PNF of the UE and Upper Trunk Flashcards
1
Q
Describe PNF concepts
A
- Originally based on historical motor control concepts
- Based on hierarchical model: abnormal movements are direct result of higher level lesions and recovery only by regaining top-down control
- Importance of feeding sensory (facilitatory) information to higher centers to improve movement
- Emphasis on different types of proprioceptive inputs to elicit desired motor responses
- Reflexes
2
Q
Traditional goals of PNF
A
- Improve performance of functional tasks by increasing strength, flexibility, & ROM
- Use developmental sequence as a guide to promote achievement of progressively higher levels of proficiency & functional independence in bed mobility, transfers, sitting, standing, & wlaking
3
Q
Current perspectives on pNF
A
- Emphasis on task oriented functional movements
- Less emphasis on developmental postural sequence, inhibiting abnormal reflexes, & details on the ‘proprioceptive facilitation’ techniques
- Incorporation of current motor control & motor learning
4
Q
Our take on PNF
A
- Used as good assistive or resistive interventions
- Help initiate movements (low level pts)
- Helps train postural control
- Helps train controlled movements of extremities while maintaining static/dynamic trunk control
- Provides ‘right sensory experience’ to replicate normal movements by providing appropriate manual feedback
5
Q
Traditional components of PNF provide proprioceptive facilitation using the following components to improve motor recovery
A
- Manual contact
- Body position and body mechanics
- Stretch
- Manual resistance
- Irradiation
- Joint facilitation
- Timing of movement
- Patterns of movement
- Visual cues
- Verbal input
6
Q
Describe manual contacts
A
- Hand on skin stimulates pressure receptors & provides pt with desired direction of movement
- Over target muscle groups & towards the direction of desired movement
- Lumbrical grip to control movement
7
Q
Describe body position
A
- Appropriate preparation
- Dynamic clinician movement to mirror pt’s direction of movement (visual feedback)
- Clinician’s body should be in line with movement
- Resistance should be provided by clinician’s body weight
8
Q
Describe a quick stretch
A
- With muscle already in elongated position it is moved slightly farther into elongation to facilitate stretch reflex could be used to facilitate movement (temporary response)
9
Q
What does stretch facilitate
A
- Facilitates synergistic muscles at the same joint & other associated muscles (temporary effects in improving tone)
10
Q
Describe a long stretch
A
- Decreases muscle activity
- Contraindicated: joint hyper mobility and/or fracture
- Precaution: pain and/or spasticity
11
Q
Describe resistance
A
- Manual, mechanical, or gravitational forces to apply resistance
- Resistance to increase motor unit recruitment for increasing strength & stability during task oriented training
- To load the neuromuscular system appropriately to drive neuroplasticity
12
Q
Describe irradiation
A
- Neuromuscular phenomenon to increase activity in related muscles in response to external resistance
- AKA overflow & reinforcement
- Magnitude of response increases with duration & intensity
- Used to increase activity of agonist muscle groups or to inhibit antagonist muscle groups
13
Q
Examples of irradiation
A
- Resistance to trunk flexion produces overflow into hip flex/ankle DF
- Resistance to trunk extension produces overflow into hip/knee ext
- Resistance to UE ext/ABD produces overflow into trunk flexion
14
Q
Describe joint facilitation
A
- Traction: elongation of body segment used to facilitate motion & decrease pain
- Approximation: compression of body structures to promote weight bearing & muscle co-contraction
15
Q
Describe timing of movement
A
- Distal to proximal for most functional movements
- Trunk & proximal muscles need to attain sufficient control prior to functional movements using distal muscles
