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 :

SUPINE WITHDRAWAL
Total flexion response towards vertebral level T10

Requires reciprocal innervation with heavy work of proximal segments

Aids in integration of TLR

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

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

NECK CONTRACTION
First real stability pattern

Activates both flexors & tonic neck extensor muscles

RECOMMENDED:
Patients needs neck stability & extraocular control

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

QUADRUPED
All Four limb

SITTING
Pressure on knees through to heels Auto facilitation.

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

INTEGRATION: Righting
Reaction & Equilibrium Reaction

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

“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 :