Proprioceptive Neuromuscular

Facilitation

ESAT 3642
Therapeutic Exercise

Proprioceptive Neuromuscular
Facilitation (PNF)
 Based on the principles of functional
anatomy and neurophysiology
 Uses proprioceptive, cutaneous, and
auditory input
 Used for increasing strength, flexibility,
and ROM
 Replicates normal movement patterns

History
 Knott & Voss, 1968
 Emphasized principles rather than
specific techniques

1
Principles of PNF
 Patient must be taught the PNF patterns
regarding the sequential movements from
starting position to terminal position
 Patient should look at the moving limb
 Visual stimuli
 Verbal cues
 Manual contact with appropriate pressure

Principles of PNF Continued

 Proper mechanics and body position
 Amount of resistance given should
facilitate a maximal response that
allows smooth, coordinated motion
 Rotational movement
 Normal timing

Principles of PNF Continued

 Timing for emphasis
 Traction or approximation
 Stretch reflex

2
PNF Patterns
 Concerned with gross movements as
opposed to specific muscle actions
 Rotational and diagonal patterns
 Functional patterns
 Three component movements
 Flexion-extension
 Abduction-adduction
 Internal-external rotation

PNF Patterns Continued

 Pattern is initiated with the muscle
groups in lengthened position
 Muscle group is contracted, moving the
body part through the ROM to
shortened position
 Diagonal 1 (D1)
 Diagonal 2 (D2)

PNF Pattern

3
UE Pattern

LE Pattern

PNF Strengthening Techniques

4
Repeated Contraction
 Weakness either at specific point or
throughout entire range
 Correct imbalances
 Isotonic work to fatigue
 When weak components are fatigued,
stretch at that point in range
 Push concentric and eccentric agonist

Slow Reversal
 Isotonic contraction of antagonist
followed by contraction of agonist
 Develops AROM of the agonists and
normal reciprocal timing between
antagonist and agonist
 Push antagonist
 Pull agonist

Slow Reversal-Hold
 Isotonic contraction of agonist followed by
isometric contraction, with a hold command
 Direction of pattern is reversed by using the
same sequence of contraction with no
relaxation before shifting to the antagonistic
pattern
 Useful for developing strength at specific
point in the ROM

5
Rhythmic Stabilization
 Isometric contraction of agonist,
followed by isometric contraction of
antagonist
 Produces cocontraction and stability of
of the two opposing muscle groups

Rhythmic Initiation
 Progression of movement from passive,
to active-assistive, to active movement
through the agonist pattern
 Slow through available ROM
 Avoid quick stretch
 Useful for patients who cannot initiate
movement, have limited ROM, or for
teaching movement pattern