PNF Flashcards
PNF Strengthening
Techniques
● used to develop muscular strength, endurance & ROM
● facilitate stability & mobility
● lays a foundation for restoring function
● hallmarks to this approach: use of diagonal patterns & sensory cues
○ proprioceptive
○ cutaneous
○ visual
○ auditory
● what are we trying to do? - elicit or augment motor responses
PNF Basic Procedures - best possible neuromuscular response
using sensory cues superimposed on the diagonal patterns
Manual contact
● how & where you place your hands on the patient
● whenever possible manual contacts placed over agonist mm
groups or tendinous insertions (ie: dorsum of hand, cubital fossa)
● adjusted based on the patient’s response & level of control
Maximal Resistance
● greatest possible amount of resistance applied during dynamic concentric mm contraction
● patient must still be able to move smoothly without pain
● adjust to accommodate strong & weak components
Traction
● slight separation of the joint surfaces
● inhibit pain
● facilitate movement during patterns
● most often applied during flexion
Approximation
● gentle compression of the joint surfaces
● either by manual compression or weightbearing
● stimulates contraction of agonist & antagonist
● enhances dynamic stability & postural control
Position & Movement of the Therapist
● facing the direction of the moving limb
● resistance applied via body weight not your upper extremities
● think about your biomechanics as best as possible
Verbal Commands
● auditory cues given to enhance motor output
● instruct the patient what to do “squeeze my fingers and pull
across your chest” “curl your toes down & in, push your leg
down & in”
Visual Cues
● patients are asked to watch and follow the movement
● allows enhanced control of the movement through the ROM
Which movements are critical components of PNF
Rotational and Diagonal
Which segment moves first in PNF
Distal segment
PNF Patterns
● Concerned with gross movements as opposed to specific muscle
actions
● Rotational and diagonal patterns
● Functional patterns of movement ie: bruising hair, reaching above, dressing
Three component movements
○ Flexion-extension
○ Abduction-adduction
○ Internal-external rotation
D1 diagonal pattern
● Starting Position
○ Shoulder extension, abduction and internal rotation, elbow extension, forearm pronation, wrist and finger extension
● End position
○ Shoulder flexion, adduction, external rotation, partial elbow flexion, forearm supination, wrist and finger flexion
D2 – Diagonal Pattern
● Starting position
○ Shoulder extension, adduction and internal rotation, elbow extension, forearm pronation, wrist & finger flexion
● End position
○ Shoulder flexion, abduction, external rotation, elbow extension, forearm supination, wrist & finger extension
D1 – Flexion Lower Extremity
● Starting Position
○ Hip extension, abduction and internal rotation, knee extension, plantar flexion, ankle eversion, toe flexion
● End Position
○ hip flex, ADd, external rotation, knee flex, dorsiflexion, inversion, toe extension, hip should be ADD across midline creating lower trunk rotation
D2 – Flexion Lower Extremity
● Starting Position
○ Hip ext, adduction and external rotation, knee ext, ankle plantar flex; foot inversion; toe flex
● Movements
○ hip flex, ABd, internal rotation, knee flex, ankle dorsiflexion & eversion, toe extension
Positioning of a pattern
● Positioning of a pattern is lengthened ROM requires
consideration of all the components from PROXIMAL to
DISTAL
● Major Muscle of flexion and extension are considered first
● Abduction and Adduction are considered next
● Rotation is considered last.
● All components are combined for a diagonal and
rotational movement pattern
PNF Strengthening
● Strengthen the body in a more functional pattern
○ Body movement in a spiral and diagonal direction
● Using sensory cues, specifically proprioceptive, cutaneous, visual
and auditory feedback, to improve muscular response
● The patterns incorporate rotational movements of the extremities
and also require core stability to successfully complete the motion
The interaction between the therapist and client is key in early
success
Rhythmic Initiation
● Incorporates passive movement of the joint through the desired
range of motion
● Is a teaching tool to re-educate the neuromuscular system to
initiate desired movement.
● This technique begins with therapist passively moving the
extremity through the desired movement pattern at the desired
speed several times.
○ Progression should be to AAROM, AROM, RROM through
the pattern to help the patient improve on coordination and
control
Slow Reversal
● Isotonic contraction of agonist & immediate contraction of the
antagonist
● It helps to develop AROM & coordinate between agonist &
antagonist
● this helps to increase strength of a specific ROM
○ this technique promotes the rapid, reciprocal activities the agonist and antagonist muscle groups need for many functional activities.
○ There is NO REST between agonist & antagonist contractions
Slow reversal hold
● This technique adds an isometric contraction (hold) at the
end-range of each muscle group.
● It’s especially beneficial in enhancing dynamic stability of the larger
proximal muscle groups.
Alternating isometrics
● This technique encourages stability of postural trunk muscles and stabilizers of the hip and shoulder girdle.
Hold Relax
● this technique involves lengthening a tight muscle and asking the patient to isometrically contract it for several seconds.
● As the patient relaxes, the clinician lengthens the involved muscle
further and holds the stretch at the newfound end-range of motion. This technique relies on the firing of GTO to cause reflexive muscle relaxation.
