Pnf

Front 1

PNF (proprioceptive neuromuscular facilitation)

Back 1

is an approach to therapeutic exercise that combines functionally based diagonal patterns of movement with techniques of neuromuscular facilitation to evoke motor responses and improve neuromuscular control and function

Kisner & Colby pg. 207

Front 2

PNF techniques can be used to develop what?

Back 2

*Muscular strength and endurance

*Facilitate stability, mobility, neuromuscular control, and coordinated movements

*Lay a foundation for the restoration of function

Kisner & Colby pg. 207

Front 3

Basic Procedures of PNF

Back 3

*Resistance

*Irradiation

*Manual Contact

*Body position and body mechanics

*Verbal commands

*Vision

*Traction and approximation

*Stretch

*Timing

*Patterns

Front 4

Resistance is used to?

Back 4

*Facilitate the muscle contraction

*Increase motor control

*Help pt gain awareness of motion

*Increase strength

Front 5

Types of resistance

Back 5

*Isotonic (concentric, eccentric, stabilizing isotonic)

*Isometric

Front 6

Irradiation

Back 6

is the spread of the response or stimulus

Front 7

Reinforcement is to ___________?

Back 7

Strengthen

Front 8

Maximal resistance may be used to cause?

Back 8

irradiation or overflow from stronger groups of muscles within a pattern to weaker groups within the same pattern

Front 9

Manual Contact

Back 9

Contact is given to aid in direction

*Pressure on a muscle aids in the muscle's ability to contract

*Use a lumbrical grip

Front 10

Body Position and Body Mechanics

Back 10

*The therapist should be in line with the desired motion or force

-Shoulders and pelvis face the direction of motion

*Resistance comes from the body while hands and arms stay relaxed

-This decreases fatigue on the therapist

Front 11

Verbal Commands

Back 11

*Command is divided into three parts:

1. Preparation - readies the patient

2. Action - tells the patient to start

3. Correction - tells the patient to modify something

Front 12

Vision

Back 12

*The feedback from the visual sensory system can promote a more powerful muscle contraction

-This can also bring in the head, neck, and trunk

Front 13

Traction

Back 13

*Facilitate motion

*Aid in elongation

*Resist some part of the pattern

Front 14

Approximation

Back 14

*Promote stabilization

*Facilitate weight-bearing

*Resist some component of motion

Front 15

Stretch

Back 15

*Stretch stimulus for strengthening uses a quick stretch to stimulate the muscle into a contraction

-using the muscle spindle

Front 16

Timing

Back 16

*Timing is the sequencing of motions

-normal timing of most motions is distal to proximal. This is for efficiency and coordination.

-Timing for emphasis involves changing the normal sequencing of motion to emphasis a particular muscle or desired activity.

Front 17

Upper Extremity

Back 17

Front 18

Upper Extremity Diagonal One and Diagonal 2

Back 18

Front 19

Shoulder Patterns

Back 19

Front 20

Scapular Patterns

Back 20

*Anterior Elevation

*Posterior Depression

*Posterior Elevation

*Anterior Depression

Front 21

Anterior Elevation

Back 21

*Levator scapulae, rhomboids, serratus anterior

*Grip - Hands on the anterior aspect of the GH joint

*Command - "shrug your shoulders toward your nose"

Front 22

Posterior Depression

Back 22

*Serratus anterior, rhomboids, latissimus dorsi

*Grip - heels of hands along vertebral border of the scapular, fingers towards acromion

*Command - "Push your shoulder blade down to me"

Front 23

Anterior Depression

Back 23

*Rhomboids, serratus anterior, Pect minor, pect major

*Grip - cupping axilla

*Command - "Pull your shoulder blade down towards your navel"

Front 24

Posterior Elevation

Back 24

*Trapezius, levator scapulae

*Grip - posterior on the upper traps muscle, superior to the spine of scapula

*Command - "Shrug your shoulders up"

Front 25

PNF patterns for the LE

Back 25

Front 26

PNF for LE

D1 Flexion - Flexion, ADDuction, and ER

D1 Extension - Extension, ABDuction, and IR

D2 Flexion - Flexion, ABDuction, and IR

D2 Extension - Extension, ADDuction, an ER

Back 26

Front 27

D1 Flexion

Back 27

*Grip - down at the foot of the bed, medial hand on top of foot with fingers lateral, lateral hand just superior to patella with fingers medial

*Commands - Pull your foot up and in, "Lift your leg up and in"

Front 28

D1 Extension

Back 28

*Grip - fingers on medial border of foot with palm on lateral border of foot, proximal hand is on the posterolateral side of the thigh

*Commands - "Point your toes, push your foot down and kick down and out"

Front 29

D2 Flexion

Back 29

*Grip - grip the dorm of the foot, fingers on lateral border. Proximal border anterior lateral surface of the thigh just proximal to the knee

*Commands - "Lift your leg up and out"

Front 30

D2 Extension

Back 30

*Grip - Hold plantar surface of foot with fingers towards the medial border. Proximal hand underneath the thigh from lateral to medial, hand on posteromedial side

*Commmands - "Push your foot down and kick down and in"

Front 31

Techniques of PNF

Back 31

Front 32

Techniques for strengthening

Back 32

*Rhythmic Initiation

*Combination Isotonic

*Dynamic Reversals

*Alternating Isometrics

*Rhythmic Stabilization

*Repeated (quick) stretch

Front 33

Rhythmic Initiation

Back 33

*Performed through desired ROM

*Teach motion, promote relaxation, aid in motion, normalize speed

*Start with PROM, progress to AAROM, and then have the patient demonstrate AROM

Front 34

Combination Isotonic

Back 34

*This is for strengthening one group of muscles called the agonist

-Concentric, eccentric, and stabilizing contractions

*Goals: active motion control, coordination, increased AROM, strengthen, eccentric control of movement

Front 35

Dynamic Reversals

Back 35

*All concentric contractions

-Changing of hand placement

*Goals: Increase AROM, increase strength, develop coordination, reduce fatigue

Front 36

Alternating Isometrics

Back 36

*Alternating isotonic contractions opposed by enough force to prevent motion

*Goals: increase stability and balance and increase muscle strength

Front 37

Rhythmic Stabilization

Back 37

*Alternating isometric contractions against resistance - no motion, but trying to get a twisting motion

*Goals: increase AROM, increase PROM, increase strength, increase balance, increase joint stability, and decrease pain

Front 38

Repeated (quick) stretch

Back 38

*Stretch reflex elicited from a muscle

*Can be performed at the beginning of the ROM or throughout the ROM wherever you find weakness

*Goals: increase AROM, increase strength, decrease fatigue