PNF Flashcards
philosophy
stronger parts utilized to strengthen weaker parts; balance of control of agonist & antagonist; stimulation of proprioceptors; patterns follow diagonals or spirals
philosophy - treatment
increase strength, flexibility & ROM
philosophy- outcomes
head & trunk control; initiate & sustain movement; control shifts in the COG; control pelvis & trunk in midline (allows for extremity movement)
chopping
combination of B UE asymmetrical patterns performed as a closed chain activity
developmental sequence
progression of motor skill acquisition: mobility, stability, controlled mobility, skill
mass movement patterns
hip, knee & ankle move into flexion or extension simultaneously
overflow
muscle activation of an involved extremity due to intense action of an uninvolved muscle/group
direct approach
application of exercise techniques and elements to an affected area
indirect approach
application of exercise techniques and elements to an uninvolved area to gain overflow excitation or relaxation effects to an affected part
procedure
all components of a specific exercise (activity, technique, sensory input)
activity
any developmental posture and the movements occurring within that posture
technique
type of contraction used in treatment
element/principle
type of sensory input used in treatment to facilitate or inhibit a response; tools to promote motor learning
quick (controlled) stretch- how
muscle in elongated position; slight movement farther into the elongated range
quick (controlled) stretch - why
facilitate voluntary movement; increase strength or voluntary contraction; follow with a form of resistance or facilitation; must be synchronized with patient’s effort
quick (controlled) stretch - contraindications
increased pain, fracture, joint instability, creating dominant reflexes (abnormal tone, spasticity)
appropriate resistance (appropriate facilitation) - what
amount of resistance that demands maximal effort from the patient without breaching the intention of the effort
appropriate resistance (appropriate facilitation) - isotonic contraction
intention is movement
commands: “push” “pull”
appropriate resistance (appropriate facilitation) - isometric contraction
holding for stability
Commands: “hold” “don’t let me move you”
appropriate resistance (appropriate facilitation) - why
used for muscle re-education
appropriate resistance (appropriate facilitation) - contraindications
increased pain, fracture, valsalva, tendon surgeries, muscle flaps, reconstructions, anything where resistance is not appropriate
irradiation/overflow
spreading of the response from strong to weak components/patterns
ipsilateral, contralateral, trunk to extremities, extremities to trunk
joint facilitation - traction
manual distraction of joint surfaces; promote movement; decrease pain
joint facilitation -traction - contraindications
increased pain, ligamentous injury, unstable joints, hypotonia
joint facilitation - approximation
manual compression of joint surfaces, promote stability, particularly postural stability
joint facilitation -approximation - contraindications
increased pain, fracture, joint replacements, inflammatory conditions (RA or JRA)
Normal timing
sequence of muscle contractions for coordinated movements; proximal develops before distal (distal before proximal execution in adults)
patterns of movement
based on groups of muscles that work synergistically in functional contexts
patterns of movement - diagonal
patterns with spiral movements; allows muscles to contract from completely lengthened to completely shortened positions
functional tasks - D1 UE
Basic pattern; self care tasks (feeding, grooming, washing hair); reaching to floor from chair seated position; holding toddlers hand while walking; using a leash to walk dog; pull luggage in airport; handshake, armswing in gait
functional tasks - D2 UE
more advanced pattern; reaching out to others, zipping up clothes; pulling clothes out of dryer & hang on hanger; put on a seatbelt (could be both); waving in a crowded restaurant
functional tasks - D1 LE
basic pattern; swing phase of gait; stair climbing; tying shoes while sitting; pulling your leg into bed; rolling over
functional tasks - D2 LE
more advanced pattern; tennis, soccer or other sports that require quick lateral movements; ballet positions; lateral transfers: getting into car, tub/sliding board transfer; sideways walking (between two cars)
scapular & pelvic patterns - why & position
improve quality, sequence, ROM & coordination of both trunk & extremity movements
Position: sidelying (or sitting if needed)
functional tasks - scapular & pelvic patterns
rolling, reciprocal arm movements, scooting in supine & sitting & gait
diagonals with scapula
posterior depression & anterior elevation
