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S3 - Clinical Practice 2 > Week 14- PNF Common Techniques > Flashcards

Week 14- PNF Common Techniques Flashcards

1
Q

What does PNF stand for and what does each term mean?

A
  • Proprioceptive = Having to do with any of the sensory receptors that give information concerning movement and position of the body.
  • Neuromuscular = Involving the nerves and muscles.
  • Facilitation = Making easier.
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2
Q

PNF utilizes what 3 inputs to produce functional improvement in motor output?

A
  • Procripceptive
  • Cutaneous
  • Auditory
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3
Q

PNF combines function based diagonal patterns with techniques to facilitate the neuro motor units to improve muscle ________ and __________.

A

control and function

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4
Q

PNF is utilized across populations to improve what?

A
  • muscle endurance
  • stability
  • control
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5
Q

What is the progression of difficulty with PNFs?

A

-PROM to isometrics to active assisted movement to higher velocity resisted movements

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6
Q

PNF requires skilled application of _______ and ________ cues to achieve desired patterns and facilitate _______ __________.

A
  • tactile and verbal cues

- quality contractions

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7
Q

PNF techniques can be used to develop what?

A
  • Muscular strength
  • Muscular endurance
  • Stability
  • Mobility
  • Neuromuscular control
  • Coordinated movement
  • Foundation for restoration of function
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8
Q

Describe these PNF terms.

  • Overflow (irradiation)
  • Manual contact
  • Therapist position
  • Approximation
  • Traction
A

Overflow (irradiation): Spread of a muscle response from stronger to weaker muscles. Primarily achieved through applying resistance.

Manual contact: stimulates the muscle to reinforce the movement AND guide the direction of the movement.

Therapist position: Needs to be directly in line with the desired motion and should be facing the direction of the desired movement.

Approximation: May facilitate increased stability, may be applied either manually or facilitated by gravity in upright, weight bearing positions.

Traction: Applied manually during PNF patterns to facilitate muscle contraction.

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9
Q

PNF Cueing.

  • _______ cues: both preparatory (to explain what is about to occur and why), as well as energetic, strong and active verbal cues during movement when require strong recruitment
  • Encourage visual __________ by the patient: watching the distal segment, mirrors, etc.
  • _______: encouraging movement of distal segments first, then moving to proximal; rotation occurs throughout the entire movement
  • ___________: facilitates the contraction by recruiting motor units
A
  • Verbal
  • attentiveness
  • Timing
  • Resistance
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10
Q

What are some specific PNF techniques used?

A
  • Diagonals
  • Lift
  • Reverse lift
  • Chop
  • Reverse chop
  • Quick Stretch
  • Rhythmic initiation
  • Alternating isometrics
  • Rhythmic stabilization
  • Dynamic reversals
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11
Q

DIAGONAL PATTERNS

A

DIAGONAL PATTERNS

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12
Q
  • Diagonal patterns are composed of _____-joint, multi-planar, diagonal, and rotational movements of the extremities, trunk, and neck.
  • What are the 2 pairs of diagonal pattern for the UE and LE?
A

-multi-joint

  • D1 Flexion or D1 Extension
  • D2 Flexion or D2 Extension
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13
Q

UE D1 Flexion End Position?

A
  • Shoulder flexion, ADD, ER
  • Forearm supination
  • Wrist radial deviation
  • Fingers flexed
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14
Q

UE D1 Extension End Position?

A

Shoulder extension, ABD, IR

  • Forearm pronation
  • Wrist ulnar deviation
  • Fingers extender
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15
Q

UE D2 Flexion End Position?

A
  • Shoulder flexion, ABD, ER
  • Forearm supination
  • Wrist radial deviation
  • Fingers extended
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16
Q

UE D2 Extension End Position?

A
  • Shoulder extension, ADD, IR
  • Forearm pronation
  • Wrist ulnar deviation
  • Fingers flexed
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17
Q

Diagonals:

  • Patterns are identified by the position of the ________ or ______ when the diagonal pattern has been completed (flexion or extension)
  • Flexion or extension of the shoulder or hip is coupled with abduction or adduction as well as external or internal rotation
  • Motions of body segments ______ to the shoulder or hip also occur simultaneously during each diagonal pattern
A
  • shoulder or hip

- distal

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18
Q

What is a good way to remember UE D1 flexion/extension cues?

A
  • D1 flexion = Reach up for your seatbelt

- D1 extension = Pull seatbelt down and buckle up

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19
Q

What is a good wat to remember UE D2 flexion/extension?

A
  • D2 flexion = Draw the sword

- D2 extension = Replace your sword

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20
Q

LE D1 Flexion End Position?

A
  • Hip flex, ADD, ER
  • Dorsiflexion
  • Inversion
  • Toes extended
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21
Q

LE D1 Extension End Position?

A
  • Hip ext, ABD, IR
  • Plantar flexion
  • Eversion
  • Toes flexed
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22
Q

LE D2 Flexion End Position?

A
  • Hip flex, ABD, IR
  • Dorsiflexion
  • Eversion
  • Toes extended
23
Q

LE D2 Extension End Position?

A
  • Hip ext, ADD, ER
  • Plantar flexion
  • Inversion
  • Toes flexed
24
Q

What is a good way to remember LE D1 flexion/extension cues?

