EXSC 508 EXAM 1 QUESTIONS AND
ANSWERS 100% CORRECT
Define Neuromuscular - ANSWER-Pertaining to the nerves and muscles
Define Facilitation - ANSWER-the promotion or hastening of any natural process (helps
promote the normal process of healing)
Define Neuromuscular Facilitation - ANSWER-Promoting or encouraging normal activity
of the neuromuscular system
Define Proprioceptive - ANSWER-Pertaining to the proprioceptors/sensory inputs
What does therapeutic exercise do/promote? - ANSWER-Movement with a purpose
Focus upon optimal afferent (sensory) input
- tactile, verbal, and visual cues are all important in this technique
Promotes optimal neuromuscular activity
What is continuous sensory input? - ANSWER-*Manual contacts* to assist, resist, block,
and/or guide motion
*Verbal guidance* to cue, coach, and enforce
*Visual feedback*; instruct patient to look at the body part you are addressing
Handling skills are very important in this technique
What is proprioceptive neuromuscular feedback (PNF)? - ANSWER-Originators of PNF
are Dr. Kabat, Maggie Knott, and Dorothy Voss
Techniques initially used with polio patients who had neurological muscle weakness
Now used in the rehabilitation of numerous injuries and conditions
Utilized to improve strength, neuromuscular control (movement dysfunctions), increase
flexibility, ROM, and facilitate stability
What are the general indicators for PNF? (4) - ANSWER-1. To decrease abnormal
muscle tone
2. To promote optimal, coordinated movement
3. To increase strength and endurance
4. To stretch tight muscles
What is the agonist muscle? - ANSWER-The muscle that produces the movement
What is the antagonist muscle? - ANSWER-The muscle that relaxes to allow for
movement
,What are the support muscles? - ANSWER-Muscles that stabilize the trunk and
proximal extremities
What are the fixator muscles? - ANSWER-The muscles that hold bones steady
What is the goal of PNF? - ANSWER-To strengthen gross motor patterns instead of
specific muscle actions
- movement in patterns encourages stronger muscle groups to assist weaker muscles
Does facilitation create an increase or decrease in excitability of motor neurons? -
ANSWER-It creates an INCREASE in excitability of motor neurons
Does inhibition create an increase or decrease in excitability of motor neurons? -
ANSWER-it creates a DECREASE in excitability of motor neurons
What is the first principle of PNF? - ANSWER-*Developmental activities are useful as a
basis for treatment of patients of all ages*
- Subconscious movement or motor programs (rolling, walking, balance) are based
upon earlier reflexes which were consciously developed and then integrated into normal
movement
- Use of such functional activities as therapeutic exercise is beneficial after complex or
simple injury
-- examples: hemiparesis following TBI; weakness and instability following ankle sprain
What is the second principle of PNF? - ANSWER-*The sensory-reflex mechanisms
underlying normal movement are recognized as potent forces influencing movement
and posture*
- sensory stimulation has a powerful impact on promoting optimal movement patterns,
and should be incorporated into therapeutic exercise activities (Example: protective
withdrawal)
- avenues of sensory facilitation used by the therapist
-- *hand contact* for guiding and cueing, tapping, and/or providing continuously
changing resistance
-- *use of voice* to instruct and encourage
-- *encourage patient to use eyes* to focus and further refine movement
What is the third principle of PNF? - ANSWER-*Co-ordinated, alternating movements
between antagonistic muscle groups are essential in normal function*
- normal movement requires a balance of strength as well as co-ordination between
muscle groups (consider the infant - a bundle of spontaneous, uncontrolled movement.
