PNF Book Flashcards
To improve understanding of information contained in PNF Book
Order of Chapters:
History and Definition of PNF The Basic Principles and Philosophy Learning Sequence Activities Functional Application of Patterns PNF - Trunk Patterns PNF - Hooklying PNF - On Elbows PNF - Hands and Knees/Elbows and Knees PNF - On Knees or Half Kneeling PNF - Sitting PNF - Gait Stabilization, Weight Shift, and Stepping PNF - Self Care
Hooklying Order
Assumption of Position
Stabilization
Movement with Fixed Distal Segments
On Elbows Order
Assumption of Position
Assessment of Hyoid and associated muscle mobility and function
Stabilization
Weight Shift
Hands and Knees/Elbows and Knees order
Functional use Assumption of Position Stabilization Weight Shift Locomotion
On Knees or Half Kneeling Order
Assumption of Position Stabilization and Balancing Weight Shift Locomotion Half-Kneeling
Sitting Order
Assumption Stabilization and Balancing Pelvic Femoral Movement Movement of Upper Trunk on Lower Trunk Locomotion - Scooting Poth Directions Side Sitting Long Sitting
Gait Stabilization, Weight Shift, and Stepping Order
Wheelchair Activities Coming to Standing Stabilization Weight Shift in Stride Position High Step and Repeated Stepping Forward Gait One - Leg Standing Balance Backwards Gait Sideways Gait.
Initially all movements are activated and controlled by
Global and Phasic Muscles
Head movements begin to activate _________ function
Deep cervical muscle
Irradiation from the ______ muscles stimulates the proximal ________ muscles
global/phasic, tonic
Activation of the __________ muscles provides stability for more controlled open kinetic activities and subsequent weight bearing activities
Tonic
Weight bearing activities place a higher demand on the tonic muscles to provide dynamic _______ and controlled _________
Proximal stability
Distal mobility
The _____________ progresses an infant from rolling to walking with efficient CoreFirst strategies when this dynamic synergy of core and phasic muscles progresses without interruption or pathology.
Developmental Sequence
The therapist must assess and train efficient function in the following elements of each posture or position in the developmental sequence
Assumption of the position
Stabilization within the position
Movement within the position over fixed distal extremity or base of support
Locomotion
Building on the current knowledge of Motor Learning, the therapist must:
Create a functional learning environment
Identify the “whole activity, and then identify specific “parts” which can be assessed and treated for mechanical capacity and neuromuscular function.
Utilize efficient parts of the whole to better facilitate proper function of the target segment or part
Reintegrate the restored functioning part to the motor control of the whole.
Progression of treatment
Facilitate efficient MNM of interconnected segment.
Utilize the interconnecting segment to facilitate appropriate CoreFirst trunk control
Utilize efficient trunk control and interconnecting segments to facilitate efficient extremity movement and function.
Progression to weight bearing activities to ensure CoreFirst strategies in all ADLs.
To set the scapula the therapist must:
Elevate the scapula to a loose packed postion
Rotate, adduct, and tip to a midline position
Be sure the trunk does not rotate
Elongating the segment ______________ emphasizes the rotational component
Over the bowl
The three end feels that may be felt in a spring test
Springy - Efficient
Hard - Inability to lengthen
Boggy - Inability to fold
The three possible motions of the scapula are:
Skid (pure anterior elevation)
Spin (pure rotation)
Roll (combination of the two - the actual pattern)
The _______ are the prime stabilizers for posterior depression
Rhomboids
Order of the scapular patterns
Anterior elevation
Posterior depression
Posterior elevation
Anterior depression.
Function of the pelvis in mid stance to just before toe off
PD with a strong core response
Function of the pelvis in Pre toe off/Heel strike of the opposite leg
Passive movement into posterior elevation
Function of the pelvis in Toe Off:
Pelvis moves in to A/E
Function of the Pelvis in Heel Strike
Pelvis drops into A/D
Hip motions in midstance to toe off:
Extension
Abduction
Internal Rotation
Hip Motions in Toe off to Heel Strike:
Flexion
Adduction
External Rotation.
