PNF/Synergy Patterns Scorebuilders
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
