1. Rood Approach

2. ROOD'S FOUR COMPONENTS OF MOTOR CONTROL
(1) Reciprocal Inhibition(Inneration)
(2) Cocontraction(Coinnervation)
(3) Heavy work
(4) Skill

3. ROOD'S FOUR COMPONENTS OF MOTOR CONTROL
(1)Reciprocal Inhibition(Innervation)
protective function을 제공하는 초기 움직임
Antagonist 이완& agoinst수축: phasic(quick)
type of movement

4. ROOD'S FOUR COMPONENTS OF MOTOR CONTROL
(2) Cocontraction(Coinnervation)
Stability제공
Tonic (static) muscle pattern

5. ROOD'S FOUR COMPONENTS OF MOTOR CONTROL
(3)Heavy work
"mobility superimposed on stability"
(by Stockmeyer)
distal muscles 고정, proximal muscles 수축

6. ROOD'S FOUR COMPONENTS OF MOTOR CONTROL
(4) Skill
highest level of motor control and combines the effort of mobility and stability
distal segment 자유롭게 움직이는 동안 proximal segment 안정됨

7. MOTOR PATTERNS (1)Supine Withdrawal(Supine Flexion)
Total flexion toward vertebral level T10
Reciprocal innervation, proximal and trunk muscles의 중요한 작용이 요구되는 이동 자세

8. MOTOR PATTERNS (2)Rollover(Toward Side Lying) 몸의 동측 arm, leg flexion
사지의 움직임과 측면 몸통근육조직 활동
supine자세의 tonic reflex patterns
vestibular system의 반고리관 자극- neck and extraocular muscles 활동

9. MOTOR PATTERNS (3) Pivot Prone(Prone Extension)
neck, shoulders, trunk , lower extremities의 full range extension 요구
upright position에서 extensor muscles의 stability준비
STNR, TLR reflexes 통합

10. MOTOR PATTERNS (4) Neck Cocontraction (Coinnervation)
first genuine stability pattern
얼굴이 바닥과 수직 이룰때 TLR reaction 유도
neck stability and extraocular control 촉진

11. ONTOGENETIC DEVELOPMENT PATTERNS
(1) On elbows(Prone on Elbows)
(2) All Fours(Quadruped Position)
(3) Static Standing
(4) Walking     

12. ONTOGENETIC DEVELOPMENT PATTERNS
(1) On elbows(Prone on Elbows)
stability of the scapular and glenohumeral regions
better visibility of the environment
shift weight from side to side
STNR 억제

13. ONTOGENETIC DEVELOPMENT PATTERNS
(2) All Fours(Quadruped Position)
stability of the neck and shoulders
lower trunk, lower extremities를 cocontracion pattern 이끔
cocontraction of the trunk flexors and extensors 발달
mobility superimposed on the stability phase
equilibrium responses

14. ONTOGENETIC DEVELOPMENT PATTERNS
(3) Static Standing
양쪽 다리에 weight분배
-> weight shifting 시작
Play higher level neurological intergration
(such as righting reactions and equilibrium reactions)

15. ONTOGENETIC DEVELOPMENT PATTERNS
(4) Walking     
gait pattern unites skill, mobility, and stability
stance phase, push off, swing, heel strike, and stride length 포함
신체의 다양한 부위의 움직임조정, weight shifting포함

16. Proprioceptive Facilitatory Techniques
muscle spindle, golgi tendon organs, joint receptors, vestibular apparatus 자극
=>Motor response 조절

17. Proprioceptive Facilitatory Techniques
(1) Heavy Joint Compression
목적: compression가해지는 joint cocontraction 을 촉진
body weight보다 더 큰 joint compression
bone의 longitudinal axis방향으로
(humerus, femur)
developmental patterns와 함께 쓰면 좋음
치료사가 손으로 pressure를 줄 수도 있고, weighted wrist cuff & sandbag을 사용

18. Proprioceptive Facilitatory Techniques
(2) Resistance
heavy resistance: muscle spindle의 primary & secondary nerve ending에 자극
developmental pattern에서 Isotonic 형태로 가함
=> stabilizer muscle에 영향
저항을 주기 전에 stabilizer muscle에 fast brushing 해주면 더 효과적
저항을 주기 전에 Quick stretching해주면 muscle spindle의 반응을 증가

19. Proprioceptive Facilitatory Techniques
(3) Vestibular Stimulation
static labyrinthine system : neck, trunk, extremities의 extensor pattern을 증진
Kinetic labyrinthine system: phasic subcortical response (protective extension)
vestibular system: antigrivity muscles & antagonist 활성화

20. Proprioceptive Facilitatory Techniques
(3) Vestibular Stimulation
tone, balance, directionality, protective response, cranial nerve function, bilateral integration,      auditory language development, eye persuit을 촉진
linear acceleration & deceleration, angular acceleration & deceleration 제공
    (예) spinning, rolling, swinging
 fast rocking: facilitatory
 slow rocking: inhibitory

21. Proprioceptive Facilitatory Techniques
(4) Inversion (Inverted position)
Inverted position=>carotid sinus의 baroreceptor를 자극 => 부교감신경계 자극 => blood   pressure감소, muscle tone감소, relaxation촉진
Vibration, Neck Compression과 같이 사용하면 selected muscle의 tone조절 용이

22. Inhibitory Techniques
(1) Neutral warmth
 5~10분 동안 이불이나 담요로 꼭 싸서 기댄 자세로 있게 함
 hypothalamus의 온도 수용체에 영향
 parasympathetic nerve system을 자극

23. Inhibitory Techniques
(1) Neutral warmth
hypertonia(spasticity, rigidity가 심한 사람), attention deficit disorder아동에게 효과적임
 효과: relax되고 tone이 감소함

24. Inhibitory Techniques
(2) Slow Stroking
 prone상태로  primary posterior rami of spine의 dorsal portion에rhythmic, moving, deep pressure
spinous process양쪽에 손가락 끝으로 pressure
 occiput에서 coccyx까지
 soft music을 제공하면 더 효과적
 3분을 초과하지 않음

25. Inhibitory Techniques
(3) Light Joint compression
체중만큼 또는 체중보다 혹은 joint compression
=> joint 주변의  spastic muscle을  inhibit
 hemiplegia 환자에게 실시하면 shoulder주위에 생기는 pain 감소

26. Inhibitory Techniques
(4) Rocking in Developmental pattern
developmental sequence를 유지하며 isometric운동을 함
 stability와 mobility를 동시에 증가
예:quadruped position3points stance하고 한 손으로는 reach 혹은 grasp

27. The touch system

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