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CP 2 > PNF > Flashcards

PNF Flashcards

1
Q

what is PNF?

A

proprioceptive neuromuscular facilitation

combines the function based diagonal patterns with techniques to facilitate the neuro motor units to improve muscle control and function

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2
Q

PNF can be used to improve/develop:

A
  1. Muscular strength
  2. Muscular endurance
  3. Stability
  4. Mobility
  5. Neuromuscular control
  6. Coordinated movement
  7. Foundation for restoration of function
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3
Q

how can PNF be modified for various levels of difficult?

A

Beginning with PROM → isometrics → active assisted movement → higher velocity resisted movements

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4
Q

Define overflow (irradiation)

A

spread of a muscle response from stronger to weaker muscles

primarily achieved through applying resistance

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5
Q

what is the role of manual contact in PNF?

A

stimulates the muscle to reinforce the movement AND guide the direction of the movement

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6
Q

where should the PT be positioned during PNF?

A

directly in line with the desired motion

should be facing the direction of the desired movement

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7
Q

what are the component of cueing in PNF?

A
  1. Verbal cues → both preparatory as well as energetic, strong and active verbal cues during movement when requiring strong recruitment
  2. encouraging visual attentiveness by the patient → watching distal segment in mirror
  3. timing → encouraging movement of distal segment first, then moving proximal; rotation occurs throughout the entire movement
  4. resistance → facilitates the contraction by recruiting motor units
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8
Q

List several specific PNF techniques

A
  1. Diagonals
  2. Lifts
  3. Reverse lift
  4. Chop
  5. Reverse Chop
  6. Quick stretch
  7. Rhythmic initation
  8. Alternating isometrics
  9. Rhythmic stabilization
  10. Dynamic reversals
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9
Q

what are the different diagonal PNF patterns?

A

D1 flexion and extension

D2 flexion and extension

(for both UE and LE)

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10
Q

describe D1 UE flexion

A

starting in D1 extension, then “the seatbelt”

  1. shoulder flex, add, ER
  2. forearm supination
  3. wrist radial deviation
  4. fingers flexed
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11
Q

describe D1 UE extension

A

start in D1 flexion then:

  1. shoulder ext, ABD, IR
  2. forearm pronation
  3. wrist ulnar deviation
  4. fingers extended
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12
Q

describe D2 UE flexion

A

start in D2 extension then “pull sword out”

  1. shoulder flex, ABD, ER
  2. forearm supination
  3. Wrist radial deviation
  4. fingers extended
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13
Q

describe D2 UE extension

A

Start in D2 flexion then “put sword back in sheath”

  1. shoulder ext, ADD, IR
  2. forearm pronation
  3. wrist ulnar deviation
  4. fingers flexed
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14
Q

describe D1 LE flexion

A

Start in D1 LE extension and think “kicking soccer ball”

  1. Hip flex, ADD, ER
  2. DF
  3. Inversion
  4. Toes extended
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15
Q

Describe D1 LE extension

A

Start in D1 flexion and think “winding up to kick”

  1. Hip ext, ABD, IR
  2. PF
  3. Eversion
  4. Toes flexed
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16
Q

Describe D2 LE flexion

A

Start in D2 LE Extension, think “dog peeing on hydrant”

  1. Hip flex, ABD, IR
  2. DF
  3. Eversion
  4. Toes extended
17
Q

Describe D2 LE extension

A

start in D2 LE flexion, think “ballerina pose”

  1. Hip ext, ADD, ER
  2. PF
  3. Inversion
  4. Toes flexed
18
Q

When are lifts, reverse lifts, chops, reverse chops used?

A

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)

19
Q

what pattern is the involved limb going through when performing a lift and reverse lift?

A
  1. Lift
    • involved limb → D2 extension to D2 flexion
  2. Reverse lift
    • involved limb → D2 flexion to D2 extension
20
Q

what pattern is the involved limb going through during a chop and reverse chop?

A
  1. Chop
    • involved limb → D1 flexion to D1 extension
  2. Reverse chop
    • involved limb → D1 extension to D1 flexion
21
Q

what is rhythmic initiation, when is it used and what are it’s goals?

A
  1. used to promote the ability to initate a movement pattern
  2. utilized for trx of dysfunctions which affect initiation, speed, direction, or quality of contraction
  3. Goals → allow the pt to become familiar w/sequence of movement and the rate at which movement is to occur
22
Q

Describe the technique for rhythmic initation (the 4 steps)

A
  1. therapist moves pt passively through pattern
  2. therapist asks pt to perform active assisted movement
  3. active movement
  4. active movement against manual resistance
23
Q

list some indications for rhythmic initation

A
  1. improve coordination
  2. potentially used to “break up tone”
  3. improve motor planning
  4. beneficial to ppl who respond better to tactile than verbal cues
24
Q

Describe alternating isometics

A

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
25
Q

how is rhythmic stabilizations different from alternating isometrics?

A

alternating isometrics only applies force from one direction and the pt knows which direction it will be coming from.

rhythmic stabilizations apply forces from all directions quickly (like perturbations) this is way more challenging as the force is multi-directional

26
Q

Describe the technique for rhythmic stabilizations

A

co-contractions of agonist and antagonist performed by placing hands on opposite sides of body and applying simultaneous resistance

no motion is allowed

shift hand placement opposite to the muscles you were just recruiting

27
Q

List some indications for rhythmic stabilization

A
  1. progression from alternating isometrics
  2. impaired strength and coordination
  3. pt can work through limited ROM
  4. appropriate for pts who have issues with postural stability and balance
  5. appropriate for pts with decreased stability at a given joint
  6. can provide PT info on pt’s ability to reinforce and maintain contractions
28
Q

what are dynamic (slow) reversals?

A

agonist → antagonist contractions eliciting bidirectional movement from patient

switch hands at the end of each movement

29
Q

List other PNF techniques

A
  1. Fast/quick stretch
  2. Repeated contraction/stretch
  3. Dynamic (slow) reversal hold
  4. Agonist reversals
30
Q

what are agonist reversals?

A

reversing the type of contraction and always working concentrically, isometrically, or eccentrically.

you work the same muscle in both directions but switch the type of contraction

CP 2 (13 decks)

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