Proprioceptive Neuromuscular Facilitation

PNF
KABAT
11 PRINCIPLES
1. 1. All human beings have potentials that have not een fully developed.
  1. 2. Normal motor development proceeds in a cervicocaudal and proximodistal direction.
    1. 3. Early motor behavior dominated by reflex activity. Mature motor behavior is supported or reinforced by postural reflexes.
      1. 4. Early motor behavior is characterized by spontaneous movement, which oscillates between extreme flexion and extension.
        5. Developing motor behavior is expressed in an orderly sequence of total patterns of movement and posture.
        6. The growth of motor behavior has cyclic trends.
        7. Normal motor development has an orderly sequence but lacks a step-by-step quality. Overlapping occurs.
        8. Locomotion depends on reciprocal contraction of flexors & extensors and the maintenance of posture requires continual adjustment for nuances of imbalance.
        9. Improvement in motor ability is dependent upon motor learning.
        10. Frequency of stimulation & repetitive activity are used to promote and retain motor learning and to develop strength and endurance.
        11. Goal-directed activities coupled c/ techniques of facilitation - used to hasten learning of total patterns of walking & self-care activities.
PATTERNS
1. Unilateral Patterns
  1. UE D1 FLEXION: hand -to-mouth motion in feeding, combing hair on L side c/ R hand, rolling from supine to prone.
    1. UE D1 EXTENSION: pushing car door open from inside, tennis backhand, rolling from prone to supine.
      1. UE D2: FLEXION: combing hair on R side c/ R hand, back stroke in swimming, lifting racquet in tennis serve.
        UE D2 EXTENSION: pitching a baseball, buttoning pants on L side c/ R hand, hitting ball on tennis serve.
  2. LE D1 FLEXION: kicking a soccer ball, rolling from supine to prone, putting shoe on c/ legs crossed.
    1. LE D1 EXTENSION: putting leg into pants, rolling from prone to supine.
      1. LE D2: FLEXION: karate kick, drawing heel up during breast stroke.
        LE D 2 EXTENSION: push-off in gait, the kick during breast stroke, long sitting c/ legs crossed.
2. BILATERAL PATTERNS
  1. SYMMETRICAL PATTERNS: paired extremities perform similar movements. D1 extension, both hands pushing off a chair.
    1. ASYMMETRICAL PATTERNS: paired extremities perform movements on one side of body, facilitates trunk rotation. Chopping and lifting patterns. L arm D2 flexion & R arm D1 flexion, putting on L earring.
  2. RECIPROCAL PATTERNS: paired extremities move in opposite directions at the same time. D1 extension in one extremity and D2 flexion in the other. Arm swing during walking.
  3. IPSILATERAL PATTERNS: extremities on the same side moving in same direction.
  4. CONTRALATERAL PATTERNS: extremities of opposite sides moving in the same direction at the same time.
  5. DIAGONAL RECIPROCAL PATTERN: contralateral extremities moving in same direction at the same time while opposite contralateral extremities move in opposite direction.
3. ADVANTAGES of using diagonal patterns: Crosses midline, helps to integrate both sides of body. These patterns use groups of muscles, typical of most functional activities.
PNF Procedures
1. Therapists hands should be placed directly on pt's. skin.
  1. STRETCH can be used to initiate voluntary movement and increase speed and strength.
    1. TRACTION facilitates the joint receptors by creating sseparation on jt surfaces.
      1. APPROXIMATION facilitates joint receptors by creating compression on jt surfaces.
        Stronger muscles & patterns reinforce weaker muscles/groups.
2. PNF TECHNIQUES
  1. REPEATED CONTRACTIONS: based on the assumption that REPETITION is needed for motor learning.
    1. RHYTHMICAL INITIATION: used to improve the ability to initiate movement.
      1. RELAXATION TECHNIQUES: contact-relax, used when there is no active ROM in the agonist pattern, against max resistance. Hold-relax, used for pain, isometric contraction.

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Proprioceptive Neuromuscular Facilitation

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	Erstellt von Pam Burns vor mehr als 11 Jahre