Neurofacilitation Techniques Flashcards
What is neuro-facilitation?
To promote normal movement patterns through application of sensory stimulation by the therapist
What are the 4 theories of neuro-facilitation?
- Brunnstorm
- Bobath (NDT)
- PNF
- Rood
List 5 similarities between the four theories of neuro-facilitation.
- Developed in the 1940s and 1950s
- Based on reflexive and Hierarchical models
- Augmentation / Manipulation of sensory inputs
- Emphasize developmental and biomechanical sequence
- Philosophy to move away from primitive, reflexive or synergistic movement to skilled, volitional, isolated movement
What is the basis of Margret Rood’s theory of neuro-facilitation?
Use of sensorimotor stimulation to facilitate muscle activity during movement/attempts to move.
What receptors did Rood believe in stimulating for light work? Examples?
Exteroreceptors for light work —upper extremity—open chain such as reaching, wrist extension
Examples: Stimulating afferent nerves through stroking, brushing, icing, warmth, pressure & vibration to increase muscle activation
What receptors did Rood believe in stimulating for heavy work? Examples?
Proprioceptors for heavy work—closed chain tasks
Examples: Stretch, resistance, positioning, joint compression & joint distraction used to stimulate reflexes
What are Rood’s 4 stages of motor control?
- Mobility—mass (synergistic) patterns (flexion and extension)
- Stability (co-contraction) —facilitation postural control
- Controlled mobility (isolated movement)
- Skill—stable proximal to allow distal aspect of limb to move
Rood’s techniques follow normal ______ patterns and include _____ and ____ techniques to help normalize ______.
- Neurodevelopmental
- Facilitation
- Inhibition
- Muscle tone
What is the normal neurodevelopmental pattern of movement followed by Rood?
Pivot prone> quadraped> kneeling>stance>gait
Provide 2 examples of facilitation and inhibition techniques promoted by Rood’s theory of neuro-facilitation.
- Working out of extensor patterns through full flexion trunk
- Utilizes rolling to facilitate lateral trunk control to promote movement upper & lower extremity into flexion
What did Signe Brunnstrom encourage during early recovery from neurological impairments? What was used to promote movement?
1; Encourages flexor/extensor synergy patterns during early recovery
- Use of reflexes, associated reactions, and mass synergies to promote movement (any movement is good)
Brunnstrom promoted use of ______ to assist in movement of involved limb for desired outcome. This technique preceded _____ techniques.
- Uninvolved limb
2. Bi-manual techniques
What belief is a limitation of the Brunnstrom theory of neuro-facilitation?
Belief that can “break out” of these synergy patterns by then facilitating antagonist of synergy
List the 5 techniques that combine to form the Brunnstrom theory of neuro-facilitation.
- Proprioceptive stimulation (Rood)
- Exteroceptive stimulation (Rood)
- Resistance is often applied to uninvolved limb to promote overflow to involved
- Push/pull technique upper ext/ flex to facilitate trunk and LE extension
- Emphasis on postural stability
What 2 things did Karel and Berta Bobath emphasize in their neurodevelopmental technique (NDT)?
- Handling techniques to normalize tone, inhibit primitive(reflexive) movement patterns (RIP)
- Promote normal movement patterns as believes continuous use of primitive movement patterns will become “habit” at the expense of normal pathways
The Bobaths emphasized that _____ is key in promoting normal muscle activity.
ALIGNMENT
Provide an example using reflex inhibiting postures (RIPs) to inhibit UE flexion synergies.
Inhibiting UE flexor synergy by placing the patient a position of extension/ER
What was the treatment emphasis of Bobath (NDT)?
Placing/Holding for co-contraction during early stages of recovery
(Place the patient in specific position and then having the patient hold this position on their own)
______ is one way of promoting proximal stability and bilateral symmetry of the limbs.
Weight bearing
____ with ____ allows distal joints to stabilize and promote proximal mobility
Weight bearing with Weight shifting
PTs should encourage the use of the _____ to prevent compensation.
Affected side
True or False: There is fair evidence for the effectiveness of using NDT in balance training in acute, subacute, and chronic stroke pts.
TRUE
True or False: There is fair evidence to support NDT for improvement in UE motor function and quality of life in acute and subacute stroke pts.
TRUE
There is limited evidence that NDT improves ____.
Quality of gait
Who are the 3 founders of PNF?
Herman Kabat
Maggie Knott
Dorothy Voss
List 6 things emphasized by the PNF theory of neuro-facilitation.
- Mass patterns
- Functionally based
- Manual contact on muscle
- Maximum resistance through ROM
- Use of stretch to facilitate
- Use of distraction and approximation
PNF incorporates Rood’s _____.
4 stages of motor control
mobility, stability, controlled mobility, skill
List 3 interventions for which PNF is superior in improving balance, gait and postural control.
- Planar strengthening exercises
- Un-resisted static balance training
- Body weight supported treadmill training (BWSTT)
