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Pnf Flashcards

1
Q

PNF philosophy

A

Belief that all humans have potentials that have not been fully developed
Neuroplasticity princple: use it and improve it

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2
Q

PNF positive approach

A

Positive feedback for pts
Setting them up for success
Use of a stronger part to influence weaker
NP: salience, specificity

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3
Q

PNF functional approach

A

Movement must be specific, purposeful, and aimed towards functional goal
Optimal movement requires well integrated neuromuscular system
Goal has value to pt
NP: salience`

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4
Q

PNF maximal repsonse

A

PT is always trying to facilitate a maximum response from pt

NP: specificity, use it or lose it, use it and improve it

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5
Q

PNF repetition

A

Rep of maximal response
Increase awareness/enhance motor function
Different positions and environment
NP: specificity, transference and repetition matters

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6
Q

PNF continued activity

A

Intensive, goal driven, will be different at every stage

NP: intensity matters, time matters

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7
Q

PNF potential

A

NP: use it and improve it

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8
Q

PNF whole person

A

NP salience

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9
Q

PNF strong to influence weak

A

NP specificity

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10
Q

PNF optimum function

A

NP salience

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11
Q

PNF basic principles

A

Proprioceptive/tactile input
Visual input
Verbal input

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12
Q

PNF tactile input - patient position

A

Influence of gravity
Reflexes
Pain
Treatment goal

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13
Q

PNF tactile input - manual contacts

A

Consider direction of desired motion

Specific - use of lumbrical grip

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14
Q

PNF PT position/ body mechanics

A

Safety of therapist
Ability to feel pt response
Neutral posture
In line w/ desired motion

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15
Q

PNF appropriate resistance

A

Amount of resistance that facilitates smooth/coordinated movement

  • facilitate contraction
  • increase awareness or motion
  • improve control and coordination
  • use w/ all types of contractions
  • can result in overflow/irradiation to desired target
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16
Q

What is the goal of traction and approximation in general?

A

Stimulates: joint receptors, muscle spindles, facial receptors

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17
Q

PNF traction

A

MOVEMENT
Elongation of a segment
Pulling, anti gravity movements
ex: reaching, swing pahse of gait

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18
Q

PNF approximation

A

STABILITY
Compression of a segment
Pushing, WB movements Ex: stance phase of gait
2 types

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19
Q

PNF quick stretch

A

High velocity, low amplitude elongation of a motion segment
Muscle spindles and GTO, joint receptors, facial receptors
Tissues need to have tension
Stimulate VOLUNTARY MOVEMENT

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20
Q

PNF normal timing

A

Sequence of muscle firing that results in strong, smooth, controlled, coordinated movement

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21
Q

PNF irradiation

A 
Overflow principle
-increase strength, ROM
-decrease tone
Directed toward functional goal 
Motor cortex activation w/ varying degrees of muscle contraction
  • Places demand on one stronger body part to facilitate recruitment of another weaker part
22
Q

PFN - patterns of facilitation

A

Optimal movement created by TRUNK and EXTREMITIES working together
Resisting a DIAGONAL allows for move muscle to participate in movement
Named for end position

23
Q

PFN visual input

A

Integrated w/ muscle synergies, facilitates coordination of head and trunk movements
Cue movement direction

24
Q

PNF verbal input

A

Tone and rhythm
Simple and precise
Preparatory command
Consider- stage of motor learning, needs of whole person

25
Q

PNF techniques aim to:

A

-teach movement or stability
- increase ROM
- improve coordination
-increase strength
-increase endurance
promote relaxation
-decr pain

26
Q

Rhythmic Initiation- indications/Goals

A
  • difficulties in initiating motion
  • movement is too slow or too fast
  • uncoordinated or dysrhytmic motion
  • general tension

GOALS: fix all the above and…help the patient relax

27
Q

rhythmic initiation- description

A
  • PT starts by moving the pt through PROM, using speed of verbal command to set rhytm
  • the pt is asked to begin working actively in the desired direction. return motion is done by PT
  • PT resists AROM, maintaining the rhythm with the verbal commands
28
Q

Combination of isotonics - description

A
  • PT resists the pts moving actively through a ROM (concentric)
  • at the end of the motion the PR tells the pt to stay in that position (stabilizing contraction)
  • when stability is attained the PT tells the pt to allow the part to be moved back slowly to starting position (eccentric)
29
Q

Combination of isotonics- goals and indications

A

Indicated if pt has:

  • decr eccentric control
  • lack of coordination or ability to move in a desired direction
  • decr AROM
  • lack of active motion in the middle of the range

GOAL: fix all the above and … strengthen.

30
Q

Dynamic reversals - description

A
  • PT resists the pts moving in one direction
  • as the end of desired ROM approaches, the PT reverse the grip on the distal portion of the moving segment
  • as the pt reaches the end of his or her AROM, th PT gives the command to reverse direction, without relaxation, and resists the new motion at the distal part
  • when the pt begins moving in the opposite direction the PT reverses the proximal grip so all resistance opposes the new direction
  • reversals may be done as often as necessary
31
Q

dynamic reversals indication/goals

A

Indicated in pt has:

  • weakness of the agonistic muscles
  • decr ability to change direction of motion
  • exercised muscles begin to fatigue

GOAL: increase AROM, incr strength, develop coordination, reduce fatigue

32
Q

stabilizing reversals- description

A
  • PT gives resistance to the pt in one direction while asking the pt to oppose the force, no motion is allowed
  • when the pt is fully resisting the force th ePT moves one hand and begins to give resistance in another direction
  • after the pt responds to the new resistance the PT moves the other hand to resist the new direction

