Which lower extremity PNF pattern is MOST appropriate for a patient who needs strengthening of the tibialis posterior?

Which lower extremity PNF pattern is MOST appropriate for a patient who needs strengthening of the tibialis posterior?

• A. Hip extension, abduction and medial rotation with ankle plantarflexion and eversion
• B. Hip flexion, adduction and lateral rotation with ankle dorsiflexion and inversion
• C. Hip extension, adduction and lateral rotation with ankle plantarflexion and inversion
• D. Hip flexion, abduction and medial rotation with ankle dorsiflexion and eversion

Answer: (C)

The key idea is to pick a lower-extremity PNF pattern that reinforces the tibialis posterior by combining ankle movements that match its primary actions: inversion and plantarflexion. Tibialis posterior helps invert the foot and supports the arch when the foot plantarflexes. Therefore, the pattern that ends with ankle plantarflexion and inversion provides the most direct strengthening stimulus for TP. The chosen pattern pairs hip extension, adduction, and external rotation with ankle plantarflexion and inversion, aligning the proximal and distal segments to create a diagonal movement that engages TP as the prime inverter and plantarflexor. Patterns that include eversion or dorsiflexion recruit the opposite muscles (peroneals for eversion, tibialis anterior for dorsiflexion) and are less effective for strengthening tibialis posterior.

The key idea is to pick a lower-extremity PNF pattern that reinforces the tibialis posterior by combining ankle movements that match its primary actions: inversion and plantarflexion. Tibialis posterior helps invert the foot and supports the arch when the foot plantarflexes. Therefore, the pattern that ends with ankle plantarflexion and inversion provides the most direct strengthening stimulus for TP.

The chosen pattern pairs hip extension, adduction, and external rotation with ankle plantarflexion and inversion, aligning the proximal and distal segments to create a diagonal movement that engages TP as the prime inverter and plantarflexor. Patterns that include eversion or dorsiflexion recruit the opposite muscles (peroneals for eversion, tibialis anterior for dorsiflexion) and are less effective for strengthening tibialis posterior.