OT EAD 322: TRADITIONAL SENSORIMOTOR APPROACHES

ROOD APPROACH • Highest level of motor control

• Proximal segments are stabilized
Key Concepts Skill while distal segment moves
1. Muscle tone and MOTOR CONTROL affect each freely
other • E.g. Typing, handwriting
2. Flexion and extension patterns coeffect each
other
Ontogenetic Development
3. Repetition of muscular response creates 1. Supine Withdrawal (Supine Flexion)
movement patterns
4. Intention / goal direction coeffects movement
5. Activities which provide approximation of real-life
context increases treatment effectiveness &
generalizability
6. Therapists use somatic markers to select
• Total flexion response towards vertebral level
interaction methods
T10
Key Components • Requires reciprocal innervation with heavy
work of proximal segments
1. Use of sensory stimulation to evoke a motor
• Recommended for patients dominated by
response extensor tone (e.g. cerebral palsy)
2. Use of developmental postures to promote 2. Roll over towards side lying
changes in muscle tone (ontogenic patterns)

2 Types of Sensory Stimulation

Facilitation Inhibition • Mobility pattern for extremities and lateral
trunk muscles
4 Components of Motor Control (in hierarchial order) • Stretches lateral trunk musculature
• Early mobility pattern 3. Pivot Prone
• Phasic and reciprocal type of
Reciprocal movement
Inhibition • Contraction of agonist and
(innervtion) relaxation (inhibition) of the
antagonist muscle • Demands full range of extension of neck,
• E.g. Elbow flexion (biceps shoulders, trunk and lower extremities
contracted, triceps relaxed) • This position is difficult to assume and
• Tonic (static) pattern maintain
• Simultaneous agonist and • Important role in preparation for stability of
Cocontraction anagonist contraction (e.g. extensor muscles in upright position
gastrocnemius and tiabialis 4. Neck cocontraction
anterior are both contracted to
maintain standing position)
• Controlled mobility pattern
• Mobility superimposed on
stability • Recommended for patient who needs neck
stability and extraocular control
Heavy work • Proximal muscle contracts and
moves while the distal segment is
fixed
 OT EAD 322: TRADITIONAL SENSORIMOTOR APPROACHES

5. Prone on Elbow Facilitation Techniques

1. Light touch/stroking

• Activates a reflex action of mobilizing muscles

• Stroke 2x per second, for approximately 10
seconds
• Stretches the upper trunk musculature • After rest period, repeat 3-5x
• Gives better visibility of the environment
• Allows weight shifting from side to side 2. Fast brushing
6. All fours or quadruped • Brushing the hairs or skin over the muscle
• Soft camel hair paintbrush can be used
• Held sideways
• Latency of 30 seconds; max facilitative state
30-40 minutes after facilitation (effect my
last only 30-45 seconds)
• Lower trunk and LE are in coordination 3. Icing
• Can do weight shifts in forward/backward,
side to side and diagonal directions
• Mobility superimposed on the stability
(similar to heavy work component of
motor control; moving proximal, fixed
distal)
7. Standing

• Weight is equally distributed on both legs

after that weight shifting begins
• UE are free to perform functions
8. Walking

4. Quick stretch
• Quick movement of the limb or tapping
(using fingertips) over the muscle or tendon
• NOTE: evoking stretch reflex WITHOUT
• Most advanced ontogenic development patient’s attempt to move is not
that requires coordinated movement therapeutic
patterns of various parts of the body 5. Vibration
• High frequency (100-300Hz, 100-
125Hz preferred)
• Electric vibrator with an excursion of 1-
2mm to the belly or tendon of a slightly
stretched muscle
• An additional form of stretch
 OT EAD 322: TRADITIONAL SENSORIMOTOR APPROACHES

• For 20 minutes
• Containdicated:For individuals with circulatory
6. Heavy joint compression
diseases and with Raynaud’s phenomenon
• Facilitates stability component of 5. Prolonged stretch
movement (cocontraction)
• Resistance – body weight of therapist • Manual stretch of a limb to its greatest length for
supported by the joint of the patient more than 20 seconds (until relaxing effect s felt
7. Resistance • E.g. prolonged stretch of a thumb in abduction
and extension to relax tight grasp
• Resist an ongoing movement or maintained
posture 6. Light joint compression
• Quick stretch may be applied before
resistance to increase responsiveness of • Less than the body weight
muscle spindle • One hand over the shoulder, the other under the
table
7. Vestibular stimulation (fast)
• Arm abduction: 35 – 45 degrees
• May be facilitatory or inhibitory depending on • Once muscles begin to relax gently and slowly
RATE of stimulation (fast or slow) circumduct the humerus in small circles to
reduce pain and stiffness.
o FAST ROCKING -> stimulates / facilitates
7. Tendon pressure
o SLOW RYTHMIC ROCKING -> generalized
relaxation response; may be done in • Pressure on tendinous insertion of a muscle
quadruped
Important note:
Inhibition Techniques
• In current practice, OTs may use these strategies
1. Slow rhythmic rocking as ADJUNCTIVE or PRELIMINARY interventions to
2. Slow stroking prepare an individual to engage in a purposeful
activity.
• Prone or unsupported sitting with back exposed • Application of quick stretch over the triceps
• Use palm or extended fingers to apply firm before instructing a client to reach for a cup or
pressure along vertebral musculature -> glass to improve elbow extension.
OCCIPUT TO COCCYX
• One hand is always in contact with patient. Limitations of the Rood approach
• Alternating hands until patient relaxes • The passive nature of sensory stimulation
• Do not exceed 3 minutes to avoid rebound • Short-lasting effect
phenomenon (rebound phe • Unpredictable effect of some of the sensory
3. Neutral warmth stimulation

• Maintaining body heat by wrapping the part to

be inhibited
• Cotton flannel or fleece blanket or a comforter
for 5 to 10 minutes

4. Prolonged Icing

• Sustained cooling (cold pack) of skin to 10

degrees Celsius