PNF/Synergy Patterns Scorebuilders

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Hold-Relax (HR)

• Isometric contraction to increase ROM. Contract for all muscles w/ limited ROM. Relaxation occurs and extremity moves through new ROM to next limitation until no further increase occur. Often used for patients with pain. • Mobility

Alternating Isometrics (AI)

• Isometric contractions are performed alternating from muscles on one side of the joint to the other side without rest. Emphasizes endurance or strengthening. • stability

Agnostic Reversals (AR)

• Isotonic concentric contraction performed against resistance followed by alternating con. and ecc. contractions with resistance. Use slow and sequential manner, used in increments of range to attain maximal control. • controlled mobility, skill

Rhythmic Rotation (RR)

• Passive technique used to decrease hypertonia by slowly rotating an extremity around the longitudinal axis. Relaxation of the extremity will increase ROM. • Mobility

Joint Distraction

• Proprioceptive component used to increase ROM around a joint. Consistent manual traction provided slowly and usually in combination with mobilization techniques. Also used with quick stretch to initiate movement. • Mobility

Slow Reversals (SR)

• Slow and resisted concentric contractions of agonists and antagonists around a joint without rest between reversals. Used to improve control of movement and posture. • Stability, Controlled Mobility, Skill

Slow Reversal Hold (SRH)

• Slow reversals with the addition of an isometric contraction that is performed at the end of each movement in order to gain stability. • Stability, Controlled Mobility, Skill

Timing for Emphasis (TE)

• Strengthen the weak component of a motor pattern. Isotonic and isometric contractions produce overflow to weak muscles. • Skill

Rhythmic Stabilization (RR)

• To inc. ROM and coordinate isometric contract. Isometric contraction of all mm. around jt. against progressive resist. pt. relax, move into new ROM and repeat. For stability, start w/ AI to stabilize all m. groups around body part. • Mobility, stabilit

Rhythmic Initiation (RI)

• Used to assist initiating movement with hypertonia. Movement progresses from passive (let me move you), to active assist (help me move you), to slight resist (move against me). Move slow & rhythmic to reduce hypertonia and allow full ROM. • Mobility

Repeated Contraction (RC)

• Used to initiate movement pattern throughout a weak movement pattern, or at a point of weakness within a movement pattern. Therapist provides a quick stretch followed by isometric or isotonic contraction. • Mobility

Hold-Relax Active Movement (HRAM)

• to improve initiation of movement, MMT gr. 1/5 or less. Place limb in shortened range, isometric contract. Overflow and facilitation assist contraction. Relax limb, lengthen w/ quick stretch. Return to shortened w/ isometric contraction. • Mobility

Normal Timing (NT)

•Used to improve coordination of all components of task. NT performed distal to proximal sequence. Proximal components are restricted until distal components are activated and initiate movement. Repetition produces a coordinated movement. • Skill

Scapula Extensor Synergy

Depression and Protraction

Ankle Flexor Synergy

Dorsiflexion with Supination

Scapula Flexor Synergy

Elevation and Retraction

Elbow extensor Synergy

Extension

Knee Extensor Synergy

Extension

Toes Flexor Synergy

Extension

Wrist Extensor Synergy

Extension

Hip Extensor Synergy

Extension, Medial Rotation, ADduction

Elbow Flexor synergy

Flexion

Knee Flexor Synergy

Flexion

Wrist Flexor Synergy

Flexion

Thumb Flexor Synergy

Flexion and ADduction

Toes Extensor Synergy

Flexion and ADduction

Fingers Extensor Synergy

Flexion with ADduction

Thumb Extensor Synergy

Flexion with ADduction

Finger Flexor Synergy

Flexion with Adduction

Resisted Progression (RP)

• A technique used to emphasize coordination of proximal components during gait. Resistance is applied to an area such as pelvis, hips, or extremity during the gait cycle in order to enhance coordination, strength, endurance. • Skill

Contract-Relax (CR)

• Increases ROM. As the extremity reaches the point of limitation the pt. performs a max. contraction of the antagonist m. group. Therapist resists mvt. for 8-10 secs w/ relaxation to follow. Repeat until no further gains in ROM are made. • mobility

Forearm Flexor Synergy

Supination

Hip Flexor Synergy

ABduction and Lateral Rotation

Shoulder Flexor Synergy

Abduction and Lateral Rotation

Shoulder Extensor Synergy

Medial rotation and ADDuction

D2 Extension Pattern LE

Pelvis: Depression; Hip: Extension, ADduction, Lateral rotation; Knee: Flexion or Extension; Ankle and toes: Plantar Flexion, Inversion;

D2 Flexion Pattern LE

Pelvis: Elevation; Hip: Flexion, ABduction, Medial Rotation; Knee: Flexion or Extension; Ankle and toes: Dorsiflexion, Eversion

D1 Flexion pattern LE

Pelvis: Protraction; Hip: Flexion, ADduction, Lateral Rotation; Knee: Flexion or Extension; Ankle and toes: Dorsiflexion, Inversion;

D1 Extension Pattern LE

Pelvis: Retraction; Hip: Extension, ABduction, Medial Rotation; Knee: Flexion or Extension; Ankle and toes: Plantar flexion, Eversion;

Ankle Extensor Synergy

Plantar Flexion with Inversion

Forearm Extensor Synergy

Pronation

D1 flexion Pattern UE

Scapula-elevation, ABduction, upward rotation; Shoulder- Flexion, adduction, Lateral rotation; Elbow-Flexion or extension; Forearm: Supination; Wrist: flexion, radial deviation; Thumb: Adduction

D2 Extension Pattern UE

Scapula: Depression, ABduction, Downward Rotation; Shoulder: Extension, Adduction, Medial Rotation; Elbow: Flexion or Extension; Forearm: Pronation; Wrist: Flexion, Ulnar deviation; Thumb: Opposition;

D1 Extension Pattern UE

Scapula: Depression, ADDuction, Downward rotation; Shoulder: Extension, ABduction, Medial rotation; Elbow: Flexion or extension; Forearm: Pronation; Wrist: Extension, Ulnar deviation Thumb: ABduction

D2 flexion Pattern UE

Scapula: Elevation, ADDuction, Upward rotation; Shoulder: Flexion, ABDuction, Lateral rotation; Elbow: Flexion or extension; Forearm: Supination; Wrist: Extension, Radial deviation; Thumb: Extension


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