PNF

Question 0

purpose of PNF (and some buzz words)

and what we are trying to tap into

Answer 0

increase functional carry over- restore spiral, reciprocal, dynamic diagonal movements

“tapping into pts untapped potential”

Question 1

PNF definitions

Answer 1

system of exercise used to influence proprioceptors to influence motor output

Question 2

irradiation
def
how we use it

Answer 2

def: overflow

we use it by keeping resistance => other MU are recruited

Question 3

successive induction

def

Answer 3

once a contraction starts, the next contraction or reciprocal contraction are easier to recruit

agonist working => antagonist working better

Question 4

reciprocal innervation/ inhibition

def

Answer 4

during contraction, antagonist has to relax

Question 5

4 types of muscle contractions

and describe them

Answer 5

isotonic:
1. concentric = shortening
2. eccentric = lengthening
3. maintained isotonic*= blocked isotonic
tell the pt to keep pushing against resistance and when u remove resistance, a lot of resistance occurs

isometric = stabilizing contraction, no change in length

Question 6

9 basic techniques of PNF

Answer 6

1. body position and body mechanics (of PT and pt)
2. manual contacts
3. appropriate resistance
4. verbal commands
5. stretch
6. traction or approximation
7. vision
8. timing
9. pattern

Question 7

what does appropriate resistance do for us?

Answer 7

helps bring in muscle spindle

Question 8

stretch helps 3 things…

must be accompanied by… to make it effective (2)

taps into…

Answer 8

1. initiate movement
2. redirect movement
3. sustain movement

*must be accompanied by:
verbal command (timing)
followed by resisting the movement we want them to do

taps into monosynaptic myotatic reflex (alpha motorneuron)

Question 9

when do we do traction vs. approximation?

what is their purpose?

Answer 9

traction: usually done during movement, helps increase movement
approximation: done before movement, done for stability

Question 10

2 types of timing

Answer 10

1. normal
2. timing for emphasis => maintained isotonic
   block stronger movement to facilitate weaker components of a movement
   block part of movement and continue other movement. irridation occurs
   can be distal -> prox or prox -> distal

Question 11

how does vision help? (3, at least)

Answer 11

increases movement
increases wt shifting
increases trunk rotation

Question 12

goal of special techniques

Answer 12

smooth and coordinated movement with normal postural control.

aka task specific training with optimal posture

Question 13

rhythmic initiation
movement pattern (3)
purpose (4)

Answer 13

PROM -> AAROM -> appropriate resistance

purpose:

1. evauluate arc of motion, tone and patients ability to complete arc
2. give pt sense of movement
3. relax pt
4. muscle re-education => successive induction

Question 15

isotonic reversals = dynamic reversals
movement pattern
purpose (5)

Answer 15

reciprocal pattern
isotonic contractions thru entire arc with appropriate resistance; can do maintained isotonic or isometric at any point in range
can use quick stretch as needed

purpose:

1. facilitate coordinated, reciprocal movement
2. improve smooth reversal of movement direction
3. facilitate agonist/antagonist pairs
4. prevent/relieve fatigue (increase endurance)
5. increase AROM

Question 16

combination of isotonics
movement pattern
when do i do these?
purpose (2)

Answer 16

use eccentric, concentric and maintained isotonic in 1 direction of given diagonal
*maintained isotonic is used when there is a weakness in arc of movement, allows MU recruitment
* at strong part give resistance
do these at various parts of movement for small arcs

purpose

1. mimic ADL
2. train pt to transition among types of contractions

Question 17

when are maintained isotonics used? why?

Answer 17

weak point in the range, this allows time for full MU recruitment

Question 18

relaxation techniques (4)

Answer 18

1. contract relax
2. hold relax
3. slow reversals
4. rhythmic rotation

Question 19

contract relax
definition
purpose (2)

Answer 19

definition: technique which employs a reciprocal inhibition and GTO inhibition to stretch a limitation w/i a pattern

purpose:
1. lengthen muscle or muscle groups
2. relax spasm

Question 20

contract relax technique (3)

VC (for contraction)

Answer 20

1. ask pt to contract agonist or antagonist against resistance -“push”
2. pt relaxes completely while therapist supports limb
3. AROM/ PROM into new range against resistance

Question 21

hold relax technique
definition
purpose
technique (4) & VC

Answer 21

definition- use of isometric contraction to lengthen a muscle or muscle group in a pattern

purpose- relax muscles

technique:

