Lecture 3 -proprioceptive Neuromuscular Facilitation (PHT 245) Flashcards
PNF techniques (jitspev)
Joint structure
Irradiation and overflow
Timing
Stretch
Pattern of movement
Eyes
Voice
Define PNF?
Involves both stretching and contracting of the muscles group being targeted in order to achieve maximum static elasticity.
-Proprioceptive means to receive stimulation within the tissues of the body.
-Neuromuscular means pertaining to the nerves and muscles.
-Facilitation means the effect produced in nerve tissue by the passage of an impulse.
what principles to remember when performing PNF exercises:
-The patient must be taught the pattern
-the technique should be demonstrated to patient
-Patient must give verbal command
-Must make manual contact and appropriate amount of pressure applied is important.
flexion/abduction/lateral rotation (D2 flexion)
starting position: extension/adduction/medial rotation (pronation of the forearm, flexion and ulnar deviation of the wrist, flexion of the fingers
Stance:
-lunge position looking towards patient’s feet
- weight on the forward right leg
-Therapist transfers her weight from the forward right leg to the other leg
-Rotates so as to watch the patients hand throughout the movement.
Grip: patients right hand is grasped with the therapist left hand
Commands; command the patient to push
Extension/adduction/medial rotation (D2 extension)
Starting position: flexion/abduction/lateral rotation (Supination of the forearm, extension of the wrist with radial deviation and extension of the fingers and thumb)
Stance:
-lung stance is reversed
-The patient faces the patients outstretched hand.
-The therapists left foot is foreword with the knee flexed.
-During movement, weight is transferred from the left foot to the right.
Grip: the therapist places fingers of her left hand on the flexor surface of the wrist approaching’s from the radial side
Flexion/adduction/lateral rotation (D1 flexion)
Starting position: Extension /abduction /medial rotation of the shoulder (pronation of the forearm, extension with ulnar deviation of the wrist, extension of the fingers)
-Therapist must ensure that the patient is near enough to the edge of the plinth to take the arm into extension
-Patients arm should only be abducted to about an arms width.
Stance:
-Therapist stands in a lunge position facing the patients feet with her weight on her forward right foot
-During the movement the therapist transfers weight from the right foot towards the left foot, so that she can watch the patients arm.
Grip:
-The therapist graps the patients right hand by placing her the left palm into the patients palm approaching from the radial side
-Use the lumbrical grip
-Makes sure does not touch the extensor surface of the patients hand
-Fingers of the right hand are placed on the flexor surface of the patient’s wrist approaching from the ulnar side.
Extension/abduction/medial rotation (D1 extension)
Starting position: Flexion/adduction/lateral rotation (supination of the forearm, flexion and radial deviation of the wrist, flexion of the fingers and flexion and adduction of the thumb)
Stance:
-The therapist stands in a lunge position facing the patients head
-The therapist transfers her weight from the left to the right foot
-Rotating so that she can watch the patients hand
Grip:
-The therapist using her right hand and the lumbrical grip grasping the dorsum of the patients right hand ensuring that the stretch is obtained.
-Emphasis is given by pressure with her fingers on the ulnar side of the patients hand
-Fingers of the therapist left hand are placed on the extensor surface of the patients wrist approaching from the flexor aspect and around the ulnar border.
Thrust into flexion/adduction
Starting position: Extension /abduction with lateral rotation of the shoulder, flexion of the elbow, supination of the forearm, wrist flexion with radial deviation and flexion of the fingers and thumbs
Stance: Stand at the head of the plinth with the right foot forward in the lunge position.
Grip:
-Left hand over the patients right hand (extensor surface)
-Giving pressure on the ulnar side
-Right hand placed with thumb abducted over the flexor aspect of upper arm and into the bend of the elbow
Thrust into extension/adduction
Starting position: Flexion/abduction/medial rotation of the shoulder, elbow flexion (hand is on the shoulder), pronation of the forearm, wrist flexed towards the ulnar side, flexion of the fingers and thumb
(position 1)
Stance: In lunge position as for the basic extension/adduction pattern
Grip:
-Left hand on the extensor surface of the patients hand obtaining stretch by exerting pressure through the fingers.
-Right hand placed on upper arm.
(position 2)
Stance::
-Therapist stands in a lunge position with the right foot forward on the patients left side (opposite to the arm being exercised).
-Facing the patients head
Grip: Left hand over the extensor surface of the patient’s hand, obtaining stretch by exerting pressure on the radial side of the hand through the thumb.
Flexion/adduction/lateral rotation (D1 flexion)
Starting position: Patient: Extension/ abduction/ internal rotation of the hip, Plantar flexion and eversion of the foot and flexion of the toes
-Patients lies on the side of the plinth
-Leg taken into full extension (over the side of plinth with minimal abduction)
Stance / body mechanics:
-Therapist stands in the lunge position
-Shift weight from the front foot to the back foot as your stretch.
-As the patient moves shift your weight onto the front foot
Grip:
-Distal Hand
-Left hand grips the patient’s foot with the fingers on the medial border and the thumb giving counter-pressure on the lateral border.
-Proximal Hand
-Place your right hand on the anterior-medial surface of the thigh just proximal to the knee.
Extension/abduction/medial rotation (D1 extension)
Starting position: Flexion/ adduction /lateral rotation of the hip, dorsiflexion and inversion of the foot, extension of the toes.
Stance:
-Therapist faces the head of the plinth in a lunge
-Weight is on the front foot
-When patient starts moving allow her to push you back onto the rear foot
-Keep elbows close to your side so that you can give resistance with body and legs.
Grip:
(Proximal Hand)
-Your right hand holds the posterior lateral side of the thigh.
(Distal Hand)
-Hold the foot with the palm of your left hand along the plantar surface. -Your thumb is at the base of the toes to facilitate toe flexion.
-Your fingers hold the medial border of the foot.
-While the heel of the hand gives counter pressure along the lateral border.
(The proximal hand gives a stretch by rapid traction of the thigh.
Use the forearm of your distal hand to traction up through the shin while you stretch the patient’s foot farther into dorsiflexion and inversion.)
Flexion/abduction/medial rotation (D2 flexion)
Starting position: Patient: Extension/ adduction/lateral rotation of the hip, plantar flexion and inversion of the foot and flexion of the toes
Opposite leg must be taken into abduction.
Stance:
-Therapist stands in a lunge position facing the foot of the plinth
-Right foot or Left foot forward depending on which side you using
Grip:
(Distal Hand)
-Your left hand grips the dorsum of the patient’s
foot.
-Your fingers are on the lateral border and your thumb gives counter-pressure on the medial border.
-Hold the sides of the foot but don’t put any contact on the plantar surface.
-To avoid blocking toe motion, keep your grip proximal to the metatarsal-
-phalangeal joints.
-Do not squeeze or pinch the foot.
(Proximal Hand)
-Place your right hand on the anterior-lateral surface of the thigh just proximal to the knee.
-The fingers are on the top, the thumb on the lateral surface.
