CEBU DOCTORS’ UNIVERSITY

COLLEGE OF REHABILITATIVE SCIENCES

DEPARTMENT OF PHYSICAL THERAPY
PT 202
TOPIC: ROOD APPROACH
- Use of sensory stimulation to evoke a motor response and use of developmental postures to promote
changes in muscle tone.
- Sensory stimulation is applied to muscles and joints to elicit specific-motor response
- Stimulation has the potential to have either an inhibitory or facilitatory effect on the muscle tone

FOUR PRINCIPLES OF ROOD’S THEORY

1. Normalization of tone and evocation of desired muscular responses are accomplished through the
use of certain, appropriately applied sensory stimuli

2. Sensorimotor control is developmentally based. Therefore, current level of development and progress
sequentially to higher levels of control.

3. Movement is purposeful. It is used as a purposeful activity to demand a response from the patient to
elicit unconsciously the desired movement pattern. The responses of agonists, antagonists and
synergists were believed to be reflexively programmed according to purpose or plan. The sensation
that occurs as a result of movements involved in the activity helps the patient learn the movements.

4. Repetition (practice) of sensorimotor responses is necessary for motor learning. Activities are used not
only to elicit purposeful responses but also MOTIVATE repetition.

RECONSTRUCTION OF ROOD
 Muscle tone and motor control coeffect each other.
o Refers to the relationship that exists between the tone of muscle and execution of the motor act.
o Muscle tone is not the only prerequisite for motor control and that those relative degrees of
motor control can exist in spite of poor or inadequate muscle tone.

 Flexion and extension patterns coeffect each other.

o Refers to the dynamic relationship between flexion and extension patters experienced through
everyday occupations.
o Balance or imbalance between flexion and extension patterns influence each other in a dynamic
system of postural patterns

 Repetition of muscular response creates movement patterns

o Refers to the learning that occurs through repeated neuromuscular actions that lay down that
lay down the engrams for repertoire of motor behavior available to a given individual.

 Intention or goal direction coeffects movement

o Intent of a motor action influences the nature and quality of motor action

COMPONENTS OF MOTOR CONTROL:

Mobility > Stability > Controlled mobility > Skill

Mobility
- Early mobility pattern that serves as a protective function
- Phasic (quick) type of movement that requires contraction of the agonist muscle as the antagonist
muscle relaxes

Stability (Cocontraction/coinnervation)
- Tonic (static) muscle pattern
- Provides ability to hold a position or object for a longer duration
- Needed for feeding, early activities, using standing tables

Heavy work (Controlled mobility)

- “Mobility superimposed on stability”
- proximal muscles that contract and move whereas the distal segment is fixed
- example: creeping

Skill
- highest level of motor control and combines the effort of mobility and stability
- proximal segment is stabilized while distal segments moves freely.
MOTOR PATTERNS

Supine Withdrawal (Supine flexion)

- total flexion response toward the vertebral level of T10
- protective position since the flexion and neck and the crossing of the arms and legs protect the anterior
surface of the body
- mobility posture that requires reciprocal innervation and heavy work of prox muscles and trunk

Rollover (toward sidelying)

- arm and leg flex on the same side of the body
- „mobility pattern for the extremities and activates lateral trunk musculature
- encouraged for patient‟s dominated by tonic reflex patterns in the supine position
- stimulates semicircular canals of the vestibular system which in turn activates the neck and extraocular
muscles

Pivot Prone (prone extension)

- demands full range extension of the neck, shoulders, trunk and lower ex
- plays an important role in the preparation for the stability of extensor muscles in the upright position

Neck cocontraction (coinnervation)

- first genuine stability pattern
- cocontraction of the neck precedes cocontraction of the trunk and extremities

ONTOGENIC DEVELOPMENTAL PATTERNS

- observed in normal development

Prone on Elbows
- bearing weight on elbows stretches the upper trunk musculature to influence stability of the scapular
and glenohumeral regions
- give patient better visibility of environment and opportunity to shift weight from side to side

All fours (quadruped)

- follows stability of the neck and shoulders
- lower trunk and LE are brought into cocontraction pattern
- initially position is static and abdomen may sag at T10 level which causes stretching of trunk and limb
girdle.
- Shifting weight provides controlled mobility and may be preparatory to equilibrium responses

Static Standing
- Skill of the upper trunk because it frees the UE for prehension and manipulation
- Weight is first equally distributed on both legs and then weight shifting begins

Walking
- Gait pattern unites mobility, stability and skill
- Normal locomotion entails the ability to support body weight, maintain balance and execute the
stepping motion
- Sophisticated process requiring coordinated movement patterns of various parts of the body including
weight shifting
 LABORATORY APPLICATION PROCEDURES:
ROOD TECHNIQUES

FACILITATION TECHNIQUES : used to address weak and hypotonic muscles.

