PNF Techniques Descriptions

Question 1

List the 12 PNF techniques

Answer 1

1. Rhythmic Initiation
2. Rhythmic Rotation
3. Hold Relax Active Movement
4. Hold Relax
5. Contract Relax
6. Alternating Isometrics
7. Rhytmic Stabilization
8. Slow Reversal
9. Slow Reversal Hold
10. Agonistic Reversal
11. Resisted Progression
12. Repeated Contractions

Question 2

Alternating Isometrics

Description: (5)

Application: (2)

Answer 2

Description

1. Intermediate step to Rythmic Stabilization
2. The pt resists and ISOMETRIC contraction of one pattern
3. Immediately followed with resistance to ISOMETRIC contraction of antagonist pattern
4. Resistance is built up within each shift and over entire sequence
5. (can have a break between, each resistance)

Application

1. use for balancing tone
   
   • when used for this purpose one side of joint is emphasized
2. often used in trunk stabilzation

Question 3

Hold Relax Active Movement

Description: (7)

Basis: (3)

Application: (2)

Answer 3

Description:

1. ISOMETRIC contraction of the agnonist (muscle facillitating the desired movement) in shortetned range of a pattern against graded resistance.
2. The HOLD is built up
3. The pt is given RELAX command.
4. When PT feels pt relax, the PT quickly moves pt to lengthened range of pattern.
5. Applying a quick stretch,
6. the PT gives appropriate command to have pt ACTIVELY return to shortened range of the pattern.
7. The PT may assist, track, or resist during active phase.

Basis:

1. the hold in short range increases muscle spindle sensitivity so that during the quick stretch in the lengthened range the muscle spindle discharge is maximized.
2. Commands are given in appropriate manner to facilitate arousal via RAS.
3. Resistance during active phase stimulates isotonics.

Application: (2)

1. pt with weakness and/or
2. unable to initate movement from lengthened range

Question 4

Rhythmic Stabilization

Description: (4)

Basis: (2)

Application: (2)

Answer 4

Description:

1. simultaneous co-contraction (ISOMETRIC) of antagonistic patterns
   
   • (resist flexion of elbow at wrist at same time resist extension of shoulder at extensor surface near elbow, then change)
2. by alternating the antagonistic patterns resisted by each hand.
3. The resistance is gradually built up within each shift and over the entire sequence.
4. (do not give pt break between each resistance)

Basis:

1. co-contraction effects both sides of the joint
2. Maintained resistance facilitates stabilization

Application:

1. when pt has limited ROM due to splinting or pain
2. Appropriate to develop tability of head, neck and trunk

Question 5

Agonistic Reversal

Description: (4)

Basis: (1)

Application: (2)

Answer 5

Description:

1. a rhyghmical reversal from shortening to lengthening contractions of a muscle/group.
2. Start out slow.
3. CONCENTRIC TO ISOMETRIC TO
4. ECCENTRIC TO ISOMETRIC contractions

Basis:

1. rhythmical slow movement is used to promote functional stability in a smooth manner

Application:

1. use when weakness prevents the pt from controlling his body through the full range of a lengthening contraction
2. use when spacticity interferes with teh pt’s ability to perform lengthening contractions

Question 6

Contract Relax

Description: (5)

Basis: (3)

Application: (2)

Answer 6

Description:

1. The techinique is done at the point of limitation in range
2. If possible the pt actively moves to that point
3. The PT resists the range limiting pattern (resist the movemenent that is opposite the desired movement) such that an ISOTONIC contraction for the rotary component and an ISOMETRIC contraction of the other componets are acheived.
4. When the pt has moved through the full range of the rotary motion, the command to RELAX is given
5. When relaxation ahas occurred, the pt moves to new range, or is passivly moved by PT

Basis:

1. GTO inhibit range limited pattern
2. when pt actively moves to range limited pattern npoint, the range limiting pattern is reciprocally inhibited.
3. Rotarly movements apear to unlock or relax

Application:

1. when motion does not increase pain
2. when involved joint has large rotary component and

Question 7

Rhytmic Initiation

Description: (3)

Basis: (3)

Application: (3)

Answer 7

Description:

1. movement is first passive,
2. then progress to active assisted,
3. then to active motion through increments of range

Basis:

1. slow rhytmical motion acts to inhibit arousal (RAS) and achieve relaxation
2. movement is through the available range, avoiding a protective response from pt
3. movement is slow and maintaned, avoiding quick stretches

Application:

1. pts who are unable to initiate movement due to increased tone
2. pts with limited ROM due to increased tone
3. use to teach an activity

Question 8

Rhythmic Rotation:

Description: (3)

Basis: (2)

Application: (2)

Answer 8

Description:

1. the pt is relaxed.
2. The PT slowly and passively moves the part through range
3. while slowly rotating and derotating the part on its axis.

