Neurophysiological facilitation of respiration [npf]

basic description for chest PNF, type and action.

1. NEUROPHYSIOLOGICAL FACILITATION OF RESPIRATION [NPF] PRESENTER: REKHA MARBATE

2. DEFINATION NPF involves the use of selective external proprioceptive and tactile stimuli that produce reflex responses in the rib cage and diaphragm to assist respiration in unconscious patients

3. INDICATIONS Unconscious/ non alert Neurological deficit Partially breathing On a ventilator

4. CONTRAINDICATION Fractures to the ribs, sternum or face Children Respiratory Failure Floating ribs

5. PRECAUTIONS Sensitive mammary tissue in Females Ceasing treatment due to undesirable treatment

6. TECHNIQUES Perioral stimulation Thoracic vertebral pressure Anterior stretch lift of the posterior basal area Intercostal stretch Moderate manual pressure Co-contraction of the abdominal pressure

7. PERIORAL STIMULATION

8. MECHANISM AND BENEFITS Initiates increased epigastric movement Sustained pressure promote further excursion of the thoracic region,so the patient appears to be deep breathing Physiology Activates the primitive reflex of sucking and swallowing

9. VERTEBRAL PRESSURE

10. MECHANISM AND BEBEFITS When pressure is applied over T2-T4 = Increased epigastric abdominal excursion T9-T11 = Increased respiratory movement of the apical thorax

11. ANYTERIOR STRETCH LIFT OF BASAL AREA

12. MECHANISM AND BENEFITS Increased excursion of the ribs laterally and posteriorly both the sides Increased epigastric movements Physiology Dorsal root mediated intersegmental reflex

13. INTERCOSTAL STRETCHING

14. MECHANISM AND BENEFITS Stretch applied over the lower ribs will increase epigastric movements Increases general movements assisting respiration PHYSIOLOGY Induce stretch reflex

15. Co-contraction of the abdominal pressure

16. MECHANISM AND BENEFITS Increase epigastric excursion Observable increase in abdominal tone As tone excursion of rib will Stimulate coughing if secretions present PHYSIOLOGY Abdominals muscles are activated by Intrafusal stretch receptor

17. MODERATE MANUAL PRESSURE

18. MECHANISM AND BENEFITS Gradual increase in rib movement under the area of pressure Specific for localized lung pathology PHYSIOLOGY Stretch reflex

19. References : Jennifer A Pryor , S Ammani Prasad. Physiotherapy for respiratory and cardiac problems 4 th edition, pg no.199-203

20. THANK YOU