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Neuro III > PNF > Flashcards

PNF Flashcards

1
Q

What is UE D1 flexion?

A

shoulder: flexion, adduction, external rotation
scapular: abduction, elevation
forearm supinated, wrist flexed and radial deviated, finger flexion and adduction

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2
Q

What is UE D1 extension?

A

shoulder: extension, abduction, internal rotation
scapular: adduction, depression
forearm pronated, wrist extension and ulnar deviation, finger extension and abduction

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3
Q

What is UE D2 flexion?

A

shoulder: flexion, abduction and external rotation
scapular: adduction, elevation, upward rotation
forearm supination, wrist extension and radial deviation, finger extension and abduction

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4
Q

What is UE D2 extension?

A

shoulder: extension, adduction, internal rotation
scapular: abduction, depression, downward rotation
forearm pronated, wrist flexion and ulnar deviation, finger flexion and adduction

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5
Q

What is LE D1 flexion?

A

hip: flexion, adduction, external rotation
knee flexed or extended
ADF and inversion

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6
Q

What is LE D1 extension?

A

hip: extension, abduction, internal rotation

knee extension, APF and eversion

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7
Q

What is LE D2 flexion?

A

hip: flexion, abduction, internal rotation
knee flexed or extended
ADF and eversion

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8
Q

What is LE D1 extension?

A

hip: extension, adduction, external rotation

knee extension, APF and inversion

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9
Q

What is the general concept and history of PNF?

A

Developed in 1940’s by Dr Herman Kabat with Margaret Knott (PT), and Dorothy Voss (PT). Based on a reflex/hierarchical model of motor control. Normal movement is based on a balance between the agonist and the antagonist muscle groups. Stronger body parts utilized to stimulate weaker parts. Initially the focus was on using resistance, stretch reflexes, approximation, traction, and manual contacts to facilitate movement. uses the developmental sequence as a guide

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10
Q

What is the basic principle of PNF?

A

a technique for promoting or hastening the response of the neuromuscular mechanism through the stimulation of proprioceptors

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11
Q

What is Beevor’s axiom?

A

the brain knows nothing of individual muscle action but knows only movement (recognizes patterns)

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12
Q

What are mass movement patterns of facilitation characterized by?

A
  1. spiral and diagonal

2. resemble mvts used in sports/work (everyday life mvts)

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13
Q

What are the 3-components of motion involved in every pattern?

A
  1. flexion or extension
  2. across or away from midline
  3. some component of rotation (early in pattern)
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14
Q

What are the 10 essential elements that motor learning is enhanced by?

A
  1. manual contacts 2. body position/mechanics 3. stretch 4. resistance 5. irradiation 6. traction/approximation 7. timing of mvt 8. patterns of mvt 9. visual cues 10. verbal input
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15
Q

What is manual contact of the 10 essential elements?

A

where you put your hands is important (especially with resistance) needs to be over target ms group, ???, lumbrical grip is used

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16
Q

What is body position/mechanics of the 10 essential elements?

A

your mvt should mirror the pt’s (same diagonal), position pt so they can go through full pattern, position yourself correctly

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17
Q

What is stretch of the 10 essential elements?

A

quick stretch is facilitory, delivered in elongated position, stretch in opposite pattern, prolonged stretch is inhibitory

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18
Q

What is resistance of the 10 essential elements?

A

manual, mechanical or gravitational; helps facilitate mvt, mobility and p! free with small resistance, stability uses more resistance but must be appropriate)

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19
Q

What is irradiation of the 10 essential elements?

A

overflow, spread of ms activity in response to resistance, stronger ms helps weaker ms

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20
Q

What is traction/approximation of the 10 essential elements?

A

distraction is facilitory and can help with p!

approximation promotes stability and weight bearing

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21
Q

What is timing of movement in the 10 essential elements?

A

normal mvt requires smooth sequencing of ms activation
proximal control before distal
mvt distal before proximal

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22
Q

What are patterns of movement in the 10 essential elements?

