NM MC/ML/Feedback/Task-Specific/Remediation-Facilitation/PNF Flashcards
Feedback given after every trial improves ___, while ___ feedback improves learning and retention
Performance
Variable
Early training should focus on ___ feedback (cognitive phase of learning), while later training should focus on ____ feedback (associative phase)
Visual
Proprioceptive
10 PNF techniques
- Rhythmic initiation
- Rhythmic rotation
- Stabilizing reversals (alternating isometrics)
- Rhythmic stabilization
- Dynamic reversals (slow reversals)
- Combination of isotonics (agonist reversals)
- Replication (hold-relax-active motion)
- Contract-relax active contraction (CRAC)
- Hold-relax (HR)
- Repeated stretch (repeated contraction)
UE D1F is what PNF pattern?
Flexion-adduction-ER
Diagonal D1 flexion
UE D1E is what PNF pattern?
Extension-abduction-IR
UE D2F is what PNF pattern?
flexion-abduction-ER
UE D2E is what PNF pattern?
Extension-adduction-IR
LE D1F PNF
Flexion-adduction-ER
LE D1E PNF
Extension-abduction-IR
LE D2F PNF
Flexion-abduction-IR
LE D2E PNF
Extension-adduction-ER
PNF: upper trunk flexion with rotation to R or L, lead arm moves in D1E, assist arm holds on top of wrist
sitting chop
PNF: upper trunk extension with rotation to R or L; lead arm moves in D2F, assist arm holds beneath wrist
sitting lift
Contraindications for sensory stimulation
-Pts who will not benefit from hands-on approach
Pts who demonstrate sufficient motor control to perform active movements
-Pts who can independently practice motor skill
-Pts who can self-correct based on feedback mechanisms
Spatial summation (multiple techniques) or temporal summation (___ ___ of same technique) may be necessary to produce desired response in some patients with reduced response
Repeated application
Functions are assumed or replaced, or substituted by different areas of the brain using different effectors or body segments
Substitution
Issues with substitution
Learned nonuse
Development of splinter skills: pt with brain damage, skills cannot easily be generalized to other tasks/environmental situations
PNF: Supine or sitting CHOPPING facilitates what?
Rolling to prone
PNF: D1 flexion LE helps with what?
Rolling in any direction
PNF Techniques for Facilitation:
Slow isotonic shortening contraction through the range followed by eccentric lengthening contraction with same muscle groups
Agonist reversals (AR)
PNF Techniques for Facilitation
What is agonist reversals (AR) indicated for?
Weak postural muscles
Inability to eccentrically control body weight during movement transitions (ex: sitting down)
PNF Techniques for Facilitation:
Joint compression
Approximation
PNF Techniques for Facilitation:
What is approximation indicated for?
Stimulate afferent nerve endings
Facilitate postural extensors to promote stability
PNF Techniques for Facilitation:
Isotonic movement in rotation followed by isometric hold of the range limiting muscles in antagonist pattern against slowly increasing resistance, then passive motion and active contraction of agonist pattern
Contract-Relax (CR)
PNF Techniques for Facilitation:
What is contract relax (CR) indicated for?
Limited ROM caused by muscle tightness or spasticity
PNF Techniques for Facilitation:
Isometric contraction of antagonist pattern against slowly increasing resistance, followed by voluntary relaxation and passive overeat into the newly gained range of the agonist pattern. Active contraction (__) of the agonists can also be performed and relaxes the antagonist through RECIPROCAL INHIBITION.
Hold-relax (HR)
PNF Techniques for Facilitation:
Indications for hold-relax (HR)?
Limitations in ROM due to muscle tightness, spasm, or pain
PNF Techniques for Facilitation:
Repeated isotonic contractions induced by quick stretches and enhanced by resistance performed through the range or part of the range at a point of weakness.
Repeated contractions (RC)
PNF Techniques for Facilitation:
Indications for repeated contractions (RC)?
Weakness
Incoordination
Muscle imbalances
Lack of endurance
PNF Techniques for Facilitation:
Voluntary relaxation followed by passive movement through increasing ROM, followed by active-assisted contractions progressing to resisted isotonic contractions
Rhythmic initiation (RI)
PNF Techniques for Facilitation:
Indications for rhythmic initiation (RI)?
Spasticity Rigidity Hypertonicity Inability to initiate motion (apraxia) Motor learning deficits Communication deficits (aphasia)
PNF Techniques for Facilitation:
Simultaneous isometric contractions of both agonist and antagonist patterns performed without relaxation using careful grading of resistance. Cocontraction of opposing muscle groups.
Rhythmic stabilization (RS)
PNF Techniques for Facilitation:
Indications for rhythmic stabilization (RS)?
Instability in WB and holding Poor antigravity control Weakness Ataxia Limited ROM caused by muscle tightness Painful muscle splinting
PNF Techniques for Facilitation:
Alternating isotonic contractions of agonist then antagonist patterns using careful grading of resistance and optimal facilitation. In ___, isometric hold is added at end of range at a point of weakness
Slow reversal (SR) Slow reversal hold (SRH)
PNF Techniques for Facilitation:
Indications for slow reversal (SR) or slow reversal hold (SRH)?
Inability to reverse directions
Muscle weakness or imbalance
Incoordination
Lack of endurance
PNF Techniques for Facilitation:
Separation of joint surfaces
Traction
PNF Techniques for Facilitation:
Indications for traction?
Facilitates flexor muscles
Mobilizing patterns
