Traditional Approach-PNF Flashcards
What was the original goal of the PNF
to lay down gross motor patterns within CNS
PNF Premise:
stronger parts of body are used to stimulate weaker parts.
Normal movement requires balance of agonist & antagonist.
Proprioceptive
having to do with the sensory receptors that provide information concerning movement and position of body
Neuromuscular=
involving nerves and muscles
Facilitation=
to make it easier
Irradiation=
a CNS excitation, “overflow” phenomenon, purposefully directed toward a goal of treatment. Demand of one body part can cause movement or stability of another body part.
Emphasizes of PNF
Uses normal developmental sequence
- Manual contacts and handling
- Short, concise verbal cues
- “Maximal” resistance through full pattern
- Sensory stimulation, especially proprioceptors
- Diagonal patterns that are functional.
Human motion occurs in spiral and diagonal patterns—functionally.
PNF principals
Normal timing
»_space;Distal to proximal activation
Traction: flexion or movement
Approximation: extension or stabilization
Verbal commands
»_space;“MOVE” use crisp, clear, short cues
»_space;“HOLD”– use long, more drawn out cues
Visual cues
»_space;ask patient to watch their moving limb
Maximal resistance
»_space;Appropriate resistance
Rhythmic Initiation
passive to active assistive to resistive. VERY helpful as patients are learning new patterns or functional skills
MOBILITY
Replication (HRAM)
teaching a movement= place patient in the “end” position where all agonists are shortened. Patient HOLDs while therapist assists all components. Ask patient to relax– move them passively in the opposite direction then actively move to the end position. Repeat whole procedure through progressively increasing ROM.
MOBILITY
Agonist reversal/Combination of Isotonics
Asking the patient to move between 3 different types of isotonic contractions: concentric, maintained (isometric) and eccentric
Concentric: stand up
Maintained: stay standing
Eccentric: sit down slowly
The same could be used for any functional activity, diagonal patterns or components of diagonal patterns.
CONTROLLED MOBILITY/SKILL
Alternating Isometrics (Stabilizing reversal- isotonic)
patient pushes into your hand– you allow only minimal movement “push”
STABILITY
Rhythmic Stabilization (Stabilizing reversal- isometric)
patient holds against your resistance “HOLD”
STABILITY
The new PNF techniques involve:
Rhythmic Rotation
Slow Reversal (Dynamic Reversal)
Slow Reversal Hold
Resisted Progression
Rhythmic Rotation
A passive technique used to decrease hypertonia by slowly rotating an extremity around the longitudinal axis.
Relaxation of the extremity will help to increase range of motion
MOBILITY
Slow Reversal (Dynamic Reversal)
A technique of slow and resisted concentric contractions of agonist and antagonists around a joint without a rest between reversals.
Used to improve the control of movement and posture
move hands on this one
STABILITY
CONTROLLED MOBILITY
SKILL
Slow reversal Hold
Using slow reversal with the addition of an isometric contraction that is performed at the end of each movement in order to gain stability.
STABILITY
CONTROLLED MOBILITY
SKILL
Resisted Progression
A technique used to emphasize coordination of proximal components during gait.
Resistance is applied to an area such as the pelvis, hips , or extremity during the gait cycle in order to enhance coordination, strength or endurance.
SKILL
applying resistance midstance phase w protracted hip for hemi
Stages of Motor Control
Mobility
The ability to initiate a movement through the functional ROM.
Stability
The ability to maintain a position or posture through co-contraction and tonic holding around a joint. (example: unsupported sitting with midline control)
Controlled Mobility
The ability to move within a weight bearing position or rotate around a long axis. (example: prone on elbows or quadriped weight shifting)
Skill
The ability to move an extremity free in space. (example: reaching, stepping)
Techniques: Mobility
KNOW
Those techniques that initiate movement or increase ROM
Contract Relax Hold Relax Rhythmic Rotation Rhythmic Initiation HRAM (replication)
Techniques: stability
KNOW
Stabilizing Reversals
Alternating Isometrics
Rhythmic Stabilization
Slow reversal
Slow reversal hold
Techniques: controlled mobility
KNOW
Agonist Reversals
Slow Reversal
Slow Reversal Hold
Techniques: SKILL
KNOW
Agonist Reversal
Resisted Progression
Slow Reversal
Slow Reversal Hold