Order of Pelvic Patterns
Anterior Elevation
Posterior Depression
Posterior Elevation
Anterior Depression
Functional Tests and Techniques
Functional Tests Rhythmic Initiation Reversal of Antagonists Repeated Quick Stretch Combination of Isotonics Irradiation Relaxation Techniques Timing For Emphasis
Reasons to Perform Functional tests:
Enhance the patient’s proprioceptive and kinesthetic awareness
Enhance the patient’s understanding of the purpose of the intervention
Promote more effective compliance when the home program is an extension of the intervention
Provide the therapist with feedback as to the appropriateness/effectiveness of the intervention.
Provide the therapist with insight as to the underlying mechanical, neuromuscular, or motor control aspects of the identified dysfunction.
What is Rhythmic Initiation
A technique designed to assist patient who have difficulty initiating and controlling a contraction.
What is the primary dysfunction treated with Rhythmic Initiation?
Motor Control
What is Rhythmic Initiation used to evaluate:
The patient’s ability to allow passive motion
To actively contract with the right neuromuscular function
To utilize the appropriate motor control to efficiently perform at a consistent speed.
The speed is determined by the needs of the patient.
Rhythmic Initiation is used to treat motor control dysfunctions of
Speed
Direction
Quality of motion
Sequence of performance of Rhythmic Initiation with commands
Passive - Relax let me move you
Active Assistance - Now you help me a little
Resistive - Now help me a little more.
Rhythmic Initiation is Unidirectional or Bidirectional?
Unidirectional
Primary dysfunctions treated with Reversal of Antagonists
Neuromuscular and Motor Control
Two types of Reversal of Antagonists Techniques
Isotonic reversals
Stabilizing or Isometric Reversals
Isotonic Reversals are used to:
Improve one’s ability to smoothly reverse direction (motor control)
Facilitate contraction of antagonists (neuromuscular)
Prevent or relieve fatigue (neuromuscular)
Improve coordination (motor control)
The speed and range of motion through which Isotonic Reversal is performed is dependent upon the:
Individual needs and abilities of the patient
Manual contacts are gradually changed from one surface to the other to facilitate a smooth change of directions. Be sure that one hand is making contact, it is pushing the other hand off so that at no time does the patient ____________ or _____________
Cease the contraction or have conflicting manual input.
If there is a strength imbalance between antagonistic muscle groups, increased resistance applied to the _________ group with facilitate a more forceful contraction of its __________
Stronger
Antagonists
A stretch reflex is used to specifically facilitate the reverse contraction, however the patients concentric contraction must take the segment to __________ so the stretch is applied to existing tension as the manual contact transitions.
The fully lengthened range
A ___________ or _________ contraction may be used at the transition of reversal of antagonists.
Maintained Isotonic
Isometric
Stabilizing or Isometric Reversals are used to:
Improve patient’s ability to accomplish and maintain a stabilizing contraction while resistance is slowly changed from one contact to another
To improve one’s control of posture and balance
To develop the necessary strength and stretch sensitivity of extensor muscles in their shortened range
To promote relaxation and pain reduction
To increase ROM.
Stabilizing or Isometric Reversals may be used in ________ patterns or from ________ for generalized position stabilization.
Antagonistic patterns
One point on the body to another.
To achieve optimal results from stabilizing or isometric reversals, it is necessary to resist the ________ components of movement
Rotary and diagonal.
Repeated quick stretch is defined as: Repeated use of the stretch reflex to __________or to __________
Initiate a muscular response
Reinforce and strengthen a pre-existing contraction
Repeated quick stretch is a valuable tool in reducing _____________ and improving ____________
Fatigue
Endurance
Repeated quick stretching can be performed in these two positions:
From Elongation
Superimposed on an existing contraction
Repeated Stretch from Elongation is effective in:
Initiating motion
Stimulating muscles not completely under volitional control
Training Coordinated movement and proper timing
Increasing patients awareness of motion
Improving endurance
When performing a quick stretch superimposed upon an existing contraction ________ must be emphasized just before the quick stretch.
