Rood Method for Cerebral Palsy Therapy
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ScribdTranslationsRood Method for Cerebral Palsy Therapy
Translated by
ScribdTranslationsROOD METHOD
Throughout history, there have been many methods to treat children with sequelae.
of CP (Cerebral Palsy). This variety spans the great diversity of
clinical pictures that we can find under the same diagnosis. Some of the
treatment methods devised in the second half of the last century are:
Bobath, Kabat, Rood, Pëto, Votja, etc. Some of these authors worked
specifically in the field of cerebral palsy and others with patients with others
neurological disorders.
In the previous article, I already talked about the Bobath method, which is based on providing the child with a
normal sensorimotor experience of movement. Through the repetition of the
movements and their incorporation into daily life activities aims to
automation and spontaneous execution by the child. Different ones are used
Techniques to normalize abnormal muscle tone, inhibit primitive reflexes, and
pathological movement patterns, facilitating the emergence of reactions of
straightening and balance. The techniques must be adjusted to the needs of each
child and should be based on a well-detailed initial assessment.
Now I am going to explain the ROOD METHOD developed by Margaret Rood, a therapist.
occupational and American physiotherapist who thought that through proper management
better muscular response is achieved through sensory stimuli due to a
normalization of tone, through a controlled evocation of motor responses
reflections; stimuli based on sensorimotor development and graduated to achieve a
reflex motor response that takes us to a higher level of control, guided towards the
carrying out significant activities or purposes at the age trying to create at a level
subcortical a correct response or motor pattern.
Rood's techniques include:
Quick brushing
2. Fast tapping
3. The Vibration that can be performed with proper vibrating devices
said or with the hand of the therapist or assistant.
4. Cold stimulation.
5. And the muscle stretching.
•1.- Rapid brushing is understood as brushing the skin or dermatomes.
corresponding to the muscles in which it is desired to sensitize the spindle
Muscular, being a high-threshold stimulus, stimulates the C fibers.
involved in maintaining posture, this brushing can be applied
3 to 5 times for 30 seconds (Spincer 1987) to produce an effect
facilitator in it, the response to this stimulus is still not very clear
regarding duration and response time, for which a threshold is given
time of up to 45 minutes after application to observe
response; therefore, the use of brushing technique is recommended
accompanied by a facilitator positioning sequence in development
of a motor activity, always keeping in mind the possibility of a
bilateral response to the stimulus. It is also important to mention that the
Brushing stops being effective once the person has achieved control.
movement volunteer.
Quick tapping: The use of quick tapping is understood as pressure
with moderately strong touches, depending on the patient, on the
surface of the muscle whether at its origin, insertion, or belly as it is
observe the reaction of the area that is to be stimulated. The use of stimulation
tactile is part of the activation of muscle-cutaneous reflexes, in the
which applies the tapping on the dermatome in which is sought the
muscle contraction, thanks to the skin receptors susceptible to
respond to that stimulus. This stimulus can be used for the muscles.
tonics such as those for the paravertebral muscles (along the entire spine) to
achieve better control of head and trunk in patients with pathologies such as:
C.P.I., Spina Bifida, Down syndrome, among others,
•3.- Vibration: Within proprioceptive stimulation, we have the use of the
vibration as a means to stimulate the muscle spindles innervated by the
primary afferent fibers, resulting in a muscle contraction
immediate with a duration only during the application of the stimulus, being more
effective when applied over the muscle tendon near the area of
insertion. The duration must last between 30 seconds and no more than 2 minutes,
potentially provoking an annoyed or inhibited response. The use of the
vibration should be suspended or not applied if the motor disorder is accentuated. It
can be done with a quick movement of the physiotherapist's hands or it
they can use special devices with constant vibration, such as the
therapeutic vibrators, the repetitions vary but it is recommended to continue with
the same amount used in the previous stimulus (rapid tapping), once
that a beneficial outcome was achieved in the patient, we will subsequently move on to the
next stage, the use of cold.
