PNF Flashcards
PNF
proprioceptive neuromuscular facilitation
-utilizes manually resisted patterns (therapist can modify resistance)
Patterns are diagonal instead of straight plane
- functionally based
- synergistic movements
Key concepts
hand holds-lumbrical grip
commands- simple and strong
vision- always instruct patient to follow with their head and eyes
techniques- several different techniques to utilize
**can use hands to help gide motion. With one hand will place distally.
Diagnosis
D1 and D2
- Each joint has a D1 flexion and a D1 extension
- Each joint has a D2 flexion and a D2 extension
UE
LE
Trunk
UE D1 flexion
shoulder- flex, add, ER
forearm-sup
wrist- radial flexion
fingers- flex
UE D1 extension
shoulder- ext, abd, IR
forearm- pronation
wrist- Ulnar extension
fingers- ext
UE D2 flexion
shoulder- flx, abd, ER
forearm- supination
wrist- Radial extrnsion
fingers- EXT
UE D2 extension
shoulder- ext, add, IR
forearm- pronation
wrist-ulnar extension
fingers-flexion
LE D1 flexion
hip- flex, add, ER
ankle- DF, Inv
toes- EXT
LE D1 extension
hip- ext, abd, IR
foot- PF, eversion
toes- flexion
LE D2 flexion
hip- flex, abd, IR
foot-DF, eversion
toes- ext
LE D2 extension
hip- ext, add, ER
foot- PF, Inversion
toes- flexion
Rhythmic initiation
rhythmic motion of the limb of body through the desired range starting with passive and progressing to active resisted
Goals- aid initiation of motion, teach a motion and improve coordination and sense of motion, slow it down or speed it up
Description- start by passively moving the patient through the motion, progress to active assist of motion, move to active resisted motion
Combined isotonics
combined concentric, eccentric, and stabilizing contractions of muscles with out relaxation
Goals- active control of motion, coordination, strengthen and increase active ROM
Description- resist the pts moving through the active desired range-concentric, at the end of the motion tell patient to stay in positive-stabilizing, slow down the part moving back to the starting position-eccentric, and no rest between activities
Dynamic reversals
active motion changing from one directionto the opposite without pause or relaxation
Goals- increase strength and active ROM, increase coordination, increase endurance
Description- therapists resists the motion in one direction, as the end of the desired range approaches, reverse the grip to resist in the opposite direction, and continue with no rests between
Stabilizing reversals
alternating isotonic contractions opposed by enough resistance to allow small ROM
command-push against me
Goals- increase stability and increase strength and coordination between agonist and antagonist
Description- give resistance while asking patient to oppose force, very little motion should be allowed, and alternate directions and move hands and force as patient opposes
Rhythmic stabilization
alternating isometric contractions against resistance, no motion is intended
command- don’t let me push you
Goals- increase active and passive ROM, increase stability, balance, strength, decrease pain
Description- therapist resists an isometric contraction of a muscle group without trying to move pt, resistance is slowly increased, and when patient is responding fully change direction
repeated stretch
stretch reflex elicited from muscles under the tension of elongation
Goals- facilitate ignition of motion and increase ROM and strength
Description- elongate the target muscles, give a quick tap to lengthen the muscles further and elicit the stretch reflex, at the same time give a command to contract the stretched muscles with the reflex response, and resisted the reflex and voluntary motion
Contract relax
resisted isotonic contraction of the restricting muscles followed by relaxation and movement into the increase range
Goals- increase PROM
Description- therapist or pt moves the joint to the end of passive range, therapist asks for a strong contraction and resists motion (5-8s), pt then asked to relax, body segment is moved into new range, and process repeats
Hold relax
resisted isometric contraction of the antagonist muscles followed by relaxation
Goals- increased PROM and decreased pain
Descriptions- therapist or pt moves the segment to the end of PROM or pain free range, therapist asks for an isometric contraction of restricting muscle with emphasis on rotation, resistance is slowly increased, no motion intended, pt then asked to relax and the segment is gradually moved into the new range
Replication
facilitates motor learning of functional activities
Goals- teach the pt the outcome or end position of a movement and assess the ts ability to sustain a contraction
Description-
place the patient in the end position of the activity where all the agonist muscles are shortened, patient holds position while PT resists all components, ask the pt to relax, move the pt passively a short distance back in the opposite direction, then ask them to return to the end position, and at the end of progress have pt perform alone
