Definition
Proprioceptive neuromuscular facilitation (PNF) is a rehabilitation technique that was initiated over 50 years ago. It is used to stimulate the neuromuscular system in an effort to excite proprioceptors (sensory organs in muscles, tendons, bones and joints) in order to produce a desired movement.
Purpose
An individual with a neuromuscular disorder may have dyscoordinated movement; that is, movement that is jerky or unsteady. PNF is a specific treatment approach that attempts to make movement more efficient and to improve function during activities of daily living.
Precautions
When using PNF, care must be taken during the movements. Injuries to tendons, muscles, or ligaments can occur if movement is not indicated or is too aggressive.
Description
PNF involves many combinations of motions. The goal is to incorporate postural and righting reflexes, which are important for maintaining balance. Usually during PNF motions or patterns, resistance is given, first during the stronger part of the range and followed by the weakest part of the range. Other techniques in PNF have the patient isometrically contract the involved muscle or muscle group (agonist), followed by immediately contracting the muscle or muscle group opposite the involved group (antagonist). This technique is called rhythmic stabilization. Another technique incorporates rhythmic stabilization alternately. Contraction of agonist and antagonist in an alternating fashion is called slow reversal.
PNF is based on flexion and extension, but is performed in diagonal patterns. This practice maximizes neuromuscular facilitation by lengthening the muscle or muscle group as much as possible, thus incorporating the stretch reflex.
There are various types of movement patterns in PNF, including unilateral and bilateral patterns. Unilateral patterns are usually based on one limb, either upper or lower, and can incorporate head and trunk movement. Bilateral patterns are done on either both upper or lower limbs at the same time. There are other techniques within the scope of PNF that are used to facilitate. Facilitatory techniques used to stimulate the neuromuscular system include stretch, traction, approximation, and maximal resistance. Other techniques that require significant participation by the patient are rhythmic stabilization, contract-relax, hold-relax, slow reversal, and repeated contractions.
