PNF Flashcards
what is PNF?
proprioceptive neuromuscular facilitation
combines the function based diagonal patterns with techniques to facilitate the neuro motor units to improve muscle control and function
PNF can be used to improve/develop:
- Muscular strength
- Muscular endurance
- Stability
- Mobility
- Neuromuscular control
- Coordinated movement
- Foundation for restoration of function
how can PNF be modified for various levels of difficult?
Beginning with PROM → isometrics → active assisted movement → higher velocity resisted movements
Define overflow (irradiation)
spread of a muscle response from stronger to weaker muscles
primarily achieved through applying resistance
what is the role of manual contact in PNF?
stimulates the muscle to reinforce the movement AND guide the direction of the movement
where should the PT be positioned during PNF?
directly in line with the desired motion
should be facing the direction of the desired movement
what are the component of cueing in PNF?
- Verbal cues → both preparatory as well as energetic, strong and active verbal cues during movement when requiring strong recruitment
- encouraging visual attentiveness by the patient → watching distal segment in mirror
- timing → encouraging movement of distal segment first, then moving proximal; rotation occurs throughout the entire movement
- resistance → facilitates the contraction by recruiting motor units
List several specific PNF techniques
- Diagonals
- Lifts
- Reverse lift
- Chop
- Reverse Chop
- Quick stretch
- Rhythmic initation
- Alternating isometrics
- Rhythmic stabilization
- Dynamic reversals
what are the different diagonal PNF patterns?
D1 flexion and extension
D2 flexion and extension
(for both UE and LE)
describe D1 UE flexion
starting in D1 extension, then “the seatbelt”
- shoulder flex, add, ER
- forearm supination
- wrist radial deviation
- fingers flexed
describe D1 UE extension
start in D1 flexion then:
- shoulder ext, ABD, IR
- forearm pronation
- wrist ulnar deviation
- fingers extended
describe D2 UE flexion
start in D2 extension then “pull sword out”
- shoulder flex, ABD, ER
- forearm supination
- Wrist radial deviation
- fingers extended
describe D2 UE extension
Start in D2 flexion then “put sword back in sheath”
- shoulder ext, ADD, IR
- forearm pronation
- wrist ulnar deviation
- fingers flexed
describe D1 LE flexion
Start in D1 LE extension and think “kicking soccer ball”
- Hip flex, ADD, ER
- DF
- Inversion
- Toes extended
Describe D1 LE extension
Start in D1 flexion and think “winding up to kick”
- Hip ext, ABD, IR
- PF
- Eversion
- Toes flexed
Describe D2 LE flexion
Start in D2 LE Extension, think “dog peeing on hydrant”
- Hip flex, ABD, IR
- DF
- Eversion
- Toes extended
Describe D2 LE extension
start in D2 LE flexion, think “ballerina pose”
- Hip ext, ADD, ER
- PF
- Inversion
- Toes flexed
When are lifts, reverse lifts, chops, reverse chops used?
when you want the patient to perform the motion but their involved limb is too weak so they need to use their other arm to perform the motion (AAROM)
what pattern is the involved limb going through when performing a lift and reverse lift?
- Lift
- involved limb → D2 extension to D2 flexion
- Reverse lift
- involved limb → D2 flexion to D2 extension
what pattern is the involved limb going through during a chop and reverse chop?
- Chop
- involved limb → D1 flexion to D1 extension
- Reverse chop
- involved limb → D1 extension to D1 flexion
what is rhythmic initiation, when is it used and what are it’s goals?
- used to promote the ability to initate a movement pattern
- utilized for trx of dysfunctions which affect initiation, speed, direction, or quality of contraction
- Goals → allow the pt to become familiar w/sequence of movement and the rate at which movement is to occur
Describe the technique for rhythmic initation (the 4 steps)
- therapist moves pt passively through pattern
- therapist asks pt to perform active assisted movement
- active movement
- active movement against manual resistance
list some indications for rhythmic initation
- improve coordination
- potentially used to “break up tone”
- improve motor planning
- beneficial to ppl who respond better to tactile than verbal cues
Describe alternating isometics
Manual resistance is applied in a single plane on one side of a body segment and then on the other
- pt instructed to “hold” his/her position as resistnace is alternated from one direction to the opposite direction
- no joint movement should occur
- Procedure isometrically strengthens agonist and antagonist
- can be applied to one/both extremities simultaneously, or to trunk
- can be applied in WB or nonWB positions
