PNF

Question 1

Neuromuscular definition

Answer 1

pertaining to the nerves and muscles

Question 2

Facilitation definition

Answer 2

promoting or hastening of any natural process

Question 3

Neuromuscular facilitation

Answer 3

promoting or encouraging normal activity of the neuromuscular system

Question 4

proprioceptive

Answer 4

pertaining to the proprioceptors/ sensory inputs

Question 5

Therapeutic Exercise

Answer 5

• movement with a purpose
• focuses on optimal afferent input
  -promotes optimal neuromuscular activity

Question 6

Continuous sensory input is provides by

Answer 6

1) manual contacts to assist, resist, block or guide
2) verbal guidance to cue, coach, enforce
3) visual feedback

Question 7

who are the originators of PNF

Answer 7

Dr. Kabat, Maggie Knott and Dorothy Voss (used on polio patients)

Question 8

what is PNF utilized for (5 things)

Answer 8

• improve strength
• neuromuscular control
• increase flexibility
• ROM
• stability

Question 9

General indicators for PNF

Answer 9

1) abnormal muscle tone
2) promote optimal and coordinated movement
3) to increase strength and endurance
4) to stretch tight muscles

Question 10

Agonist

Answer 10

the muscle that produces the movement

Question 11

Antagonist

Answer 11

the muscle that needs to relax to allow for movement

Question 12

Supporters

Answer 12

muscles that stabilize the trunk and extremities

Question 13

Fixators

Answer 13

muscles that hold bones steady

Question 14

PNF goal

Answer 14

to strengthen the gross motor patterns instead of specific muscle actions

Question 15

PNF Facilitation

Answer 15

creates an increase in excitability of motor neurons (weak muscles)

Question 16

PNF Inhibition

Answer 16

creates a decrease in excitability of motor neurons (spasticity or tight muscles)

Question 17

Sensory facilitation used by therapist

Answer 17

hand contact, voice, breathing, and encourage patients to use their eyes

Question 18

what does normal movement require?

Answer 18

the balance of strength and co-ordination between muscle groups and being able to work in combined diagonal motions

Question 19

neuro-irradiation (overflow)

Answer 19

activating weak muscles by using surrounding strong ones; produces an overflow of electrical impulses surrounding the muscle. Done by successive induction and reciprocal inhibition

Question 20

PNF application steps

Answer 20

1) know the movement pattern from start to finish
2) have the patient look at limb for visual cues
3) use verbal cues for coordination
4) provide hands on contact with appropriate pressure
5) PT should maintain proper body mechanics
6) PT gives an appropriate resistance
7) Allow for rotational movement
8) have appropriate timing
9) give a quick stretch to facilitate in muscle activation

Question 21

Upper D1 Flexion

Answer 21

Shoulder: flexion, adduction, and external rot.
Forearm: supination
Wrist: Flexion and radial deviation
Hand: Flexion and Adduction

Question 22

Upper D1 Extension

Answer 22

Shoulder: Extension, Abduction, and internal rot.
Forearm: pronation
Wrist: extension and ulnar deviation
Hand: extension and abduction

Question 23

Upper D2 Flexion

Answer 23

Shoulder: flexion, abduction, external rot.
Forearm: supination
Wrist: Extension and radial deviation
Hand: Extension and abduction

Question 24

Upper D2 Extension

Answer 24

Shoulder: extension, adduction, internal rot.
Forearm: pronated
Wrist: flexion and ulnar deviation
Hands: flexion and adduction

Question 25

Lower D1 Flexion

Answer 25

Hip: flexion, adduction, external rot. Knee: flexion Ankle: dorsiflexion and inversion Toes: extension

Question 26

LE D1 Extension

Answer 26

Hip: Extension, Abduction, and internal rot. Knee: extension Ankle: planter flexion and eversion Toes: flexion

Question 27

Lower D2 Flexion

Answer 27

Hip: Flexion, Abduction, internal rot. Knee: flexion Ankle: dorsiflexion and eversion Toes: extension

Question 28

Lower D2 Extension

Answer 28

Hip: extension, Adduction, external rot. Knee: extension Ankle: plantarflexion and inversion Toes: Flexion

Question 29

Hold - Relax (stretching)

Answer 29

-Affected body part is moved until resistance is felt. -PT provides resistance for an Isometric hold (5-10 secs) -Autogenic Inhibition (agonist muscle) -Finish with PROM into new range

Question 30

Contract - Relax (stretching)

Answer 30

- affected body part is moved until resistance is felt - **Reciprocal inhibition**. (concentric contraction of antagonist) - PT applies resistance for 5-10 seconds then move into new range. - Voluntary relaxation

Question 31

Hold - Relax - Antagonist - Contract (stretching)

Answer 31

the same steps/ methods as hold-relax besides patient uses AROM to move into new range (concentric contraction of antagonist)

Question 32

Rhythmic Initiation (strengthening)

Answer 32

-Used with patients who are unable to initiate movement or very limited ROM. -Directed at **agonist movers** - teaches patient movement pattern -Do the ROM first passive (4-6), then active assisted (4-6), then active (4-6) - movement is slow and goes through available range.

Question 33

Repeated Contraction (strengthening)

Answer 33

-directed toward **agonist muscles** -repeated dynamic contractions concentrically against max resistance until fatigue

Question 34

Slow Reversal (strengthening)

Answer 34

-Isotonic contraction of agonist muscle followed by isotonic contraction of antagonist muscle - develops normal reciprocal timing of agonist and antagonist muscles -**reversal of agonists**

Question 35

Slow reversal hold (strengthening)

Answer 35

same as slow reversal but an isometric contraction is added at the end of each range.

Question 36

Rhythmic stabilization (strengthening)

Answer 36

-helps promote stability through co-contractions of trunk, pelvic girdle or shoulder -provide gentle perturbations for 5-10 secs - **reversal of agonists**

Question 37

when to use muscle activation techniques

Answer 37

-non-optimal motor control -strength -endurance -co-ordination

Question 38

when to use relaxation (stretching) techniques

Answer 38

muscular tension or tightness

Question 39

reciprocal inhibition

Answer 39

-muscle spindle -senses muscles strength -facilitate agonist by turning off the agonist

Question 40

autogenic inhibition

Answer 40

-GTO -sense tendon stretch -cause agonist inhibition

Question 41

Historical principles of PNF

Answer 41

1) developmental activities are useful bases for treatment 2) Sensory reflex influences movement and posture 3)Co-ordinated, alternating movement between agonist and antagonist muscles groups are important for normal function. 4) use known principles of motor learning activities 5) Movement occurs in diagonal activity not planar motions