ROODS THEORY

1 NORMALIZE MUSCLE TONE

2.TREATMENT BEGINS AT THE DEVELOPMENTAL LEVEL

OF FUNCTIONING

3.MOVEMENT IS DIRECTED TOWARD FUNCTIONAL

GOALS

4.REPETITION IS NECESSARY FOR THE R E-EDUCATION

OF MUSCULAR RESPONSES
1.NORMALIZE MUSCLE TONE:
normalized muscle tone is a prerequisite to
movement
MUSCLE
HIGHER CENTERS

REFLEXES

VOLUNTRY MOTOR
2.TREATMENT BEGINS AT THE DEVELOPMENTAL LEVEL OF
FUNCTIONING
CEPHALOCAUDAL

FLEXORS EXTENSORS ADDUCTORS

ABDUCTORS
3.MOVEMENT IS DIRECTED TOWARD FUNCTIONAL
GOALS
4. REPETITION IS NECESSARY FOR THE RE-EDUCATION OF
MUSCULAR RESPONSES
Axoplasmic flow  changes nerve & muscle tissue
molecules.
Sufficient period of time  changes in muscle unit type.
Regimes planned to follow in daily routine at home 
beneficial.
 PRINCIPLES OF TREATMENT
1.TONIC NECT AND LABYRINTHINE REFLEXES CAN
ASSIST OR RETARD
THE EFFECTS OF SENSORY STIMULATION

2.STIMULATION OF SPECIFIC RECEPTORS CAN

PRODUCE THREE MAJOR REACTIONS

3.MUSCLES HAVE DIFFERENT DUTIES

4.HEAVY WORK MUSCLES SHOULD BE INTEGRATED

BEFORE LIGHT
WORK MUSCLES
1.TONIC NECT AND LABYRINTHINE REFLEXES CAN
ASSIST OR RETARD
THE EFFECTS OF SENSORY STIMULATION
TNR

DORSIFLEXION OF THE NECK VENTRAL FLEXION

OF THE NECK

EXTENDS UE FLEXES LE FLEXES UE

EXTENDS LE
ROTATION

INCREASE EXTENSOR TONE OF UE/LE

 BIPEDAL
ABOVE STANCE
HORIZONT 180 ‘ NEUTRA
AL L
POSTITION
STATIC
TLR
MAXIMAL
60’
TNR
-9o’
TLR,TN
R

BELOW
HORIZONT
TNR,TL AL
R EXTENSOR
RIGHTIN
TONE
G
-60’
REACTI
ON
2.STIMULATION OF SPECIFIC RECEPTORS CAN
PRODUCE THREE MAJOR REACTIONS

 A F AST BRIEF STIMULUS PRODUCES A LARGE

SYNCHRONOUS MOTOR OUTPUT
 A FAST REPETITIVE SENSORY INPUT PRODUCES A
MAINTAINED RESPONSE
 A MAINTAINED SENSORY INPUT PRODUCES A
MAINTAINED RESPONSE
 SLOW RHYTHMICAL REPETITIVE SENSORY INPUT
DEACTIVATES BODY AND MIND
3.MUSCLES HAVE DIFFERENT DUTIES

 Light :  Heavy:

◦ Phasic. ◦ Tonic.

◦ Fast glycol tic. ◦ Slow oxidative.

◦ Superficial. ◦ Deep.

◦ Multiarthrodial. ◦ Single joint muscle.

◦ Fusiform or strap. ◦ Pennate.

◦ Small area attachment. ◦ Large area attachment.

◦ Active↑Blood supply. ◦ All time rich in blood.

◦ High metabolic cost. ◦ Low metabolic cost.

◦ Rapidly fatigue. ◦ Slow fatigue.

◦ Flexors & Adductors. ◦ Extensors & abductors.

10
4.HEAVY WORK MUSCLES SHOULD BE INTEGRATED
BEFORE LIGHT WORK MUSCLES
SEQUENCE OF MOTOR
DEVELOPMENT
1.RECIPROCAL INHIBITION ( INNERVATION)
contraction of the agonist muscle
relaxes antagonist muscle

2.CO-CONTRACTION (CO-INNERVATION)
tonic pattern
3.HEAVY WORK
mobility superimposed on stability

4.SKILL
mobility and stability
ONTOGENETICE MOTOR
PATTERNS
1.SUPINE WITHDRWAL (SUPINE FLEXION )

2.ROLLOVER (TOWARD SIDE LYING)

3.PIVOT PRONE ( PRONE EXTENSION)

4.NECK CO-CNTRACTION (CO-INNERVATION)

5.ON ELBOWS (PRONE ON ELBOWS)

6.ALL FOURS (QUADUPED POSITION)
7.STATIC STANDING
8.WALKING
 1.SUPINE WITHDEAWAL (SUPINE FLEXION)

A1:
Supine.
pattern.
Total flexion.
Tonic heavy work.
Reciprocal innervation.
Bilateral.
Centered at 10th thoracic
vertebrae.
 2.ROLLOVER (TOWARD SIDE LYING)

 A2:

◦ Roll over.

