Rood Approach

ROOD’S SENSORY MOTOR APPROACH
- Application of sensory stimulus to develop skills (sequential and developmental)

- Proponent: Margaret Rood
 8 ONTOGENIC MOTOR PATTERS SSPNSASW
1. Supine Withdrawal 5. Support on Elbows
2. Segmental Rolling 6. All Fours
3. Pivot Prone 7. Standing
4. Neck Co-contraction 8. Walking
 FACILITATORY TECHNIQUES (Direction of application: Muscle insertion to origin) LFACAVSP – facilitates

weak muscles or kulang activation.
1. Light Moving Touch
- Use of fingertips/ 3-5 applications over dermatome/ rest for 30 seconds for muscle contractions
2. Fast Brushing
- Use brush with thick bristles/3-5 applications over dermatome/ rest for 30 seconds
- Better than LMT as it stimulates muscle and sensory function
3. A-Icing
- Use of ice cubes wrapped in gauze or cloth in 3 quick swipes then wipe with hanky
4. C-Icing
- Use of ice cubes same with A-icing but with downward pressure pressed for 3 minutes on ms.
- For px with poor postural muscle or anti-gravity muscle like poor sitting balance & head control
5. Approximation
o Manual approximation of muscle (force ms. to be close to other ms.; weights
6. Vibration
o Electrical vibrator 100-300 cycles per second, 1-2 minutes (because of heat friction may burn)
o Example: electric toothbrush
7. Stretch
a. Intrinsic – muscles of the hand; provide hard objects to grip
b. Secondary Ending – principle: exert more effort = activate of muscles; any type of muscle na
gusto istretch; gradually adding resistance then release; to increase ROM in tightness
c. Stretch Pressure – use index, middle, thumb; add pressure to insertion of muscles then move
thumb away from 2 fingers
8. Proprioception
a. Resistance – apply resistance; same with SE; facilitates muscle response/contraction
b. Tapping – use of hands to tap 3-5 times over muscle belly
c. Vestibular Stimulation – patient in supine position, move head in plane of motion; activates
anti-gravity ms.
d. Inversion – activates anti-gravity and postural muscles/ prone; tilt 60-70 degrees/ head is
lowered/ activate anti-gravity muscle and postural muscles
 INHIBITORY TECHNIQUES GNSST
1. Gentle Shaking – first apply approximation then apply circumduction movement; achieves general
body relaxation which can inhibit spastic muscle
2. Slow Rolling – rhythmical prone-supine and vv; applied on both sides of patient (roll from right to
left and vice versa)
3. Neutral Warmth – use blanket while px in supine position for 10-20 minutes/ stimulates
thermoreceptors of skin which can provide calming feelings sa body; play calm music; towels, hot
packs, tepid water, air splints
4. Slow Stroking – px should be shirtless; prone / rebound phenomenon happens if more than 3
minutes/ slow rhythmical strokes with both hands together and fingertips touching px body from
occiput to coccyx for 3 mins. only
5. Tendinous Pressure – apply pressure sa muscle insertion then stretch
Purpose of tendon stretch: prevents Muscle Stretch Reflex – protective reflex that prevent injury
of muscle
PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION (PNF)

- Stretching technique utilized to increase ROM and flexibility
- Principle: Overflow/irradiation
- Proponent: Herman Kabat, Maggie Knott, Dorothy Voss
(+) Resistance
(+) Facilitation
(+) Contraction of weak muscles
 DIAGONAL/SPIRAL PATTERNS
D1 ✓ D1 / D2 ✓ D2 /
SHOULDER FADER EXABIR FABER EXADIR
ELBOW ✓ / ✓ /
FOREARM Supine Prone Supine Prone
WRIST ✓ / / ✓
FINGERS ✓ / / ✓
Occupation- Shaving, brushing Swimming, Waiter, mag Remove seatbelt
based activities teeth, putting on pulling trolley, limos, pull out
makeup, combing sweeping floor, sword
on opposite side skiing, rowing
Muscles Pectoralis Major
involved Deltoid
Biceps
S.A
Coracobrachialis
Supinator
Flexor carpi
Palmaris
Flexor digiti minimi
 BILATERAL PATTERNS
1. BILATERAL SYMMETRICAL
Pattern: Same
Direction: Same
2. BILATERAL ASYMMETRICAL (Lift & Chop Movement)
Pattern: Opposite
Direction: Same
3. BILATERAL RECIPROCAL
Pattern: Same
Direction: Opposite
4. CROSS DIAGONAL
Pattern: Opposite
Direction: Opposite
PNF TECHNIQUES
- Contract relax and hold relax are used for patients with muscle problem only
1. CONTRACT-RELAX
- Used when antagonistic muscles are tight
- Hold for 5 secs. Repeat until ROM increases
- Repeat until ROM doesn’t increase na
- Greater force applied to resistance
- Agonist – deltoid, biceps, hamstrings; Antagonist – latissimus dorsi, triceps, quads
 DIRECT CRT (Autogenic Inhibition)
a. Position Joint in the available end-range
b. Resisted Isotonic contraction of antagonist muscles
c. Relaxation
 INDIRECT CRT (Reciprocal Inhibition)
- Used if there is pain/weakness on antagonistic muscles
- Should be completed with an exercise/activity in the newly improved range
2. HOLD-RELAX
- Used when resisted isotonic contractions are painful or when isotonic contractions are too
strong for the therapist to handle.
- Equal resistance and force applied
- Isotonic – muscle length changes; Concentric – shorten and Eccentric - lengthen
- Isometric – increase tension w/o change in muscle length
 DIRECT HRT
a. Position joint at end-range
b. Resisted isoms of antagonistic muscles (isometric=core muscles, increase stability of weak joints/muscles)
c. Relax
 INDIRECT HRT
- Stimulate synergistic muscles if there is pain
3. REPEATED STRETCH
- Used to activate stretch reflex and muscle contractions
- Used to improve AROM, inhibition of motion, strength, reduce fatigue
- Contraindications: osteoporosis, joint instability, damaged muscles & tendon, severe joint pain
 BEGINNING OF RANGE
a. Plan an activity
b. Analyze movement patterns
c. Quick stretch
d. Perform motion
 THROUGH RANGE
a. Plan an activity
b. Analyze movement patterns
c. Quick stretch
d. Perform motion (+) quick stretch
4. REPLICATION TECHNIQUE
- For patients having difficulty in performing functional activities
- For voluntary movement/patients moved out of synergy
- Copying to facilitate motor learning
- Gives opportunity for the patient to feel the functional outcome of an activity
a. Choose activity
b. Motion analysis
c. Keep body part in the end position
d. Resist shortened agonist muscles (5-8 secs)
e. Relax
f. Move (passively)
g. Return to end position

Rood Approach

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ROOD’S SENSORY MOTOR APPROACH

- Application of sensory stimulus to develop skills (sequential and developmental)

 FACILITATORY TECHNIQUES (Direction of application: Muscle insertion to origin) LFACAVSP – facilitates

PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION (PNF)

(+) Contraction of weak muscles

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