Voluntary motion is intact and strong, but co-ordination between agonist and antagonist
is absent)
, - dynamic and static reversing contractions should be incorporated into optimal
therapeutic exercise
What is the fourth principle of PNF? - ANSWER-*Utilize known principles of motor
learning in therapeutic exercise (from the work of Sherrington)*
- length tension
- neuro-irradiation (overflow) [get carry over from the stronger side to assist the weaker
side]
- successive induction [pattern of muscle recruitment; example: low back pain caused
by abnormal muscle recruitment in the core, NOT core weakness]
- reciprocal inhibition [contraction of the agonist inhibits the antagonist to fully lengthen
and the agonist to maximally contract]
- hierarchy of motor learning goals: mobility, stability, skill
What is the fifth principle of PNF? - ANSWER-*Normal functional movement does not
occur in isolated planar motions, but in combined diagonal activities*
- incorporate combined joint and body movements in diagonal patterns into optimal in
therapeutic exercise
What are the 9 principles of PNF application? - ANSWER-*1. *pt. is taught the
movement pattern from start position to end position. Instructions are brief and simple.
Therapist can begin by passively moving the patient's limb through the pattern
*2. *pt. benefits from looking at the moving limb. Visual input offers feedback for
direction and positional control
*3. * use verbal cues for coordination. Cues are simple and firm. Most common cues
"push," "pull," "hold," and "relax"
*4. * hands on contact with appropriate pressure assists with direction of motion and
facilitating a maximal response
*5. * Therapist mechanics and body position should be in line with the direction of
movement in the diagonal pattern. Therapist knees should be bent.
*6. * Resistance given by therapist should facilitate a maximal response allowing for
smooth and coordinated movement. The resistance might change through out the ROM
and might vary based on patient's ability. Maximal resistance might be used during
isometric contractions or isotonic contraction throughout a full ROM. (goes along with
the length tension relationship)
*7. * rotational movement is a critical component in all PNF patterns
*8. * Appropriate timing: distal movements of the patterns occur first
*9. * a quick stretch given to the muscle before muscle contraction can facilitate a
muscle to respond with greater force through the stretch reflex mechanism
PNF stretching: Hold-relax - ANSWER-Affected body part moved until resistance
(gentle stretch) is felt
Isometric hold for 5-10 seconds, PT provides resistance
*Autogenic inhibition* (trying to fatigue the muscle you are trying to stretch [agonist])
ANSWERS 100% CORRECT
Define Neuromuscular - ANSWER-Pertaining to the nerves and muscles
Define Facilitation - ANSWER-the promotion or hastening of any natural process (helps
promote the normal process of healing)
Define Neuromuscular Facilitation - ANSWER-Promoting or encouraging normal activity
of the neuromuscular system
Define Proprioceptive - ANSWER-Pertaining to the proprioceptors/sensory inputs
What does therapeutic exercise do/promote? - ANSWER-Movement with a purpose
Focus upon optimal afferent (sensory) input
- tactile, verbal, and visual cues are all important in this technique
Promotes optimal neuromuscular activity
What is continuous sensory input? - ANSWER-*Manual contacts* to assist, resist, block,
and/or guide motion
*Verbal guidance* to cue, coach, and enforce
*Visual feedback*; instruct patient to look at the body part you are addressing
Handling skills are very important in this technique
What is proprioceptive neuromuscular feedback (PNF)? - ANSWER-Originators of PNF
are Dr. Kabat, Maggie Knott, and Dorothy Voss
Techniques initially used with polio patients who had neurological muscle weakness
Now used in the rehabilitation of numerous injuries and conditions
Utilized to improve strength, neuromuscular control (movement dysfunctions), increase
flexibility, ROM, and facilitate stability
What are the general indicators for PNF? (4) - ANSWER-1. To decrease abnormal
muscle tone
2. To promote optimal, coordinated movement
3. To increase strength and endurance
4. To stretch tight muscles
What is the agonist muscle? - ANSWER-The muscle that produces the movement
What is the antagonist muscle? - ANSWER-The muscle that relaxes to allow for
movement
,What are the support muscles? - ANSWER-Muscles that stabilize the trunk and
proximal extremities
What are the fixator muscles? - ANSWER-The muscles that hold bones steady