A
  • D1 flexion = pull up and across

- D1 extension = push down and out

25
Q

What is a good way to remember LE D2 flexion/extension cues?

A
  • D2 flexion = get frog legged

- D2 extension = from frog to ballerina

26
Q

LIFT, REVERSE LIFT, CHOP, REVERSE CHOP

A

LIFT, REVERSE LIFT, CHOP, REVERSE CHOP

27
Q

Lift pattern involves one side helping lift the other into ____ flexion.

A

D2

28
Q

Reverse lift pattern involves one side helping lower the other into ______ extension.

A

D2

29
Q

Chop pattern involves one side helping lower the other into ___ extension.

A

D1

30
Q

Reverse chop involves one side helping lift the other into _____ flexion.

A

D1

31
Q

RHYTHMIC INITIATION

A

RHYTHMIC INITIATION

32
Q

Rhythmic initiation is used to promote the ability to initiate a _________ ________.

A

movement pattern

33
Q

Rhythmic initiation is utilized for treatment of dysfunctions which affect _______, __________, ______, or ________ of contraction.

A

initiation, speed, direction, or quality

34
Q

How is difficulty progressed with rhythmic initiation?

A

patient response

35
Q

What are the goals of rhythmic initiation?

A

Allow the patient to become familiar with the sequence of movement and the rate at which movement is to occur.

36
Q

What are the 4 steps in the technique (progression) of rhythmic initiation?

A
  • Step 1- Therapist moves patient passively through pattern.
  • Step 2- Therapist asks patient to perform active assisted movement.
  • Step 3- Active movement.
  • Step 4- Active movement against manual resistance.
37
Q

What are the indications for rhythmic initiation?

A
  • improves coordination
  • may “break up” tone
  • improves motor planning
  • beneficial for people who respond better to tactile than verbal cues
38
Q

ALTERNATING ISOMETRICS

A

ALTERNATING ISOMETRICS

39
Q

Alternating isometrics is a technique to improve isometric strength and stability of the _______ muscles of the trunk or proximal stabilizing muscles of the shoulder girdle and/or core.

A

postural

40
Q

In alternating isometrics, manual resistance is applied in a _________ plane on one sode of a body segment and then on the other.

A

-single

41
Q

With Alternating Isometrics:

  • The patient is instructed to “hold” his or her position as resistance is alternated from one direction to the opposite direction.
  • _____ joint movement should occur.
  • This procedure isometrically strengthens agonists and antagonists, and it can be applied to one extremity, to both extremities simultaneously, or to the trunk.
  • Alternating isometrics can be applied with the extremities in ____ or _____positions.
A
  • No

- WB or NWB

42
Q

RHYTHMIC STABILIZATION

A

RHYTHMIC STABILIZATION

43
Q

Rhythmic stabilization involves isometric contraction “______ ___ _____” and the focus is on eliciting co-contractions for _________.

A
  • from all sides

- stability

44
Q

Rhythmic Stabilization Technique:

  • Progression of alternating isometric
  • ___-___________ of agonist and antagonist performed by placing hands on opposite sides of body and applying simultaneous resistance.
  • No motion is allowed
  • “______” your resistance to allow patient build a strong contraction
  • Shift hand placement opposite to the muscles you were just recruiting
A
  • Co-contraction

- “Build”

45
Q

What are the indications for Rhythmic Stabilization?

A
  • Impaired strength and coordination
  • Can work through limited ROM
  • Appropriate for patients who have issues with postural stability and balance
  • Appropriate for patients with decrease stability at a given joint
  • Can provide therapist information on patient’s ability to reinforce and maintain contractions
46
Q

DYNAMIC REVERSALS

A

DYNAMIC REVERSALS

47
Q

Dynamic (slow) reversals involve _______ -> __________ contractions eliciting bidirectional movement from patient.

A

agonist -> antagonist

48
Q

What are the 2 steps in the technique of dynamic reversals?

A
  • Step 1- Elicit contraction and movement of the muscle you desire to recruit first.
  • Step 2- When patient has almost completed first movement, switch hand placement and ask the patient to move in the opposite direction.
49
Q

What are the indications for dynamic reversals?

A
  • Improve coordination specifically for those patients who demonstrate co contractions
  • Can be modified to work through limited ROM
  • Can improve strength and coordination
  • Improves muscle endurance due to continuous nature
50
Q

What are some other PNF techniques used?

A
  • Fast/quick stretch
  • Repeated contraction/stretch
  • Dynamic (slow) reversal hold
  • Agonist reversals
51
Q

Explain fast/quick stretch?

A
  • Provide a quick stretch of the agonist when changing directions
  • Produces a relatively short-lived contraction of the agonist’s muscle and short-lived inhibition of the antagonist muscle which facilitates a muscle contraction (muscle spindle)
52
Q

Explain repeated contraction/stretch?

A

Move through a pattern pausing and applying a quick stretch, press through more motion, pause, quick stretch, push. Emphasizes strengthening in specific ranges throughout the motion

53
Q

Explain dynamic (slow) reversal hold?

A

Same as dynamic reversals but with an isometric hold at end of the motion prior to changing directions

54
Q

Explain agonist reversals?

A

Reversing the type of contraction you are eliciting from your patient, working concentrically, isometrically, and eccentrically

S3 - Clinical Practice 2 (13 decks)

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