Neuro-Therapeutic Facilitation--Lab Flashcards
Heel Slides
- Definition
- Philosophic Basis
- Definition: PT facilitate hip and knee flexion of involved LE (hand on knee and lat foot)–>reverse to extended position
- Basis: Brunnstrom, NDT
Heel Slides
-Rationale
- Prep for bridging/bed mobility
- Break up extensor tone
- facilitate movement into flexion
- Rolling/scooting in bed
Bridging
- Definition
- Philosophic Basis
- Definition: LEs flexed with feet on flat surface; PT hands on gluts (up) or knees (fwd and up)
- Philosophic Basis: NDT, PNF, Brunnstrom
Bridging
-Rationale
- WB on LE
- Hip extension/knee flexion
- strengthen hip extensors
- bed scooting
- Core stabilizer
Half-Bridging
- Definition
- Philosophic Basis
- Definition: Involved LE flexed with foot flat on surface; LE IR/add at hip; pt lifts hip; PT hands on glut/knee to facilitate up and over movement
- Philosophic Basis: NDT
Half-Bridging
-Rationale
- WB involved LE
- Dissociation of R-L LEs
- Trunk elongation
- Rolling
- Scooting in bed
Hip Abd-Add in Hook-Lying
- Definition
- Philosophic Basis
- Definition: LE flexed with feet on flat surface; pt bring knees apart and together; PT hands on knees; For pts with no active contraction, can resist other LE to encourage associated reaction of involved LE
- Philosophic Basis: NDT, Brunnstrom
Hip Abd-Add in Hook-Lying
-Rationale
- Increase active movement of LE
- Precursor to rolling and moving in bed
- Rolling strength
- Low level strengthening
- Bed mobility: rolling/swing legs over edge of bed
- Help initiate Mm contraction
Inhibition of Knee Extension w/ Hip extension
- Definition
- Philosophic Basis
- Definition: Pt supine with invoved hip on edge of bed; LE flexed; bring LE into flexion and then over side of bed; contact at knee and lat foot
- Philosophic Basis: NDT, Brunnstrom
Inhibition of Knee extension w/ hip extension
-Rationale
- volitional inhibition of spasticity
- precursor to gait
- getting out of bed
- Strengthening for gait
Facilitation of Active DF
- Definition
- Philosophic Basis
- Definition: Pt supine w/ involved LE flexed (foot flat); hand contact on knee and lateral foot; facilitate DF; gradually extend knee and practice DF
- Philosophic Basis: NDT, Brunnstrom
Facilitation of Active DF
-Rationale
- Reduce tone
- precursor to gait
- don shoes/socks
- increase ant tib strength
Trunk forward bending
- Definition
- Philosophic Basis
- Definition: pt sit on mat and cradles involved UE with other; PT sits in front and supports elbows; PT guides pt fwd encouraging flexion at hips
- Philosophic Basis: Brunnstrom
Trunk forward bending
-Rationale
Improve control/balance in sitting
- trunk control for sit-to-stand
- anticipatory balance
- confidence
Oblique trunk flexion
- Definition
- Philosophic Basis
- Definition: same as trunk fwd bending but diagonal movement of trunk with flexion
- Philosophic Basis: Brunnstrom
Oblique trunk flexion
-rationale
-Improve control/balance in sitting
- Reaching
- Confidence
Scapular Mobilizations
- Definition
- Philosophic Basis
- Definition: pt sidelying with involved UE up; PT hand on scapula and supports UE; facilitate protraction and upward rotation of scapula (can be done in supine or sitting)
- Philosophic Basis: NDT
Scapular mobilizations
-Rationale
- reduce neglect
- reduce tone in UE
- scap stability
- gain ROM with passive stretching
- Prep for reaching
Scapular Elevation
- Definition
- Philosophic Basis
- Definition: pt seated; PT hands on shoulders; ask for contraction of uninvolved shoulder into elevation and look for associated reaction on involved; then try only involved shoulder without associated reaction
- Philosophic Basis: Brunnstrom
Scapular Elevation
-Rationale
-Used to elicit contraction of shoulder Mm
- posture
- hold/carry objects
- washing hair
- reaching
Humeral Movements
- Definition
- Philosophic Basis
- Definition: pt supine; PT hands on scapula (to protract) and wrist/hand; PT facilitates protraction during UE elevation (can do by clasping hands with pt)
- Philosophic Basis: NDT
Humeral Movements
-Rationale
- develop proximal control of UE
- reduce neglect
- reduce tone
- Reaching
- UE tasks
WB on stable surface
- Definition
- Philosophic Basis
- Definition: pt sitting with UE on table; PT contact on shoulder and UE to assist w/ WB (ensure humeral head doesn’t sublux); pt move trunk over UE in all directions
- Philosophic Basis: NDT
WB on stable surface
-Rationale
- Develop prox stability of UE via WB
- reduce neglect
- normalize tone
- Shoulder stability
- decrease subluxation
- wrist flexor stretch
- elbow flexor stretch
- prep for sit to stand (pushing off chair)
UE PNF D1
- Definition
- Philosophic Basis
- Flexion: start arm by side palm facing out; close fist, supinate forearm, flex shoulder and elbow diagonally across trunk
- Extension: start where flexion ends; open hand, pronate (palm out), extend elbow and shoulder back to starting position
- Eyes/head follow arm
-Philosophic Basis: PNF
UE PNF D1
-Rationale
-improve functional performance and coordination
- coordination
- strength
- trunk rotation
UE PNF D2
- Definition
- Philosophic Basis
- Flexion: start with arm at opposite hip hand closed/forearm pronated; open hand, supinate, flex shoulder and extend elbow above on ipsilateral side
- Extension: start where flexion ends; close hand, pronate forearm, reach back across to opposite hip
- Eyes/head follow arm
-Philosophic Basis: PNF
UE PNF D2
-Rationale
-improve functional performance and coordination
- coordination
- strength
- trunk extension (bilateral D2 flexin; parkinson’s)
- Rotate trunk
LE PNF D1
- Definition
- Philosophic Basis
- Flexion: LE out (hip ext, abd, IR), knee extended, ankle PF and Everted; starting at ankle move into: ankle DF/inversion, knee flexion, hip add/ER/flex
- Extension: Start where flexion ended; return to beginning position of flexion
-Philosophic Basis: PNF
LE PNF D1
-Rationale
-improve functional performance and coordination
LE PNF D2
- Definition
- Philosophic Basis
- Flexion: start with LE hip ext/add/ER, knee ext, & ankle PF/inverted; end with ankle DF/everted, knee flexed, hip abd/flex/(IR or ER ?????)