◦ Flexion top arm & leg.

◦ Phasic movement.
 3.PIVOT PRONE ( PRONE EXTENSION)

 A3:
◦ Pivot pattern.

◦ Total extension.

◦ Reciprocal
innervation.

◦ Bilateral.

◦ Cen at 10th
vertebrae.
4.NECK CO-CNTRACTION (CO-INNERVATION)

 B1:
◦ Neck Co contraction,
Vertebral extension.

◦ For head & neck

hyperkinesia.

◦ To stabilise eyes if
nystagmus.
5.ON ELBOWS (PRONE ON ELBOWS)

 B2:
◦ Forearm support.

◦ Gleno humeral joint

alignment.
 6.ALL FOURS (QUADUPED POSITION)

 B3:
◦ All fours.

 B4:
◦ Sitting.

◦ Pressure on knees
through to heels Auto
facilitation.
 STATIC STANDING

◦ Movement over fixed distal segment.

◦ To ↑ Dynamic stability.

◦ Rock side to side, back and forward.

◦ Turning movements.
 WALKING

◦ Skilled movement distal end of limbs free.

◦ To ↑ mobility.

◦ Reaching , Crawling, Walking.

◦ Objective & Functional.

 FACILITATION TECHNIQUES
CUTANEOUS FACILITATION

Cutaneous stimulation  Exteroceptors  A

delta and C fibers

Non discriminative exteroceptive 

Spinothalamic and spinoreticular  CNS

Discriminative stimuli ,viibration,stereognosis

 Dorsal columns
 CUTANEOUS FACILITATION TECHNIQUES
Light moving touch
Fast brushing
Icing

PROPRIOCEPTIVE FACILITATION TRCHNIQUES

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

INHIBITORY TECHNIQUES
Neutral warmth
Joint approximation
Slow stroking
Rocking
Gentle shaking or rocking
Tendinous pressure
Maintained stretch
Slow rolling
 LIGHT MOVING TOUCH
TECHNIQUE :
 Stimulation applied by fingertips, cotton ball, or camel hair brush
 Limited to three to five strokes with 30 sec intervals between
applications
COMMENTS:
• evokes a low -threshold response
• patient accommodates rapidly
• resistance must be applied to maintain contraction

EFFECTS :
• increase sympathetic arousal ,produce fight –or –flight
responses
• contraindicate in patients with autonomic instability
FAST BRUSHING

TECHNIQUE :
 Use of battery – operated brush over dermatomal area supplying
muscle to be stimulated
 Application limited to 3 – 5 sec with 30 sec intervals between
application
COMMENTS:
• non specific high-intensity stimulus
• inverted position is more effective

EFFECTS :
• contraindicated area like ,outer ring of the trigeminal nerve
• avoided patients with high cervical S C I
• Ear , outer 3rd forehead  central inhi. Avoid in brain stem
injury.
ICING

 Three different applications techniques to stimulate client’s level of

alertness, postural responses, & or parasympathetic responses
• A-icing or qiick icing-three quick swipes
• C-icing
• autonomic icing
PRECAUTIONS
◦ Behind ear  sudden ↓ of blood pressure.
◦ Sole , Palm  nociceptive(avoid in children & emotionally
unstable).
◦ Ice over posterior primary rami which shares nerve supply to
vessels supplies organ.
◦ Left shoulder in cardiac diseased
PROPRIOCEPTIVE FACILITORY TECHNIQUES
HEAVY JOINT COMPRESSION

TECHNIQUE :
 Pressure greater than body weight applied through longitudinal axis
of bone
 Most commonly used through long bones
 May be accomplished in combination with developmental positions
( prone on elbows, quadruped, standing )
COMMENTS:
resistance must be used to maintain the contraction
EFFECTS :
 Contraindication in inflamed joints
QUICK STRETCH
TECHNIQUE :
 Accomplished by providing a quick stretch movement to limb in
opposite direction of desired movement just distal to joint while
stabilizing proximally
 Facilitates or enhances agonist contraction, inhibits antagonists
and facilitates synergists .

