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Here are concise, exam-ready short notes on the Rood's Approach:
ROOD'S APPROACH - SHORT NOTES (Exam Based)
1. Introduction
- Developed by Margaret Rood in 1940
- A neurophysiological approach for patients with motor control problems
- Deals with activation or deactivation of sensory receptors
- Concerns interaction of somatic, autonomic, and psychic factors in motor behavior regulation
- Based on reflex/hierarchical model of CNS
Key assertion: Motor patterns develop from primitive reflexes through proper sensory stimuli to appropriate sensory receptors
2. Basic Principles (4)
| Principle | Description |
|---|---|
| Normalization of tone | Using appropriate sensory stimuli to evoke desired muscular response |
| Ontogenic developmental sequence | Treatment follows developmental sequence; assess current level, progress to next |
| Purposeful movement | Use purposeful activities to achieve desired movement patterns |
| Repetition of movement | Repetitive movements promote motor learning |
3. Four Basic Concepts
A. Mobility and Stability Muscles (Tonic vs Phasic)
| Feature | Phasic (Mobility) | Tonic (Stability) |
|---|---|---|
| Also called | Light work muscles | Heavy work muscles |
| Function | Skilled movement, reciprocal inhibition | Joint stability, co-contraction |
| Examples | Flexors, adductors | Deep postural muscles |
| Fiber type | Fast glycolytic | Slow oxidative |
| Location | Superficial, 1 joint | Deep, 1-2 joints |
| Fatigue | Rapid | Slow |
| Metabolic cost | High | Low |
| Structure | - | Pennate, large attachment area |
B. Ontogenic Sequence (Two Categories)
i. Motor Development Sequence (leads to skilled coordinated movements):
- Supine withdrawal
- Roll over
- Pivot prone
- Neck co-contraction
- Prone on elbow
- Quadruped
- Standing
- Walking
Four Phases of Motor Development:
| Phase | Description | Patterns included |
|---|---|---|
| Mobility (reciprocal innervation) | Reflex governed, spinal/supraspinal | Supine withdrawal, roll over, pivot prone |
| Stability (co-contraction) | Simultaneous agonist-antagonist contraction | Pivot prone, neck co-contraction, prone on elbow, quadruped, standing |
| Mobility superimposed on stability | Proximal movement with distal end fixed | Weight shifting in prone on elbows, quadruped rocking, crawling |
| Skill (distal mobility + proximal stability) | Finely coordinated distal movement; highest cortical level | - |
ii. Vital Functions Sequence (leads to well-articulated speech):
- Inspiration → 2. Expiration → 3. Sucking → 4. Swallowing liquids → 5. Phonation → 6. Chewing and swallowing solids → 7. Speech
C. Appropriate Sensory Stimulation
Four types of receptors stimulated:
- Proprioceptive receptors
- Exteroceptive receptors
- Vestibular receptors
- Special sense organs
D. Manipulation of Autonomic Nervous System
| ANS | Indication | Stimuli |
|---|---|---|
| Sympathetic | Hypotonic patients | Icing, unpleasant smells/tastes, sharp vocal commands, bright flashing lights, fast/arrhythmic music |
| Parasympathetic | Hypertonic, hyperkinetic, hyper-excitable patients | Slow rhythmical rocking, neutral warmth, soft voice, soft music, contact on palms/soles/abdomen, pleasant odors |
4. Facilitation Techniques
A. Cutaneous Facilitation
- Stimulates exteroceptors of skin
- Produces alertness, protective withdrawal, rapid limb movements
1. Light Moving Touch
- Activates superficial mobilizing (phasic) muscles
- Activates low threshold hair end organs and free nerve endings
- Impulses travel along A-delta fibers → synapse with fusimotor system
- Causes reciprocal innervation → phasic withdrawal response
- Applied with fingertip, camel brush, or cotton swab
- Frequency: 3-5 strokes with 30-second rest between strokes (prevents primary afferent depolarization)
2. Fast Brushing
- Non-specific high intensity stimulus that increases fusimotor activity
- Applied over dermatomes of same segment supplying the target muscle
- Duration: 3-5 seconds, repeated after 30 seconds
- Contraindicated: outer ring of trigeminal nerve, C2 dermatomes, pinna of ear, along midline axis
3. Icing (Three Types)
| Type | Fiber | Use |
|---|---|---|
| A-icing | A-delta (myelinated) | Hypotonia/relaxation; reflex withdrawal; applied 3 quick swipes, blotted after each |
| C-icing | C fibers (non-specific) | Facilitates postural responses; pressed on dermatome |
