Anspannen Entspannen
CR=Contract relax;
Isotonic Contraction of the muscle through its spiral-diagonal PNF pattern, followed by stretch
Increased passive range of motion
Resisted isotonic contraction of the restricting muscles (antagonists) followed by relaxation and movement into the increased range.
The therapist or the patient moves the joint or body segment to the end of the passive range of motion. Active motion or motion against a little resistance is preferred.
The therapist asks the patient for a strong contraction of the restricting muscle or pattern (antagonists). (The authors feel that the contraction should be held for at least 5–8 seconds)
A maximal contraction in the most lengthened position of the muscle chain will provoke a structural change in the actin-myosin complex (Rothwell 1994).
Enough motion is allowed for the therapist to be certain that all the desired muscles, particularly the rotators, are contracting.
After sufficient time, the therapist tells the patient to relax.
Both the patient and the therapist relax.
The joint or body part is repositioned, either actively by the patient or passively by the therapist, to the new limit of the passive range. Active motion is preferred and may be resisted.
The technique is repeated until no more range is gained.
Active resisted exercise of the agonistic and antagonistic muscles in the new range of motion finishes the activity.
Allow enough motion to occur for both you and the patient to know that all the muscles in the pattern, particularly the rotators, are contracting. “Keep pulling your arm down.”
After resisting the contraction (for a sufficient amount of time), both you and the patient relax. “Relax, let everything go loose.”
Now, resist the patient’s motion into the newly gained range. “Open your hand and lift your arm up farther.”
When no more range is gained, exercise the agonistic and antagonistic patterns, either in the new range or throughout the entire range
Example Increasing the range of shoulder fl exion, abduction, and external rotation. The patient moves the arm to the end of the range of fl exion-abduction-external rotation. “Open your hand and lift your arm up as high as you can.” Resist an isotonic contraction of the pattern of extension-adduction-internal rotation. “Squeeze my hand and pull your arm down and across. Keep turning your hand down.”
CRAC= Contract relax, agonist contract;
Contraction of the muscle through its spiral-diagonal PNF pattern, followed by contraction of opposite muscle to stretch target muscle
Th e technique uses contraction of the agonistic muscles instead of the shortened muscles.
Use the indirect method when the contraction of the restricting muscles is too painful or too weak to produce an eff ective contraction.
The technique is only to increase passive range of motion The patient’s active motion is always preferred When the contraction of the restricting (antagonist) muscles is painful or weak, use the agonist
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