Principles of PNF Flashcards
Neuromuscular facilitation
promoting or encouraging normal activity of the neuromuscular system
proprioceptive
pertaining to the proprioceptors or sensory inputs
what does it mean if a muscle is hypertonic?
Hypertonia is an increase in muscle tone. Muscles are stiff and rigid as the muscles are too constricted.
what does it mean if the muscle is hypotonic?
Hypotonia is a decrease in muscle tone. Muscles are limp and floppy as the muscles are too relaxed.
what provides to continuous sensory output? (3)
- manual contact (assist, resist, block, guide)
- verbal guidance (cue, coach, enforce)
- visual feedback
What is the purpose of PNF?
PNF is used to improve strength, neuromuscular control, flexibility, and range of motion. It can also facilitate stability.
When is PNF indicated? (4)
- To increase abnormal muscle tone
- To produce coordinated movement
- To increase strength, endurance, or ROM
- To stretch tight muscles
What are agonist muscles?
agonist muscles produce movement
what are antagonist muscles?
antagonist muscles relax to allow movement
what are support muscles?
Muscles that stabilize the trunk and proximal extremities
what are fixator muscles?
Muscles that hold bones steady
what are static contractions?
contractions of the muscles without a change in muscle length (isometric)
what are dynamic contractions?
Dynamic muscle contractions can be concentric or eccentric. There is a change in muscle length.
what is the goal of PNF? Why?
To strengthen gross motor patterns instead of specific muscle actions. Movement in patterns encourages stronger muscle groups to assist weaker muscles.
What can PNF do for weak muscles?
PNF can facilitate an increase in excitability of motor neurons
what can PNF do for tight or spastic muscles?
PNF can inhibit and create a decrease in excitability of motor neurons
There are 9 principles of PNF application. What is the 1st principle? (3 points)
-The patient is taught a movement pattern from start to end position.
-brief and simple instruction
-passive motion of pt limb through the pattern
There are 9 principles of PNF application. What is the 2nd principle?
-visual feedback for direction and positional control
There are 9 principles of PNF application. What is the 3rd principle? What is are the most common cues?
- Simple and firm verbal cues for coordination.
- push, pull, hold, relax
There are 9 principles of PNF application. What is the 4th principle?
-Hands on contact with appropriate pressure to facilitate a maximal response
There are 9 principles of PNF application. What is the 5th principle?
- The therapist should move with the patient and movement that they want to facilitate
There are 9 principles of PNF application. What is the 6th principle?
- Resistance given by the therapist should facilitate a max response for smooth and coordinated movement.
what is an isotonic contraction?
An isotonic contraction is when the muscle generates force and a velocity (length change) under condition of a constant load
There are 9 principles of PNF application. What is the 7th principle?
Rotational movement is critical in all PNF patterns
There are 9 principles of PNF application. What is the 8th principle?
Appropriate timing. All distal movement of patterns must occur first.
There are 9 principles of PNF application. What is the 9th principle?
A quick stretch given to muscle before muscle contraction can facilitate a muscle to respond with greater force through the stretch reflex mechanism (GTO)
Describe D1 flexion of the upper extremity
-shoulder
- scapula
- elbow
- forearm
-wrist
-hand
- shoulder: FLEX, ADD, ER
-scapula: elevation, abd, upward rotation - elbow: flexion or extension
-forearm: supination
-wrist: flexion and radial deviation - hand: flexion and adduction
Describe D1 extension of the upper extremity
-shoulder
- scapula
- elbow
- forearm
-wrist
-hand
-shoulder: EXT, ABD, IR
-scapula: depression, add, downward rotation
-elbow: flexion or extension
-forearm: pronation
-wrist: extension and ulnar deviation
- hand: extension and abd
Describe D2 flexion of the upper extremity
-shoulder
-scapula
-elbow
-forearm
-wrist
-hand
-Shoulder: Flex, ABD, ER
-Scapula: Elevation, ABD, upward rotation
-Elbow: flex or ext
-Forearm: supination
-Wrist: extension and radial deviation
-Hand: extension and ABD
Describe D2 extension of the upper extremity
-shoulder
-scapula
-elbow
-forearm
-wrist
-hand
-Shoulder: EXT, ADD, IR
-Scapula: Depression, ADD, downward rotation
-Elbow: flex or ext
-Forearm: pronation
-Wrist: flexion and ulnar deviation
-Hand: flexion and ADD
Describe D1 flexion of the lower extremity
-hip
-knee
-ankle
-toes
-hip: FLEX, ADD, ER
-knee: Flexion
-ankle: Dorsiflex and INV
-toes: Extension
Describe D1 extension of the lower extremity
-hip
-knee
-ankle
-toes
-Hip: EXT, ABD, IR
-Knee: Extension
-Ankle: Plantarflex and eversion
-Toes: Flexion
Describe D2 flexion of the lower extremity
-hip
-knee
-ankle
-toes
-hip: FLEX, ABD, IR
-knee: Flex
-ankle: dorsiflex and eversion
-toes: extension
Describe D2 extension of the lower extremity
-hip
-knee
-ankle
-toes
-hip: EXT, ADD, ER
-knee: Ext
-ankle: plantarflex and inv
-toes: flexion
How can you remember D1 flexion and extension of the upper extremity?
D1 flexion: Reach across to brush your hair or grab your seatbelt
D1 extension: Close the car door behind you
How can you remember D2 flexion and extension of the upper extremity?
D2 flexion: waiter holding tray
D2 extension: reach for the sword
How can you remember D1 flexion and extension of the lower extremity?
D1 flexion: hackysack
D1 extension: toe point
how can you remember D2 flexion and extension of the lower extremity?
D2 flexion: Peeing dog
D2 extension: cross your legs to hold your pee
what have studies revealed about PNF stretching techniques?
PNF stretching is effective in increasing flexibility and ROM
when would you want to use muscular activation PNF techniques? (4)
- if a patient has non-optimal motor control
- to increase strength
- to increase endurance
- to improve coordination
when would you want to use PNF relaxation techniques?
for muscular tension and tightness
