PNF for the Neurologic Pt Flashcards
proprioceptive
stimuli produced w/in an organism by movement of its tissues
what is stimulated –> proprioceptive
sensory receptors
sensory receptors –> proprioceptive
muscle spindles
GTOs
jt CT
eyes
ears
inner ear receptor
skin exteroceptors
what stimulates sensory receptors –> proprioceptive
mm length or tension
joint angle
head position
neuromuscular
can mm properly initiate?
does the pt have appropriate strength?
what is the mm endurance?
facilitation
the increase in performance of any action resulting from the decrease in nerve resistance by applying a continued stimulus
what should facilitation ultimately do
make a movement easier by evoking a response
what should there be an… –> facilitation
inhibition of abnormal tone and movement patterns
PNF history
one of the move recognizable tx concepts since the 1940s
developed by Herman Kabat and Margaret Knott
why was PNF created
had to be more to txing pts than just using RW and performing PROM
what could mm response be influenced by
resistance
stretch reflex
irradiation
other proprioceptive input
3 C’s to display to a pt when using PNF
confidence
compassion
comfortable
underlying premise for the utilization of the basic principles
enhance the postural response or movement patterns of the pt
goal of PNF
facilitate the pt to achieve movement or posture which has be identified to be in a state of dysfxn
PNF uses
manual contact
manual contact
provide a specific direction of movement
what type of grip should we use with manual contact
lumbrical grip
where should we apply contact
identify specific location for contact
choose a surface directly into the line of movement desired
body position
shoulders, forearm and hips face direction of movement
body mechanics
spine in neutral
movement occurs from the legs, hips and UE
PT body part is behind pt’s body part
where does resistance come from
PT’s trunk, pelvic and legs
NOT THE ARMS
resistance
isotonic
concentric
eccentric
maintained isotonic
isometric
isotonic contraction
dynamic
internal force overcomes the external force allowing movement
concentric contraction
push or pull
eccentric
let go slowly or slowly let go
maintained isotonic contraction
concentric contraction which resistance is applied by PT allowing minimal to no motion
“keep it there”
“dont let me move you”
isometric contraction
static
external force overcomes internal force and no movement is allowed
“hold it, don’t let me move you. Don’t push.”
traction
elongation of a segment to increase muscular response and promote movement or proximal stability
how is traction maintained
throughout movement and combined with appropriate resistance
what may traction be effective in
reducing pain
approximation
compression of a segment to increase muscular response and promote stability
what does approximation aid in
txing painful and unstable joints
what is approximation used for
facilitate isometric or stabilizing contraction
quick stretch
elongating a group of MM in pattern can get greater facilitation
what is best facilitated by a quick stretch
reflex contraction
what should we always do before applying a quick stretch
spring test
where should we perform a quick stretch
must be in recoil zone
quick stretch is not
a jerk
quick stretch is
synchronized w/ verbal command
when should resistance be given –> quick stretch
must occur w/in first few degrees of movement by pt
what is quick stretch used to achieve
facilitate initiation of movement
increase strength of contraction
increase endurance
influence direction of movement
contraindications to quick stretch
involuntary hyperactive stretch reflex
pain
mm, tendons, bones or joints are injured
verbal stimuli –> verbal commands should be
simple
concise
audible
specific to the contraction desired
visual stimuli should initiate
learning of activities
visual stimuli should identify
direction of movement
position in space
visual stimuli should increase
ROM
visual stimuli should direct
motion of head, trunk and extremities across midline on the same side
how’re activities performed
in diagonal direction w/ spiral components
how is mm response when resistance is applied in a diagonals
more coordinated and forceful
patterns of facilitation consist of
3 components
3 components of each pattern
flexion or extension
abduction or adduction
rotation
timing
sequencing of motor recruitment which takes place in a normal fxnal activity or movement
when would I use different techniques? –> approximation
stabilization and balance
when would I use different techniques? –> traction and stretch
increases ability to move
when would I use different techniques? –> resistance
reinforced learning of activity
when would I use different techniques? –> timing for emphasis
enables therapist to use strong motions to exercise weaker ones
when would I use different techniques? –> patterns
improve performance of fxn activities
when would I use different techniques? –> commands
clear and relate to fxn goals
stability or motion