Basis:

1. slow and rhytmical motion acts to inhibit (RAS)
2. Rotary movments seem to “unlock” and relax muscles

Application:

1. for pt whose spacticity increases markedly with active movement
2. pts with spacticity and no active movement

Question 9

Slow Reversal Hold

Description: (6)

Basis: (1)

Application: (3)

Answer 9

Description:

1. the pt ISOTONICALLY contracts the agnoist,
2. followed by an ISOMETRIC contraction of the agonist
3. the pt changes direction (REVERSAL) by repeating saem sequence of contraction of the antagonist
4. The pattern does not relax before shifting to opposing pattern
5. SRH DEC - through decrement of range
   
   • the PT gradually DECREASES the amount of ROM that the pt movemes through
6. SRH INC - through increment of range
   
   • the PT gradually INCREASES the amount of ROM that the pt moves through

Basis:

1. aids in the transition from mobility to stability

Application: (3)

1. SRH: to develop endurance and strength within a pattern of movement (basically the same as repeated contraction)
2. SRH DEC: when a pt cannot stabilize (ataxic),
   
   1. builds up the ability to stabilize
3. SRH INC: when a pt does not have control through the full range of an activity
   
   1. builds u pability to move through full range with control

Question 10

Resisted Progression

Description: (1)

Basis: (1)

Application: (3)

Answer 10

Description: (4)

1. RESISTED ISOTONIC movement in a pattern of locomotion (gait)

Basis:

1. resistance results in overflow

Application:

1. use to develop endurance,
2. use to promote motor learning of an activity
3. use to develop strength

creeping, crawling, walking, tall kneeling

Question 11

Slow Reversal

Description: (3)

Basis: (2)

Application: (3)

Answer 11

Description:

1. an isotonic contraction of one pattern FOLLOWED by an isotonic contraction of the antagonist pattern.
2. The movements are slow and rhythmical
3. Resistance may be used, but is usually minimal (this is what differentiates from RI)

Basis: (2)

1. the slow rhythmical movements inhibit arousal via RAS
2. resistance stimulates activation

Application: (2)

1. when pt has weakness limiting ability to initiate movement
2. when increased tone limites initiation of movement or motion through range
3. to teach an activity

This is for a higher functioning pt than rhythmic initiation.

Question 12

Repeated Contractions

Description: (6)

Basis: (1)

Application: (1)

Answer 12

Description: (1)

1. the pt ISOTONICALLY contracts the weak pattern
2. an ISOMETRIC contraction (of the muscle facillitating the desired motion) is asked for at the point the pattern deteriorates
3. The ISOMETRIC contraction is built up
4. a quick stretch is applied to the whole pattern (stretches the muscle facillitating the desired motion) as the pt is asked to move (into the desired position) again.
5. At the end of the range, and ISOMETRIC contraction is performed (like before)
6. The sequence is repeated

Basis:

1. muscle spindle facilitation and overflow

Application:

1. use when pt has weankess of whole pattern

(this is like davies multiple angle isometrics). Pt has weakness for part of range, as opposed to ataxia (where Slow Reversal Hold would be more appropriate)

Question 13

Hold Relax

Description: (7)

Basis: (2)

Application: (2)

Answer 13

Description:

1. This technique is performed at the point of limited range
2. The pt may actively (ore passively) move to the point of limitation.
3. The PT resists ISOMETRIC contraction (for the muscle to be stretched) for the range limiteing pattern.
4. The reisistance is built up to pt tolerance (maximal) and
5. then maintained (no joint motion is allowed).
6. The command to RELAX is given.
7. When relaxation is felt, the pt is asked to actively move into the desired motion.

Basis:

1. GTO firing will inhibit the range limiting pattern
2. Having pt actively move into desired pattern will result in reciprocal inhibition of the range limiting pattern.

Application:

1. When pt has pain on movement
2. used when involved joint does not have a large rotary component

Question 14

What PNF technique?

• pt has pain on movement
• invovled joint does not have a large rotary component

Answer 14

Hold Relax

Question 15

What PNF technique if

• pt wo are unable to initiate movement due to increased tone
• you want to teach an activity
• pt has limited ROM due to increased tone

Answer 15

Rhythmic Initiation

(Different from Slow Reversal because no weakness was listed in reasons!)

Question 16

What PNF technique?

• use when pt has weakness of whole pattern

Answer 16

Repeated Contractions

Question 17

What PNF technique?

• want to balance tone by emphasizing one side of joint
• want to stabilize trunk

(pt is low functioning)

Answer 17

Alternating Isometrics

Question 18

What PNF technique?

• to teach an activity
• when pt has weakness limiting ability to initiate movement
• when increased tone limits initiation of movement or motion through range

Answer 18

Slow Reversal

(different from Rhythmic Initiation because weakness is limiting ability to initiate movement)

Question 19

What PNF technique?

pt with weakness and/or unable to initiate movement from lengthened range

Answer 19

Hold Relax Active Movement

Question 20

What PNF technique?

• pt has limited ROM due to spliniting or pain
• appropriate to develop stability of head, neck, and trunk

Answer 20

Rhythmic Stabilization

Question 21

What PNF technique?

• involved joint has large rotary component
• motion does not increase pain

Answer 21

Contract Relax

Question 22

What PNF technique?

• To develop endurance and strength within a pattern of movement
• when a pt cannot stabilize (ataxic)
• when a pt does not have control through the full range of an activity

Answer 22

Slow Reversal Hold:

• To develop endurance and strength within a pattern of movement

Slow Reversal Hold - DECrement

• when a pt cannot stabilize (ataxic), builds up the ability to stabilize

Slow Reversal Hold - INCrement

• when a pt does not have control through the full range of an activity, builds up ability to move through full range with control

Question 23

What PNF technique?

• pt whose spacticity increases markedly with active movement
• pts with spacticity and no active movement

Answer 23

Rhytmic Rotation

Question 24

What PNF technique?

• when weakness prevents pt from controlling his body through the full range of a lengthening contraction
• when spacticity interferes with pt’s ability to perform lengthening contrations

Answer 24

Agonistic Reversal

Question 25

What PNF technique? * use to develop endurance * use to promote motor learning of an activity * use to develop strength

Answer 25

Resisted Progression (particularly related to gait and pre-gait activities)