FACILITATION

Patient contract isometrically resulted in increased

response of the agonist, this was named rhythmic

stabilization. Following using this stabilization, it was

found slow reversal technique, alternate resistance to

isotonic contractions of antagonist and agonist also had

a facilitating effect

Definitions of PNF:Therefore, PNF can be defined as,

methods of promoting or hastening the response of the neuromuscular mechanism through stimulation of the proprioceptors.

To perform PNF exercises, it is important to remember the following

principles: Patient must be taught the pattern. Have the patient watch the moving limb moved

passively. The patient must give proper verbal command. Manual contact with appropriate pressure is very

important.

Principles: •Contraction of the muscle group is facilitated by hand placement. •Apply maximal resistance throughout ROM. •Resistance will change. •Rotation of movement will change throughout ROM. •Distal movement should occur first .

Plan of volume:1. Patterns of motion2. Various techniques used to promote the desired

response3. Application of the method for improvement of vital

and related functions.4. Suggestions for evaluation of the patient

performance and for planning treatment program.

D1 Flexion Upper Extremity

Taken from Prentice, Rehabilitation Techniques in Sports Medicine, 3rd ed

Shoulder Flexion

External Rotation

Adduction

Forearm Supination

Wrist Radial Deviation

Fingers Flexion

D1 Extension Upper Extremity

Taken from Prentice, Rehabilitation Techniques in Sports Medicine, 3rd ed

Shoulder Extension

Internal Rotation

Abduction

Forearm Pronation

Wrist Ulnar Deviation

Fingers Extension

D2 Flexion Upper Extremity

Taken from Prentice, Rehabilitation Techniques in Sports Medicine, 3rd ed

Shoulder Flexion

External Rotation

Abduction

Forearm Supination

Wrist Radial Deviation

Fingers Extension

D2 Extension Upper Extremity

Taken from Prentice, Rehabilitation Techniques in Sports Medicine, 3rd ed

Shoulder Extension

Internal Rotation

Adduction

Forearm Pronation

Wrist Ulnar Deviation

Fingers Flexion

Types of exercises used for upper extremity proprioceptive training:

1. Balance training. One major category ofproprioceptive exercise is balance training. Theseexercises help to train the proprioceptive system in amostly static activity. Activities or exercises in weightbearing using unstable supporting surface, profitter,swiss ball, balance board are example of balancetraining in the upper extremity.

2. Kinetic chain exercises . Open-chain manual resistance exercises with rhythmic stabilization are also considered proprioceptively enriched. In either case, resistance can be modified, depending on pain, as the patient progresses

Quadruped stabilization on a balance

Four closed-chain exercises have been described

to stimulate co-activation in the shoulder: pushups, horizontal abduction on a slide board, and tracing circular motions on a slide board with the dominant and non-dominant arms. These exercises accommodate for the individual's tolerance to joint loads by progressing from a quadruped to a push-up position

Wall push-ups are also useful and can be proprioceptively enhanced by having a physical therapist or resistance band provide resistance to the patient's back.

WALL PUSH EXERCISE

3. Sport-specific maneuvers. Rehabilitation is incomplete until maneuvers specific to the sport and the athlete's position in the sport can be performed maximally and without pain or loss of function.

Starting sport-specific maneuvers with weighted resistance (eg, swinging a weighted tennis racket or baseball bat), Functional positions, such as overhead throwing, should be incorporated and are more sport-specific.

4. PNF (Proprioceptive neuromuscular facilitation): These techniques may be defined as methods of promoting or hastening the response of the neuromuscular mechanism through stimulation of the proprioceptors. Emphasis is placed on the application of maximal resistance through out the range of motion, using many combinations of motions in a pattern format. Motion is first performed in the strongest part of the range, with progression toward the weaker parts of the range of motion. The patterns used are spiral and diagonal in character and closely resemble the movements used in sports and in occupational activities.

5. Plyometrics. It is a quick powerful movement involving pre-stretching of a muscle, followed by a shortening cycle. The stretch shortening cycle occurs when elastic loading, through a quick eccentric muscular contraction, is followed by a burst of concentric muscular contraction.

1 INCREASE FLEXIBILITY 2 ENHANCE MOTIONS 3 REHABILITATION OF INJURIES

4 REDUCE INJURY RISK