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PNF & Joint Mobilization

The document discusses proprioceptive neuromuscular facilitation (PNF) techniques and joint mobilization. It covers PNF patterns and techniques, types of joint movements, and indications and contraindications for treatment. It also provides examples of specific treatment glides for different joints to improve range of motion.

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Harini Karthikeyan
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14 views

PNF & Joint Mobilization

The document discusses proprioceptive neuromuscular facilitation (PNF) techniques and joint mobilization. It covers PNF patterns and techniques, types of joint movements, and indications and contraindications for treatment. It also provides examples of specific treatment glides for different joints to improve range of motion.

Uploaded by

Harini Karthikeyan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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PNF & JOINT MOBILISATION

Dr. V. PAVITHRALOCHANI
MPT( NEURO),MMTFI,MIAP.
FACULTY OF PHYSIOTHERAPY.
SYNOPSIS

• Techniques of PNF
• PNF patterns
• Types of movements (joint mobility)
• Indications, contra-indications & treatment.
• Proprioceptive:Sensory receptors that give
information concerning movement and position
of the body.
• Neuromuscular:Involving the nerve and
muscles.
• Facilitation: Making easier.
• PNF is a concept of treatment. Its underlying
philosophy is that all human being, including
those with disabilities have a untapped existing
potential.
Uses of PNF
• It uses
– Proprioceptive
– Cutaneous
– Auditory input
To produce functional improvement in motor
output and can be a vital element in the
rehabilitation process of sports related injury.
Techniques of PNF

• Repeated
contraction
• Slow reversal
Strengthening
• Rhythmic
& stretching stabilization
techniques • Hold relax
• Rhythmic initiation
1.Repeated contraction
• Patient moves isotonically against maximum
resistance repeatedly until fatigue is evidenced.
• When fatigue is evident then a stretch at that
point in the range should facilitate the weaker
muscles and results in coordinated movements.
USED IN:
• To develop strength & endurance.
2.Slow reversal
• Involves isotonic contraction of the agonist
followed immediately by an isotonic
contraction of the antagonist.

USED IN:
• For development of active ROM
• Normal reciprocal timing b/w agonist &
antagonist.
3. Rhythmic stabilization

• Uses as an isometric contraction of the agonist,


followed by an isometric contraction of the
antagonist.

USED IN:
• To increase strength and endurance.
4.Hold relax

• Begins with isometric contraction of the


antagonist against resistance, followed by
contraction of the agonist muscle.
5.Rhythmic initiation
• Progression from ( agonist pattern)
Passive
Active assisted

Active

USED IN :
• Limited ROM due to increase tone.
• Those who are unable to initiate movement.
PNF PATTERNS
• Each pattern has three dimension-
1. Flexion or extension
2. Abduction or adduction
3. Rotation
• Movement occurs in a straight line, in diagonal
direction with a rotatory component.
UPPER EXTREMITY
LOWER EXTREMITY
TYPES OF MOVEMENTS

• Physiological movement
• Accessory movements
• Physiological movements:
Movements you see (osteokinematics)
• Accessory movements:
Movements you feel (Arthrokinematics)
Arthrokinematics movements

Arthro - Joint, Kinematics – motion


The movement which occur in the joint surface is
called arthrokinematics.
• The arthrokinematic movements are called as
“joint play movements”.
Types of Arthrokinematic
movements
It is of the following types:
• Rolling
• Sliding (gliding)
• Spinning
• Traction
• Compression
ROLLING

• Rolling occurs when the new equidistant point


of moving surface comes into contact with the
new equidistant points on the stable surface.
• It occurs between the flat and curved surface.
Eg: ball rolling on the floor.
• Joint surface is incongruent.
• Rolling results in angular motion.
• It combines with gliding, spinning during
physiological movement.
GLIDING

• Gliding occurs between the surface when the


same point of the moving surface comes into
contact with the new point on the stable
surface.
• Gliding occurs between either the flat or
curved surface.
Eg: Square box moving on an oblique floor.
• Joint surfaces are congruent.
• Direction of gliding depends on whether the
moving surface is convex or concave.
CONVEX- CONCAVE RULE
• More the congruent surface, more the sliding
occurs and more the incongruent surface,
more the rolling occurs.
• While concave surface moves on convex
surface gliding rolling occurs towards the
angular movement.
• While convex surface moves on concave
surface rolling occurs towards the angular
movement and gliding occurs opposite to that.
SPINNING
• Moving surface rotates on stable surface.
• Rotation occurs in stationary mechanical axis.
• Spinning combines with
rolling and gliding and results
in rotatory type
of physiological movements.
Eg: Radio humeral joint
pronation and supination
movements.
TRACTION
• Articular surfaces are drawn or pulled apart
• Normally, distal bony surface is pulled apart at
right angle.
• The joint space
increases during traction.
• It reduces joint friction.
• Enhances joint play
movement.
COMPRESSION
• Articular parts are pushed towards each other.
• Distal articular surface moves towards the
proximal articular surface.
• More common in weight bearing
joints.
• Articular surface will be having more
contact with each other.
• Over compression leads to joint
structure deterioration.
AIMS OF JOINT MOBILISATION
 Restores normal ROM
 Pain gate theory
 Descending inhibition
 Increased local blood flow
 Synovial sweep
INDICATIONS
• Post traumatic stiffness of the joint.
• Post operative stiffness of the joint.
• Post immobilization stiffness of the joint.
• Adhesion formation around the joint.
• Atrophy of the capsule.
• Atrophy of synovial membrane.
• Painful joint.
• Disuse atrophy of the joint structure.
CONTRAINDICATIONS
• Synovial effusion
• Hemarthrosis
• Recent fractures around joints
• Dislocation
• Recent injuries around joints
• Acute RA
• Malignant tumors
• TJR
• Scoliotic spin
• spondylolisthesis
TREATMENT GLIDES
• To improve glenohumeral flexion:
Apply posterior glide.
• To improve GH extension:
Apply anterior glide.
• To improve GH internal rotation:
Apply posterior glide.
• To improve GH external rotation:
Apply anterior glide.
• To improve GH abduction:
Apply inferior glide.
• To improve tibiofemoral flexion:
Apply posterior glide.
• To improve tibiofemoral extension:
Apply anterior glide.
• Patellofemoral glide:
Apply superior glide to improve extension;
inferior glide to improve flexion.
• To improve ankle plantarflexion:
Apply anterior glide (talocrural jt.)
• To improve ankle dorsiflexion:
Apply posterior glide (talocrural jt.)
• To improve inversion:
Apply lateral glide (subtalar jt.)
• To improve eversion:
Apply medial glide (subtalar jt.)
• To improve wrist flexion:
Apply dorsal (posterior) glide
• To improve wrist extension:
Apply volar (anterior) glide.
• To improve radial deviation:
Apply medial glide.
• To improve ulnar glide:
Apply lateral glide.
• To improve elbow flexion:
Apply humeral-ulnar distal glide.
• To improve elbow extension:
Apply humeral-radial posterior glide.
REFERENCE

• M. Dena Gardiner, The principles of exercise therapy,


4th edition.
• Kisner and Colby. Therapeutic exercise: Foundations
and techniques, 4th edition.
• Cynthia C. Norkin, D. Joyce White, 4th edition.
• Lakshmi Narayanan, Textbook of Therapeutic
Exercises.
THANK YOU…!!!

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