EXAM 3: 3.21 PNF Flashcards
PNF
Proprioceptive
Neuromuscular
Facilitation
Where did the idea for PNF begin? What was it based on?
neuro pts
- proximal muscles tend to irradiate into distal musculature
- muscles fire in certain movement patterns
Why is it important to know that muscles fire in certain movement patterns? (impact on rehab)
- If we teach pts those patterns, get summated irradiation
- get overflow into muscles that aren’t firing well
PNF and stroke/neuro pts
works - somehow gets their system to wake up
Benefit to using PNF with ortho pts
- can wear them out with just a few reps
- can change resistance with every rep
- adds value to what you do by putting hands on them
What are the essential components of PNF? (10)
- manual contact
- body position/body mechanics
- stretch
- manual resistance
- irradiation
- joint facilitation
- timing of movement
- patterns of movement
- visual cues
- verbal input
PNF components: manual contact
- typically use lumbrical grip (no fingernails)
- go right to where you need to go without searching around
- where your hands are indicate which muscle needs to contract (hand on quad, quad contracts)
PNF components: body position/body mechanics
- typically on a plinth or mat justified toward therapist (on edge)
- therapist in proper position (able to weight shift)
PNF components: stretch
- quick stretch of a muscle facilitates contraction
PNF: stretch with neuro/stroke/TBI pt benefit
quick stretch of muscle to be contracted will give an additional signal to contract
PNF components: manual resistance
- almost always start PROM
- doesn’t take much to overcome and wear out certain muscles
PNF: Why use PROM first?
- see available range
- motor learning - person has no idea what you want them to do with their limb
- gives you the ability to see that everything is in the right position
PNF components: irradiation
- can’t take a flaccid limb and make it contract
- as we continue to do patterns, we hope other muscles that aren’t working will begin to fire
- Don’t want to give too much resistance, need to build up irradiation
PNF components: joint facilitation
- stretch out joint capsule a little, relaxes the muscles that attach
- pushing the joint together to approximate, muscles tighten (cocontraction)
PNF: joint approximation
- body thinks WB is happening
- resulting cocontraction creates stability at joint
PNF components: timing of movement
“dance” between you and the pt
PNF components: patterns of movement
D1
D2
- flexion/ext of UE
- flexion/ext of LE
PNF components: visual cues
- pt needs to be looking at what they’re doing
- being able to see their hand gives them extra feedback
PNF components: verbal input
time out verbal cues so you don’t confuse the pt
diagonals
These are the movements that create the most irradiation
D1
starts outside the body and come across
D2
starts in and goes out
UE D1 flexion
start: hand pronated, elbow extended
end: up and across (wrist toward face, fingers flex)
UE D1 extension
opposite of D1 flexion
D2 flexion
pulling out a sword
D2 extension
put the sword back in
