Neuro

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Author:
jessiekate22
ID:
170956
Filename:
Neuro
Updated:
2012-09-15 06:44:52
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PNF
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VIVA
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  1. What is proprioceptive?
    • - having to do with any of the sensory receptors that give information on movement and position of the body
    • - golgi tendon
    • - joint
    • - mm
    • - senses- vision, touch, hear, smell 
  2. Neuromuscular
    involves that nerves
  3. What is the facilitaiton component of PNF? 
    - you assisting making the movement easier
  4. What is the aim of PNF?
    - promote functional movement through facilitation, inhibition, strengthening and relaxation of mm groups
  5. What is the philosophy of PNF?
    • - positive approach- set up for success, achievable tasks
    • - highest functional level: functional approach
    • - mobilise potential by intensive training: active participation, motor learning, self training
    • - consider the total human being work in envt
    • - use of motor control and motor learning principles: variability of ractivce/ repetition
    • - no pain thru movement
  6. What are the characteristics of PNF?
    • - facilitation of spiral and diagonal movement patterns
    • - movements performed may be passive, active- assisted, or active depending on pt
    • - isotonic and isometric movements can be used
    • - sensroy stimulu is used: stretch, traction and approximation (push jts together), maunal contacts, and appropriate verbal commands
    • - resistance- overflow/ irridation from strong to weak mm
    • - developmental sequence important- cephalocaudal and proximodistal
    • - goal directed activites used to hasten learning of functional patterns
  7. What are the essential components of manual contacts of PNF?
    • - use pressure as a faciliating mechanism
    • - demonstrated by positioning of hands in holds use during patterns (and changes between reciprocal patterns)- lumbrical grip
    • - mirror pts direction of movement for effective facilitation
    • - in linewith the movementwhere possible
    • - move
  8. What are the essential components of PNF?
    • Stretch
    • - a mm responds with greater force after stretch
    • - must be placed in lengthened position
    • - stretch reflex can be elicited by repeated stretch through range (can be used to initiate movement in pt who is weak or paralysed)
    • - quick stretch increases motor ability- better mm activity
    • - prolonged stretch decreases motor activity >15 sec
  9. When is quick facilitory stretch contraindicated?
    • - jt hypermobility
    • - #
    • - P
    • - spacsticity
  10. What manual resistance should be part of PNF?
    • - movement performed against resistance of sufficient degree to demand maximal effort from pt (match the pts effort with your resistance) = strength
    • - defined as greatest amount of resistance that can be applied to isotonic contraction and still allow full range of movement to occur if working on mobility
    • - greatest amount of resistance for isometric hod to still allow hold to be sustained which is working on stability
    • - maximal resistancec can be dangerous
    • - watch for abnormal patterns UMNL 
  11. What is irradiation?
    • - think of kate sitting up the front
    • - resistance- overflow/ irradiation from strong to weak mm
    • - increase mm activity in agonist or inhibit in antagonists
    • egs
    • - resistance to trunk flexion produces overflow- hip flexors and DF
    • - resistance to trunk ext produces over flow- hip and knee ext
    • - resistance to UL ext and adduction overflow - trunk flex
  12. What are the two types of jt facilitation?
    • - traction
    • - approximation
  13. what is traction?
    • - separating jt surfaces
    • - directe toward jt receptors
    • - used were motion is one of pulling eg flexion
    • - facilitate motion and decrease pain
  14. What is approximation?
    • - info thru jt receptors
    • - directed towards jt reeptors
    • - used where motion is one of pushin eg ext
    • may be used to gain postural holding response esp in mat work
    • - promotes stability and weight bearing
  15. What should the timing of the movement be?
    • - speed should be function of the movement and pt
    • - sufficient trunk and prox jts control must be attained to be able to move successfully with distal jts
  16. What are the patterns of movements for PNF?
    • - diagonal patterns (mm groups work together, mimics function)
    • - functional patterns - pt performs functional movements using facilitory or inhibitory techniques