anterior depression & posterior elevation
techniques related to motor control - mobility
initiate movement: rhythmic initiation, rhythmic rotation, repeated contractions
increase ROM: rhythmic initiation, hold relax, contract relax
techniques related to motor control - stability
slow reversal hold, alternating isometrics, rhythmic stabilization
techniques related to motor control -controlled mobility
slow reversals, slow reversal hold, repeated contractions, agonist reversals
techniques related to motor control - skill
slow reversals, slow reversal hold, repeated contractions, agonist reversals, resisted progression
rhythmic initiation (mobility)
initiate movement when hypertonia exists; progress PROM-AAROM-resisted ROM; slow & rhythmical (reduce hypertonia, allow full ROM)
rhythmic rotation (mobility)
decrease hypertonia & increase ROM; passive movement; slow rotation around longitudinal axis
hold/relax (mobility)
isometric contraction to increase ROM (patient’s w/no pain); joint to end of it’s range, isometric contraction of antagonist; resistance built up; once relaxation is achieved, limb moved to new range slowly & then repeated till no new range is attained
hold relax active movement (HRAM) (mobility)
improve initiation of movement to muscle(s) tested 1/5
contract/relax (mobility)
increase ROM; move pt to end range (hold/stretch), then provide resistance for isotonic contraction through full ROM in direction of antagonist (8-10 sec), then move back up through end range (start pos), should have new ROM, repeat until no new range is gained; not ideal for its in pain
alternating isometrics (stability)
increase strength & endurance; isometric contractions performed alternating from muscles on one side of the joint to the other side without rest; maintain contact, use palms
rhythmic stabilization (mobility & stability)
increase ROM-iso contractions of all muscles around a joint against progressive resistance; pt should relax & move into new range & repeat
coordinate isometric contractions-iso contractions of all muscles around joint against progressive resistance; should follow alternating isometrics if progressing stability
slow reversal (stability, controlled mobility, skill) AKA- reversal of antagonists
improve control of movement & posture (strength, ROM, coordination, power); slow & resisted concentric contractions of agonists & antagonists w/out rest between reversals
slow reversal hold (stability, controlled mobility, skill)
an isometric contraction at the end range of movement pattern is added before beginning the return pattern; hold is to facilitate stability at the joint (at end range)
agonistic reversals (controlled mobility, skill)
increase strength/endurance, coordination, training eccentric control; isotonic movement; alternates between concentric & eccentric contractions of agonists
resisted progression (skill)
resistance is used to increase strength & endurance, develop normal timing or reinforce motor learning; used during walking, creeping, crawling (walking - resist at pelvis, shoulder, rib cage)
repeated contractions (mobility)
initiate & sustain movement through ROM; utilizes stretch reflex to promote initiation of muscle activity to reinforce & strengthen an existing contraction (repeated quick stretch); concentric contractions of components in agonist pattern
joint distraction (mobility)
increase ROM; consistent manual traction is provided slowly & usually in combo w/mob techniques
normal timing (skill)
improve coordination of all components of a task; distal to proximal; proximal components are restricted until distal components are activated & initiate movement; repetition of pattern produce coordinated movement of all components
timing for emphasis (skill)
strengthen the weak components of a motor pattern; isotonic & isometric contractions produce overflow to weak muscles
techniques to treat impairments - decrease pain
alternating isometrics
hold/relax
rhythmic stabilization
techniques to treat impairments - increase strength
agonist reversal
rhythmic stabilization
slow reversal
techniques to treat impairments - increase ROM
alternating isometrics
contract/relax, hold/relax
hold relax active motion
rhythmic stabilization
techniques to treat impairments - increase coordination
alternating isometrics
agonist reversal
rhythmic initiation
slow reversal
techniques to treat impairments - increase stability
alternating isometrics
agonistic reversal
rhythmic stabilization
techniques to treat impairments - initiate movement
rhythmic initiation
hold relax active motion
techniques to treat impairments - promote tone reduction
rhythmic initiation
rhythmic rotation
hold/relax
techniques to treat impairments - increase endurance
alternating isometrics
rhythmic stabilization
slow reversals