NDT, PNF, muscle tone

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  1. Who developed PNF?
    • proprioceptive neuromuscular faciliation
    • Dorothy Voss
    • Herman Kabat
    • Margaret Knott
  2. What are the key concepts of PNF?
    • approximation
    • stretch reflexes
    • resistance
    • traction
    • manual contacts
    • *to faciliate mvmt
  3. What is proprioceptive?
    sensory receptors stimulated by some aspect muscle length, m tension, joint angle, head position, and or touch/temp
  4. What is facilitation?
    increase ease of performance of any action, resulting from the lessening of nerve resistance by continued, successive application of the necessary stimulus
  5. manual contact
    hand placement onĀ  the body/skin provides info about the mvmt you would like to perform

    key points of control- instructions you are giving with hands
  6. body position and body mechanics
    imperative the clinicians mvmt mirrors the pts
  7. stretch-the-stretch reflex
    • utilized to facilitate m activity
    • quick stretch -> strengthen
  8. manual resistance
    internal or external force that alters that alters the difficulty of moving
  9. irridation
    spread of m activity in response to resistance (overflow, carry over, reinforcement)
  10. joint facilitation
    • traction - elongates
    • approximation - compresses

    can use with active mvmts or stabilization
  11. timing of mvmt
    normal mvmt requires smooth sequencing of m activation
  12. patterns of mvmt
    PNF utilizes diagonal patterns of mvmt (mm work together syngergistically)
  13. visual cues
    can help pt control and correct body position and motion
  14. verbal input
    the command should be concise and provide a directional cue
  15. What are some proprioceptive techniques?
    • resistance
    • approximation
    • QS-quick stretch
    • AI-alternating isometrics
    • RS-rhythmic stabilization
    • prolonged stretch
    • vibration
    • inhibitory pressure
  16. resistance
    • manually or mechanically
    • increase feedback from the mm to joint receptors
    • improves kinesthetic awareness and improves strength and stabilization
  17. approximation
    • compression
    • facilitate extensor motor control and stability around the joint
    • facilitates holding responses of postural mm
    • contraindication- acute inflammatory condition
    • low tone pts
  18. QS - quick stretch
    • gentle push or force to a muscle in the lengthened range
    • facilitates m contraction
    • most effective when m is lengthened
  19. AI- alternating isometrics
    isometric contractions are alternated from one side to another without relaxation between contractions
  20. RS- rhytmic stabilization
    • simultaneous isometric contraction of the agonist and antagonist without relaxation between contractions
    • rotation
  21. prolonged stretch
    • produces inhibition or dampens m response
    • manual, mechanical, or through gravity and positioning
    • lengthened range of m is most effective
  22. vibration
    • facilitory or inhibitory
    • mechanical or manual
    • sustained contraction is elicted
  23. inhibitory pressure
    • inhibits m tone
    • firm, moderate pressure is applied to tendon of the m you wish to reduce tension
  24. What are some exteroceptive stimulation techniques?
    • manual contact
    • repetitive brushing
    • prolonged icing
    • maintained touch
    • slow stroking
    • neutral warmth
    • vestibular stimulation (slow, fast, inverted head position)
  25. manual contact
    • facilitate mvmt and direction, alter tone, provide security, support unstable body segment
    • contraindicated in pts with arousal instability
    • location, time, pressure is important
  26. repetitive brushing
    • stimulates tactile receptors to facilitate mvmt
    • battery powered brush is used to stimulate skin surface of m
  27. prolonged icing
    • inhibits postural tone and pain
    • ice chips, iced towels, ice packs, cold baths
    • for high toned pts
  28. maintained touch
    • desensitize hypersensitive areas
    • for pts who overreact to stimulation
    • firm, maintained pressure
    • use the pressure that bothers them
  29. slow stroking
    • produces calming effect
    • slow deep pressure
    • high toned areas
  30. neutral warmth
    • inhibitory technique to reduce postural tone and pain
    • wrap in towels, blanket, snug clothing, tepid bath or shower
  31. vestibular stimulation
    • increase or decrease tone and mvmt of the head, trunk , or extremities
    • can aid in coordinated eye mvmt..may produce nystagmus, nausea, vomiting

    • slow- for decreased tone, produces calming, soothing effect and inhibits postural tone
    • fast- for increased tone, stimuli are irregular, rapid, and of high intensity..use swiss ball
    • inverted head position- either tone, depression of sympathetic responses and arousal of the parasympathetic responses
  32. what are inhibiton techniques
    • slow, repetitive, used when hypertonicity or abnormal development patterns are present
    • decreased tone
  33. musculoskeletal/muscle system inhibition techniques
    • estim
    • placing in reflex-inhibiting positions
    • slow, sustained stretch
    • prolonged application of ice, immersion of limb in ice bath
    • facilitation of antagonists of spastic mm
    • neutral warmth
    • slow stroking
    • gentle shaking or rocking
    • slow rolling
    • pressure on the insertion of the m
  34. auditory inhibition techniques
    • soft tone of voice
    • regular rhythms in speech
    • reduction in environmental sounds
  35. olfactory/gustatory inhibition techniques
    • warm fluids may be inhibitory to hyperactive oral pathology
    • pleasant odors have calming effect
  36. visual inhibition techniques
    • cool colors, monotone color scheme
    • removal of excess visual stimuli from the immediate environment
  37. What does stimulation of the parasympathetic nervous system result in?
    • decreased pulse rate, BP, and general reduction in excitiability
    • slow stroking
    • maintained pressure on palms, soles of feet or over lip
  38. sensory modalities and stimulation techniques - daily routine
    • timing of care giving routines and avoid overstimulating and loss of control
    • space out activities
    • give 15 min recovery periods
    • prep for stressful events
    • avoid interruptions in sleep cycle
    • maintain calm environment
    • establish predictable patterns with sleep and waking events
  39. sensory modalities and stimulation techniques - auditory
    • prefer voice to mechanical sound
    • prefer female to male voice
    • perfer sounds within range of human voice
    • particularly sensitive to rhythmic and continuous speed (singing, heartbeat)
    • avoid slamming doors, loud talking over bed
  40. sensory modalities and stimulation techniques - visual
    • initially sees black and white colors (avoid cluttered crib)
    • prefer contrasting lines and colors
    • prefers complex vs simple shapes
    • prefers human face to anything
    • infant may not appear to have visual capabilites until at state 4 (quiet alert)
    • can use toys visually to stimulate but dont use random toys
    • infants between 32-38 weeks gestation place object 19-22 cm away
    • reduce light by shielding eyes, placing blanket over crib, or dim light
  41. chemoreceptors
    smell, taste, internal stimuli
  42. photoreceptor
    sensitive to light
  43. thermoreceptors
    sensitive to stimulation by heat
  44. mechanoreceptors
    excited by mechanical pressures or distortions (touch, ms contractions)
  45. nociceptors
    for pain caused by injury, physical, or chemical to body tissues
  46. telereceptors
    sensitive to stimuli originating at a distance, such as a nerve ending existing in the ear, nose, or eye
  47. How is sensory info transmitted, and what are 2 two pathways?
    • from the spinal cord to the brain
    • posterior columns
    • spinothalamic tracts
  48. posterior columns are responsible for what?
    • fine touch
    • stereognosis (perceiving and understanding the form and nature of objects by touch - close eyes, grab object, and feel/tell what it is)
    • weight discrimination
    • proprioception
    • vibration sense
  49. spinothalamic tract
    • lateral - pain and temp
    • ventral - crude touch/pressure
Card Set:
NDT, PNF, muscle tone
2012-09-19 01:58:37

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