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04/10/23 C.B.SENTHILKUMAR 1
ROOD APPROACHMuscles have different duties. Most of them
are a combination, but some predominate, in “light work” , others in “heavy work”.
Margaret Rood, American Physical therapist, 1956.
Neurological ?
RA,OA, Soft tissue injury, Post fractures ?
04/10/23 C.B.SENTHILKUMAR 2
Muscle WorkLight :
Phasic.
Fast glycolytic.
Superficial.
Multiarthrodial.
Heavy:
Tonic.
Slow oxidative.
Deep.
Single joint muscle.
04/10/23 C.B.SENTHILKUMAR 3
Fusiform or strap. Small area
attachment.
Active↑Blood supply.
High metabolic cost.
Rapidly fatigue.
Flexors & Adductors.
Pennate.
Large area attachment.
All time rich in blood.
Low metabolic cost.
Slow fatigue.
Extensors & abductors.
04/10/23 C.B.SENTHILKUMAR 4
To normalize the muscle toneFacilitatory technique:
--To normalize the muscle tone from a flaccid state. --Icing, fast brushing, tapping, stroking, quick stretch.
Inhibitory technique:
--To normalize the muscle tone from hypertonic or spastic state. --Deep pressure, slow rolling, and slow rocking.
04/10/23 C.B.SENTHILKUMAR 5
FacilitationLight Work:
Quick stretch.
Unpleasant stimuli.
Pain stimu(Nociceptors).
Lips, tongue, feet, palm.
SCC(head movement).
Heavy Work:Quick stretch.
Joint compression.
Pressure wt. bearing.
Resistance.
Utricle & Saccule(Static).
04/10/23 C.B.SENTHILKUMAR 6
Features Identification of goal.
Identification of factors Poor function.
Selecting the relevant need(motor activity).
Selecting afferent stimuli.
Timing of stimuli.
Ensuring repetition.
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Goals
Communication.
Manipulative skills.
Gross motor function.
04/10/23 C.B.SENTHILKUMAR 8
Examination Sensation.
Perception.
Postural reaction.
Quality of movement.
Muscle tone.
Circulatory defects.
04/10/23 C.B.SENTHILKUMAR 9
Sequences in Gross Motor DevelopmentA1:
Supine.
Withdrawal pattern.
Total flexion.
Tonic heavy work.
Reciprocal innervation.
Bilateral.
Centered at 10th
thoracic vertebrae.
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A2:
Roll over.
Flexion top arm & leg.
Phasic movement.
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A3:Pivot pattern.
Total extension.
Reciprocal innervation.
Bilateral.
Cen at 10th vertebrae.
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B. Fixed Distal Segments B1:
Neck Co contraction, Vertebral extension.
For head & neck hyperkinesia.
To stabilise eyes if nystagmus.
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B2:Forearm support.
Gleno humeral joint alignment.
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B3:All fours.
B4:Sitting.
Pressure on knees through to heels Auto facilitation.
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C:
Movement over fixed distal segment.
To ↑ Dynamic
stability.
Rock side to side, back and forward.
Turning movements.
D:
Skilled movement distal end of limbs free.
To ↑ mobility.
Reaching , Crawling, Walking.
Objective & Functional.
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Movement Control SequenceFlexion.
Extension.
Adduction.
Abduction.
Rotation.
04/10/23 C.B.SENTHILKUMAR 17
Receptors Cutaneous:
Quick light brushing:
Nerve root.
Soft artist or decorator’s brush or electrically powered.
Anterior primary rami local, superficial muscles.
Posterior primary rami deep back muscle.
Face muscles of mastication & expression( V VII ).
04/10/23 C.B.SENTHILKUMAR 18
Delay upto 20 min for inhibited not used recently.
Rapid stimulation effective over Poor circulation.
‘Cutaneous stimulation rapid & large ms spindle modulation thro gamma motoneuron reflexes’- Loeb & Hoffer (1981).
04/10/23 C.B.SENTHILKUMAR 19
Brief Cold ApplicationQuick wipe with ice cube.
Warm limb.
Immediate & most effective.
Limb Extensors.
To palm of hand ↑ mental process.
Lips , tongue suck, swallow, speech.
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Slow Stroking
Neck to sacrum over centre of back ↓
chorea athetosis or excessive muscle tone.
Rhythmically for 3 minutes.
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Precautions Brush:
Aware of effect.3 sec in one place.Repeated in bursts at intervals.Do not use mechanical tools.In flaccid infant seizures(stroking adviced).Ear , outer 3rd forehead central inhi. Avoid
in brain stem injury.
04/10/23 C.B.SENTHILKUMAR 22
Precautions Ice:
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.
04/10/23 C.B.SENTHILKUMAR 23
Muscle SpindlesQuick Stretch:
Ia afferent Facilitatory.Slow Stretch:
Single joint deep muscles 5 minutes II(length measuring from nuclear chain fibres) Inhi.
Quadriceps, hip abductors, lumbar & cervical deep extensors, glenohumeral & shoulder girdle retractors.
04/10/23 C.B.SENTHILKUMAR 24
Vibration
Mech vibrator muscle on stretch muscle spindle stim tonic vibratory reflex.
Cutaneous brushing prior to vibrator effective.
04/10/23 C.B.SENTHILKUMAR 25
Golgi Tendon Organs(Ib)
Contraction receptors.Auto inhi to a non resisted repeated
contraction.Multiarthrodial.Fast glycolytic.Slow repeated Flexors &
Adductorsstrong isotonic for extensors.Inhi only for flexor not for extensors…………?
04/10/23 C.B.SENTHILKUMAR 26
Mechanoreceptors Maintained pressure medial heel↑dorsiflexor.
Pressure Heel of hand normalization.
Pisiform pressure.
Skull to ischial weighted cap, shoulder bag athetosis.
Skin stimu over convex part.
Compression over concave part.
Prone on elbow , hand rock forward & back.
04/10/23 C.B.SENTHILKUMAR 27
Labyrinthine SystemHead mvmt in vetical (revolving chair)
SCC ↓postural tone & improves in bradykinesia.
Prone on tilting plinth , large ball head rock up &
down activation of fast twitch muscles.
04/10/23 C.B.SENTHILKUMAR 28
Special Sense OrgansNose & 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…..?04/10/23 C.B.SENTHILKUMAR 29
Timing Body position & activity.
Head control before swallow or speech therapy.
Skin brushing precedes all other stimuli.
Verbal coincide with stimuli(icing).
04/10/23 C.B.SENTHILKUMAR 30
Repetition 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.
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?
04/10/23 C.B.SENTHILKUMAR 32
Thank U
04/10/23 C.B.SENTHILKUMAR 33