What is the goal of PNF? - ANSWER-To strengthen gross motor patterns instead of
specific muscle actions
- movement in patterns encourages stronger muscle groups to assist weaker muscles
Does facilitation create an increase or decrease in excitability of motor neurons? -
ANSWER-It creates an INCREASE in excitability of motor neurons
Does inhibition create an increase or decrease in excitability of motor neurons? -
ANSWER-it creates a DECREASE in excitability of motor neurons
What is the first principle of PNF? - ANSWER-*Developmental activities are useful as a
basis for treatment of patients of all ages*
- Subconscious movement or motor programs (rolling, walking, balance) are based
upon earlier reflexes which were consciously developed and then integrated into normal
movement
- Use of such functional activities as therapeutic exercise is beneficial after complex or
simple injury
-- examples: hemiparesis following TBI; weakness and instability following ankle sprain
What is the second principle of PNF? - ANSWER-*The sensory-reflex mechanisms
underlying normal movement are recognized as potent forces influencing movement
and posture*
- sensory stimulation has a powerful impact on promoting optimal movement patterns,
and should be incorporated into therapeutic exercise activities (Example: protective
withdrawal)
- avenues of sensory facilitation used by the therapist
-- *hand contact* for guiding and cueing, tapping, and/or providing continuously
changing resistance
-- *use of voice* to instruct and encourage
-- *encourage patient to use eyes* to focus and further refine movement
What is the third principle of PNF? - ANSWER-*Co-ordinated, alternating movements
between antagonistic muscle groups are essential in normal function*
- normal movement requires a balance of strength as well as co-ordination between
muscle groups (consider the infant - a bundle of spontaneous, uncontrolled movement.
Voluntary motion is intact and strong, but co-ordination between agonist and antagonist
is absent)
, - dynamic and static reversing contractions should be incorporated into optimal
therapeutic exercise
What is the fourth principle of PNF? - ANSWER-*Utilize known principles of motor
learning in therapeutic exercise (from the work of Sherrington)*
- length tension
- neuro-irradiation (overflow) [get carry over from the stronger side to assist the weaker
side]
- successive induction [pattern of muscle recruitment; example: low back pain caused
by abnormal muscle recruitment in the core, NOT core weakness]
- reciprocal inhibition [contraction of the agonist inhibits the antagonist to fully lengthen
and the agonist to maximally contract]
- hierarchy of motor learning goals: mobility, stability, skill
What is the fifth principle of PNF? - ANSWER-*Normal functional movement does not
occur in isolated planar motions, but in combined diagonal activities*
- incorporate combined joint and body movements in diagonal patterns into optimal in
therapeutic exercise
What are the 9 principles of PNF application? - ANSWER-*1. *pt. is taught the
movement pattern from start position to end position. Instructions are brief and simple.
Therapist can begin by passively moving the patient's limb through the pattern
*2. *pt. benefits from looking at the moving limb. Visual input offers feedback for
direction and positional control
*3. * use verbal cues for coordination. Cues are simple and firm. Most common cues
"push," "pull," "hold," and "relax"
*4. * hands on contact with appropriate pressure assists with direction of motion and
facilitating a maximal response
*5. * Therapist mechanics and body position should be in line with the direction of
movement in the diagonal pattern. Therapist knees should be bent.
*6. * Resistance given by therapist should facilitate a maximal response allowing for
smooth and coordinated movement. The resistance might change through out the ROM
and might vary based on patient's ability. Maximal resistance might be used during
isometric contractions or isotonic contraction throughout a full ROM. (goes along with
the length tension relationship)
*7. * rotational movement is a critical component in all PNF patterns
*8. * Appropriate timing: distal movements of the patterns occur first
*9. * a quick stretch given to the muscle before muscle contraction can facilitate a
muscle to respond with greater force through the stretch reflex mechanism
PNF stretching: Hold-relax - ANSWER-Affected body part moved until resistance
(gentle stretch) is felt
Isometric hold for 5-10 seconds, PT provides resistance
*Autogenic inhibition* (trying to fatigue the muscle you are trying to stretch [agonist])
