Topic 1 - PNF

Question 1

Lie between skeletal muscle fibres. They provide information (excitatory signals) to the CNS about how far and how fast a muscle is being stretched.

Answer 1

Muscle Spindles

Question 2

When the CNS sends an impulse back to the muscle telling it to contract to prevent overstretching.

Answer 2

Stretch Reflex

Question 3

Located in the musculotendinous junction. They are activated when there is an increase in muscle tension (from over contraction) and send inhibitory signals to the brain.

Answer 3

Golgi Tendon Organ (GTO)

Question 4

At a muscle’s shortest possible length — the muscle generates little active tension because there is excessive overlap of the contraction sites.

Answer 4

Active Insufficiency

Question 5

At a muscle’s longest possible length — the muscle is unable to generate sufficient tension because the contraction sites are too far apart.

Answer 5

Passive Insufficiency

Question 6

When testing rhomboids and middle traps. By externally rotating the GH joint, the rhomboids become __________. This will result in the rhomboids being _________ insufficient compared to middle traps.

Answer 6

Lengthened
Passively

Question 7

A time dependent deformation to viscoelastic properties in response to a constant load.

Answer 7

Creep

Question 8

Inhibition of a muscle either by its own activity, or that of its antagonist due to the activation of the GTO and/or the muscle spindles.

Answer 8

Active Inhibition

Question 9

What are the 2 types of active inhibition?

Answer 9

1) Autogenic Inhibition
2) Reciprocal Inhibition

Question 10

What occurs in the target muscle is contracted voluntarily and then voluntarily relaxes. During the relaxation period there is a decrease in the muscle’s excitability because of inhibitory signals sent from the GTOs in the target muscle. This relaxation is necessary for the tissue to be elongated.

Answer 10

Autogenic Inhibition (aka. Inverse Stretch Reflex, Antimyotatic Reflex)

Question 11

What occurs in the target muscle when the opposing muscle is contracted voluntarily. The effect of this connection is inhibitory and causes relaxation of the target muscle therefore allowing for elongation.

Answer 11

Reciprocal Inhibition

Question 12

An advanced stretching technique used to improve muscle elasticity. Studies have shown it proves to be the most effective for short term gains in ROM.

Answer 12

Proprioceptive Neuromuscular Facilitation (PNF) Stretching (aka. Active/Facilitative Stretching)

Question 13

PNF stretching integrates _________ muscle contractions into stretching with the purpose of:
1) Inhibiting or facilitating muscle activation
2) Ensuring the muscle to be stretched is _______ as much as possible

Answer 13

Voluntary
Relaxed

Question 14

PNF stretching involves theory (current) sensorimotor processing, with ____________ adaptations of the muscle-tendon units and changes in the patient’s tolerance to stretch. This is known as _____.

Answer 14

Viscoelastic
Creep

Question 15

PNF stretching requires “______” innervation and _________ control over agonist and antagonist muscle groups.

Answer 15

“Normal”
Voluntary

Question 16

T/F - PNF stretching techniques are effective for patients with paralysis or spasticity resulting from neuromuscular disease or injury.

Answer 16

False - PNF stretching techniques are NOT AS effective for patients with paralysis or spasticity resulting from neuromuscular disease or injury.

Question 17

T/F - PNF stretching is designed to affect contractile tissue and is less appropriate for non-contractile tissues like fibrotic contractures.

Answer 17

True

Question 18

T/F - Patients do not have to warmup the tissue prior to application of PNF stretching techniques.

Answer 18

False - Patients SHOULD warmup the tissue prior to application of PNF stretching techniques.

Question 19

Indications for PNF stretching include:
- Increase AROM and ______
- Increase strength
- Increase stability
- Improve _____________ control
- Improve controlled ________
- Re-educate muscle firing

Answer 19

PROM
Neuromuscular
Mobility

Question 20

Contraindications for PNF stretching include:
- Hematoma
- Recent ________
- Rheumatoid/inflammatory arthritis
- Joint _____________
- When ____________ are present in order to maintain a specific joint position (for stability, post surgical)

Answer 20

Fracture
Hypermobility
Contractures

Question 21

Fill in the blanks for the Hold-Relax (HR) PNF stretching protocol:
1) Place target muscle in a comfortable but lengthened/stretched position (first barrier); hold for ___ seconds.
2) The patient will perform an _________ contraction of the targeted muscle against at 50% of their maximal strength for __ to ___ seconds followed by relaxing the target muscle.
3) During the relaxation phase, therapist then _________ moves patient into newly gained range and will hold this for 10 seconds.

Answer 21

30 seconds
Isometric
5-10 seconds
Passively

Question 22

T/F - Hold-Relax PNF stretching is considered autogenic.

Answer 22

True

Question 23

Fill in the blanks for the Contract-Relax (CR) PNF stretching protocol:
1) Place target muscle in a comfortable but lengthened/stretched position (first barrier); hold for ___ seconds.
2) The patient will perform an __________ contraction of the targeted muscle against at 50% of their maximal strength for __ to ___ seconds followed by relaxing the target muscle.
3) During the relaxation phase, therapist then _________ moves patient into newly gained range and will hold this for 10 seconds.

Answer 23

30 seconds
Concentric
5-10 seconds
Passively

Question 24

T/F - Contract-Relax PNF stretching is considered reciprocal.

Answer 24

False - Contract-Relax PNF stretching is considered AUTOGENIC.