what is PNF and the main goal of PNF?
Definition: A motor learning approach used improve motor function and facilitate maximal muscular contraction Goal: Facilitate the patient in achieving a movement or posture.
Proprioception: Knowing body and limb position in space.
Neuromuscular: Neurological and musculoskeletal system interaction. difficulties with posture and movement
Facilitation: Assisting and/or promoting an improved patient movement response.
how do we use PNF?
- assessment and treatment
what is the evidence supporting pnf?
Possible mechanisms: Stretch reflex Muscle properties autogenic inhibition reciprocal inhibition passive properties of the musculoskeletal unit stretch perception
what are the basic principles of PNF?
what are the key concepts of PNF?
Why choose anterior elevation of the scapula? what muscles does it use?
- Stability
- you need to stabilize the scapula in AE to carry out overhead activities - Mobility
- you need mobility in the direction of scapular AE to bring the arm overhead towards Flexion-Adduction-External Rotation - Functional Activities
- you need the combination of mobility and stability to efficiently carry out functional activities
muscles: Scalenes, Sup. fibers of Serratus Anterior, Upper Traps
Why choose posterior depression of the scapula? muscles used?
- Posture
- more efficient posture
- more stable trunk
- contributes to better neck and UE ROM - Stability
- more stable lower trunk
- less stress in lower back when doing certain activities (lifting) - Mobility
- need scapular PD for UE activities requiring Extension-Abduction-Internal Rotation - Function
- you need a combination of mobility and stability to efficiently carry out certain functional activities - Reduction of Tone
- scapular PD may help to decrease UE tone - Ambulation
- scapular AE and PD contribute to good trunk movement and efficient arm swing in gait
musclues used:
- Latissimus Dorsi
- Rhomboids
- Inf. Fibers of Serratus Anterior
what are pelvic patterns of PNF used for?
what muscles are involved with posterior depression of the pelvis?
Transverse abdominus
Internal obliques
Why choose anterior depression of the scapula? muscles involved?
- Stability
- need to stabilize the scapula in AD to reach for an object - Mobility
- need scapular AD mobility to reach in the direction of Extension-Adduction-
Internal Rotation
- Functional Activities
- put on pants, socks, remove brakes, etc.
- Scapular AD can be used indirectly to facilitate abdominals
muscles involved: Pect minor, Pect major
- Mr. Humerus is a 56 yo male who has difficulty performing overhead activities with his R arm.
- Goal: Improve movements with R arm with overhead activities.
- What PNF pattern and specific PNF technique would you use to accomplish this goal? Demonstrate.
- Anteror elevation movement
- Rhythmic initiation
-Mme G lacks some motor control for her trunk and tends to sit with her trunk side-flexed or slumped on the right side. Her right hip is also slightly flexed than the left side. Goal: train better sitting posture using PNF principles and techniques.
- Combined contraction technique (anterior elevation (on contralateral side) or posterior depression (on ipsilateral side))
- Not wrong to do one technique over another but know the differences btw the 2 and be able to explain why you use on
Why choose mass trunk flexion?
Functional Reason:
- teach a patient that can roll with effort, to roll more efficiently
- teach a patient that cannot roll to roll
- preparation to teach a patient to sit up
* combines AD of the scapula with AE of the pelvis
Direction of Elongation
- towards posterior elevation of the scapula
- towards posterior depression of the pelvis
Verbal Command: curl
Lying to sitting
Different components that you may need to assist the patient:
- Push off the bed using the arms
- Bring up the trunk allowing the patient to come up on the elbow and hand
- Elongation of the trunk
(AE of the scapula and PD of the pelvis)
*remember to first always assess their movement first (have them do the movement first)
*remember to do the approximations after each movement (ask what is an approximation)
-rythmic initiation of anterior depression of scapula and then trunk curl movement
??
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- Circumduction of right leg
- Step forward and back with hand on front of hip and front of upper leg
- Approximation = pushing on the hip down and back on asis 45 degrees)
goals of posterior elevation of scapula
associated w flexion, abduction, ext rotation
for overhead activities, wash hair, put on sweater, sports (tennis, v-ball)
lab manual 205
