This article includes PDF PNF lower extremity diagonal patterns with detailed explanations of D1 and D2 flexion and extension, movement sequences, techniques and rehabilitation applications.
D1 Flexion
Starting Position
The lower extremity begins in hip extension, abduction, and internal rotation with the knee extended. The ankle is positioned in plantar flexion and eversion, and the toes are flexed.
Hand Placement
The therapist places one hand on the dorsal-medial surface of the foot and toes, while the other hand is positioned on the anteromedial aspect of the thigh just above the knee.
Verbal Commands
A quick stretch is applied to facilitate the movement pattern. The patient is instructed to “Bring your foot and toes up and in, bend your knee, and pull your leg up and across.”
Ending Position
The movement ends in hip flexion, adduction, and external rotation with knee flexion or extension. The ankle moves into dorsiflexion and inversion, the toes extend, and the leg crosses the midline producing rotation of the lower trunk.
D1 Extension
Starting Position
The lower extremity begins in hip flexion, adduction, and external rotation with the knee flexed or extended. The ankle is dorsiflexed and inverted, and the toes are extended.
Hand Placement
The therapist places one hand on the plantar-lateral surface of the foot at the base of the toes and the other hand behind the knee in the popliteal region.
Verbal Commands
A quick stretch is applied to the plantar flexors and toe flexors. The patient is instructed to “Curl your toes and push your leg down and out.”
Ending Position
The pattern ends in hip extension, abduction, and internal rotation. The knee may remain extended or flexed, while the ankle moves into plantar flexion and eversion and the toes flex.
D2 Flexion
Starting Position
The lower extremity starts in hip extension, adduction, and external rotation with the knee extended. The ankle is plantar flexed and inverted, and the toes are flexed.
Hand Placement
The therapist places one hand along the dorsal-lateral surface of the foot and the other hand on the anterolateral aspect of the thigh just above the knee.
Verbal Commands
After applying a quick stretch, the patient is instructed to “Bring your foot and toes up and out, and lift your leg up and out.”
Ending Position
The movement finishes in hip flexion, abduction, and internal rotation with knee flexion or extension. The ankle moves into dorsiflexion and eversion, and the toes extend.
D2 Extension
Starting Position
The lower extremity begins in hip flexion, abduction, and internal rotation with the knee flexed or extended. The ankle is dorsiflexed and everted, and the toes are extended.
Hand Placement
The therapist places one hand on the plantar-medial surface of the foot at the base of the toes and the other hand on the posteromedial aspect of the thigh just above the knee.
Verbal Commands
A quick stretch is applied to facilitate the pattern. The patient is instructed to “Curl your toes down and in, and push your leg down and in.”
Ending Position
The movement ends in hip extension, adduction, and external rotation with the knee extended. The ankle moves into plantar flexion and inversion, and the toes flex.
Click here for Upper Extremity Diagonal Patterns
Click here for Principle of PNF
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