PNF Continuing Education

Course Objectives

Upon Successful Completion of this course the participant will be able to:

• Describe the basic principles and philosophy of PNF.
• Recognize common problems in mobility in the CVA population, analyze dysfunctional movement patterns and discuss their implication on functional mobility, as well as prioritize which impairment is having the most significant effect on function.
• Utilize Critical thinking and principles of specificity of exercise to implement specific treatment interventions and to progress patient treatment using manual facilitation and exercise.
• Recognize the transitional movements, break down each movement into its component parts and utilize techniques to incorporate each piece back into the whole activity.
• Utilize techniques that promote stability and mobility in the different phases of movement from supine to standing.
• Identify and perform specific PNF patterns and techniques to address mobility issues to enhance patient performance with hook lying, bed mobility, bridging, scooting, rolling on the side, sitting up on the elbow, sitting up on hand and sit to stand.
• Develop an organized treatment plan based upon-specific assessment findings to promote synchronized control for functional mobility.
• Identify when to combine patterns into mass patterns to promote purposeful movement.
• Discuss the evidence-based research that supports specific PNF techniques and principles to enhance movement with a variety of diagnoses and through the different transitional positions.
• Perform techniques that promote transitional movement and positions
• Recognize when to use stabilizing reversals and other techniques to promote stability within a transitional position.
• Recognize the appropriate timing to begin training for mobility with a transitional position.
• Identify the evidence-based research that specifies the importance of normal timing when transitioning from sit to stand.
• Perform the techniques by utilizing the right amount of resistance and or assistance for the patient at each particular transitional movement.
• Discuss the importance of utilizing specific PNF techniques when progressing a patient through supine progression, being on their side, going up onto one elbow, going up onto one hand, up to sitting, standing and pre-gait activities.
• Develop comprehensive, progressive manual therapy and exercise based programs to obtain desired functional outcomes.

Learn From the Expert - Cathy Finch, PT

Catherine Finch, PT, MOL is a graduate of California State University in Fresno with dual degrees in health science and physical therapy. Her impressive credentials include extensive experience in acute rehabilitation, inpatient rehabilitation, outpatient orthopedics, and 25 years of physical therapy.

More specifically, Ms. Finch has a wealth of knowledge, training and experience in the area of Proprioceptive Neuromuscular Facilitation (PNF).

Review of the PNF Principles and Philosophy

• Application of principles and concepts to multiple diagnoses
• Review of history and philosophy of PNF
• Understand the principles of PNF
• Review of principles: Stretch and verbal cues
• Review of principles: Resistance and irradiation
• Facilitating normal movement patterns
• Learn the power of PNF techniques
• The instructors experience travelling and utilizing PNF

Lab: Facilitating Transitional Movements from Spine to Standing

• Traditional exercises with PNF principles applied
• Bed mobility
  • Lower trunk rotation
  • Hip Abduction/Adduction
  • D1 Flexion/Extension
  • Bridging
  • Scooting
  • Rolling
• Hooklying
• Stability in Hooklying
• Hooklying-Mobility
  • Hip abduction/adduction
  • Bridging
  • Lower trunk rotation

Lab: Overview of Patterns: Mass Flexion and Extension, Advanced Scapular and Pelvic

• Combining patterns into mass patterns
• Upper extremity patterns
• Supine leg patterns for transitional movements D1 Flexion and extension patterns
• facilitating movement through transitional positions-Supine to transition
Transitional Movements-Bridging
• Bridging-mobility
• Bridging and scooting
• Relate the functional activity of scooting

Lab: Rolling Utilizing Mass Patterns

• The development of rolling serves as the foundation for strength and neuromuscular integration
• Rolling with Mass Flexion
• Rolling with Mass Extension

Lab:Upper Extremity Patterns

• D1 flexion and extension pattern and PNF Patterns
• D2 flexion and extension pattern
• Proper utilization of upper extremity patterns

Lab: Supine to Sit Progression

• Relating arm patterns and the positions of the developmental sequence
• Facilitating movement through transitional positions
• Supine to Sit Transition
• Sidelying to Sidesitting
• On Elbow to up on hand
• Analyzing and using the PNF framework

Lab: Sitting Stability and Mobility

• Stabilizing reversals in sitting
• The purpose of treating a patient in the sitting position
• Facilitate pelvic movement
• Rhythmic initiation
• A combination of isotonics

Lab: Functional Activity of Scooting

• The functional activity of scooting
• A dissociation of the pelvis from the upper trunk
• A really great home exercise program
• Cue the anterior elevation
• Using the weight-shift
• Learn to create the stability in this position

Lab: Sit to Stand

• Anticipation of the sit to stand motion
• Sit to stand facilitated using assistance or resistance
• The therapist is dynamic and mirrors the movement
• Facilitation for sit to stand
• The cue at the pelvis
• Missing momentum from sit to stand?

Lab: Standing Stability and Mobility

• Stabilization in standing is one of the first activities assessed prior to gait
• Teach alignment of the trunk and pelvis
• Teach alignment of the trunk and pelvis in the standing position
• Facilitate hip extensors, abdominals and lower extremity musculature
• Use traction and approximation to elicit postural responses
• Facilitate trunk extension and scapular posterior depression
• Teach balance and stability in a static posture
• Facilitate patient standing without being locked in anterior tilt

Treatment Ideas for Difficult Patient Scenarios

• Patient can’t bridge independently which impacts bed mobility and sit to stand transition
• Limited trunk rotation interfering with gait and functional mobility i.e. rolling
• Patient sitting shortened on the right trunk
• Cervical spine patient needs dorsal extension but too painful for direct treatment of spine
• Right TKA patient with limited ability to contract quadriceps on surgical side