Why we need PNE + Flashcards
is PNE alone enough to tx a patient
no, PNE+ is the best choice
what are activities that can be included in PNE+?
- Mobilization and manipulation
- Soft tissue massage
- Muscle and neural mobilization
- Trunk stabilization
- Circuit based aerobic exercise
- Movement exercises
- Pacing of ADLs
- Graded exposure with ADLs
- Trigger point dry needling
- Neck stabilization exercises
- Aquatic exercise program
what are the 4 pillars of PNE+
- sleep hygine
- aerobic exericse
- PNE
- goal setting
How does stress alter hormones?
alters catecholamines cortisol and adrenaline which are mediated by systems: immune sympa, para, endocrine, lingustic, motor
what does prolonged stress do? what metaphor can be used?
prolonged changes in systems such as immune sympa, para, endocrine, lingustic, motor can cause long lasting changes in CP patients
- lion metaphor
what are some sympathetic changes we can see and why?
Sympa response diverts blood to areas of need in a emergency
- this response over time can lead to adrenal fatigue
- may increae nerve sensitivity due to change in ion sensitivity to adreneline
- this can lead to sensitive GI, increase in BP, Vessel wall damage and arthrosclerosis
what are some motor system changes we can see and why?
- blood is diverted to other areas
- may lead to ishemia
- delays in contraction
- pain changes motor control for spine stabilization
- change in balance and coordination 2/2 the effect pn has on proprioception
what are some endocrine system changes we can see and why?
acute responses to threat are similar to adrenaline- shunt blood, mobilize energy and increase vigilance
changes that occur include fatigue, memory lodd, libido, sleep and apetite
what are the clinical guidelines for PNE?
- skilled med delivery
- make the threat smaller
- aerobic ex
- resistance training
- spinal stabilization
- posture education
- relaxation
- nutrition
- sleep hygine
- journaling
- coping skills
what are mantra you can tell pts to say?
- motion is lotion
- hurt does not equal harm
- im sore but im safe
- departure from this is either a patient who does too little or much
what is a good analogy to use for pain threshold
popping popcorn or dating your pain
what is a good pain level for patients to perform exercise?
0-2 is safe
3-5 is acceptable
we need acceptable pain in order to progress
are CP patients weak?
no. inform them true weakness occurs after 70% of muscle loss. They are experiencing deconditioning
how should you prime resistnace ex
- sensitive nerves analogy
- pt may think youre saying pt is weak by giving them resistnace ex
- emphasis on reps not pain
can isometrics be used for hypoanelgesia?
yes
