Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                
Scribd Logo
Upload

Welcome to Scribd!

  • 117 views

    PNF Techniques

    Uploaded by

    abdul haseeb
    This document provides guidance on physiotherapy techniques for gait training and vital functions like breathing. It discusses: 1) Procedures for gait training including emphasizing trunk control through pelvic approximation and stretch, and using resistance for balance and motion. 2) Techniques for approximation and stretch at the pelvis to facilitate muscle contraction and trunk stability during gait. 3) Using approximation and resistance at the pelvis and shoulders to target specific muscle groups for standing, sitting, and stepping exercises. 4) Guidance on hand placement and types of resistance for walking exercises. 5) Techniques for facilitating breathing through chest expansion exercises in various positions using pressure and resistance.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd

    PNF Techniques

    Uploaded by

    abdul haseeb
    117 views26 pages
    This document provides guidance on physiotherapy techniques for gait training and vital functions like breathing. It discusses: 1) Procedures for gait training including emphasizing trunk control through pelvic approximation and stretch, and using resistance for balance and motion. 2) Techniques for approximation and stretch at the pelvis to facilitate muscle contraction and trunk stability during gait. 3) Using approximation and resistance at the pelvis and shoulders to target specific muscle groups for standing, sitting, and stepping exercises. 4) Guidance on hand placement and types of resistance for walking exercises. 5) Techniques for facilitating breathing through chest expansion exercises in various positions using pressure and resistance.

    Original Title

    Pnf Techniques

    Copyright

    © © All Rights Reserved

    Available Formats

    PPTX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document provides guidance on physiotherapy techniques for gait training and vital functions like breathing. It discusses: 1) Procedures for gait training including emphasizing trunk control through pelvic approximation and stretch, and using resistance for balance and motion. 2) Techniques for approximation and stretch at the pelvis to facilitate muscle contraction and trunk stability during gait. 3) Using approximation and resistance at the pelvis and shoulders to target specific muscle groups for standing, sitting, and stepping exercises. 4) Guidance on hand placement and types of resistance for walking exercises. 5) Techniques for facilitating breathing through chest expansion exercises in various positions using pressure and resistance.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    117 views26 pages

    PNF Techniques

    Uploaded by

    abdul haseeb
    This document provides guidance on physiotherapy techniques for gait training and vital functions like breathing. It discusses: 1) Procedures for gait training including emphasizing trunk control through pelvic approximation and stretch, and using resistance for balance and motion. 2) Techniques for approximation and stretch at the pelvis to facilitate muscle contraction and trunk stability during gait. 3) Using approximation and resistance at the pelvis and shoulders to target specific muscle groups for standing, sitting, and stepping exercises. 4) Guidance on hand placement and types of resistance for walking exercises. 5) Techniques for facilitating breathing through chest expansion exercises in various positions using pressure and resistance.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    You are on page 1of 26

    PNF TECHNIQUES

    DR. SADAF AZIZ (PT)

    D P T, M S P T, C H P E , C K T P, C H C Q M
    THE PROCEDURES OF GAIT TRAINING
    •The primary emphasis in gait training is on the patient’s trunk.
    •Approximation through the pelvis during stance and stretch reflex to the pelvis during swing
    facilitate the muscles of the lower extremities and the trunk
    •Proper placement of the hands allows the therapist to control the position of the patient’s pelvis,
    moving it toward an anterior or posterior tilt as needed.
    •When pelvic motion and stability are facilitated the legs can function more efficiently.
    •Our hands can also be on the shoulder and on the head for stabilizing or facilitating trunk rotation.
    •Resistance to balance and motion is most effective when given in a diagonal direction.
    •The therapist controls the direction of resistance by standing in the chosen diagonal. The
    therapist’s body position also allows the use of body weight for approximation and resistance
    APPROXIMATION AND STRETCH
    •Approximation facilitates contraction of the extensor muscles of the legs and promotes trunk
    stability.
    •Correct timing of approximation during the stance phase is important.
    •The first approximation comes at or just after heel strike to promote weight acceptance.
    •The approximation may be repeated at any time during stance to maintain proper weight-bearing.
    •To approximate, place the heel (carpal ridge) of each hand on the anterior crest of the ilium, above
    the anterior superior iliac spine (ASIS).
    •Your fingers point down and back in the direction of the force.
    • Keep the patient’s pelvis in a slight posterior tilt.
    •The direction of the approximation force should go through the ischial tuberosities towards the
    patient’s heels.
    •Apply the approximation sharply and maintain it while adding resistance.
    The stretch response facilitates contraction of the abdominal muscles and the flexor
    muscles of the swing leg.
    Correct timing of the stretch is when all the weight is off the foot (toe off ).
    To apply the stretch reflex at the pelvis, use the same grip as used for approximation.
    When the patient’s foot is unweighted, stretch the pelvis down and back.
    The direction of the stretch is the same as for the pattern of anterior elevation of the
    pelvis.
    USING APPROXIMATION AND STRETCH REFLEX