A 
groups of ms work together
function mvt is triplanar mostly
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23
Q

What are visual cures of the 10 essential elements?

A

have them watch you or themselves so they can see what they are doing

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24
Q

What is verbal input in the 10 essential elements?

A

helps convey what you want them to do
tone is important (changes for relaxation or facilitation)
actual wording could help as well
make them direct and to the point

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25
Q

What are some verbal inputs to use with your patients?

A

hold for isometric tasks
push/pull for isotonic tasks
let go slowly for eccentric tasks

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26
Q

What are facilitory techniques?

A

ice, tapping, stroking, manual contacts, quick stretch, verbal cues, traction, resistance

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27
Q

What are inhibitory techniques?

A

compression, weight bearing, verbal cues (tone), prolonged stretch

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28
Q

What are the biomechanical influences for PNF?

A
  1. base of support (width)
  2. COG from support surface (higher is more unstable)
  3. number of weight bearing joints being controlled
  4. length of lever arm
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29
Q

What are the two scapular patterns?

A

anterior elevation and posterior depression

anterior depression and posterior elevation

30
Q

What is the pelvic pattern?

A

anterior elevation and posterior depression

31
Q

What is the pattern for head, neck and upper trunk?

A

opposite directions for flexion and extension

32
Q

What is a chop pattern?

A

upper trunk and neck flex with bilateral asymmetrical UE extension diagonals
used for supine to prone and heel sitting to standing

33
Q

What is the lift pattern?

A

upper trunk and neck extend with bilateral asymmetrical UE flexion diagonals
used for prone to supine and heel sitting to standing

34
Q

What are the five stages of motor control?

A
  1. Mobility
  2. Stability
  3. Controlled mobility
  4. Static-dynamic activities
  5. Skill
35
Q

What is mobility?

A

being able to move into movement

getting into the particular position

36
Q

What is stability?

A 
being able to maintain a position
tonic holding (against gravity)
co-contraction (resistance/perturbations)
37
Q

What is controlled mobility?

A

moving with stability
weight shifting
rotation (rolling is the ability to log roll)

38
Q

What is static-dynamic activities?

A

altering BOS
reducing extremity support (altering BOS i.e. lifting arms)
rotation (segmental rolling)

39
Q

What is skill?

A

the highest level of motor control
reasons for developing (explore and manipulate environment i.e. combat crawl)
rotation and counter rotation

40
Q

What is the rolling progression?

A

supine
sidelying
rolling

41
Q

What is the supine progression?

A

hooklying
bridging
scooting in bed

42
Q

What is the prone progression?

A

prone on elbows
quadruped
kneeling
1/2 kneeling

43
Q

What is the upright progression?

A

sitting
modified plantargrade
standing
walking/running

44
Q

What is the developmental sequence for rolling?

A 
ability to initiate rolling (mobility)
co-contraction in sidelying (stability)
log roll (controlled mobility)
segmental rolling (static-dynamic)
counter rotation (skill)
45
Q

What is the developmental sequence of prone on elbows?

A 
POE (mobility)
POE against resistance (stability)
Weight shift in POE (controlled mobility)
Lifting UE (static-dynamic)
combat crawl (skill)
46
Q

What is the developmental sequence of quadruped?

A

quadruped (mobility)
quadruped against resistance (stability)
weight shift flexion and extension and side to side (controlled mobility)
lifting UE, LE or alternating (static-dynamic)
creeping (skill)

47
Q

What is the developmental sequence of kneeling?

A

tall kneeling (mobility)
tall kneeling against resistance at hips then shoulders(stability)
weight shift, one in front of the other, narrow vs wide (controlled mobility)
knee walking (skill)
static-dynamic is not functional
half kneeling use stronger leg forward

48
Q

What is the developmental sequence of bridging?

A 
bridge (mobility)
bridge against resistance (stability)
moving hips up and down (controlled mobility)
lifting one LE (static-dynamic)
reverse crab walking (skill)
49
Q

What is the developmental sequence of sitting?