A. TACTILE STIMULI
Light touch
 Light stroking of the dorsum of the webs of the fingers or toes, or of the palms of the hands or the
soles of the feet elicits a fast, short-lived withdrawal motion of the stimulated limb
 Done twice per second for 10 seconds
 Repeated 3-5 more times
 Example: dorsum of the webs of fingers and toes, palms of hand, sole of feet

Fast Brushing
 Use of a soft camel hair paintbrush (high-frequency, high intensity)
 Held sideways to avoid catching and pulling hair
 Applied on each skin area to be stimulated
 Limited to 3-5 seconds, Latency of 30 seconds, maximum facilitative state of 30-40 minutes
 Effect lasts only 30-45 seconds

Tapping
 Tap 3-5 times over muscle belly before or during muscle contraction

B. THERMAL STIMULI
A-Icing
 Apply 3 quick swipes of an ice cube to evoke a reflex withdrawal
 Applied to the palms or soles or the dorsal webs of the hands or feet
 Water is blotted up after every swipe
 Touching lips with ice open the mouth
 Swiping the ice upward over the skin of the sternal notch promotes swallowing

C-Icing
 High-threshold stimulus
 Stimulate postural tonic responses
 Hold ice cube in place for 3-5 seconds, then wiping away the water

C. PROPRIOCEPTIVE STIMULI
Quick stretch
 Low-threshold stimulus
 Applied in the form of quick movement of the limb or tapping over the muscle or tendon
 Therapists uses fingertips to vigorously tap the skin

Vibration
 High-frequency (100-300 Hz, with 100-125 Hz preferred) vibration (electric vibrator)
 Action: repeated mechanical stretch to the muscle

Stretch to finger intrinsics

 Facilitate co-contraction of the muscles around the shoulder joint
 Forcefully grasping handles of tools obtains this response
 Patients with distal movement but proximal weakness

Heavy joint compression

 Facilitates co-contraction of muscles around a joint
 Resistance greater than body weight that is applied longitudinal axes of the bones whose articular
surfaces approximate
 Force>normal body weight
 Example: quadruped with single limb raised
INHIBITION TECHNIQUES: used to address hypertonicity or spasticity.

A. TACTILE STIMULI
Slow stroking
 Index and long digits in V position, stroking down from spine from occiput to coccyx
 Alternating hands for about 3 minutes

B. THERMAL STIMULI
Neutral warmth
 Maintaining body heat by wrapping the specific area to be inhibited
 Use of cotton flannel or fleece blanket or down comforter for 10-20 minutes
 Elastic bandages and air splints can be used

Prolonged cooling
 Sustained cooling of the skin to 50 F (10 C) decreases the monosynaptic stretch reflex excitability
 Cold pack applied for 20 minutes

C. PROPRIOCEPTIVE STIMULI
Prolonged stretch
 Used to inhibit a specific spastic muscle in order to move more easily
 Limb is held so that the muscle is steadily kept at its greatest length for more than 20 seconds, until
letting go is felt as the muscle adjusts to the longer length

Joint approximation
 Light joint compression
 Force <=Body weight
 Commonly performed at the shoulder
 Grasp the patient‟s elbow and, while holding the humerus abducted to about 35-45 degrees, gently
move the head of the humerus into the glenoid fossa and hold it there until it relaxes

Tendon Pressure
 Pressure on the tendinous insertion of a muscle
 Apply constant pressure over the length of the long tendons through grasp of enlarged, hard
handles of tools or utensils or via splints

D. VESTIBULAR STIMULI
Slow Vestibular Stimulation
 Slow, rhythmical movement
 Slow rolling
 Holding patient at the hip and shoulder and slowly rolling him or her from supine to side-lying