1. take part to end range in pattern
2. ask pt to isometrically contract agonists or antagonists while therapist resists all movements “hold”
3. pt relaxes completely
4. pt moves into new range against less resistance or passively

Question 22

difference btwn contract relax & hold relax

Answer 22

contract relax = is blocked isotonic, tell pt to “push”

hold relax = isometric, tell pt to hold “hold”

Question 23

slow reversal hold relax

technique (3)

Answer 23

1. maintained isotonic at end range, then isometric at end range in same direction
   (push => hold)
2. relax
3. isotonic with light resistance into new range

Question 24

hold relax active motion
purpose (3)
technique (3)

Answer 24

purpose:
1. strength at end range
2. decrease muscle imbalances
3. improve endurance

technique:

1. isometric at end range
2. therapist passively takes part to start of diagonal
3. pt performs isotonic contraction with appropriate resistance through full diagonal- using the same muscle group as did with isometric

Question 25

3 techniques for reversals of antagonists

Answer 25

1. isotonic reversals (dynamic reversals) 2. stabilizing reversals 3. rhythmic stabilization

Question 26

stabilizing reversals characterizatio purpose (3) indications (4)

Answer 26

characterization: alternating isotonic contractions with appropriate resistance goals: 1. increase stability and balance 2. increase muscle strength 3. increase coordination btwn agonist and antagonist indications: 1. decreased stability 2. weakness 3. patient is unable to contract muscle isometrically and needs resistance in 1 way direction

Question 27

stabilizing reversals | technique (2)

Answer 27

1. therapist gives resistance in stronger direction- blocked isotonic so "push into me" 2. when pt is fully resisting, switch hand and give resistance in another direction

Question 28

rhythmic stabilization characterization goals (4) indications (4)

Answer 28

characterization: resisting isometric contractions (dont let me move u) goals: 1. increase A & PROM 2. increase strength 3. increase stability & balance 4. decrease pain indications: 1. limited ROM 2. weakness in antagonist muscle group 3. decreased balance 4. pain when motion is attempted 5. joint instability

Question 29

rhythmic stabilization | technique (5)

Answer 29

1. resist isometric contraction of agonistic muscle group 2. resistance increased as pt builds matching force 3. when pt is fully responding, therapist moves hand and begins resisting antagonistic motion at distal part 4. new resistance builds up slowly, then therapist goes to new antagonist resistance 5. use traction and approximation as needed

Question 30

repeated stretch techniques (2)

Answer 30

1. repeated stretch from beginning of range | 2. repeated stretch thru range

Question 31

learning sequence definition

Answer 31

set of postures and movements that progressively develop motor skills as the nervous system matures or heals

Question 32

learning sequence purposes (3)

Answer 32

1. increase variety of movement 2. reduce fear and improve learning environment 3. allow integration of basic and advance motor patterns

Question 33

evaluation (4)

Answer 33

1. handling and observation (we constantly evaluate with our hands thru all motions) 2. determine missing components 3. train missing components 4. re-check entire task

Question 34

PNF patterns of scap and pelvis (2)

Answer 34

1. anterior elevation/ posterior depression | 2. posterior elevation/ anterior depression

Question 35

LE PNF patterns named for... and paired with... D1 flexion D1 extension

Answer 35

named for hip components, ``` D1 flexion: flexion, aDduction, ER ankle: DF, invert toes: Ext ab D1 paired with pelvis (1) => anterior elevation of pelvis D1 extension: extension aBduction, IR ```

Question 36

D2 LE PNF patterns named for... and paired with... D2 flexion D2 extension

Answer 36

D2 flexion: flexion aBduction, IR ankle: DF evert toes: ext, aD D2 paired with pelvis (2) => posterior elevation of pelvis D2 extension: extension, aDduction, ER

Question 37

D1 UE PNF patterns named for.... paired with D1 flexion D1 extension

Answer 37

named for GH components, matched with scapula => D1 = anterior elevation D1 flexion= flexion, adduction, ER forearm= supinated wrist = radi dev, flexion fingers = flex, add D1 extension= extension, aBduction, IR

Question 38

D2 UE PNF patterns named for.... paired with D2 flexion D2 extension

Answer 38

named for GH components, matched with scapula => D2 = posteriorelevation D2 flexion= flexion, aBduction, IR forearm= supinated wrist = radi dev, extended fingers = extended, add D2 extension= extension, adduction, ER