- Extension
-Philosophic Basis
LE PNF D2
-Rationale
-improve functional performance and coordination
Rhythmic Rotation
- Definition
- Philosophic Basis
- Definition: passive rhythmic rotation around long axis of bone; to end range with stretch; or sidelying for trunk
- Philosophic Basis: PNF, NDT
Rhythmic Rotation
-Rationale
- decrease tone
- increase ROM
- decrease co-contraction
- promote mobility
Rhythmic Initiation (RI)
- Definition
- Philosophic Basis
- Definition: passively (slowly) take pt through movement several times–>AAROM–>AROM; along long axis
- Philosophic Basis: PNF
Rhythmic Initiation (RI) -Rationale
- assist movements in pts who can’t initiate or complete movement; give pt idea of motion
- relaxation and decrease tone
-decrease co-contraction
Contract Relax (CR)
- Definition
- Philosophic Basis
- Definition: position joint/limb at end ROM; ask for strong ISOTONIC contraction of range constricting muscle; hold 5-8 sec; voluntary relaxation; active movement into new range of agonist muscle
- -FOCUSES ON ROTATION
- -increase ROM
- Philosophic Basis: PNF
Contract Relax (CR) -Rationale
-Improve ROM via autogenic inhibition/reciprocal inhibition
Hold Relax (HR)
- Definition
- Philosophic Basis
- Definition: position joint at end ROM before pain; ask for strong ISOMETRIC contraction of range restricging muscle; hold; voluntary relaxation; move into new range
- -NOT focused on rotation
- Philosophic Basis: PNF
Hold Relax (HR) -Rationale
-Improve ROM via autogenic inhibition/reciprocal inhibition
Hold Relax Active Motion (HRAM)
- Definition
- Philosophic Basis
- Definition: appropriate for weak Mm (2/5 or less); passvely move into shortened range; perform isometric hold; have pt relax; passively move back to beginning of ROM; ask for active movement to end of range
- Philosophic Basis: PNF
Hold Relax Active Motion (HRAM)
-Rationale
-reinforce end ROM to give pt idea where to move to
Approximation
- Definition
- Philosophic Basis
- Definition: compression through joint
- Philosophic Basis: PNF
Approximatino
-Rationale
- stimulate joint receptors
- increase stability around joint
- pressure/proprioception
- decrease neglect
Tapping
- Definition
- Philosophic Basis
- Definition: use fingertips to tap on muscle belly that is contributing to movement
- Philosophic Basis: PNF, NDT
Tapping
-Rationale
- provide quick stretch to muscle (maybe)
- Sensory feedback
Resisted flex/ext of trunk/limb
(aka stabilizing reversals/alternating isometrics)
-Definition
-Philosophic Basis
- Definition: body segment in midline or WB position; resist isometric contraction of one side of joint; move hands to other side (no relaxation) isometric contraction of muscle on other side
- Philosophic Basis: PNF
Resisted flex/ext of trunk/limb
(aka stabilizing reversals/alternating isometrics)
-Rationale
-increase stability at mid range
Resisted rotation of trunk/limb
(aka Rhythmic stabilization)
-Definition
-Philosophic Basis
- Definition: simultaneous isometric contraction of agonist and antag Mm w/o relaxation in between contractions; resist rotatory components
- Philosophic Basis: PNF
Resisted rotation of trunk/limb
(aka Rhythmic stabilization)
-rationale
good progression from resisted flex/ext due to increased number of Mm involved
Dynamic Reversals (or hold)
- Definition
- Philosophic Basis
- Definition: pt weight shift while tracking PT hand (or weight shift and resist PT there)
- Philosophic Basis: PNF
Dynamic reversals (or hold) -rationale
-controlled mobility (and core strength)
