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ROOD

Rood treatment approach

QuestionAnswer
Treatment approach utilizing combined controlled sensory stimulation and orthogenetic sequences of motor behavior to achieve a purposeful muscular response ROOD treatment approach
Development occurs cephalocaudal (head to tail) and from proximal to distal
when working on feeding the clinician would first direct treatment on controlled reaching for the utensil before focusing on the holding of the utensil
is necessary for the reeducation of muscular response Repetition
can be used to assist or retard the effects of sensory stimulation Reflexes (TNR & TLR)
Triggered by changes in the relationships between head and neck TNR (tonic neck reflex)
Occur with changes in the relationship of the head to gravity TLR (tonic labyrinthine reflex)
a slow rocking stimulus produce a calming effect and may be beneficial for patients with high tone or agitation Sensory stimulation of receptors can produce predictable responses
are stabilizers and more proximal (extensors and abductors) Heavy work muscles
are mobilizers and more distal (flexors and adductors) Light work muscles
Integrate ___________ before ____________ muscle groups first HEAVY LIGHT
fine fingertip manipulation (light work muscles) is not functional if the proximal muscles (heavy work muscles) are not strong enough to lift and stabilize the position of the arms Example of heavy before light
a.Early mobility phase that serves a protective function b.Muscle acting on one side of a joint (agonist) quickly contracts while its opposite (antagonist) relaxes i.Ex: infants who randomly flex and extend their arms and legs Reciprocal inhibition (innervations)
a.Opposing muscles contract simultaneously, resulting in stabilization of the joint b.Allows a person to hold an object for a long time c.Standing upright is a result of co-contraction of the trunk Co-contraction
“mobility on stability” Proximal muscles move, distal muscles are fixed Ex: During creeping the infant is in a quadruped (all-fours) position. The hands and feet are in a fixed position, but the shoulders and hips move Heavy work
a.Highest level of control and combines the efforts of mobility and stability Ex: reaching overhead to unscrew a light bulb Skill
2 types of SENSORY stimulation utilized in ROOD Cutaneous stimulation and Proprioceptive stimulation
DO NOT PERFORM cutaneous stimulation if Patient is unstable
3 types of Cutaneous stimulation Light moving touch Fast brushing Icing
a. Refers to the facilitation of joint and muscle receptors and the vestibular system. Gives clinician more control over motor response. Motor response lasts as long as the stimulus is applied Proprioceptive stimulation
facilitated contraction at the joint undergoing compression 1.Combined with developmental patters-prone on elbows, quadruped, sitting and standing 2.Most effective when applied on the longitudinal axis of long bones (humerus and the femur) Heavy joint compression
Applied by holding the proximal bony prominences of the limb to be stretched while moving the distal joint in one direction Quick stretch
over muscle belly with finger tips (3-5 times) can be done before and during the time a pt is voluntarily contracting the muscle Avoid prolong or excessive tapping to prevent spasticity Tapping
1. Extreme caution should be taken because of the negative effect it can have on the body. Requires proper supervision and training Vestibular stimulation
produces tonal changes Avoid vibration over spastic muscles, or muscles prone to developing spasticity. Avoid in children <3 and use caution with those >65 Vibration
an inhibitory technique, to reduce muscle tone and for general relaxation Neutral warmth
to inhibit spastic or tight muscle groups in which the tendons are accessible Apply pressure to the tendinous insertion of a muscle or across long tendons Manual pressure
to inhibit spastic muscles around a joint 1.Use with hemiplegic pt, to alleviate pain and to offset muscles imbalance temporarily around the should joint 2.Normal weight will inhibit Light joint compression
Position hypertonic extremities in the _________________ for various periods. Maintaining stretch in this position has an inhibitory effect Ex: casting or splinting Elongated position
1.Vanilla-produces calming effect 2.Sulfa and ammonia-triggers protective response such as coughing and sneezing Olfactory and gustatory stimuli
Initially -if severe neurological damage is present, the pt may need to begin with reflexive movements
Progress the pt along with the ontogenic developmental patterns
can reinforce patterns and can be used to inhibit or facilitate specific muscles activity-used to prepare pt for purposeful activity Sensory stimulation
roll over pattern can be reinforced by have the pt turn in bed to reach bed controls ontogenic patterns when positioning patients for activities
Prone-on –elbows can be adapted for tabletop use by having the pt sit at a table and lean on the affected elbow and forearm while playing a recreational game ontogenic patterns when positioning patients for activities
Grooming activities can also be positioned so that the pt must lean on affected elbow and forearm while reaching for objects ontogenic patterns when positioning patients for activities
Standing position provides best position for performing ADLs
while performing a homemaking activity, the individual can reach up to place objects in a cabinet While standing, the pt can use his/her arms to explore and manipulate the environment
Created by: OTrocks on 2009-11-21



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