| Term | Definition |
|---|
| Proprioceptive Neuromuscular Facilitation (PNF) | Original goal of treatment was to lay down gross motor patterns within the CNS. Based on the premise that stronger parts of the body are utilized to stimulate and strengthen the weaker parts. Normal movement and posture is based on a balance between control of antagonist and agonist muscle groups. Moveme t patterns follow diagonals or spirals that each possess a flexion, extension, and rotatory component and are directed toward or away from the midline. |
| Chopping | A combination of bilateral upper extremity asymmetrical extensor patterns performed as a closed chain activity. |
| Developmental sequence | A progression of motor skill acquisition. The stages of motor control include mobility, stability, controlled mobility, and skill. |
| 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. |
| UE D1 Flexion Pattern | SCAPULA - elevation, adduction, upward rotation; SHOULDER - flexion adduction, lateral rotation; ELBOW - flexion; RADIOULNAR - supination; WRIST - flexion, radial deviation; THUMB - adduction |
| UE D1 Extension Pattern | SCAPULA - depression, adduction, downward rotation; SHOULDER - extension, abduction, medial rotation; ELBOW - extension; RADIOULNAR - pronation; WRIST - extenstion, ulnar deviation; THUMB - abduction |
| UE D2 Flexion Pattern | SCAPULA - elevation, adduction, upward rotation; SHOULDER - flexion, abduction, lateral rotation; ELBOW - flexion; WRIST - extension, radial deviation; THUMB - extension |
| UE D2 Extension Pattern | SCAPULA - depression, abduction, downward rotation; SHOULDER - extension adduction, medial rotation; ELBOW - extension; RADIOULNAR - pronation; WRIST - extension; THUMB - opposition |
| LE D1 Flexion Pattern | PELVIS - protraction; HIP - flexion, adduction, lateral rotation; KNEE - flexion; ANKLE & TOES - dorsiflexion, inversion |
| LE D1 Extension Pattern | PELVIS - retraction; HIP - extension, abduction, medial rotation; KNEE - extension; ANKLES & TOES - plantar flexion, eversion |
| LE D2 Flexion Pattern | PELVIS - elevation; HIP - flexion, abduction, medial rotation; KNEE - flexion; ANKLES & TOES - dorsiflexion, eversion |
| LE D2 Extension Pattern | PELVIS - depression; HIP - extension, adduction, lateral rotation; KNEE - extension; ANKLE & TOES - plantar flexion, inversion |
| Intervention | A patient learns diagonal patterns of movement. Techniques must have accurate timing, specific commands, and correct hand placement. Verbal commands must be short and concise. Repetition is important in motor learning. Resistance given during the movement pattern is greater if the objective is stability, less if the objective is mobility. |
| Intervention (2) | Techniques utilize isometric and isotonic muscle contractions. Treatment objectives will dictate the use of techniques though either rull movement or at points within the range. Developmental sequence is used in conjunction with PNF techniques in order to increase the balance between agonists and antagonsits |
| Intervention (3) | PNF techniques are implemented to progress a patient through the stages of motor control. Functional patterns of movement are used to increase control. Techniques should be utilized that increase strength or improve relaxation by enhancing irradiation from the stronger to the weaker muscles. |
| Mobility | The ability to initiate movement through a functional ROM |
| Stability | The ability to maintain a position or posture through cocontraction and tonic holding around a joint. Unsupported sitting with midline control is an example of stability. |
| Controlled Mobility | The ability to move within a weight bearing position or rotate around a long axis. Activities in prone on elbows or weight shifting in quadruped are examples of controlled mobility. |
| Skill | The ability to consistently perform functional tasks and manipulate the environment with normal postural reflex mechanisms and balance reactions. Skill activities include ADLs and community locomotion. |
| Agnostic Reversals (AR) | Controlled mobility, skill: An isotonic cocnetric contraction performed against resistance followed by alternating concentric and eccentric contractions with resistance. Requires use in a slow and sequential manner, and may be used in increments throughout the range to attain maximum control. |
| Alternating Isometrics (AI) | Stability: Isometric contractions are performed alternating from muscles on one side of the joint to the other side without rest. Emphasizes endurance and strengthening. |
| Contract-Relax (CR) | Mobility: A technique used to increase ROM. As the extremity reaches the point of limitation the patient performs a maximal contraction of the antagonistic muscle group. The therapist resists movement for eight to ten seconds with relaxation to follow. The technique is repeated until further gains in ROM are noted during the session. |
| Hold-Relax (HR) | Mobility: An isometric contraction used to increase ROM. The contraction is facilitated for all muscle groups at the limiting point in the ROM. Relaxation occurs and the extremity moves through the newly acquired range to the next point of limitation until nor further increases in ROM occur. The technique is often used for patients that present with pain. |
| Hold-Relax Active Movement (HRAM) | Mobility: A technique to improve initiation of movement to muscle groups tested at 1/5 or less. An isometric contraction is performed once the extremity i passively placed into a shortened range within the pattern. Overflow and facilitation may be used to assist with the contraction. Upon relaxation the extremity is immediately moved into a lengthened position of the pattern with a quick stretch. The patient is asked to return the extremity to shortened position through an isotonic contraction. |
| Joint Distraction | Mobility: A proprioceptive component used to increase ROM around a joint. Consistent manual traction is provided slowly and usually in combination with mobilization techniques. It can also be used in combination with quick stretch to initiate movement. |
| Normal Timing (NT) | Skill: A technique used to improve coordination of all components of a task. Performed in a distal to proximal sequence. Proximal components are restricted until the distal components are activated and initiate movement. Prepetition of the pattern produces a coordinated movement of all components. |
| Repeated Contractions (RC) | Mobility: Technique used to initiate movement and sustane a contraction through the ROM. Repeated contractions is used to initiate a movement pattern, throughout a weak movement pattern or at a point provides a quick stretch followed by isometric or isotonic contractions. |
| Resisted Progression (RP) | Skill: A technique used to emphasize coordination of proximal components during gait. Resistance is applied to an area such as the pelvis, hips, or extremity druing the gait cycle in order to enhance coordination, strength or endurance. |
| Rhythmic Initiation (RI) | Mobility: A technique used to assist initiating movement when hypertonia exists. Movement progresses from passive, to active, to slightly resistive. Movements must be slow and rhythmical to reduce the hypertonia and allow for full ROM. |
| Rhythmical Rotation (RR) | Mobility: A passive technique used to decrease hyeprtonia by slowly rotating an extremity around the longitudinal axis. Relaxation of the extremity will increase ROM. |
| Rhythmic Stabilization (RS) | Mobility, Stability: A technique used to increase ROM and coordinate isometric contractions. The technique requires isometric contraction of all muscles around a joint against progressive resistance. The patient should relax and move into the newly acquired range and repeat the technique. If stability is the goal, RS should be aplied as a progression from AI in order to simultaneously stabilize all muscle groups around the specific body part. |
| Slow Reversal (SR) | Stability, Controlled Mobility, Skill: A technique of slow and resisted concentric contraction of agonist and antagonists around a joint without rest between reversals. This technique is used to improve control and movement and posture. |
| Slow Reversal Hold (SRH) | Stability, Controlled Mobility, Skill: Using slow reversal with the additin of an isometric contraction that is performed at the end of each movement in order to gain stability. |
| Timing for Emphasis (TE) | Skill: Used to strengthen the weak component of a motor pattern. Isotonic and isometric contraction produce overflow to weak muscles. |
| Kabat, Knott, and Voss Theory of Neurogical Rehabilitation (PNF) | Page 81-85 |
Combine with other sets
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