PNF Chop and Lift Patterns

Overview

This lecture covers the mechanics and clinical application of chop and lift patterns in Proprioceptive Neuromuscular Facilitation (PNF), focusing on reference arms, diagonal movement patterns, and patient rehabilitation strategies.

Chop Pattern

• The chop pattern starts with the reference arm in D1 flexion (fist near the opposite ear) and moves to D1 extension (hand open by the side).
• The non-reference (good) arm assists the reference (affected) arm during the chop motion.
• Moving back from D1 extension to D1 flexion with a fist is called a reverse chop.
• The reference arm determines whether the action is named chop or reverse chop.

Lift Pattern

• The lift pattern starts with the reference arm in D2 extension (fist at opposite hip) and moves to D2 flexion (hand open, lifting diagonally across the body).
• The non-reference arm helps the movement, similar to the chop pattern.
• Moving from D2 flexion back to D2 extension is called a reverse lift.
• Pattern naming depends on which arm is the reference arm.

Reference Arm & Pattern Confusion

• Correctly identifying the reference arm (usually the weaker or affected arm) is crucial for naming and performing the pattern.
• Each arm's movement is the opposite diagonal of the other.
• Both chop/reverse chop and lift/reverse lift are described based on the action of the reference arm.

Clinical Applications

• PNF chop and lift patterns are often used in stroke rehabilitation to encourage movement outside of synergy patterns.
• The unaffected arm assists the affected arm to provide active-assisted range of motion and improve function.
• These patterns are also used for shoulder injuries and in patients with rolling difficulties due to spinal cord injuries.

Key Terms & Definitions

• PNF (Proprioceptive Neuromuscular Facilitation) — a therapeutic exercise method using diagonal movement patterns.
• Reference Arm — the arm being targeted or rehabilitated in PNF patterns.
• D1 Flexion/Extension — diagonal movement patterns, flexion towards the body, extension away.
• D2 Flexion/Extension — diagonal movement patterns, flexion across and out from the body, extension in and down.
• Synergy — abnormal muscle co-activation commonly seen post-stroke.

Action Items / Next Steps

• Practice identifying reference arms and performing chop and lift patterns.
• Review video demonstrations for correct PNF pattern technique.
• Apply PNF chop and lift exercises in patient scenarios involving hemiparesis, shoulder injuries, or rolling difficulties.