PNF Flashcards
PNF
system of promoting and facilitating the response of the neuromuscular mechanism by stimulating the proprioceptors
use of spiral and diagonal movement patterns
Reciprocal Innervation
contraction of muscles is accompanied by the simultaneous inhibition of their antagonists
Successive Induction
increased excitation of the agonist muscles follows the stimulation and contraction of their antagonist
Irradiation
spreading of excitation leads to increased strength of the response
strength of the strongest can leak to the weakest to strengthen it
PNF Principles
Potentials that have not been fully developed
Rhythmic and reversing in character of movement
Orderly sequence of total patterns of movement and posture
Repetition for retention of motor learning
Goal-directed activities
Selection of appropriate sensory cues
UE D1 Flexion Pattern
ST: Elevation, Abd, UR
GH: FADER
Elbow: Flexion
RU: Supination
Wrist: Flexion, RD
Fingers: Flexion, Add
Thumb: Add
wearing seatbelt/picking apples
UE D1 Extension Pattern
ST: Depression, Add, DR
GH: EXABIR
Elbow: Extension
RU: Pronation
Wrist: Extension
Fingers: Extension
Thumb: Abd
UE D2 Flexion Pattern
ST: Elevation, Abd, UR
GH: FABER
Elbow: Flexion
RU: Supination
Wrist: Flexion
Fingers: Extension
Thumb: Extension
throwing a sword away
UE D2 Extension Pattern
ST: Depression, Add, DR
GH: EXADIR
Elbow: Extension
RU: Pronation
Wrist: Extension
Fingers: Flexion
Thumb: Flexion
LE D1 Flexion Pattern
Hip: FADER
Knee: Flexion
Ankle: DF, Inversion
Toes: Extension, Abd
LE D1 Extension Pattern
Hip: EXABIR
Knee: Extension
Ankle: PF, Eversion
Toes: Flexion, Add
LE D2 Flexion Pattern
Hip: FABIR
Knee: Flexion
Ankle: DF, Eversion
Toes: Extension, Abd
LE D2 Extension Pattern
Hip: EXADER
Knee: Extension
Ankle: PF, Inversion
Toes: Flexion, Add
Bilateral Patterns
Symmetric
Asymmetric
Reciprocal
Symmetric Patterns
paired extremities perform same movements at the same time
ex. rowing, weightlifting
Asymmetric Patterns
paired extremities perform movements towards the same side
ex. canoeing
Reciprocal Patterns
paired extremities perform movements towards opposite directions
Upper & Lower Extremities Combined Movements
Ipsilateral Patterns
Contralateral Patterns
Diagonal Reciprocal Patterns
PNF Progressions
total to individuated
proximal to distal, distal to proximal
mobile to stable
gross to selective
reflexive to deliberate
overlapping to integrative
incoordinate to coordinate
PNF Basic Procedures
Manual Contact (MC)
Command and Communication
Stretch (STR)
Traction (TR) and Approximation (AP)
Maximal Resistance (MR)
Timing; Timing for Emphasis (TE)
Manual Contact (MC)
tactile cues, stabilization, manual resistance
Command and Communication
clear instructions and goals of itnervention
modulated voice depending on the situation (encouraging or relaxing)
Stretch (STR)
proprioceptors should be stimulated
Traction (TR) and Approximation (AP)
traction: mobility (pull away)
approximation: stability (stick together)
T/F
Manual resistance is not common for neuro/stroke
False
it is more common
Facilitation: Directed to Agonist Techniques
Repeated Contraction
Rhythmic Initiation
Hold Relax Active Motion
Alternating Isometrics
Facilitation: Reversal of Antagonist Techniques
Slow Reversal
Slow Reversal Hold
Rhythmic Stabilization
Quick Reversal
Relaxation Techniques
Contract Relax
Hold Relax
Slow Reversal Hold Relax
Rhythmic Rotation
Repeated Contraction
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
Indications: Weakness, Muscle imbalances,
Lack of endurance
Procedure: Perform repeated isotonic contractions induced by quick stretches; Apply resistance through the range or part of the range at a point of weakness;10 reps per set
Hold-Relax-Active Motion
Technique of emphasis provides repetition of isotonic contraction without sustained effort
Indications: inability to initiate movement, hypotonia, weakness
Procedure: Apply isometric contraction in the mid to shortened range of the target pattern (6 secs); Allow voluntary relaxation of the target pattern; Passively move the limb into the lengthened range of the target pattern;
Perform isotonic contraction of the target pattern
Rhythmic Initiation (RI)
Used to improve the ability to initiate movement; similar to PROM towards the PNF pattern
Indications: spasticity, rigidity, inability to initiate movement (apraxia), motor learning deficits, communication deficits (aphasia)
Procedure: voluntary relaxation followed by passive movement through increasing ROM;
followed by active-assisted contraction progressing to tracking resistance (light, facilitatory resistance) to isotonic contractions
Alternating Isometrics (AI)
alternating holding contractions of opposing muscle groups; used to increase sitting and standing balance of pt
Indications: instability in weight-bearing and holding, poor antigravity control, weakness, ataxia
Procedure: Isometric contraction is facilitated first on one side of the body or body part;
Followed by isometric contraction of other side
Slow Reversal (SR)
involves an isotonic contraction of the antagonist, followed by an isotonic contraction of the agonist
Indications: inability to reverse directions, muscle imbalances, weakness, incoordination, lack of endurance
Slow Reversal-Hold (SRH)
involves an isotonic contraction, followed by isometric contraction of the antagonist, followed by an isotonic contraction of the agonist
Indications: inability to reverse directions, muscle imbalances, weakness, incoordination, lack of endurance
Quick Reversal (QR)
requires rapidly alternating isotonic contractions of antagonists
Indications: inability to reverse directions, muscle imbalances, weakness, incoordination, lack of endurance
Rhythmic Stabilization (RS)
co-contraction of opposing muscle groups; simultaneous isometric contractions of both agonist and antagonist patterns and results in co-contraction of opposing muscle groups
Indications: instability in weight-bearing & holding, poor antigravity control, weakness, ataxia, LOM due to muscle tightness, painful muscle splinting
Procedure: Do simultaneous isometric contractions of both agonist and antagonist patterns; 6 sec hold x 10 reps per set
Contract Relax (CR)
Indications: LOM caused by tightness, spasticity
Procedure: isom contraction of the antagonistic pattern against maximal resistance; allow a period of relaxation of the antagonistic pattern
Hold-Relax (HR)
usually performed at the point of limited ROM in the agonist pattern
Indications: LOM caused by muscle tightness, muscle spasm and pain
Procedure: isom contraction of range-limiting antagonist pattern is performed; followed by voluntary relaxation and passive movement into the newly gained range of the antagonist pattern
Slow Reversal – Hold – Relax (SRHR)
Procedure: isotonic contraction of the range-limiting pattern (antagonistic pattern); apply an isometric contraction of the antagonistic pattern; brief period of voluntary relaxation; finish with an isotonic contraction of the agonistic pattern
Rhythmic Rotation (RRo)
Indication: hypertonia that results to LOM
Procedure: pt should be comfortably positioned to induce voluntary relaxation; apply slow, passive, rhythmic rotation of the body or body part around its longitudinal axis; passively move the part into the newly gained range
