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PNF application to Stages of Motor Control. Seung-sub Shin IPNFA Certified Therapist KPNFA. Contents. Definition : Motor control Stages of Motor control PNF application Patient ’ s Demo by Video. Motor control. The ability to regulate or direct the mechanisms essential to movement.

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pnf application to stages of motor control

PNF application to Stages of Motor Control

Seung-sub Shin

IPNFA Certified Therapist

KPNFA

contents
Contents
  • Definition : Motor control
  • Stages of Motor control
  • PNF application
    • Patient’s Demo by Video
motor control
Motor control
  • The ability to regulate or direct the mechanisms essential to movement.
  • The individual generates movement to meet the demands of the task being performed within a specific environment.

Task

M

Environment

Individual

Movement

motor control1
Motor control
  • Stability
  • Mobility
  • Manipulation
  • Perception
  • Cognition
  • Action
  • Regulatory
  • Nonregulatory
stages of motor control
Stages of Motor control
  • Initial Mobility
  • Stability
  • Control Mobility
  • Skill
initial mobility
Initial Mobility
  • The ability to initiate active movement through range.
    • Increasing ROM
    • Increasing initiation of active movement
  • The ability to attain a certain body position to accomplish a specific goal
  • The ability to plan or organize the movement
initial mobility1
Initial Mobility
  • The cause of immobility is depend on patients
    • Ex- Elbow jt. restriction
    • Hemi-patient or Fractured patient
  • Initial Mobility may be limited when
    • Tissues stiffness, muscle weakness
    • Sensory problem (mainly deep sensation or pain)
    • Problems with Ability to plan or organize the movement and Cognitive ability
initial mobility2
Initial Mobility
  • Hypertonicity
    • Cognitive relaxation
    • Use of tone-reduction position and activities to facilitate ease of movement.
      • Gravity-assisted movement
      • Trunk rotation or elongation
    • Low effort and resistance
    • Slow stroking, Slow vestibular rocking.
initial mobility3
Initial Mobility
  • Hypotonicity
    • Light resistance
    • Isometric holding to develop muscle spindle-stretch sensitivity
    • Progression from isometric to eccentric to concentric contractions
    • Quick stretching, tapping, Fast vestibular stimulation (fast rolling), loud verbal commend.
stability
Stability
  • The state or quality of being stable
    • (Oxford University Press, 2007)
  • Refers to the ability to maintain a new position against gravity.
  • Muscles co-contraction to stabilize around a joint and ensure maintenance of upright posture against gravity.
stability1
Stability
  • Muscle
    • Sustained isometric contractions shortened range for increasing duration
  • Posture
    • Coordinated isometric contractions in midline or weight-bearing postures
    • Stabilizing reversal
    • Rhythmic stabilization
stability2
Stability
  • Stabilizing reversal
  • Rhythmic stabilization

Agonist

Antagonist

Agonist

Antagonist

stability3
Stability
  • Practical application
    • Isometric contraction in shortening range, progressing to midrange control
    • Joint approximation
    • Weight bearing and holding in antigravity postures
control mobility
Control Mobility
  • Is the ability to move while maintaining a stable upright posture.
  • The combined function of both mobility and stability with smooth reversal of the antagonists
  • Weight shifting in weight-bearing postures
control mobility1
Control Mobility
  • Practical application
    • Smooth movement and antagonistic muscle contraction.
    • Carefully graded assistance using key movement
    • Eccentric control to concentric control
    • Gradually increasing ROM
    • Functional activities : reaching, supine-to-sitting transitions
skill
Skill
  • Is defined as the ability to perform various tasks (environment). distally with stable proximal body parts.
  • Allow attainment of a goal with an economic effort.
  • Automatic stage.
  • ADL
    • More strengthening and endurance needed
skill1
Skill
  • Practical application
    • Dual tasks can be selected to develop control of simultaneous movement (Ex-walking and bouncing ball).
    • A variety of environment (in door or out door).
    • Agility or more difficult task that combine both coordination and upright postural control (balance).
    • Subcortical practice
pnf application
PNF application
  • All of PNF philosophy, procedures and techniques can be used for facilitating the each stage based on the patient’s values and therapist’s treatment goal.

Ex: Rhythmic initiation

          • Initiate motion
          • Learn a motion
          • Change rage of motion
          • Pain
          • Coordination and control
          • Relaxation Etc.
references
References
  • Anne Shumway-cook. Motor control 3rd Lippincott Williams & Wilkins 2007.
  • Adler, D.Becker, M. Buck. The Neck, Vital function. In : PNF in Practice 2nd. Springer, 2000.
  • O'Sullivan SB, Schmitz TJ. Physical rehabilitation laboratory manual focus onfunctional training. FA DAVIS. 1999.
  • Patricia E Sullivan and Prudence D. Markos. Clinical decision making in therapeutic exercise. Appleton & Lange. 1995.