Traction
Superimposed Repeated Stretch assists in facilitating:
A more forceful muscular contraction Redirection of Motion Improvement of coordinated movement An increase in active ROM A reduction of fatigue.
Combination of Isotonics is the use of controlled resistance to facilitate the patients ability to execute each type of contraction and efficiently transition between:
Isometric
Maintained Isotonic
Concentric
Eccentric contractions
Combination of Isotonics is used to:
Heighten the patient’s awareness of a specific position or contraction
Used for neuromuscular and motor control
Can be used to improve ROM
When new range of motion is gained, you should always complete treatment with:
Prolonged holds and COI in and out of the end range
When using COI to improve Neuromuscular control or Motor Control - Where should the segment be positioned?
Where the poor strategy exists
What type of contraction is desired first when improving Neuromuscular and Motor control?
Isometric
After building an isometric contraction for combination of isotonics you gradually move to a ______ contraction
Maintained Isotonic
When gaining new ranges of motion in combination of isotonics you first use an _________ contraction followed by a ___________ contraction
Eccentric, concentric
When using combination of isotonics to promote an efficient end feel you first take the pattern to __________ to test it
End Range
To treat a hard end feel with combination of isotonics you begin with an ___________ then a _________ then slowly between ____________, _______________, and finally __________ contractions
Isometric Maintained Isotonic Eccentric Maintained Isotonic Concentric
When treating a hard end feel with combination of isotonics you begin in a _____________ position
Loose Packed
__________ results from a steady increase in local stimulus
Temporal Summation
__________ results in an increase in strength of the contraction through various points of facilitation.
Spatial Summation.
Irradiation Definition in PNF:
The spreading of a muscular response from one muscle group to another by altering the emphasis of resistance
The _______ is the pattern or body segment that does not demonstrate appropriate neuromuscular function. The _____________ is an efficient pattern or body segment that has appropriate initiation, strength, and endurance which can be used and generate irradiation
Target Segment
Source Segment
When using irradiation to facilitate a tonic spread, the therapist must facilitate a ____________ - Or a state in which both the source and target respond as one unit.
Magnetic Click
Irradiation may occur:
Ipsilateral
Contralateral
Extremities to trunk
Trunk to extremities.
Definition of Prolonged Holds
The use of maintained resistance to facilitate an overflow or irradiation to another body part
Definition of Phasic Shakes
Use of irradiation from the phasic to the tonic muscles.
Tonic Spread:
Initial resistance is low load, primary target is loca/tonic muscles. The resistance builds to an appropriate motor control strategy of efficient local/global initiating strength and control, Therapist must facilitate a magnetic click.
Controlled Specific response using irradiation depends upon:
The correct positioning of the patient and use of proper manual contact
Body position of the therapist
Appropriate resistance at various points of contact
Types of relaxation techniques:
Contract relax
Hold Relax
Contract relax is used to:
Increase ROM and facilitate relaxation
When Performing a contract relax the resistance is given at the point of limitation of the pattern to a concentric contraction of either
Agonist (direct relaxation)
Antagonist (reciprocal inhibition)
When using a contract relax all patterns are resisted with a few degrees of motion with an emphasis on _________
Rotation
The amount and duration of resistance applied during a contract relax technique varies based on the following:
Needs of the patient and underlying pathology
A Contract Relax is followed by this
Complete and Total relaxation
Hold relax is used to
Facilitate relaxation and increase ROM when pain is present or when a patient is overpowering with a contract relax.
A Hold Relax technique uses a ________ contraction
Isometric
The technique of timing for emphasis is used to use a __________ or _______________ elements to facilitate the response of __________ or ___________elements
Stronger, More responsive
Weaker, less responsive
