Same pattern or functional
activity (optimal !!!)
 Special techniques allow us to
SPECIFICALLY address underlying
problems
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› Strengthening
› Correction of muscle imbalances
› Re-education of movement
patterns
› Improves muscular co-ordination
› Improves ROM
› Improves balance
› Pain relief
Strengthening
 Correction of muscle imbalances
 Re-education of movement patterns
 Improves muscular co-ordination
 Improves ROM
 Improves balance
 Pain relief
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Limb passively, at a normal speed through the ROM. This is
reinforced by verbal commands.
The patient is then encouraged to work actively and the
movement becomes actively assisted.
The return movement remains passive.
Once the patient has gained active control of the
movement together with the correct co-ordination at the
appropriate speed,
Resistance is then applied
Indications:
Can be used to teach a patient a pattern
Difficulty in initiating movement
Uncoordinated movement
Movement is too slow or fast
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Isometric technique
Used to facilitate the contraction of muscles around a joint in order to
encourage stabilization.
Indications:
Pain on joint movement
Limited ROM
Joint instability
Poor muscle co-ordination
She then resists the contraction of the stronger group of muscles first
(“Don’t let me move you”) initiating a strong isometric contraction. The
resistance is gradually increased until the patient responds fully. The then
moves to resist the opposite pattern.
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These techniques are used to facilitate
and increase ROM when the muscle is
thought to be the limiting factor.
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Based on the principle of after maximal
contraction follows maximal relaxation
resulting in improved ROM
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The therapist/patient moves the limb to the limit of
the ROM.
The therapist then asks the patient to produce a
strong contraction of the restriction muscle group
(antagonist pattern).
The therapist resists most of the motion
Contraction is held for 3-6 seconds.
The patient is then told to relax for 2 minutes.
The limb is then taken to the new limit of the range .
Repeat
Indication:
Limited ROM
The antagonist is resisted
allowing no movement
(isometric contraction).
 “PNF stretching” used in
sport circles
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Indication:
Pain (active contraction of
the muscle is limited by
pain)
 Limited ROM
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Repeated contractions makes use of isotonic contractions
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Indications:
Muscle weakness
Address muscle imbalances
 Improve endurance
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The limb is placed in a lengthened position, the rotational
component is stretched and pattern is started
 If weakness is detected through the pattern the rotational
component is re-stretched to encourage heightened
muscle activity in order to complete ROM
In cases where a detectable weakness is
identified at a specific point in the ROM.
 The same is done as above, but an
isometric hold (“hold it there do not let
me move you”) can be added at the
point of weakness, before completing
the pattern
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Usually in case of more distal weakness
 Stronger overflow from the stronger
proximal to distal muscles is facilitated.
 Stop pattern in mid ROM
 Re-stretch weaker distal component to
complete pattern
 Bent patterns
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This is an isotonic technique in which the stronger muscles
in the stronger pattern in a diagonal are facilitated
 Active motion is continued at the end of the pattern with
the agonistic pattern without relaxation or stopping .
 The technique is ended in the weaker pattern.
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Indications:
 Strengthening
 Improve endurance
 Improve co-ordination of movement
Stabilizing reversals = rhythmic stabilization
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The patient contracts actively through the desired
pattern
He is then asked to hold the position at end pattern
He must then allow you to slowly and passively move
the limb back to the starting position.
The limb is re-stretched and the pattern repeated.
Indications:
Improving the concentric and eccentric control.
Improve co-ordination
Strengthening