| Autonomic icing | Sympathetic NS | Influences thyroid and adrenal gland output |
- Contraindicated in cardiovascular problems
B. Proprioceptive Facilitation Techniques
| Technique | Key Points |
|---|---|
| Heavy Joint Compression | Force > body weight; along longitudinal bone axis; facilitates co-contraction; done manually or with weighted cuffs |
| Quick Stretch | Uses reciprocal innervation; facilitates Ia afferent of muscle spindle; alpha motor neuron activation |
| Intrinsic Stretch | Uses intrinsic muscles to promote scapulohumeral stability; resistance increases fusimotor activity |
| Secondary Ending Stretch | Combined resistance + maintained stretch; always facilitatory to flexors, inhibitory to extensors |
| Resistance | Heavy resistance stimulates primary and secondary endings; used in isotonic fashion |
| Tapping | 3-5 percussions over muscle belly; acts on muscle spindle afferents; increases skeletal muscle tone |
| Osteopressure | Pressure on bony prominences to facilitate or inhibit voluntary muscle |
C. Vestibular Stimulation
- Powerful proprioceptive input
- Static labyrinthine system: promotes extensor patterns of neck, trunk, extremities
- Kinetic labyrinthine system: elicits phasic subcortical responses
- Stimulated by: linear acceleration/deceleration (horizontal/vertical) and angular acceleration/deceleration
Therapeutic Vibration
- Series of rapid touch stimuli
- Activates Ia afferent of muscle spindle → contraction of that muscle + inhibition of antagonist + suppression of stretch reflex
- Short latency period; effect lasts only while stimulus is applied
- Applied parallel to muscle fibers over muscle belly to elicit tonic vibration reflex
5. Inhibition Techniques
| Technique | Mechanism | Indication |
|---|---|---|
| Neutral Warmth | Affects hypothalamic temperature receptors; activates parasympathetic NS | Hypertonia (spasticity, rigidity); wrap in blanket 5-10 min |
| Gentle Shaking & Rocking | Affects proprioceptors of neck and vestibular apparatus; alters semicircular canal discharge | General inhibition |
| Slow Stroking | Deep rhythmic pressure over posterior primary rami (occiput to coccyx); affects sympathetic outflow | Inhibition; patient in prone |
| Slow Rolling | Patient in side-lying; rhythmic rolling side-lying to prone and back | General inhibition |
| Light Joint Compression | Body weight or less | Inhibits spastic muscles around joint |
| Tendinous Pressure | Pressure on tendinous insertion or across long tendons | Inhibitory effect; hard surface preferred |
| Maintained Stretch | Elongated position of hypertonic extremities | Resets muscle spindle afferents to longer position; reduces stretch sensitivity |
6. Special Senses Stimulation
| Sense | Stimulus | Nerve | Effect |
|---|---|---|---|
| Visual | Bright colours, pen light, photo cards | CN 2 | Alertness, stimulation; soft light/cool colours = relaxation |
| Auditory | Verbal commands, variable sounds, audiotapes | CN 8 | Auditory discrimination and awareness |
| Olfactory | Vanilla (pleasant), ammonia/vinegar (stimulant) | CN 1 | Facilitatory via stimulant odors |
| Gustatory | Various food tastes | CN 7, 9, 10 | Activates emotional context and recognition |
| Multi-sensory | Tactile + vestibular + proprioceptive + visual | Multiple | Combined with purposeful tasks |
7. Vestibular Stimulation Summary
| Goal | Technique |
|---|---|
| Total body inhibition | Slow rocking, slow anterior-posterior, horizontal, vertical, or linear movement; inverted position |
| Total body facilitation | Rolling patterns, rocking on elbows, crawling, spinning |
| Facilitation of postural extensors | Rapid anterior-posterior or angular acceleration; child in prone position |
Quick Memory Aid - EXAM TIPS
- Rood = 1940, Neurophysiological, Margaret Rood
- 4 Principles: Tone normalization, Ontogenic sequence, Purposeful movement, Repetition
- 4 Basic Concepts: Tonic/Phasic muscles, Ontogenic sequence, Sensory stimulation, ANS manipulation
- Fast brushing = dermatome rule (same segment as target muscle)
- 30-second rest between light touch stimuli (prevent presynaptic inhibition)
- A-icing = A-delta fibers; C-icing = C fibers
- Vital functions sequence ends with speech
- Motor development sequence ends with walking
- Hypertonic → Parasympathetic stimuli; Hypotonic → Sympathetic stimuli
- Tendinous pressure = inhibitory; Tapping = facilitatory
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