•4.- Cold stimulation: The use of cold produces a facilitating effect.
as an inhibitor, Tombly explains that a high threshold stimulus is applied,
captured by C-type fibers, to provoke postural and tonic responses by
intermediate of type A fibers and size C. Due to a temperature change.
dramatic focused on a specific region of the body, the body recognizes it
as a harmful stimulus for which the organism reacts in a way
protective, at the moment of observing the response at the place of application
It should involve opposing some resistance to the movement without stopping it.
use an ice cube by passing it over the area to be treated for 3 to 5 seconds.
ice application for a period longer than 30 seconds produces an effect of
temporary inhibition resulting in a greater range of
movement. In professional practice, the application of ice during times
prolonged, allows for muscle stretching, through the technique
contraction - relaxation, this is part of proprioceptive neurofacilitation
in which the static contraction of shortened muscle is used that
found inhibited by the application of ice along its entire length.
5.- Muscle stretching: it is explained by the action of the spindles.
neurotendinous (Golgi tendon organs) found at the junctions
of the muscles with the tendon, is part of the defense mechanism of
muscle upon detecting a change in its intrafusal fibers, which are activated
when the muscle is stretched beyond its maximum length, responding
with a reflexive muscle contraction or an inhibition favoring
relaxation. In therapeutic activity, the combination of
light and quick stretching with load positioning to achieve that the
proximal stabilizing muscles are activated.
It is important to know the correct direction in which stimuli should be applied. There are
to take into account that the stimulus should be applied from proximal to distal
body segment and from distal to proximal in muscle fibers. Why? according to
some authors I agree with say that our motor development occurs cephalocaudally
caudal but the muscle-tendinous nerve information (afferent and efferent) presents
in most cases a contraction of the muscle from insertion to origin also
known as open kinetic chain where the shortening of the muscle fibers
it is done in the manner previously mentioned (from distal to proximal).
In case we have a patient with altered muscle tone (increased,
decreased or fluctuating) this technique should be used. In the first case, if there is a tone
muscle hypertrophy in some muscles, the technique should be applied in the
antagonists that present on the contrary a low tone and with this seek a balance
muscular; in the second case when the muscle tone is rather decreased
you must apply stimuli to the agonist and antagonist muscles to seek
a new balance and in the last case a thorough prior evaluation must be made
to see which muscles are hindering the patient's movement at a given time
specific and from there apply the method.
In cases with pediatric patients diagnosed with PCI, it is very common to find that
in addition to all the motor deficiencies and pathological reflexes, the reactions of
Straightening, balance, and defense are found with little or no development. Let's go.
to give a practical example, in the case that one wants, like one of the many objectives
specifically improve in a PCI the head control to then move on to the trunk control,
The Rood method can be very useful for stimulating the cervical paravertebral muscles.
so over time the ones from the trunk, of course we must not forget that also
we can use this technique alone or combined with Bobath, Vojta, and therapy of
sensory integration to normalize muscle tone, pathological reflexes, among others
alterations observed by the physiotherapists in their assessment.
Another important point is that each of the stimuli can be applied separately.
and not necessarily in the order mentioned, depending on the
patient needs. For example, in the case of wanting to stimulate motor skills.
Finally, one can apply an isolated stimulus such as only cold. Or if desired.
Continue with the normal technique (all stimuli in succession).
Finally, the repetitions, duration, and intensity of application of the technique depend on
of the patient's condition, but in general repetitions occur until the tone
muscle increased or decreased adapt or normalize a little and allow the
desired movement.
The Margaret Rood Method is used in many countries as a very good
therapeutic tool because it can be combined with other techniques and methods
in order to achieve better results in the shortest time possible such as for example
it can be applied: Rood-FNP, Rood-Bobath, Rood-Medek and finally with a great
variety of other techniques.
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