Motor Control ???? ??? Proprioceptive Neuromuscluar Factilitation

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Motor Control ???? ???ProprioceptiveNeuromusclua
rFactilitation

• DONG-EUI MEDICAL CENTER
• KIM JEONG-HUI

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? ? ? ?

• PNF vs Bobath
• PNF pattern?? ADL ?? (??)
• PNF pattern? ??? ?? (???)

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PNF vs Bobath

• Theorietical
• Dr.Kabats theorietical base guided the
  development of PNF
• Developed during the poliomyelitis epidemic
  multiple sclerosis

• Empirical
• Mrs.Bobaths clinical observation developed the
  concept
• Developed at first with a patient suffering from
  a stroke later continued with cerebral palsy

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PNF vs Bobath

• PNF Neurophysiology
• ?Sherrington (1947)
• - temporal summation
• - after discharde
• - irradiation
• - reciprocal innervation
• - successure induction

• Bobath Neurophysiology
• ?Magnus (1926)
• Shunting rule
• ?Sherrington
• - reciprocal innervation
• - normal movement
• - requires normal
• - background tonus

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PNF vs Bobath

• ?Gellhorn (1949)
• The use of resistance
• to increase stretch
• reflex effectiveness
• ?Hierachy

• ?Eccles (1973)
• - inhibition
• ?Magoun and Thines
• (1946)
• - Gamma spasticity
• ?Hierachy

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PNF vs Bobath

• PNF Neurophysiology
• Emphasized activity at the spinal cord
  neuromusclar level
• influnenced from higher
• centers movement input
• Tactile kinesthetic
• Visual
• Auditory
• cognition

• Bobath Neurophysiology
• Attempted to integrate higher center
  organization to explain and treat movement
  disorders
• integrate
• Righting reaction
• Postural reaction
• Equilibrium reaction

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PNF vs Bobath

• Positive approach
• ?Treat the whole person
• ?Goal acheve highest
• ?Level of function

• Problem-solving approach
• The Bobath concepts is
• problem-solving approach
• to the assessment and
• treatment of indivisuals
• with disturbances of
• function, movement and
• tone due to a CNS lesion

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PNF vs Bobath

• - Pattern / Groove
• - Resistance
• - Techniques
• - Lumbrical grip
• - Stretch reflex
• - Traction / Approximation
• - Verbal stimulations
• - Visual stimulations
• - Guiding
• - Trunk

• - Normal movement
• - 24 hour concept
• - Spasticity
• - Tone
• Inhibition / Facilitation
• - Handing
• - Trunk

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Proprioceptive Neuromuscular Facilitation
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Proprioceptive Neuromuscular Facilitation
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Proprioceptive Neuromuscular Facilitation
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Proprioceptive Neuromuscular Facilitation
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Proprioceptive Neuromuscular Facilitation
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Proprioceptive Neuromuscular Facilitation
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Proprioceptive Neuromuscular Facilitation

• Diagonal One Diagonal
  Two

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Proprioceptive Neuromuscular Facilitation

• Bilateral Asymmetrical Bilateral
  Asymmetrical
• Chopping
  Lifting