Rood’s Approach: Neurodevelopmental Treatment

IF IT WERE POSSIBLE TO APPLY THE PROPER SENSORY STIMULI TO THE APPROPRIATE SENSORY RECEPTOR AS IT IS UTILIZED IN NORMAL SEQUENTIAL DEVELOPMENT.” said by Margaret Rood.

The Rood Approach for the treatment of central nervous system disorders was developed by Margaret Rood in the 1950s. Rood’s technique can be categorized as one of facilitation and inhibition of movement.

It is one of several of the neurophysiological Approaches which developed at that time and is centered upon four basic concepts to consider during treatment: duality, the ontogenetic sequence, manipulation of the autonomic nervous system and the level of excitability of the anterior horn cell.

Rood’s Approach

STAGES OF MOTOR CONTROL :

  • Mobility
  • Stability
  • Controlled Mobility
  • Skill

SEQUENCE OF MOTOR DEVELOPMENT :

1. RECIPROCAL INHIBITION (INNERVATION)/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) /STABILITY

  • –Simultaneous agonist & antagonist contraction with antagonist supreme

3. HEAVY WORK /CONTROLLED MOBILITY

  • Stockmeyer “ mobility superimposed on stability”
  • Creeping

4. SKILL

  • Crawling, walking, reaching, activities requiring the coordinated use of hands

TO NORMALIZE THE MUSCLE TONE

Facilitatory technique:

  • To normalize the muscle tone from a flaccid state.
  • Icing, fast brushing, tapping, stroking, quick stretch.

Rood’s approach inhibitory techniques

  • To normalize the muscle tone from hypertonic or spastic state.
  • Deep pressure, slow rolling, and slow rocking.

SEQUENCES IN GROSS MOTOR DEVELOPMENT :

 

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

SUPINE WIDRAWAL

RECOMMENDED:
Patients with no reciprocal flexion
Patients dominated by extensor tone

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

ROLL OVER

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

PIVOT PRONE

NECK CONTRACTION
First real stability pattern

Activates both flexors & tonic neck extensor muscles

RECOMMENDED:
Patients needs neck stability & extraocular control

NECK CO-CONTRACTION

PRONE ON ELBOWS
Stretches the upper trunk musculature

Influences stability scapular and glenohumeral regions

Gives better visibility of the environment

Allows weight shifting from side to side

RECOMMENDED:
Patients needs to inhibit STNR

PRONE ON ELBOW

QUADRUPED
All Four limb

QUEDRUPED

SITTING
Pressure on knees through to heels Auto facilitation.

SITTING

STANDING
A skill of upper trunk because it frees upper extremity for manipulation

INTEGRATION: Righting
Reaction & Equilibrium Reaction

STANDING

WALKING
Sophisticated process requiring coordinated movement patterns of various parts of body.

WALKING

“Support the body weight, maintain balance & execute the stepping motion” – Murray

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

CONTROLLED SENSORY INPUT

FACILITATORY TECHNIQE :

Light moving touch
Fast brushing
Icing.

Rood sensorimotor approach :

Following Proprioceptive Fascilitatory techniques are used :

  • Heavy joint compression
  • Stretch
  • Intrinsic stretch
  • Secondary ending stretch
  • Stretch pressure
  • Resistance
  • Tapping
  • Vestibular stimulation
  • Inversion
  • Therapeutic vibration
  • Osteopressure

INHIBITATORY TECHNIQE :

  • Gentle shaking or rocking
  • Slow stroking
  • Slow rolling
  • Light joint compression
  • Tendinous pressure
  • Maintained stretch
  • Rocking in developmental stages

Dr Rohit Bhaskar, Physio
Dr Rohit Bhaskar, Physio Dr. Rohit Bhaskar, Physio is Founder of Bhaskar Health and Physiotherapy and is also a consulting physiotherapist. He completed his Graduation in Physiotherapy from Uttar Pradesh University of Medical Sciences. His clinical interests are in Chest Physiotherapy, stroke rehab, parkinson’s and head injury rehab. Bhaskar Health is dedicated to readers, doctors, physiotherapists, nurses, paramedics, pharmacists and other healthcare professionals. Bhaskar Health audience is the reason I feel so passionate about this project, so thanks for reading and sharing Bhaskar Health.

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