Proprioceptive Neuromuscular Facilitation

WHAT IS PNF? PNF - Propriocpetive neuromuscular facilitation is exercise based on the principles of functional human anatomy and neurophysiology.PNF - Propriocpetive neuromuscular facilitation is exercise based on the principles of functional human anatomy and neurophysiology. ProprioceptiveProprioceptive CutaneousCutaneous Auditory imputAuditory imput

FACILITATION Facilitory - an impulse causing the recruitment and discharge of additional motor neurons in the spinal cordFacilitory - an impulse causing the recruitment and discharge of additional motor neurons in the spinal cord Results in increased excitability in the muscles.Results in increased excitability in the muscles. Weak muscles would be aided through facilitationWeak muscles would be aided through facilitation

INHIBITION Inhibitory - any stimulus that causes motor neurons to drop away from the discharge zone and away from the spinal cord.Inhibitory - any stimulus that causes motor neurons to drop away from the discharge zone and away from the spinal cord. Inhibition results in decreased excitability of motor neurons.Inhibition results in decreased excitability of motor neurons. Muscle spasticity can be decreasedMuscle spasticity can be decreased

NEUROPHYSIOLGOICAL BASIS Stretch RelfexStretch Relfex Muscle spindlesMuscle spindles Change in lengthChange in length Rate of change in lengthRate of change in length Golgi tendon organs = tensionGolgi tendon organs = tension

NEUROPHYSIOLGOICAL BASIS Autogenic Inhibiltion - inhibition mediated by afferent fibers from a stretched muscle.Autogenic Inhibiltion - inhibition mediated by afferent fibers from a stretched muscle. Stretching the hamstringsStretching the hamstrings Excitatory and inhibitory informationExcitatory and inhibitory information Stretch is extended, inhibitory impulses take over.Stretch is extended, inhibitory impulses take over. Protective mechanismProtective mechanism

NEUROPHYSIOLGOICAL BASIS Reciprocal InhibitionReciprocal Inhibition Agonist/antagonist muscle patternAgonist/antagonist muscle pattern Biceps and TricepsBiceps and Triceps

RATIONAL FOR USE Techniques used for…Techniques used for… Increasing strengthIncreasing strength FlexibilityFlexibility Range of motionRange of motion Increase coordinationIncrease coordination

PRINCIPELS OF PNF Patient must be taught the patternPatient must be taught the pattern Visual stimulus is need earlyVisual stimulus is need early Use specific verbal cuesUse specific verbal cues “PUSH”, “HOLD” “PULL”, “RELAX”“PUSH”, “HOLD” “PULL”, “RELAX” Appropriate pressure with manual contactAppropriate pressure with manual contact Body positioningBody positioning Resistance should be constantResistance should be constant Rotational movement is criticalRotational movement is critical

PATTERNSPATTERNS SHOULDER D1 Flexion Shoulder FLEX, ADD, ER Forearm - Sup Wrist - Rad. Flexion Fingers - flexion D1 Flexion Shoulder FLEX, ADD, ER Forearm - Sup Wrist - Rad. Flexion Fingers - flexion D2 Flexion Shoulder FLEX, ABD, ER Forearm - Sup Wrist - Rad. Flexion Fingers - Extension D2 Flexion Shoulder FLEX, ABD, ER Forearm - Sup Wrist - Rad. Flexion Fingers - Extension D1 Extension Shoulder EXT, ABD, IR Forearm - Pro Wrist - Ulnar. extension Fingers - Extension D1 Extension Shoulder EXT, ABD, IR Forearm - Pro Wrist - Ulnar. extension Fingers - Extension D2 Extension Shoulder EXT, ADD, IR Forearm - Pro Wrist - Ulnar ext. Fingers - flexion D2 Extension Shoulder EXT, ADD, IR Forearm - Pro Wrist - Ulnar ext. Fingers - flexion

TECHNIQUES StrengtheningStrengthening Rhythmic initiation - initial passive, active assistive, active motion without a quick stretchRhythmic initiation - initial passive, active assistive, active motion without a quick stretch Repeated contraction - weakness at a point or through a range of motionRepeated contraction - weakness at a point or through a range of motion Rhythmic stabilization - Isometric contraction of the agonist followed by isometric contraction of the antagonist, produces stabilityRhythmic stabilization - Isometric contraction of the agonist followed by isometric contraction of the antagonist, produces stability