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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
What are some verbal inputs to use with your patients?
hold for isometric tasks push/pull for isotonic tasks let go slowly for eccentric tasks
26
What are facilitory techniques?
ice, tapping, stroking, manual contacts, quick stretch, verbal cues, traction, resistance
27
What are inhibitory techniques?
compression, weight bearing, verbal cues (tone), prolonged stretch
28
What are the biomechanical influences for PNF?
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
29
What are the two scapular patterns?
anterior elevation and posterior depression | anterior depression and posterior elevation
30
What is the pelvic pattern?
anterior elevation and posterior depression
31
What is the pattern for head, neck and upper trunk?
opposite directions for flexion and extension
32
What is a chop pattern?
upper trunk and neck flex with bilateral asymmetrical UE extension diagonals used for supine to prone and heel sitting to standing
33
What is the lift pattern?
upper trunk and neck extend with bilateral asymmetrical UE flexion diagonals used for prone to supine and heel sitting to standing
34
What are the five stages of motor control?
1. Mobility 2. Stability 3. Controlled mobility 4. Static-dynamic activities 5. Skill
35
What is mobility?
being able to move into movement | getting into the particular position
36
What is stability?
``` being able to maintain a position tonic holding (against gravity) co-contraction (resistance/perturbations) ```
37
What is controlled mobility?
moving with stability weight shifting rotation (rolling is the ability to log roll)
38
What is static-dynamic activities?
altering BOS reducing extremity support (altering BOS i.e. lifting arms) rotation (segmental rolling)
39
What is skill?
the highest level of motor control reasons for developing (explore and manipulate environment i.e. combat crawl) rotation and counter rotation
40
What is the rolling progression?
supine sidelying rolling
41
What is the supine progression?
hooklying bridging scooting in bed
42
What is the prone progression?
prone on elbows quadruped kneeling 1/2 kneeling
43
What is the upright progression?
sitting modified plantargrade standing walking/running
44
What is the developmental sequence for rolling?
``` ability to initiate rolling (mobility) co-contraction in sidelying (stability) log roll (controlled mobility) segmental rolling (static-dynamic) counter rotation (skill) ```
45
What is the developmental sequence of prone on elbows?
``` POE (mobility) POE against resistance (stability) Weight shift in POE (controlled mobility) Lifting UE (static-dynamic) combat crawl (skill) ```
46
What is the developmental sequence of quadruped?
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
What is the developmental sequence of kneeling?
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
What is the developmental sequence of bridging?
``` bridge (mobility) bridge against resistance (stability) moving hips up and down (controlled mobility) lifting one LE (static-dynamic) reverse crab walking (skill) ```
49
What is the developmental sequence of sitting?
``` sitting (mobility) sitting against resistance (stability) weight shift (controlled mobility) lifting one LE, kicking foot (static-dynamic) function task with UE (skill) ```
50
What is the developmental sequence of modified plantargrade?
plantargrade (mobility) plantargrade against resistance (stability) weight shifting UE and LE (controlled mobility) lifting UE, LE, or alternating (static-dynamic) cruising (skill)
51
What is the developmental sequence of standing?
standing (mobility) standing altering BOS, tandem (stability) weight shift, squatting (controlled mobility) lifting one LE, alternating stepping (static-dynamic) walking, running, grapevine (skill)
52
What is rhythmic initiation (RI)?
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
What is slow reversal (SR)?
stage: stability, controlled mobility, skill bi-directional perform diagonal with resistance in both directions start with stronger pattern (both weak start with extension)
54
What is slow reversal hold (SRH)?
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
What is rhythmic rotation (RR)?
stage: mobility bi-directional stop when you feel tone and rotate in pattern slowly used for: increase in ROM, passive techniques
56
What is repeated contractions (RC)?
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
What is hold relax active movement (HRAM)?
unidirectional | isometric in shortened position-relaxation-passive movement to lengthened range-QS-isotonic in lengthened position
58
What is hold relax (HR)?
``` stage: mobility unidirectional used for: flexibility and range resist tight ms and PROM or AROM resist opposite tight ms and PROM or AROM ```
59
What is the alternating isometrics (AI)?
stage: stability both hands on same side of joint used for core stability isometric strong ms-isometric weak ms-repeat until fatigued
60
What is rhythmic stabilization (RS)?
stage: stability rotary force is emphasized hands on opposite side of joint isometric opposing ms simultaneously-switch manual contacts-repeat until fatigued
61
What is resisted progression (RP)?
stage: skill focuses on skill level of locomotion resistance (proximal/distal), quick stretch (must unweight limb first) crawling, creeping or walking
62
What is the patient position in PNF patterns?
sitting on edge of support surface | hips and knees at 90
63
What is the PT position in PNF?
D1: facing pt's head D2: facing pt's feet PT should move parallel to the diagonal with rotation 1st
64
What are the manual contacts for PNF?
lumbrical vs wrap around grip on correct surface to provide resistance slide from surface to surface
65
What is the patient position for scapular patterns?
pt should be sidelying, pillows under head, UE, and between knees
66
What is PT position during anterior elevation and posterior depression of scapula?
face head | hands at inferior aspect of the scapula and then top of shoulder
67
What is PT position during anterior depression and posterior elevation of scapula?
face feet | hands around arm pit and top of shoulder
68
What is the patient position for pelvic patterns?
pt should be sidelying with pillows under head, between knees and ankles
69
What is PT position during pelvic patterns?
face head | hands on ischial tuberosity and flat contact at ASIS/iliac crest
70
What is patient and PT position for the chop pattern?
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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