    Standing Use approximation to facilitate balance and weight bearing.


    Give resistance immediately to the resulting muscle contractions.
    The direction of the resistance determines which muscles are emphasized:
    Resistance directed diagonally backward facilitates and strengthens the anterior trunk and limb
    muscles.
    Resistance directed diagonally forward facilitates and strengthens the posterior trunk and limb
    muscles.
    Rotational resistance facilitates and strengthens all the trunk and limb muscles with an emphasis
    on their rotational component
    Approximation with resistance through the shoulder girdle places
    more demand on the upper trunk muscles.
    Put your hands on the top of the shoulder girdle to give the
    approximation.
    Be sure that the patient’s spine is properly aligned before giving
    any downward pressure
    STANDING UP AND SITTING DOWN
    Standing up is both a functional activity and a first stage in walking.
    The timed “stand up and go” test is a perfect test to evaluate the patient’s progression
    The person should be able to stand up and sit down on surfaces of different heights.
    The first part of the activity:
    ◦ The head, neck, and trunk move into flexion.
    ◦ The pelvis moves into a relative anterior tilt.
    ◦ The knees begin to extend and move forward over the base of support
    The last part
    ◦ The head, neck, and trunk extend back toward a vertical
    position.
    ◦ The pelvis goes from an anterior to a posterior tilt.
    ◦ The knees continue extending and move backward as the trunk
    comes over the base of support
    To increase the patient’s ability to stand up, place your hands on the patient’s
    iliac crests, rock or stretch the pelvis into a posterior tilt, and resist or assist
    as it moves into an anterior tilt.
    Rhythmic Initiation works well with this activity.
    Three repetitions of the motion are usually enough.
    On the third repetition give the command to stand up.
    Guide the pelvis up and into an anterior tilt as the patient moves toward
    standing.
    Assist the motion if that is needed, but resist when the patient can accomplish
    the act without help.
    As soon as the patient is upright guide the pelvis into the proper amount of
    posterior tilt.
    Approximate through the pelvis to promote weight bearing
    Sitting Down Placing hands to assist:
    Use the same techniques as in standing up to teach patients where to put their hands.
    Sitting down:
    Use resistance at the pelvis or pelvis and shoulders for eccentric control. When the patient is able,
    use Combination of Isotonics by having the patient stop part way down and then stand again.
    STANDING

    Stand in a diagonal in front of the leg that is to take the patient’s weight
    initially.
    Guide the patient to that side and use approximation and stabilizing
    resistance at the pelvis to promote weight-bearing on that leg
    If weight is to be borne equally on both legs stand directly in front of the
    patient.
    Stabilization Combine Approximation and Stabilizing Reversals at
    the pelvis for the lower trunk and legs
    Combine Approximation and Stabilizing Reversals at the shoulders
    for the upper and lower trunk
    Using Combination of Isotonics with small motions or Stabilizing
    Reversals, resist balance in all directions. Work at the head, the
    shoulders, the pelvis, and combination of these.
    REPEATED STEPPING (FORWARD AND BACKWARD) RIGHT LEG

    Stabilize on the back (right) leg.

    Resist the weight shift to the forward (left) leg.

    Stabilize on the forward leg.

    Stretch and resist: when the patient’s weight is on the left leg, stretch the right side of the pelvis down and back. Resist
    the upward and forward motion of the pelvis to facilitate the forward step of the right leg.

