
Sole , Palm nociceptive(avoid in children &
emotionally unstable).
Ice over posterior primary rami which shares
nerve supply to vessels supplies organ.
Left shoulder in cardiac diseased.

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Muscle Spindles
Quick Stretch:
Ia afferent Facilitatory.
Slow Stretch:
Single joint deep muscles 5 minutes 
II(length measuring from nuclear chain fibres) 
Inhi.
Quadriceps, hip abductors, lumbar & cervical
deep extensors, glenohumeral & shoulder girdle
retractors.

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Vibration
Mech vibrator  muscle on stretch  muscle
spindle stim tonic vibratory reflex.

Cutaneous brushing prior to vibrator 


effective.

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Golgi Tendon Organs(Ib)
Contraction receptors.
Auto inhi to a non resisted repeated
contraction.
Multiarthrodial.
Fast glycolytic.
Slow repeated Flexors & Adductorsstrong
isotonic for extensors.
Inhi only for flexor not for extensors…………?

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Mechanoreceptors
Maintained pressure medial heel↑dorsiflexor.
Pressure Heel of hand normalization.
Pisiform pressure.

Skull to ischial weighted cap, shoulder bag

athetosis.
Skin stimu over convex part.

Compression over concave part.

Prone on elbow
11/29/08 , hand rock forward & back.
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Labyrinthine System
Head mvmt in vetical (revolving chair)  SCC

 ↓postural tone & improves in bradykinesia.

Prone on tilting plinth , large ball  head rock

up & down  activation of fast twitch

muscles.

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Special Sense Organs
Nose & Mouth face & tongue mvmt.

Quinine on back of tongue  ↓ tongue thrust.

Ammonia  nose  ↓ Parkinson mask.

Lemon juice  salivation swallowing , clear


secretion from throat.
Optical righting reactions.

Rood’s  facili resp ms in unconscious


patients…..?
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Timing
Body position & activity.

Head control before swallow or speech


therapy.

Skin brushing precedes all other stimuli.

Verbal coincide with stimuli(icing).

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Repetition
Axoplasmic flow  changes nerve & muscle
tissue molecules.

Sufficient period of time  changes in muscle


unit type.

Regimes planned to follow in daily routine at


home  beneficial.

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?

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Thank U

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