Principles Of PNF Flashcards
What are ways to provide continuous sensory input?
-manual contacts (assist, resist, block, and/or guide motion)
-verbal guidance (cue, coach or enforce)
-visual feedback
What does PNF stand for?
Proprioceptive neuromuscular facilitation
What are general purposes of PNF?
-to decrease abnormal muscle tone
-to promote optimal, coordinated movement
-to increase strength and endurance
-to stretch tight muscles
What are the muscle groups in the muscular system?
Agonist, antagonist, supports, fixators
Agonist purpose/function
Produce movement
Antagonist purpose/function
Relax to allow movement
Muscle supports purpose/function
Stabilize trunk and proximal extremities
Muscle fixators purpose/function
Hold bones steady
Goal of PNF
Strengthen gross motor patterns instead of specific muscle actions
Purpose of facilitation during PNF
Increase action potential of motor neurons
Purpose of inhibition during PNF
Creates a decrease in excitability of motor neurons (spasticity or tightness of muscles)
Shoulder flexion and extension D1
Flexion, ADD, ER
Extension, ABD, IR
Scapula flexion and extension D1
Flexion: elevation, ABD, upward rotation
Extension: depression, ADD, downward rotation
Elbow flexion and extension D1 and D2
Flex or extension (for both flex/ext)
Forearm flexion and extension D1 and D2
Flexion: supination
Extension: pronation
Wrist flexion and extension D1
Flexion, radial deviation
Extension, ulnar deviation
Hand flexion and extension D1
Flexion, ADD
Extension, ABD
Shoulder flexion and extension D2
Flexion, ABD, ER
Extension ADD, IR
Scapula flexion and extension D2
Flexion: elevation, ABD, upward rotation
Extension: depression, ADD, downward rotation
Wrist flexion and extension D2
Flexion: extension, radial deviation
Extension: flexion, ulnar deviation
Hand flexion and extension D2
Flexion: extension, ABD
Extension: flexion, ADD
Hip flexion and extension D1
Flexion, ADD, ER
Extension, ABD, IR
Knee flexion and extension D1 and D2
Flexion
Extension
Ankle flexion and extension D1
Flexion: DF, INV
Extension: PF, EV
Toes flexion and extension D1 and D2
Flexion: extension
Extension: flexion
Hip flexion and extension D2
Flexion, ABD, IR
Extension, ADD, ER
Ankle flexion and extension D2
Flexion: DF, EV
Extension: PF, INV
What are the 3 PNF stretching/relaxation techniques
Hold-relax (HR)
Contract-relax (CR)
Hold-relax-antagonist-contract
Purpose of PNF stretching techniques
-increase flexibility and ROM
-used for muscular tension/tightness
Purpose of muscular activation PNF techniques
Non-optimal motor control, strength, endurance, coordination
Steps for Hold-Relax (HR)
-move until resistance is felt
-isometric hold for 5-10 sec
-passively move to increase range
-repeat 3-4x or as needed
What type of muscle is primarily involved for Hold-Relax? What type of inhibition?
Agonist, autogenic inhibition
What type of muscle is primarily involved for Contract-Relax ? What type of inhibition?
Antagonist, reciprocal inhibition
Steps for Contract-Relax (CR)
-PT moves body part to limitation
-Resistance applied to activate antagonist for 5-10 sec
-PT moves body part to new range passively
-repeat if or when needed
Steps of Hold-Relax-Antagonist-Contract
-PT moves body part to limitation
-resistance applied to activate agonist, isometric hold for 5-10 sec
-concentric contraction of antagonist
-hold new range for 10-15 sec
-repeat several times
What are the PNF strengthening techniques?
Rhythmic initiation
Repeated contraction
Slow reversal
Slow reversal hold
Rhythmic stabilization
When is Rhythmic Initiation used?
-For pts that are unable to initiate movement and who have limited ROM b/c of increase in tone
-teach movement pattern
What is the order of ROM for Rhythmic Initiation? Muscles focused on?
PROM -> AAROM -> AROM w/o resistance
Agonist movers
Example of Rhythmic Initiation
Scapular patterns flexion/extension
-pt SLying, PT moves scapula between anterior shoulder and inferior angle
-PROM 4-6x, AAROM 4-6x, AROM 4-6x
What is Repeated Contraction used? What type of muscle does it focus on?
-for pts w/ weakness at specific point in pattern or throughout the entire pattern (ROM)
-agonist movers
What occurs during Repeated Contraction?
Repeated, dynamic contractions of agonist concentrically against max resistance until fatigue
What is Slow Reversal used for? What type(s) of muscles are focused on?
-useful in development of AROM and normal reciprocal timing of agonist and antagonist muscles
-reversal of agonists
What occurs during Slow Reversal?
Isotonic contraction on agonist followed by isotonic contraction of antagonist muscle
What occurs during Slow Reversal Hold?
Isotonic contraction of agonist followed by isometric contraction w/ command of “hold” at the end of active range
What is Slow Reversal Hold used for? What type(s) of muscle(s) focused on?
-useful for developing strength at a specific point in AROM
-reversal of agonists
What is Rhythmic Stabilization used for? What type of muscle focused on?
-promote stability through co-contraction of proximal muscle stabilization of trunk, pelvic girdle, or shoulder
-reversal of agonists
