This document discusses inhibitory and facilitatory techniques used in physical therapy. Facilitatory techniques like light touch, brushing and stretching are used to improve muscle tone and initiate movement. Inhibitory techniques like prolonged stretching, pressure and slow stroking are used to decrease muscle tone and provide relaxation. The goal of these techniques is to normalize muscle tone and movement based on developmental patterns from cephalocaudal and proximal to distal. Specific techniques activate or deactivate sensory receptors to facilitate or inhibit motor function.

1. Inhibitory & facilitatory technique
By: Dr.Sagar S. Gajra (F.Y.MPT)

2. Objectives
 Introduction
 Goals
 Principles of treatment
 Ontogenic motor pattern
 Sequence of motor development
 Ontogenetic motor patterns
 Facilitation technique
 Inhibition technique

3. Facilitatory Technique
 It is process of intervention , which used to the improved postural
tone in a goal directed activity.
 Facilitation makes movement easier but in the treatment it also
means “make it possible” & “making it have to happen”
 In this, tactile, vestibular & proprioceptive input also assist in the
regulation of the body responses to movement.

4. Inhibitory Technique
• This technique also used to maintain muscle tone
• This technique is opposed to facilitatory technique

5. Rood Approach
 This approach developed by margaret rood in 1956.
 Rood approach deals with the activation or de-activation of
sensory receptors, which is concerned with the interaction of
somatic, autonomic and psychic factors and their role in the
regulation of motor behavior
 This approaches was designed for the patient with motor control
problem.

6. Goals
 Normalize muscle tone
 Treatment begins at developmental level of functioning
- Cephalocaudal rule
- Proximal to distal
 Movement is directed toward functional goals
 Repetition is necessary for re-education of muscular response

7. Principles of treatment
Sensory Motor Homunculus

8. Ontogenic Motor Pattern
a. Supine withdrawl
b. Roll over
c. Pivot pattern
d. Neck co-contraction
e. Prone on elbow
f. All four
g. Walking

9. Sequence Of Motor Development
1. Reciprocal innervation
2. Co-contraction
3. Mobility superimposed on stability
4. Distal mobility with proximal stability

10. Facilitatory Technique
 Light touch
 Brushing
 Fast stroking
 Icing
 Joint compression / approximation
 Stretching
 Resistance
 Positioning

11. Inhibitory Technique
 Neutral
 Warmth
 Gentle shaking
 Slow stroking
 Light joint compression
 Pressure

12. Facilitatory Technique

13. 1. Light Touch
 Stimulus: brief , light contact to skin
 Receptor: rapidly adapting tactile receptor
 Higher center: ANS (sympathetic division)
 Response: increased arousal , withdrawal response to
 Ix: initiating a generalize movement response , to elicit arousal
 Cx: agitated patient , ANS unstable

14. 2. Fast Brushing
 Stimulus: battery operated brush , camel hair brush use over skin
overlying the myotomes
 Receptor: hair end organs , free nerve ending
 Response: increased arousal ,activate muscle & improve the
sensory function
 Higher center: reticular activating center

15.  Ix: sensory integration patient
 Use: for 3sec over same area

16. 3. Icing
 Stimulate: ice cube over skin overlying the muscle
 Receptor: free nerve ending
 Type: 2
1. A icing /quick icing
2. C icing

17.  Response: - in A icing facilitate the muscle contraction
- In C icing improve the postural tone
 Use: 3- 5 stroke in one time
 Cx: in cardiovascular problem & don't applied over neck which
cause sudden low BP

18. 4. Quick Stretch
 Stimulus: quick stretch or tapping over a muscle belly or tendon
 Receptor: muscle spindle ia
 Response: activates agonist to contract; reciprocally inhibit the
antagonist activation
 CX: in spasticity

19. 5. Resistance
 Stimulus: manually or with body weight or gravity; mechanical
weights
 Receptor: muscle spindle
 Response: enhances muscles contraction through recruitment ;
enhances kinesthetic awareness

20. 6. Approximation/Joint Compression
 Stimulus: compression of joint surface ; manual or mechanical or
mechanical; bouncing applied in weight bearing
 Receptor: joint receptor
 Response: enhances muscular co-contraction , postural stabity &
increase kinesthetic awareness
 Cx: inflamed joint

21. 7. Traction
 Stimulus: joint surface distracted , usually manually and at
beginning of movement
 Receptor: joint receptor
 Response: facilitates muscle activation to improve mobility and
movement initiation

22. 8.Fast Vestibular Stimulation
 Stimulus: fast or irregular movement with an acceleration and
deceleration component , such as spinning , use of a scooter board ,
fast rolling
 Receptor: semicircular canals
 Response: facilitates general muscle tone and promote postural
response to movement

23.  Ix: hypotonia ( CP , Down syndrome ) ; used to promote sensory
integration(required specialized training and certification)

24. Inhibitory Techniques

25. 1. Prolonged Stretch
 Stimulus: maintained stretch in a lengthened range
 Receptor: muscle spindle ia and ii endings, Golgi tendon organs
 Response: inhibits muscle contraction

26. 2. Inhibitory Pressure
 Stimulus: firm pressure manually or with body weight over
muscle belly or tendon
 Receptor: GTO , muscle spindles , tactile receptors
 Response: inhibits muscle activity
 Equipment uses: casts , splints , placing cones in hand, position at
use of wheelchair lap tray ; weight bearing positioning (open hand
to inhibit finger flexors

27. 3. Maintained Touch
 Stimulus: maintained contact or pressure
 Receptor: slowly adapting tactile receptors
 Higher center: ANS (para-sympathetic division)
 Responses: calming effect, desensitizes skin , general inhibition
 Ix: patient with higher level of arousal or hypersensitivity

28. 4. Neutral Warmth
 Stimulus: Towel or elastic wrap of body or body parts
 Receptor: Thermo receptors
 Response: Provides general relaxation & inhibition; decreased
muscle tone ; decreased agitation or pain
 Higher center: ANS (parasympathetic division)
 Use: use for 10-15min; avoid overheating; appropriate for highly
agitated patient or individual with increased sympathetic response

29. 5. Slow Vestibular Stimulation
 Stimulus: slow rocking , slow movement on ball , in hammock , in
rocking chair
 Receptor: Tonic vestibular receptors
 Response: Produce calming effect , decreased arousal ,
generalized inhibition
 Ix: patient who are defensive to sensory stimulation ,
hyperreactive to stimulation , hypertonic or agitated

30. 6. Slow Stroking
 Stimulus: slow , firm stroking with flat hand over neck or trunk
extensors
 Receptor: Tactile Receptor
 Response: produce calming effect , general inhibition ; induces
feeling of security
 Higher Center: ANS (parasympathetic division)
 Ix: over arousal patient