    As the patient steps with the right leg, you step back with your left leg. Stabilize on the forward leg.

    Resist the weight shift back to the left leg:


    ◦ Eccentric: maintain the same grip as you push the patient slowly back over the left leg.
    ◦ Concentric: shift your grip to the posterior pelvic crest and resist the patient shifting his or her weight back over the
    left leg.

    Resist a backward step with the right leg:


    ◦ Eccentric: tell the patient to step back slowly while you maintain the same grip and try to push the pelvis and leg
    back rapidly.
    ◦ Concentric: shift your grip to the posterior pelvic crest, then stretch and resist an upward and backward pelvic motion
    to facilitate a backward step with the right leg.
    WALKING

    Standing in Front of the Patient Mirror the patient’s steps.


    As the patient steps forward with the right leg you step back with your left .
    Use the same procedures and techniques as you used for repeated stepping
    Standing Behind the Patient
    Both you and the patient step with the same leg.
    When standing behind, your fingers are on the iliac crest.
    Your hands and forearms form a line that points down through the ischial tuberosities towards the
    patient’s heels.
    Your forearms press against the patients gluteal muscles.
    Standing behind is advantageous when:
    ◦ The patient is much taller than you are:
    ◦ you can use your body weight to pull down and back on the pelvis for approximation, stretch, and resistance.
    ◦ You want to give the patient an unobstructed view forward.
    ◦ The patient is using a walker or other walking aid.
    VITAL FUNCTIONS
    BREATHING

    Direct indications are breathing problems itself.


    Breathing problems can involve both breathing in (inhalation) and breathing out
    (exhalation).
    Treat the sternal, costal, and diaphragmatic areas to improve inspiration.
    Exercise the abdominal muscles to strengthen forced exhalation.
    Indirect indications are for chest mobilization, trunk and shoulder mobility, active
    recuperation after exercise, relief of pain, relaxation and to decrease spasticity.
    All the procedures and techniques are used in this area of care.
    Hand alignment is particularly important to guide the force in line with normal chest motion.
    Use the stretch reflex to facilitate the initiation of inhalation.
    Continue with Repeated Stretch through range (Repeated Contractions) to facilitate an
    increase in inspiratory volume.
    Appropriate resistance strengthens the muscles and guides the chest motion.
    Preventing motion on the stronger or more mobile side (timing for emphasis) will facilitate
    activity on the restricted or weaker side.
    Combination of Isotonics is useful when working on breath control. The patient should do
    breathing exercises in all positions. Emphasize treatment in functional positions.
    Supine
    Place both hands on the sternum and apply oblique downward
    pressure (caudal and dorsal, towards the sacrum)
    Apply pressure on the lower ribs, diagonally in a caudal and medial
    direction, with both hands.
    Place your hands obliquely with the fingers following the line of the
    ribs
    Exercise the upper ribs in the same way, placing your hands on the
    pectoralis major muscles.
    Side Lying
    Use one hand on the sternum, the other on the back to
    stabilize and give counter pressure.
    Ribs: Put your hands on the area of the chest you wish to
    emphasize.
    Give the pressure diagonally in a caudal and medial
    direction to follow the line of the ribs. Point your fingers
    point in the same direction. In side lying the supporting
    surface will resist the motion of the other side of the chest)
    Prone
    Give pressure caudally along the line of the ribs.
    Place your hands on each side of the rib cage over the
    area to be emphasized.
    Your fingers follow the line of the ribs
    Facilitation of the Diaphragm
    You can facilitate the diaphragm directly by pushing upward and laterally with the thumbs
    or fingers from below the rib cage
    Apply stretch and resist the downward motion of the contracting diaphragm.
    The patient’s abdominal muscles must be relaxed for you to reach the diaphragm.
    If this is difficult, flex both hips to get more relaxation in the abdominal muscles and the
    hip flexor muscles.
    To give indirect facilitation for diaphragmatic motion, place your hands over the abdomen
    and ask the patient to inhale while pushing up into the gentle pressure
    Teach your patients to do this facilitation on their own.
    THANK YOU.

    You might also like