A 
sitting (mobility)
sitting against resistance (stability)
weight shift (controlled mobility)
lifting one LE, kicking foot (static-dynamic)
function task with UE (skill)
50
Q

What is the developmental sequence of modified plantargrade?

A

plantargrade (mobility)
plantargrade against resistance (stability)
weight shifting UE and LE (controlled mobility)
lifting UE, LE, or alternating (static-dynamic)
cruising (skill)

51
Q

What is the developmental sequence of standing?

A

standing (mobility)
standing altering BOS, tandem (stability)
weight shift, squatting (controlled mobility)
lifting one LE, alternating stepping (static-dynamic)
walking, running, grapevine (skill)

52
Q

What is rhythmic initiation (RI)?

A

stage: mobility
bi-directional technique
used for: increase mobility, relaxation of abnormal tone, initiate mobility, small resistance for cueing
PROM-AAROM-AROM-both directions

53
Q

What is slow reversal (SR)?

A

stage: stability, controlled mobility, skill
bi-directional
perform diagonal with resistance in both directions
start with stronger pattern (both weak start with extension)

54
Q

What is slow reversal hold (SRH)?

A

stage: stability, controlled mobility, skill
same as SR except resisted isometric contraction is held at completion of each direction and any point in range where there is weakness

55
Q

What is rhythmic rotation (RR)?

A

stage: mobility
bi-directional
stop when you feel tone and rotate in pattern slowly
used for: increase in ROM, passive techniques

56
Q

What is repeated contractions (RC)?

A

stage: mobility, controlled mobility, skill
unidirectional
repeated quick stretches
used for: weakness, hypotonicity on one side of the joint
QS lengthened position-AROM-QS-AROM-QS-end with isometric

57
Q

What is hold relax active movement (HRAM)?

A

unidirectional

isometric in shortened position-relaxation-passive movement to lengthened range-QS-isotonic in lengthened position

58
Q

What is hold relax (HR)?

A 
stage: mobility
unidirectional 
used for: flexibility and range
resist tight ms and PROM or AROM
resist opposite tight ms and PROM or AROM
59
Q

What is the alternating isometrics (AI)?

A

stage: stability
both hands on same side of joint
used for core stability
isometric strong ms-isometric weak ms-repeat until fatigued

60
Q

What is rhythmic stabilization (RS)?

A

stage: stability
rotary force is emphasized
hands on opposite side of joint
isometric opposing ms simultaneously-switch manual contacts-repeat until fatigued

61
Q

What is resisted progression (RP)?

A

stage: skill
focuses on skill level of locomotion
resistance (proximal/distal), quick stretch (must unweight limb first)
crawling, creeping or walking

62
Q

What is the patient position in PNF patterns?

A

sitting on edge of support surface

hips and knees at 90

63
Q

What is the PT position in PNF?

A

D1: facing pt’s head
D2: facing pt’s feet
PT should move parallel to the diagonal with rotation 1st

64
Q

What are the manual contacts for PNF?

A

lumbrical vs wrap around grip
on correct surface to provide resistance
slide from surface to surface

65
Q

What is the patient position for scapular patterns?

A

pt should be sidelying, pillows under head, UE, and between knees

66
Q

What is PT position during anterior elevation and posterior depression of scapula?

A

face head

hands at inferior aspect of the scapula and then top of shoulder

67
Q

What is PT position during anterior depression and posterior elevation of scapula?

A

face feet

hands around arm pit and top of shoulder

68
Q

What is the patient position for pelvic patterns?

A

pt should be sidelying with pillows under head, between knees and ankles

69
Q

What is PT position during pelvic patterns?

A

face head

hands on ischial tuberosity and flat contact at ASIS/iliac crest

70
Q

What is patient and PT position for the chop pattern?

A

PT should face head, one hand proximal and one distal, aim to have pt’s arms off table if not fearful, pt’s eyes and head should follow arms, cross pt’s ankles
practice motion and increase resistance to create roll

Neuro III (7 decks)

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