Techniques
Contract Relax: Passive placement of the restricted muscle into a position of stretch followed by an isometric contraction of the restricted muscle. Most isometric contractions in PNF stretching techniques should he held for a minimum of 3 seconds at a sub maximal effort (20-50% of maximal effort) to avoid muscle fatigue and injury. After the contraction period the patient is instructed to relax the restricted muscle that was just contracting and activate the opposing muscle to move the limb into a greater position of stretch. Through Reciprocal Inhibition, the tight muscle is relaxed, and allowed to lengthen.
Hold Relax: Very similar to the Contract Relax technique. This is utilised when the agonist is too weak to activate properly. The patient's restricted muscle is put in a position of stretch followed by an isometric contraction of the restricted muscle. After the allotted time the restricted muscle is passively moved to a position of greater stretch. Contraction times and efforts will remain the same as the Contract Relax technique. This technique utilizes the golgi tendon organ, which relaxes a muscle after a sustained contraction has been applied to it for longer than 6 seconds.
Rhythmic Initiation: Developed to help patients with Parkinsonism overcome their rigidity. Begins with the therapist moving the patient through the desired movement using passive range of motion, followed by active-assistive, active, and finally active-resisted range of motion.
Rhythmic Stabilisation: and Alternating Isometrics are very similar in that they both encourage stability of the trunk, hip, and shoulder girdle. With this technique, the patient holds a weight-bearing position while the therapist applies manual resistance. No motion should occur from the patient. The patient should simply resist the therapist's movements. For example, the patient can be in a sitting, kneeling, half-kneeling, or standing position when the therapist applies manual resistance to the shoulders. Usually, the therapist applies simultaneous resistance to the anterior left shoulder and posterior right shoulder for 2–3 seconds before switching the resistance to the posterior left shoulder and the anterior right shoulder. The therapist's movements should be smooth, fluid, and continuous. In AI, resistance is applied on the same side of the joint. In RS, resistance is applied on opposite sides of the joint. Note this is not a stretching technique, but instead a technique used to strengthen joint musculature and improve proprioception.
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