Summary of Neurophysiological Principles Flashcards Preview

phty1221-pnf > Summary of Neurophysiological Principles > Flashcards

Flashcards in Summary of Neurophysiological Principles Deck (23)
Loading flashcards...
1

Summary of Neurophysiological Principles

After Discharge
• Temporal Summation
• Spatial Summation
• Irradiation
• Successive Induction
• Reciprocal Innervation (Inhibition)
• Autogenic Inhibition

2

After discharge:

• Any somatosensory stimulation (touch, pressure, proprioception) has a continuation of the stimulus after cessation of stimulation.
• The greater the stimulus, the greater the discharge.

3

Temporal Summation:

• Repeated stimuli (generally weaker)
• Occurring within a short period of time
• Combine to cause excitation
(CONTINOUSLY STABBING SOMEONE AT SAME SPOT)

4

Spatial Summation:

DIFFERENT SPACES/LOCATIONS AT SAME TIME
• Weak stimuli applied to different areas of the body simultaneously.
• Reinforces the facilitatory effect to cause excitation.

5

Irradiation:

• Spreading of the response>overflow from stronger muscle groups to weaker muscle groups.
• Increased strength of the response.
• Increased number of stimuli OR Increased intensity of stimulus.
* HAVE STRONGER MUSCLES HELP WITH RECRUITMENT

6

Successive Induction:

• Strong contraction of the antagonist muscle (muscles opposing the action) causes reciprocal inhibition of the agonist (muscles contributing to the desired direction of movement).
• Once the antagonist relaxes, the inhibition ceases and there is an increased excitation of the agonist.

7

Reciprocal Innervation (Inhibition):

• Contraction of muscles leads to simultaneous relaxation (inhibition) of their antagonists.
Example - Reciprocal inhibition in stretch reflex:
• Joints are controlled by opposing muscle groups (flexors / extensors).
• When a muscle spindle stretches and activates the stretch reflex, the opposing muscle group needs to be inhibited so that it doesn’t work against the contraction of the desired muscle.
• Remember muscle spindles lie within the muscle belly and respond to stretch (changes in muscle length).

8

Autogenic Inhibition:

• Reflex relaxation that will occur in the same muscle that the Golgi tendon organ is stimulated in (this occurs by isometrically contracting a stretched muscle)a - Lowers resistance to stretch therefore can increase ROM.
• Remember, GTO are located in muscle tendons and respond to force / muscle tension.

9

TECHNIQUES

Facilitatory – used to gain muscle activity Example: Mm strength, mm endurance, coordination
Inhibitory – used to reduce muscle activity Example: Increase range, decrease tone

10

PNF TECHNIQUES

• Methods by which the patterns of movement are applied to achieve various responses.
• PNF uses concentric, eccentric and isometric muscle contractions combined with suitable resistance and specific facilitatory techniques.
• Examples:
– Use facilitation to increase strength and / or stability.
– Use inhibition combined with facilitation to increase range.
• Treatment goals can include:
– Increase ROM
– Increase strength
– Develop co-ordination
– Reduce fatigue
– Decrease pain

11

Facilitation

• Utilise facilitatory neurophysiological principles – after discharge, temporal and spatial summation, irradiation, successive induction
• Physiotherapists can utilise facilitation techniques to make movement easier and more accurate for patients.
• The accuracy in movement is imperative in prevention of musculoskeletal injuries, and also vital for efficient functioning.
• Treatment methods / approaches that use facilitation methods include PNF (Kabat, Knott & Voss), Bobaths, Rood, Ayres and Sahrmann.

12

When is facilitation appropriate?

If you are trying to get a muscle contraction when it is difficult for the patient to contract the muscle due to:
– Weakness – Pain
– CNS damage
– Abnormal recruitment patterns

13

Facilitation Specific Techniques

• Rythmic initiations
• Slow reversals
• Slow reversals hold
• Repeated contractions
• Rhythmic stabilisations
(Listed in order of typical progressions)

14

Rhythmic Initiation

• Assists patient to initiate movement (e.g. apraxic patient)
• ALWAYS start with this to ensure the patient understands the movement and is performing correctly.
• Improves co-ordination and sense of motion
• Normalizes the rate of motion
• Teaches the motion
• Can help the patient relax
• Can classify as a ‘strengthening’ exercise in very low level patients

15

Rhythmic Initiation
Application:

• Passively move the limb / part through full available range in the PNF pattern.
• Patient watches / concentrates on feeling the movement.
• Ask the patient to assist your movement (or may ask them to do it themselves if strong enough) to ensure they have understood.
• Progression > Slow reversals.

16

Slow Reversals

• Can be used for improving muscular strength
• Can be used for improving muscular endurance
• Can be used to facilitate normal timing between agonists and antagonists.
• Example = Useinpatientswithmuscleweakness.

17

Slow Reversals Application:

• If you have gone through rhythmic initiation and the patient is tolerating ok,
then you can add resistance to the agonist and antagonist patterns through full available range > this becomes a slow reversal technique
• Start in direction of pattern with weaker muscle groups (isotonic contraction of agonists)
• Smoothly reverse into antagonist pattern (isotonic contraction of antagonists). Repeat.
• MAXIMISE all sensory inputs – voice, touch, visual cues
• Progression > Slow reversal holds

18

Slow Reversals Hold

• Used to increase the motor unit recruitment and strength at a particular point in the motion
• Might add/progress to repeated contraction application to enhance the HOLD
Application:
• An isometric hold is applied at any point in the execution of a diagonal pattern of movement where muscle response is less / weaker.

19

Repeated Contractions

• Enhances recruitment of motor units.
• Used mainly when muscle WEAKNESS is a problem or when initiation of movement is difficult.
Advantages:
• Learning and skill acquisition occurs through repeated stimulus of CNS: o Allows focus to specific muscle / group of muscles.
o Uses repeated stretch of muscle spindle to recruit motor units. o Focus on voluntary contraction response.
• Enables increased strength / endurance in very weak muscles.
• When fatigue of muscle response is evident, you MUST stop and allow recovery.

20

Repeated Contractions
Application:

Move out of the agonist pattern a short amount (+stretch stimulus) à initiate command to move into agonist pattern again
Commands:
• Now PULL (apply stretch and resist flexion)
• Or now PUSH (apply stretch and resist extension)

21

Rhythmic Stabilisations

• Used to gain stability and increase endurance.
Example = In a patient with poor globa land/or local stability.
• Aims to gain isometric contraction of agonists and antagonists to provide joint/s stability.
• Particularly useful if there is PAIN when motion is attempted.
• Prescription guideline: 10 x 10 second holds

22

Rhythmic Stabilisations APPLICATION:

• Get the patient to perform an isometric contraction of the agonist/s.
• Following this, get the patient to perform an isometric contraction of the antagonist/s.
• Do NOT apply too much resistance – contraction is isometric & aims for co- contraction.

23

PNF AIMS

PNF aims to combine the many facilitatory factors such as sight, hearing, touch, pressure and resistance to give a bigger sensory demand and so a bigger motor response is elicited.