PNF FOR LOWER EXTREMITY

D1Flexion Starting Position (Fig. 6.37A) Position the lower extremity in hip extension, abduction, and internal rotation; knee extension; plantar flexion and eversion of the ankle; and toe flexion

Hand Placement: Place your (R) hand on the dorsal and medial surface of the foot and toes and your (L) hand on the anteromedialaspect of the thigh just proximal to the knee. Verbal Commands: As you apply a quick stretch to the ankle dorsiflexors and invertors and toe extensors, tell the patient, “Foot and toes up and in; bend your knee; pull your leg over and across.”

Ending Position (Fig. 6.37B) Complete the pattern in hip flexion, adduction, and external rotation; knee flexion (or extension); ankle dorsiflexion and inversion; toe extension. The hip should be adducted across the midline, creating lower trunk rotation to the patient’s (L) side.

D1Extension Starting Position (Fig. 6.38A) Begin as described for completion of D1 Flexion

Hand Placement: Place your (R) hand on the plantar and lateral surface of the foot at the base of the toes. Place your (L) hand (palm up) at the posterior aspect of the knee at the popliteal fossa. Verbal Commands: As you apply a quick stretch to the plantarflexors of the ankle and toes, tell the patient, “Curl (point) your toes; push down and out.”

Ending Position (Fig. 6.38B) Finish the pattern in hip extension, abduction, and internal rotation; knee extension or flexion; ankle plantarflexion and eversion; and toe flexion.

D2Flexion Starting Position (Fig. 6.39A) Place the lower extremity in hip extension, adduction, and external rotation; knee extension; ankle plantarflexion and inversion; and toe flexion.

Hand Placement: Place your (R) hand along the dorsal and lateral surfaces of the foot and your (L) hand on the anterolateral aspect of the thigh just proximal to the knee. The fingers of your (L) hand should point distally. Verbal Commands: As you apply a quick stretch to the ankle dorsiflexors and evertors and toe extensors, tell the patient, “Foot and toes up and out; lift your leg up and out.” Ending Position (Fig. 6.39B) Complete the pattern in hip flexion, abduction, and internal rotation; knee flexion (or extension); ankle dorsiflexion and eversion; and toe extension.

D2Extension Starting Position (Fig. 6.40A) Begin as described for the completion of D2 Flexion

Hand Placement: Place your (R) hand on the plantar and medial surface of the foot at the base of the toes and your (L) hand at the posteromedial aspect of the thigh, just proximal to the knee. Verbal Commands: As you apply a quick stretch to the plantarflexors and invertors of the ankle and toe flexors, tell the patient, “Curl (point) your toes down and in; push your leg down and in.” Ending Position (Fig. 6.40B) Complete the pattern in hip extension, adduction, and external rotation; knee extension; ankle plantarflexion and inversion; and toe flexion.