Agonistic Reversals
Controlled mobility
Skill
proximal dynamic stability. Isotonic concentric contraction performed against resistance followed by alternating concentric and eccentric contractions with resistance.
Alternating Isometrics
Stability
Strength
Isometric contractions on one side of joint to other w/o rest; Emphasizes endurance or strengthening
Contract-Relax
Mobility
Increase ROM; Max contraction of antagonist for 8-10sec at point of limitation
Hold-Relax
Mobility-Increase ROM.
Isometric contraction of all muscle groups at limiting point in the ROM ; to increase ROM in patients w/ pain
Hold-Relax Active Movement
Mobility - initiate movement
Improve initiation of movement to muscles graded 1/5 or less ; Isometric contraction once extremity is passively placed into shortened position . Upon relaxation , extremity immediately moved into lengthened position w/ quick
Joint Distraction
Mobility-Increase ROM
initiate movement.
Proprioceptive component; Increase ROM; Consistent manual traction; can be used with quick stretch to initiate movement
Repeated Contractions
Mobility-Initiate movement
Strength.
Used to initiate movement and sustain a contraction though the ROM; Begins w/ a quick stretch followed by isometric or isotonic contractions.
Rhythmic Initiation
Mobility;
Assist initiating movement when hypertonia exists; Movements must be slow and rhythmical to reduce hypertonia
Rhythmical Rotation
Mobility - Increase ROM
Initiate movement
Passive technique to decrease hypertonia ; Relaxation will increase ROM
Rhythmic Stabilization
Mobility-increase ROM
Stability
Increase ROM & coordinate isometric contractions; a progression from alternating isometrics; stabilize all muscle groups simultaneously around the specific body part
Slow Reversal
Stability
Controlled mobility
Skill
Distal functional movement; Slow & resisted concentric contractions of agonists and antagonists; Improves control of movement and posture
Slow Reversal Hold
Stability
Controlled Mobility
Skill-Distal functional movement
Slow reversal with the addition of an isometric contraction; Performed at the end of each movement to gain stability
Timing for Emphasis
Strengthen the weak component of a motor pattern; Contractions produce overflow to weak muscles
Normal Timing
Skill
Distal functional movement; To improve coordination of all components of a task, performed distal to proximal.
Resisted Progression
Skill
Proximal dynamic stability
Strength
Used to emphasize coordination of proximal components during gait. Resistance applied to area (hips, pelvis, LE, etc) during gait cycle to increase coordination, strength, or endurance
PNF GOALS FOR MOBILITY TECHNIQUES
? ROM
INITIATE MVMT
Techniques to increase ROM
contract-relax,
hold-relax,
joint distraction,
rhythmic rotation,
rhythmic stabilization
Techniques to initiate movement
Hold-relax active movement
joint distraction
repeated contractions,
rhythmic initiation,
rhythmic rotation
Techniques to increase stability
alternating isometrics
rhythmic stabilization
slow reversal
slow reversal hold
Techniques to increase controlled mobility
agonistic reversals
slow reversal
slow reversal hold
PNF GOALS FOR SKILL TECHNIQUES
? DISTAL FUNCTIONAL MVMT
? PROXIMAL FUNCTIONAL MVMT
Techniques to increase distal functional movement
normal timing
slow reversal
slow reversal hold
Techniques to increase proximal dynamic stability
agonistic reversals
resisted progression
Techniques to increase strength
alternating isometrics
repeated contractions
resisted progression
timing for emphasis
PNF History
Introduced in the 1950's
Kabat, Knoww and Voss
, � Developed 1940's
Dr. Herman Kabot
- Polio era
� Maggie Knott 1947; Dorothy Voss 1953
- Collaborated and further went on to expand/ refine
- Authored the first book on PNF techniques in1956
PNF
�Original Goal: Establish gross motor patterns w/in the CNS
�Based on premise that stronger parts of the body are utilized to stimulate and strengthen the weaker parts
�Normal mvmt and posture based on balance b/w control of antogonist and agonist mm grou
PNF Intervention Constructs
Learn diagonal patters of Mvmt
Techniques must have accurate timing, specific commands and correct hand placement
Verbal commands must be short/concise
Repitition of tasks - imp. for motor learning
Resistance given during mvmt pattern is greater if the ob
Key Terms for PNF
...
Chopping
a combination of bilateral upper extremity asymmetrical extensor patterns performed as a closed-chain activity
Developmental sequence
-Mobility (Receiprocal Innervation); POE
-Stability (Co-Innervation); POE + hold head
-Heavy Work (Mobility super-imposed on stability WB); POE + hold head + weight shift
-Skill (Mobility super-imposed on stability NWB)
Mass Movement Patterns
The hip, knee, and ankle move into flexion or extension simultaneously.
Overflow
muscle activation of an involved extremity due to intense action of an uninvolved muscle or group of muscles