  17. Visual cues of PNF?
    • - pt watcheslimb movement
    • - corrects body position and alignment
  18. Verbal input of PNF?
    • - clear concise commands
    • - focus on movement directions
    • - volme and intonation important
    • - pt needs to be involved
    • - volume of voice needs to be considered
  19. Applications of PNF
    • - hands on body in direction of movement
    • - therapist body aligned wuth movement
    • - arm or leg elogated and given a quick stretch
    • - concise command at start of movement
    • - resistance graded for desired response
    • - normal timing reinforced during movement
  20. What is the PNF checklist?
    • - pt and therapist position
    • - therpist body mechanics
    • - manual contacts
    • - desired movement
    • - stretch
    • - verbal commands
    • - resistance
  21. What is the biomechnical checklist?
    • - BOS
    • - COG
    • - number of weight bearing jts
    • - length of the lever arm
  22. What are the diagonal movement patterns?
    • - D1 and D2
    • - patterns are named for proximal direction
    • - diagonals flex or ext
    • - middle joints may be flexed or extended
    • - straight arm/ leg patterns impact proximally
    • - when middle jts are flexed you get more emphasis distally
  23. What are the cooperative function of mm?
    • - the spiral and diagonal patterns of facilitation provide for an optimal contraction of the major mm components
    • - they allow mm to contract from completely lengthened state
    • - each mm contributes three components of action as far as its location and structure will allow
    • - one pattern works the agoinst and antagonist
  24. what are the types of mm contractions?
    • - isotonic: active, voluntary shortening of the mm
    • - isometic: static hold against equal resistance
    • - eccentric: active voluntary lengthening of mm
  25. Appropraite commands for PNF?
    • - preparatory commands must be clear and concise
    • - tone of voice may influence quality of response
    • - instruction of action need to short, accurate and timed- push, pull, hold, relax, let go
  26. What tone should you use when you want a maximal effort?
    - strong, shrap commands
  27. What tone do you use when you want your pt to do best efort?
    - moderate tone
  28. What tone do you use whenyou want to reassure ur pt?
    - soft voice
  29. WHat is the PNF belief of development?
    • - development is cephalocaudal and proximodistal
    • - use of positioning related to primitive reflexes to facilitate movement patterns
  30. ensure
    • - goals are directed 
    • - strengthening goals
    • - functional goals important
  31. Technique of PNF
    - passive active light resistance- need to ensure the right communication
  32. Hold- relax active movement does?
    • - facilitates agonists
    • - - stretches/ relaxes/ inhibits antagonists
  33. What is the contract relax technique?
    • - similar to hold relax but with rot
    • - rot is good for parkinsons disease
  34. Multidirectional resistance
    • - usually rotationary
    • - for pt with decrease strength, coordination
  35. What is the slow reversal
    • - concentric contractions of alternating mm groups
    • - can vary as slow reversal holds (hold at end of range each direction), agonist reversal (works 1 mm group concentric, then eccentric)
