Lecture 18: PNF Flashcards
Propioceptive
receiving stimulation with the tissues of the body
Neuromuscular
pertaining to nerves and muscles
Faciliation
making it easer
Definition of PNF
an approach to therapeutic exercise that combines functionally based diagonal patterns of movement with techniques of neuromuscular facilitation to evoke a motor response and improve neuromuscular control and function
Indications of PNF
- improve initiation of movement
- improve coordination of movement
- improve control of movement
- improve stability and mobility
contraindications of PNF
- wound/post-operative site
- acute conditions/recent fx
- acture cardiopulm conditions
- joint traction with flaccidity
- spasticity that increases with reps
general guidelines to PNF
- total movement patterns
- spiral or diagonal based patterns
- focus on major body parts: UE/LE, trunk, head/neck
*LE and head/neck often dont use PNF
PNF patterns have __ dimensions
3
- flexion/extension
- abduction/adduction
- rotation
PNF movement occurs in a ___ direction with ___ component
diagonal direction with rotatory component
D1 flexion pattern
flexion, adduction, external rotation
d1 extension pattern
extension, abduction, internal rotation
d2 flexion
flexion, abduction, external rotation
d2 extension pattern
extension, adduction, internal rotation
D1 flexion picture
D1 extension picture
D2 flexion picture
D2 extension picture
D1 flexion is functional for
combing hair
d1 extension pattern is functional for
reaching back for something
PNF application essentials
- teach patterns start to finish
- mechanics and body position are essential
- begin pattern with distal component (fingers)
- appropriate pressure
- patient should look at limb
- use verbal cues
- rotation is pivotal
therapist position for PNF
- visualize diagnoal line of movement
- watch body mechanics (stay in diagnol - GROOVE)
Manual contact of therapist
- lumbrical grip used by therapist to control movement and resist rotation
- pressure comes from flexion at MCP joints
- therapist fingers conform to body part
- do not cause pain due to squeezing or putting too much pressure on the bony body parts
communication and demands
- hand contact #1 form of communcation
- verbal commands very important
- vision theirs and yours
techniques of faciliation
- slow reversal
- slow-reveral hold
- quick stretch
- repeated contractions
- hold relax
- contract relax
- otthers
quick stretch
utilization of the stretch reflex to facilitate a muscular response
slow-reversal
- isotonic contraction followed immediately by isotonic contraction of antagonist muscles
- overflow from strong pattern to weaker pattern
- purpose: increase strength and facilitate normal timing and coordination
slow-reversal hold
- isometric hold performed at the end of an isotonic diagnol pattern
- purpose: increase strength in a particularly weak or uncoordinated portion of range
related contractions
- repeated concentric contractions (often initiated with quick stretches)
- can be used at any point in the range of motion when more weakness is noted
- principle of irradiation
wrist finger flexion 1/5 - which PNF pattern would be best
D2 extension
D1 flexion
-both positions require wrist and fingers to be in flexion
go-to technique for administering PNF
slow-reversal
quick stretch may come in handy if not initiating well at the beginning (may be probable for stroke patients)
do not perform PNF on patients who have difficulty
following multi-level commands