COMMENTS:
Quick stretch evokes a low threshold phasic response ,shot-
lived
add résistance to maintain muscle contraction
EFFECTS :
Increase spasticity
 INTRINSIC STRETCH :
Resistance is a form of stretching

SECONDARY ENDING STRETCH :

Combined resistance and maintained stretch to
facilitate developmental muscle patterns
STRETCH PRESSURE
 Manual stretching of belly of muscle being facilitated with finger
tips while applying pressure
RESISTANCE
• Heavy resistance to stimulate both primary and
secondary endings of the muscle spindle.
• Quick stretch, fast brushing  resistance
TAPPING
Tapping 3 – 5 times over belly of muscle being facilitated with finger
tips before or during muscle contraction
VESTIBULAR STIMULATION
slow maintained vestibular stimulation:
 low intensity, slow vestibular stimulation
 Assisted ricking with equipment
 For hypertonic, hyperactive.
fast vestibular stimulation
 High –intensity
 Fast spinning
 Fast acceleration-deceleration movements
 Spd, hypotone
 Condraindiation for seizures
INVERSION
 To alter muscle tone in selected muscles
 Extreme care for patients with cardiovascular diseases

THERAPEUTIC VIBRATION
 Use of small hand – held vibrator parallel to muscle fibers on belly
of muscle being facilitated
 1 or 2 minutes ,
 prone position -flexor ms
 supine position –extensor ms
 Contra indicated in young children
OSTEOPRESSURE
 Pressure on bony prominences
 INHIBITION TECHNIQUES

NEUTRAL WARMTH
 Entire body is wrapped
 10 to 20 minutes
 Overheating should be avoided.
 GENTLE ROCKING OR SHAKING
 Rhythmical, controlled rocking or shaking movement that
incorporates joint approximation & distraction
 Commonly used at head, shoulder, forearm, pelvis & lower
extremities
 Precise hand placement & manipulation skills are necessary
 SLOW STROKING
TECHNIQUE
 Application of firm, direct pressure to both sides of spinous
process( primary post rami ) from occiput to coccyx for up to 3 or
5min, with client in prone
 May be accomplished with index & long digits in V position,
stroking down the spine
 As one hand reaches coccyx area, alternate hand begins to repeat
stroking from occipital area to ensure continuous pressure

COMMENTS:
Slow stroking is useful with patients who demonstrate high
arousal .
 SLOW ROLLING
TECHNIQUE :
 Slow, passive rolling of client by therapist from side lying toward
prone
 May include slow manual rotation of pelvis & trunk
 Technique should be completed on each side
 JOINT COMPRESSION (APPROXIMATION)
TECHNIQUE :
 Application of pressure less than or equal to body weight to move
bones on either side of a joint closer together
 Commonly performed at shoulder followed by moving humerus in
small circles, resulting in decreased pain & stiffness
 May also be a accomplished by client in weight bearing position in
which pressure is less than body weight
 joint compression either manual or mechanical using weight
cuffs
 Bouncing whill sitting on a swiss ball

COMMENTS;
 Resistance must be used to maintain the contraction
EFFECTS:
 Contraindicated in inflamed joints
 DEEP TENDON PRESSURE
TECHNIQUE :
 Deep, direct pressure at tendon insertion site of targeted muscle
 Firm pressure, applied manually or with body weight
 Mechanical pressure-holding firm objects (cones) in hand
 Inhibitory splints, casts

COMMENTS:
 weight-bearing postures are used

EFFECTS :
 Sustained positioning may dampen muscle contraction .affect
functional performance
 MAINTAINED STRETCH
TECHNIQUE :
 Maintenance of affected muscle in elongated position
 A prolonged stretch activates muscle spindles (Ia II ending )
 Manual contacts
 Inhibitory splinting
 RIP
 Mechanical low – load weights

COMMENTS:
More effective in extensor muscles then flexors .
ROCKING IN DEVELOPMENTAL P ATTERNS
 SPECIAL SENSES FOR FACILITATION OR
INHIBITION
 Nose & Mouth face & tongue mvmt.
 Quinine on back of tongue  ↓ tongue thrust.
 Ammonia  nose  ↓ Parkinson mask.
 Lemon juice  salivation swallowing , clear secretion from

throat.
 Optical righting reactions.

 Rood’s  facili resp ms in unconscious patients…..?

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APPLICATION OF THE ROOD
APPROACH IN OCCUPATIONAL
THERAPY
1.SUPINE WITHDRAWAL :
supine position activities –
2.ROLLOVER:
rolling activities
3.PIVOT PRONE :
scooter board activities
vestibular activities
4.NECK CO-CONTRACTION:
oral motor activities
5.ON ELBOWS ;
weight bearing ,bilateral activities
ALL FOURS ;

Reciprocal movements between the UE and LE

STATIC STANDING ;
Weight shift and equilibrium activities
WALKING ;
All purposeful activities.
TRADITIONAL ROOD RECONSTRUCTION OF
 Normalization of muscle ROOD
tone is a prerequisite for  Muscle tone and motor
movement. control
 Treatment begins at the Co effect each other
developmental level of  Flexion and extension
functioning patterns
 Reeducation of muscular Creates movement patterns
responses occurs through  Repetition of muscular
repetition
responses creates movement
 Movement is directed patterns
toward functional goals  Intention or goal direction
 Approximation of real life co effects movement
context increases treatment  Approximation of real life
effectiveness and
context increases treatment
generalizability
effectiveness and
generalizability
 Therapeutic use of self  Therapists use somatic
should match client needs markers
To select interaction
methods with clients
Comments and
Questions?