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ROOD’S TECHNIQUE. John Christopher A. de Luna, PTRP. Sensory - Motor System. C.N.S. SPINAL CORD. BRAIN. BRAIN STEM CEREBELLUM CEREBRAL CORTEX. PYRAMIDAL EXTRAPYRAMIDAL. Motor Homunculus. MOVEMENT. SENSORY + MOTOR =. SENSORY ORGANIZATION.
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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