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ROOD’S TECHNIQUE

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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ROOD’S TECHNIQUE

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

  2. Sensory - Motor System C.N.S. SPINAL CORD BRAIN BRAIN STEM CEREBELLUM CEREBRAL CORTEX PYRAMIDAL EXTRAPYRAMIDAL

  3. Motor Homunculus

  4. MOVEMENT SENSORY + MOTOR =

  5. SENSORY ORGANIZATION • ANTERIOR SPINOTHALAMIC TRACT & LATERAL SPINOTHALAMIC TRACT • LEMNISCAL / DORSAL COLUMNS • PROPIOCEPTIVE TRACTS CEREBRAL CORTEX THALAMUS 1st order neuron 2nd order neuron

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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

  11. PROPRIOCEPTORS 2.UNCONSCIOUS • GOLGI TENDON ORGANS (GTO) • Greater sensitivity muscle contraction • MUSCLE SPINDLE

  12. Margaret Rood P.T. O.T.

  13. Clinician Researcher

  14. PREMISE • “ IF IT WERE POSSIBLE TO APPLY THE PROPER SENSORY STIMULI TO THE APPROPRIATE SENSORYRECEPTOR AS IT IS UTILIZED IN NORMAL SEQUENTIAL DEVELOPMENT. “ • Rood, 1954

  15. Stages of Motor Control • Mobility • Stability • Controlled Mobility • Skill

  16. 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

  17. 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

  18. ONTOGENIC MOTOR PATTERS

  19. ONTOGENIC MOTOR PATTERS • 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

  20. ONTOGENIC MOTOR PATTERS • 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

  21. ONTOGENIC MOTOR PATTERS • 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

  22. ONTOGENIC MOTOR PATTERS • NECK CONTRACTION • First real stability pattern • Activates both flexors & tonic neck extensor muscles • RECOMMENDED: • Patients needs neck stability & extraocular control

  23. ONTOGENIC MOTOR PATTERS • 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

  24. ONTOGENIC MOTOR PATTERS • QUADRUPED • STANDING • A skill of upper trunk because it frees upper extremity for manipulation • INTEGRATION: righting reaction & equilibrium reaction

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

  26. 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

  27. What do we do now? EVALUATION GOAL-SETTING PT PLAN OF CARE ROOD'S NDT

  28. 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 CONTROLLED SENSORY INPUT

  29. WHICH SENSORY INPUT WILL I USE FOR MY PATIENT? MEDIATED BY: PROCEDURE: EFFECT:

  30. Rood's Technique's FACILATATORY

  31. SPECIFIC FACILITATION TECHNIQUES USED IN TREATMENT:

  32. 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

  33. SPECIFIC FACILITATION TECHNIQUES USED IN TREATMENT:

  34. FAST BRUSHING

  35. SPECIFIC FACILITATION TECHNIQUES USED IN TREATMENT:

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

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

  38. Proprioceptive Facilitatory Technique

  39. Proprioceptive Facilitatory Technique

  40. Proprioceptive Facilitatory Technique

  41. Proprioceptive Facilitatory Technique

  42. Proprioceptive Facilitatory Technique

  43. VIBRATION

  44. Rood's Technique's INHIBITATORY TECHNIQUES

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