Rood treatment approach
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| Treatment approach utilizing combined controlled sensory stimulation and orthogenetic sequences of motor behavior to achieve a purposeful muscular response | ROOD treatment approach
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| Development occurs | cephalocaudal (head to tail) and from proximal to distal
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| when working on feeding the clinician would first direct treatment on controlled reaching for the utensil before | focusing on the holding of the utensil
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| is necessary for the reeducation of muscular response | Repetition
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| can be used to assist or retard the effects of sensory stimulation | Reflexes (TNR & TLR)
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| Triggered by changes in the relationships between head and neck | TNR (tonic neck reflex)
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| Occur with changes in the relationship of the head to gravity | TLR (tonic labyrinthine reflex)
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| 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
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| are stabilizers and more proximal (extensors and abductors) | Heavy work muscles
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| are mobilizers and more distal (flexors and adductors) | Light work muscles
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| Integrate ___________ before ____________ muscle groups first | HEAVY LIGHT
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| 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
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| 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)
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| 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
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| “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
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| a.Highest level of control and combines the efforts of mobility and stability Ex: reaching overhead to unscrew a light bulb | Skill
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| 2 types of SENSORY stimulation utilized in ROOD | Cutaneous stimulation
and
Proprioceptive stimulation
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| DO NOT PERFORM cutaneous stimulation if | Patient is unstable
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| 3 types of Cutaneous stimulation | Light moving touch
Fast brushing
Icing
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| 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
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| 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
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| Applied by holding the proximal bony prominences of the limb to be stretched while moving the distal joint in one direction | Quick stretch
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| 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
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| 1. Extreme caution should be taken because of the negative effect it can have on the body. Requires proper supervision and training | Vestibular stimulation
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| 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
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| an inhibitory technique, to reduce muscle tone and for general relaxation | Neutral warmth
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| 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
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| 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
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| Position hypertonic extremities in the _________________ for various periods. Maintaining stretch in this position has an inhibitory effect Ex: casting or splinting | Elongated position
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| 1.Vanilla-produces calming effect 2.Sulfa and ammonia-triggers protective response such as coughing and sneezing | Olfactory and gustatory stimuli
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| Initially -if severe neurological damage is present, the pt may need to begin with | reflexive movements
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| Progress the pt along with the | ontogenic developmental patterns
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| can reinforce patterns and can be used to inhibit or facilitate specific muscles activity-used to prepare pt for purposeful activity | Sensory stimulation
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| roll over pattern can be reinforced by have the pt turn in bed to reach bed controls | ontogenic patterns when positioning patients for activities
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| 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
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| 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
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| Standing position provides best position for | performing ADLs
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| 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
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