PNF

Question 1

Contract Relax

Answer 1

Maximal isometric contraction of a muscle (shorted, to be treated) triggers inhibition of the SAME muscle through GTO response; “mobility” stage c ROM
e.g., to train hamstring (need more range), flex hip it to end , hold at maximum contraction (need enough volume; pt push into ext) until start to fail, relax, stretch to a new end, do it again. Not a good method for pain
Not for hypertonicity pt: 1)↑effort ->↑tone; 2) no relaxation

Question 2

Hold Relax

Answer 2

Contract antagonist of m (shortened) to be treated (contract & relax opposite ms); use reciprocal inhibition by firing antagonist to inhibit agonist; “mobility” stage c ROM;
good for pain, because you are applying resistance in the opposite direction that provokes their pain
e.g., 1) if shoulder IR contracture and want to train IR, ER shoulder to end, hold at maximum contraction (pt try to ER; fire Exors to relax IRors), ER to a new end, do it again

Question 3

Rhythmic Rotation

Answer 3

Passive; Works by targeting the parasympathetic nervous system; confuses the proprioceptors; Rotate the limb or trunk until it becomes heavy (sign that tone has reduced) then take up the ROM; can do it by taking vision out of it.
Purpose: ↓pain; ↑ROM due to pt guarding; limited ROM due to muscular; can’t contract (paralyzed)
e.g., to train hamstring, rotate leg in long axis, flex hip; try to ↓tone until when feeling heavier
e.g, in prone (take out vision), rock leg
when not working: lack of ROM when capsular is in origin; work when limited in muscular

Question 4

Shortened Held Resisted Contraction (SHRC)

Answer 4

Purpose: facilitation contractility
Treated m in shortened ranged (reset γ-bias), ask m to fire, relaxing by antagonist by inhibition
e.g., ER shoulder is limited, put shoulder in ER (shortened position for ER) ; ask for isometric hold to fire ERors (pt push into ER)
e.g., pivot prone: baby’s back has been lengthened, put back in shortened position (G is R);

Question 5

Rhythmic Initiation (RI)

Answer 5

Purpose: ↓tone, good for pt c high tension and tight, co-contract rigidity; PD; can’t isolate ms
e.g., pt sidely on bed, start with rock hands on shoulder and pelvis forward & back, contralateral rock (when shoulder forward, pelvis back), ask pt to work with you (active A is provided), ask pt keeping rotating while pushing against PT’s R (active R)
lumbercal grip: get both sides of jts, rock; push back/forth on pt shoulder , use small contract

Question 6

Alternating Isometrics: (AI)

Answer 6

usually SHRC, strengthening;
Purpose: posture stabilizer, not moving (“just meet me, don’t beat me”);
push in the frontal/sagittal plane from one side, leave your hands on them, and push from the other side.
e.g. pt sitting, posture of sitting, MCs on both shoulders, indicate hands on where, P shift from one side to the other without visible gap, order is “switch”, (scapular to clavicle)

Question 7

Rhythmic Stabilization (RS)

Answer 7

After Alternating Isometrics: (AI)
Diagonal to pt, use a rotational component with one hand
AI: no gap
This one: harder, nothing gets rest, B, work at same time; hands move in opposite directions

Question 8

Tracking resistance

Answer 8

PT set an amount of R, PT move and pt follow while keeping constant R.

Question 9

Slow Reversals

Answer 9

Hands move around and pt weight shift; Move to one position, hold, push and go to the other position. No relaxation, go back and forth, concentric followed by concentric, need pt to lots of work; tell pt where to go

Question 10

Slow Reversal Hold

Answer 10

Set R; has movement to establish direction, then pt isometric hold

Question 11

Repeated progression (RP)

Answer 11

use tracking R to stretch motion when its ought to come

Pt has to be high level; e.g., no pelvis rot, use tracing R to stretch pelvis rot

Question 12

Timing for emphasis: (TE)

Answer 12

facilitate mv, hold, get overflow: add quick stress