  36. All patterns of PNF can be applied?
    • - diagonal patterns
    • - functional movements
  37. What are the disadvantages of PNF?
    • - outdated theory- 1930s
    • insufficient use of time
    • - can teach pt to be helpless
  38. What are the PNF techniques for the lower limb?
    • - D1 and D2 flexion
    • - D1 and D2 extension
    • - pelvic patterns
  39. Perform a PNF LL D1 flexion?
    • - leg
    • - pt supine
    • - hip ext, abduction, internal rotation, knee extension, ankle PF, eversion
    • - hands 
    • - end in flexion, adduction, ext rot, knee flexion, ankle PF, inversion
    • - eg to cross one leg over the other in sitting to eg take off shoe
  40. Perform a PNF LL D1 extension?
    • - start in hip flexion/ adduction/ external rotation, knee flexion, ankle DF, eversion 
    • - have pt on a diagonal and face out
    • - push your foot down and out
    • - end in hip ext/ abduction/ internal rot, knee extension and ankle plantar flexion and eversion
    • eg stance phase of gait and coming up to stand from a seat
  41. Perform a PNF LL D2 flexion
    • - dog coking its leg
    • - start in hip ext/ adduction and ext rot, knee ext and PF/ inversion
    • - pullyour foot up and lift your leg out to the side
    • - end in hip flex/ abduction and internal rot, knee flexion, DF and inversion
  42. Perform a PNF for lower extremity D2 extension?
    • - hip flexion/ abduction and internal rotation, knee in flexion and DF, eversion
    • - stepdown into my hand
    • - end in hip ext/adduction and ext rot, knee ext, PF and inversion
    • - eg soccer kicking in standing
    • - can put opp leg on a stool
  43. Perform PNF anterior elevation of the pelvis
    • - arch of movement- rock over elvis
    • - lumbical grip over asis
    • - pull back for stretch
    • - pt- pull up
  44. Perform a PNF of the pelvis with posterior depression
    • - hand on ischial tuberosity- rock
    • - use body
    • - push up 
    • - pt pull back
  45. SEE PAGE 86 in manual
  46. What grip?
    Lumbical grip
  47. What do you use for jt proprioception?
    - traction and proximation
  48. Perform upper extremity D1flexion
    • - start- shoulder ext/ slight abd/ medial rot, scap in anterior elevation, elbow ext, forearm pronation, wrist flex and ulnar deviation
    • - tell pt to squeeze my hand, turn your hand and pull acros your body
    • - end position- shoulder flex/ add/ lateral rot, scapposterior depression, forearm supination, wrist and fingers flexed and radial deviation
    • eg- reaching up to bring a scarf off the op shoulder.
  49. Perform a D1 extension of the UL?
    • - start with shoulder flexion/ adduction/ lateral rot, scap posterior depression, elbow ext, forearm, wrist and finger flexed ad radial deviation
    • - have ur hand over the back
    • - tell pt to turn your hand down, push down and out to the side
    • - end with shoulder ext/ slight abduction/ medial rotation, scapular anterior elevation, elbow ext, forearm pronantion, fingers extended and radial deviation
    • - eg feeding movement
  50. Perform a PNF on the upper extremity D2 flexion
    • start- shoulder ext/ add/ medial rot/ scap ant depression, elbow ext, forearm supination and wrist flex, ulnar deviation
    • - open ur hand, lift your thumb up and out and move arm up
    • end- shoulder flexion/ add/ lateral rot/scap posterior elevation, forearm promation, wrist ext, radial deviation and finger ext
    • - like throwing a bouquet over same shoulder
  51. Perform a PNF upper extremmity D2 extension?
    • - start- shoulder flex/abd/ext rot, scap posterior elevation, elbow ext, forearm pronation, wrist ext/ radial deviation and finger ext
    • - squeeze my hand, turn your thumb down and forward to ur opp hip
    • - end- shoulder ext/add/ med rot, scap ant depression, forearm supination, wrist flex/ ulnar deviation and finger flex
    • - eg placing a sword into a sheath
  52. Perform a PNF scapula D1 flexion
    • - anterior elevation
    • - pt sidelying- hips, knee 70-90 degrees
    • - head in neutral
    • - lumbricals grip- hands on each other
    • - stand behind pt
    • - get pt to pull up to ear
    • - you resist
    • - eg shrug ur shoulder towards your ear
  53. Perform posterior depression aka D1 extenion of the scap
    • - pt sidelying
    • - hand on scappush up angle of scap 
    • - pt push down against u
    • - think of putting your inferior angle of the right scap into the left hippocket
  54. Perform D2 flexion of the scap- posterior depression
    • - along the line of humerus
    • - pt sidelying
    • - stand in line with diagonal
    • - hands on top of acromion
    • - pt push up
    • - lift fingers off- so palm just touched 
  55. Perform D2 extension ant depression of scap
    • - sidlying- hand around shoulders so on either side of axilla
    • - when pull down- you go up and over
    • - ensure you move your entire body
    • - good to use to assist getting up off bed

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