**alternating isotonic contractions opposed by enough resistance to prevent motion

33
Q

stabilizing reversals- indication/goals

A

Indicated if pt has:

  • decr stability
  • weakness
  • Pt unable to contract muscle isometrically

GOAL: incr stability and incr muscle strneth

34
Q

Rhythmic stabilization- description

A
  • PT resist an isometric contraction of the antagonistic muscle group. PT maintains the position of the part w/o trying to move
  • resistance is incr slowly as the pt builds a matching force.
  • when the pt is responding fully, the PT moves one hand to begin resisting the antagonistic motion at the distal part
  • the new resistance is built up slowly. as the pt responds the PT moves the other hand to resist the antagonistic motion also
  • reversals are repeated as often as needed
35
Q

Rhytmic stabilization- indication / goals

A

Indicated if pt has:

  • limited ROM
  • pain, particularly when motion is attempted
  • Jt stability
  • weakness of the antagonistic muscle groups
  • decr balance
36
Q

CONTRAINDICATIONS of rhythmic stabilization

A
  • cerebellar involvement

- Pt unable to follow instructions due to age, language difficulty, cerebral dysfunction

37
Q

Repeated stretch (quick stretch at beginning of range) - description

A
  • PT gives a prepatory command while elongating fully all the muscles in t hepattern. particular attention is paid to rotation
  • a quick “tap” is given to lengthen the muscles further and evoke the stretch reflex
  • at the ame time as the stretch the PT gives a command to link the pts voluntary efforts to contract the stretchd muscles with the reflex response
  • the resulting muscle contraction, reflec and voluntary , is resisted
38
Q 
repeated stretch (quick stretch at beginning of range
-indication/goals
A

Indicated if a pt has:

  • weakness
  • inability to initiate motion due to weakness or rigidity
  • fatigue
  • decr awareness of motion

GOAL:facilitate initiation, incr AROM, incr strength, reduce fatigue, guide motion in desired direction

39
Q 
Repeated stretch (quick stretch at beginning of range)
-CONTRAINDICATION
A
  • joint stability
    -pain
    unstable bones due to fracture or Osteoporosis
    -damaged muscle or tendon
40
Q

repeated stretch (QS through Range)- description

A
  • PT resists a pattern of motion so all the muscles are contracting and tense
  • PT gives a prepatory command to coordinate the stretch reflex with a new, incr effort by the pt
  • at the same time the PT slightly elongates the muscles by momentarily giving too much resistance.
  • a new stronger muscle contraction is asked for and resisted
  • the stretch may be repeated to strengthen or redirect the motion as the pt moves through the range
  • pt must be allowed to move before the next stretch reflex is given
  • pt must not relax or reverse direction during the stretch
41
Q

repeated stretch ( QS through range) - indication/goals

A

Indicated if pt has:

  • weakness
  • fatigue
  • decr awareness of desired motion

Goals: incr AROM and strength, reduce fatigue, guide motion in the desired direction

42
Q

repeated stretch (QS through range)- CONTRAINDICATIONS

A
  • joint stability
  • pain
    unstable bones due to fracture or osteoporosis-damaged muscle or tendon
    -insufficient strength to maintain contraction of the muscles
43
Q

Contract relax - description

A
  • PT or the pt moves the joint or body segment to the end of the PROM. Active motion is preferred and the PT may resist it
  • PT asks the pt for a strong contraction of the restricting muscle 3or pattern (antagonist)
  • enough motion is allowed to happen for the PT to be certain that all the desired muscles, particularly rotators, are contracting,
  • after sufficient time , PT tells the pt to relac
  • both the pt and the PT relax
  • the joint or body part is repositioned, wither actively by the pt or passively by the PT, to the new limit of PROM. active motion is preferred and may be resisted
  • the technique is repeated until no more range is gained
  • active resisted ex of the agonistic and antagonistic muscles is done in the new range of motion
44
Q

contract relax - indications/ goals

A

indicated if pt has:

- decr ROM

45
Q

hold relax- description for incr ROM

A
  • PT or pt moves the joint or body segment to the end of the passive or pain-free ROM. active motion is preferred. the therapist may resist if it does not cause pain
    -PT asks for an isometric contraction of the restricting muscles ir pattern with emphasis on rotation
    -resistance is incr slowly
  • no motion is intended by either pt or PT
  • after holding the contraction for enough time the PT asks the pt to relax
    -both the PT and the pt relax gradually
    -joint of body pattern is repositioned either actively or passively to the new limit of range. active motion is preferred if it is pain free. the motion may be resisted if that does not cause pain.
    repeat all steps in the new limit of range
46
Q

hold relax description for decr pain

A

Direct tx-

  • pt is comfortable position
  • PT resists isometric contraction of musclews affecting painful segment

Indirect tx-

  • pt in comfortable position
  • PT resist isometric contractions of muscles distant from the painful segment
  • resistance is built up slowly and remains at a level below that which causes pain
  • during the relaxation the resistance decr slowly
47
Q

Hold relax - indication/goals

A

Indicated if pt has:

  • decr PROM
  • pts isotonis contrcations are too strong for the therapist to control
  • pain
48
Q

hold relax- CONTRAINDICATION

A

-pt is unable to do an isometric contrcation

49
Q

replication- description

A
  • place the pt in the end position where all the agonist muscles are shortened
  • pt holds that position while the PT resist all the components
  • ask the pt to relax. move pt passively a short distance back in the opposite direction, then ask pt to return to end position
  • for each replication of the movement start further toward the beginning of the movement to challenge pt through an incr ROM
50
Q

replication- Indictaion/goals

A
  • to teach the pt the end position of the movement

- to assess the pts ability to sustain a contraction when the agonist muscles are shortened

NeuroRehab (33 decks)

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