Lecture 6-PNF Flashcards
What does PNF stand for?
Proprioceptive Neuromuscular Facilitation
What are PNF patterns?
Extremity patterns of movement that are rotational and diagonal facilitating synergistic patterns which is the way we move
What are the components of positive approach?
- no pain
- achievable task
- set up for success
- direct and indirect treatment
- start with the strong
What are the components of Highest functioning level?
- Functional approach using ICF
- include treatment of impairments
- activity limitations
What are the components of mobilize potential?
- Intensive action training
- active participation
- motor learning
- self-training
What does consider to total human being mean?
The entire person with his/her environment, personal, physical, and emotional factors
How can you use motor control and motor leaning principles?
Repetition in different context, respect stages of motor control, variability of practice
how are PNF patterns named
What is happening at the proximal joint or by the diagonal
PNF patterns are ________, combining motions in all three planes
spiral and diagonal
What are the three planes
- flexion/extension
- Abduction/adduction
- transverse rotation
What are the components of D1 flexion of UE?
Flexion, abduction, and ER
What are the cues for D1 UE flexion
squeeze my hand, turn, and pull up and across your face
What are the components of D1 extension of UE ?
extension, adduction and IR
What are the cues for D1 UE extension?
“Open your hand, turn, and push down and out toward me”
What are the components for D2 UE flexion
Flexion-abduction-external rotation
What are the cues for D2 UE flexion
“Open your hand, turn, and lift up and out toward me”
What are the components for D2 UE extension
extension-adduction-IR
What are the cues for D2 UE extension
“Squeeze my hand, turn, and pull down and across your body”
What are the components for D1 LE flexion
flexion-adduction-ER
What are the components for D1 LE extension
Extension- abduction-internal rotation
What are the components for D2 LE flexion
Flexion-abduction-internal rotation
What are the components for D2 LE extension
Extension-adduction-external rotation
What are the cues for D1 LE flexion
“Pull your foot up, turn your heel in, and pull your leg up and across your body”
What are the cues for D1 LE extension
“Push your foot down, turn your heel out, and push down and out toward me”
What are the cues for D2 LE flexion
“Foot up, turn and lift your leg up and out toward me”
What are the cues for D2 LE extension
“Foot down, turn and push your leg down and across your body”
What are the components and cues for chop
- Lead arm moves in D1E
- “Push your arms down and toward me, turn and look down at your hands. Reach down towards your knee”
What are the components and cues for reverse chop
- lead arm moves in D1F
- “Squeeze my hand, turn and pull your arms up and across your face, turn and look up at your hands. Reach up and around”
What are the components and cues for lift
- Lead arm moves in D2F
- “Lift your arms up and out toward me, turn and look up at your hands. Reach up and around”
What are the components and cues for reverse lift
- Lead arm moves in D2E
- “Squeeze my hand, turn, and pull your arms down and across your body. Lift and turn your head. Reach down and across”
What are the 12 foundational procedures/principles
- Timing
- Timing for emphasis
- Resistance
- Overflow or irradiation
- Manual contacts
- Positioning
- Therapist position and body mechanics
- Verbal cues
- Visual guidance
- Stretch
- Approximation
- Traction
What is rhythmic initiation
- Therapist moves patient through range passively with appropriate speed/rhythm
- Active-assisted movement through range
- Light resistance through range
- active movement by patient
What is dynamic reversals
- Resist contraction of one pattern, then at the end of the desired range a preparatory command is given to reverse the direction and therapist’s hand placements are switched
- slow concentric followed by concentric
What is stabilizing reversals
- Allowing only very limited movement (small ROM)
- Don’t let me move you
What is rhythmic stabilization
- uses isometric contractions, focusing on co-contraction of muscles
- don’t let me twist you
What is repeated stretch
-Quick stretch enhanced by resistance
what is combination of isotonics
-Resisted concentric contraction moving through the range followed by a stabilizing contraction (hold the position) and then eccentric contraction moving slowly back to starting position
what is replication
- Patient positioned in end range and the isometric contraction is resisted
- Isometric contraction is resisted then voluntary relaxation
- Patient is passively moved back to starting position and asked to actively move into end position again
What is contract relax
- At point of limited ROM an isometric contraction is held for 5 to 8 seconds followed by a resisted active movement into the new ROM
what is hold relax
- At point of limited ROM an isometric contraction is held for 5 to 8 seconds followed by therapist passively moving limb into the new ROM
what is hold-relax-active contraction
- Similar to HR expect movement into the newly gained range is active by the patient, not passive
- Active contraction is always desirable as it serves to maintain the inhibitory influence through the effects of reciprocal inhibition
What is rhythmic rotation
- Relaxation is achieved using slow, repeated rotations of the limb or body segment
- can be active or passive
what is resisted progression
- Stretch, approximation, and tracking resistance are applied manually to facilitate lower trunk/pelvic motion and progression during locomotion
- resistance is light as to not disrupt momentum
What are the goals of Rhythmic Initiation?
- promote initiation of movement
- teach the movement
- improve coordination
- promote relaxation
- promote independent movement
What are the goals for dynamic reversals?
- improve coordination
- improve strength
- improve AROM
- improve endurance
- reduce fatigue
What are the goals for stabilizing reversals
- improve stability
- improve coordination
- improve strength
- improve ROM
- improve endurance
what are the goals for rhythmic stabilization
- improve stability
- improve coordination
- improve strength
- improve ROM
- improve endurance
- promote relaxation
- decrease pain
what are the goals for repeated stretch
- enhance initiation of motion
- motor learning
- increase agonist strength
- increase endurance
- increase coordination
- increase ROM
- reduce fatigue
what are the goals of combination of isotonics
- improve motor learning
- improve coordination
- increase strength
- promote stability and eccentric control
What is the goal for contract relax
improve ROM
what are the goals of HRAC
improve ROM and decrease pain
what are the goals for replication
- promote motor learning
- improve coordination and control in the shortened range
what are the indications for rhythmic initiation
- inability to relax
- hypertonicity
- difficulty imitating movements
- uncoordinated movement
- motor planning or motor deficits
- communication deficits
what are the indications for dynamic reversals
- impaired strength, range and coordination
- inability to easily reverse directions between agonist and antagonist
- fatigue
What are the indications for stabilizing reversals
- impaired strength, stability and balance
- impaired coordination
what are the indications for rhythmic stabilizations
- impaired strength and coordination
- limitations ROM
- impaired stabilization control and balance
What are the indications for combination of istotonics
- weak postural muscles
- inability to eccentrically control body weight during movement transitions
- poor dynamic postural control
What is the indication for contract relax
limitations in ROM
what are the indications for HRAC
limitations in PROM with pain
What are the indications for Replication
- marked weakness
- inability to sustain a contraction in the shortened range
what are the indications for resisted progression
- impaired timing and control of lower trunk/pelvic segments during locomotion
- impaired endurance
What are the indications for rhythmic rotation
-relaxation of hypertonia (spasticity/rigidity) combined with passive or active ROM of the range-limiting muscles
