Principles Of PNF Flashcards
Neuromuscular
Pertaining to nerves & muscles
Facilitation
Promotion or hastening of any natural process
Neuromuscular Facilitation
Promoting or encouraging normal activity of the neuromuscular systems
Proprioceptive
Pertaining to the proprioceptors/ sensory inputs
Form of therapeutic exercise
- Movement with a purpose
- Focus upon optimal afferent (sensory) input
Ex: tactile, verbal & visual cues are all important in this technique - Promotes optimal neuromuscular activity
Continuous Sensory Input
Provided by:
- Manual contact to assist, resist, block and/or guide motion
- verbal guidance to cue, coach, enforce
- visual feedback
Proprioceptive Neuromuscular Facilitation
- Originators of PNF are Dr. Kabat, Maggie Knott & Dorothy Voss
- technique initially used with polio patients who had neurological weakness
- now used in the rehabilitation of numerous injuries & conditions
- utilized to improve strength, neuromuscular control, increase flexibility, ROM & facilitate stability
PNF Theory
- The muscular system is comprised of muscle groups classified as:
1) Agonist : produce movement
2) Antagonist: relax to allow movement
3) Supporters: stabilize the trunk & proximal extremities
4) Fixators: hold bones steady
The muscle groups in Specific movement patterns must contract in a certain order or sequence
- contractions are static or dynamic
Indicators for PNF
1) To decrease abnormal muscle tone
2) To promote optimal, coordinated movement
3) To increase strength & endurance
4) To stretch tight muscles
PNF
Goal = strengthen the gross motor patterns instead of specific muscle actions
- movement in patterns encourages muscle groups to assist weaker muscles
Facilitation = creates an increase in excitability of motor neurons
EX: weak muscles
Inhibition= creates a decrease in excitability of motor neurons
EX: spasticity or tightness of muscles
Historical Principles of PNF
1) Developmental Activities are useful as a basis for treatment of patients of all ages
- Subconscious movement or motor programs (rolling, walking, balance)
- Use of functional activities as ther ex. Is beneficial after complex or simple injury
2) Sensory- reflex mechanisms underlying normal movement recognized as potent forces influencing movement & posture
- Sensory stimulation has a powerful impact on promoting optimal movement patterns
3) Co-ordinated, Alternating movements between Antagonistic muscle groups are essential in normal function
- normal movement needs a balance of strength & co-ordination
- dynamic & static reversing contractions should be incorporated
4) Utilize Known principles of motor learning in Ther Ex.
- Length tension —> mid-range optimal for force generation
- Neuro-irradiation - activating weak muscles using surrounding strong ones; overflow of electrical impulses of surrounding muscles
- Successive induction: contraction of agonist group to encourage antagonist muscle to contract
- Reciprocal Inhibition: Agonsit turns on & antagonist turns off
- Heirarchy of Motor Learning goals: #1 Mobility #2 Stability #3 Skill
5) Normal Functional Movement does NOT occur in isolated planar motions, but in combined diagonal activities
- incorporate combined joint & body movements in diagonal patterns
Principles of PNF Application
- Patient is taught the movement pattern from start position to end position. Instructions are brief & simple. Therapist can begin by passively moving the patient’s limb through the pattern.
- Patient benefits from looking at the moving limb. Visual input offers feedback for direction & positional control.
- Use verbal cues for coordination. SIMPLE & FIRM. Most common cues “push, pull, hold relax”
- Hands on contact w/ appropriate pressure assists with direction of motion & facilitating a maximal response.
- Therapists mechanics & body position should be in line with the direction of movement in the diagonal pattern. Therapists knees should be bent
PNF application con’t
- Resistance given by therapist should facilitate maximal response allowing for smooth & coordinated movement.
- Rotational movement is a critical component in all PNF directions
- Appropriate timing: distal movements of patterns occur first
- A quick stretch given to muscle before muscle contraction can facilitate a muscle to respond with greater force
Hold Relax
Autogenic Inhibition
Isometric hold of the agonist the restricted/ tight muscle (5-10secs) — passively move into new range
Contract Relax
Affected body part moved until resistance is felt (Reciprocal Inhibition)
- activating the antagonist of the restricted muscle needing to be stretched
Hold - Relax -Antagonist - Contract
Begins activating Agonist (hold 5-10secs) followed by Antagonist concentric contraction in new range (5-10 secs)
PNF stretching
1) Hold relax
2) Contract relax
3) Hold - relax- Antagonist -contract
PNF Strengthening
1) Rhythmic Initiation: #1 Passive movement #2 Active assistive #3 Active movement
2) Repeated contraction - repeated dynamic contraction of AGONIST concentrically
*used for patients who have a weakness at specifics point in a pattern
3) Slow Reversal - Isotonic contraction of the agonist muscle followed immediately by an isotonic contraction of the antagonist muscle
*useful to develop Active ROM & normal reciprocal timing of agonist & antagonist
4) Slow Reversal Hold- Isotonic contraction of the agonist followed by an immediate isometric contraction
*useful for developing strength at specific point in AROM
5) Rythmic Stabilization - co contraction of proximal muscles
*useful to promote stabilization of trunk, pelvic girdle or shoulder
