Beruflich Dokumente
Kultur Dokumente
Objectives
Neurophysiological
• To understand the application of various techniques of
Facilitation of Respiration proprioceptive neurophysiological facilitation for
improvement in respiratory mechanics and ventilation
Introduction
• Normal rate of spontaneous breathing is 12-18
• PNF of Respiration is a terminology used to describe breaths/min
externally applied proprioceptive and tactile stimuli that • It includes involuntary spontaneous deep breaths
produce reflex respiratory movement responses and called as ‘sighs’ every 5 – 10 min in the ventilatory
appear to alter the rate and depth of breathing cycle
• Various experiments to study the development of
• Developed empirically for treating unconscious patients
atelectasis have shown that this alteration in depth of
in neurological ICU at Victoria Hospital in London by
breathing is essential to prevent collapse of alveoli.
Delva D Bethune in 1975
• Unconscious patients- Monotonous shallow breathing
- inadequate ventilation - Atelectasis
3 4
1
12/1/2015
7 8
2
12/1/2015
15 16
Co-contraction of Abdomen
Mechanism:
3
12/1/2015
Response: Mechanism:
4
12/1/2015
• Methods: • Position:
In P.N.F. positioning continues to be single most
Pectoralis facilitation
important aspect of all ventilatory facilitation
Sternocledomastoid and Scalene facilitation
techniques
Upper Trapezius facilitation
Example
Counter rotation ( Butterfly technique )
Slightly posterior tilted pelvis tends to facilitate
diaphragmatic breathing .
Where as slightly anterior tilted pelvis facilitate
upper chest breathing .
27 28
5
12/1/2015
Clinical Application
• Assessment of vital parameters, breathing pattern,
respiratory rhythm, thoracic excursion, and
auscultation should be done before and after treatment
• Patient’s response determines the duration of
treatment
• Procedure of choice is used till the desired effects are
achieved
• Patient’s responsiveness might improve – flutter eye
lids, turn head, push therapist’s hand away etc
Counter-Rotation Technique 31 32
Summary Reference
• Use of tactile and proprioceptive stimulus to improve • International Perspectives in Physical Therapy
respiratory mechanics Respiratory Care- Jennifer Pryor & Barbara Webber
• Response is observed better in deeply comatose
patients
• Response does not sustain for a long time
• It is cumulative to a repeated stimulus applied over a
period of time.
• Responses might not be consistent i.e. may vary from
patient to patient
33 34
Questions
3 Marks
• Name any 3 techniques of neurophysiological facilitation
of respiration
• Enlist the type of responses expected after application of
neurophysiological facilitation of respiration
• Butterfly counter-rotation
7 Marks
• What is neurophysiological facilitation of respiration?
Explain the method, responses and mechanism of any two
techniques in detail 35 36
6
12/1/2015
Reference
• International Perspectives in Physical Therapy
Respiratory Care- Jennifer Pryor & Barbara Webber
37