Proprioceptive Neuromuscular Facilitation

WHAT IS PNF?
PNF - Propriocpetive neuromuscular facilitation is exercise based on the principles of functional human anatomy and neurophysiology.
Proprioceptive Cutaneous Auditory imput

EARLY RESEARCH
Sharrington..
Concepts of facilitation and inhibition

FACILITATION
Facilitory - an impulse causing the recruitment and discharge of additional motor neurons in the spinal cord
Results in increased excitability in the muscles. Weak muscles would be aided through facilitation

INHIBITION
Inhibitory - any stimulus that causes motor neurons to drop away from the discharge zone and away from the spinal cord.
Inhibition results in decreased excitability of motor neurons. Muscle spasticity can be decreased

NEUROPHYSIOLGOICAL BASIS
Stretch Relfex
Muscle spindles
Change in length Rate of change in length

Golgi tendon organs = tension

NEUROPHYSIOLGOICAL BASIS
Autogenic Inhibiltion - inhibition mediated by afferent fibers from a stretched muscle.
Stretching the hamstrings
Excitatory and inhibitory information Stretch is extended, inhibitory impulses take over. Protective mechanism

NEUROPHYSIOLGOICAL BASIS
Reciprocal Inhibition
Agonist/antagonist muscle pattern
Biceps and Triceps

RATIONAL FOR USE

Techniques used for
Increasing strength Flexibility Range of motion Increase coordination

PRINCIPELS OF PNF
Patient must be taught the pattern Visual stimulus is need early Use specific verbal cues
PUSH, HOLD PULL, RELAX

Appropriate pressure with manual contact Body positioning Resistance should be constant Rotational movement is critical

PATTERNS
D1 Flexion
Shoulder FLEX, ADD, ER Forearm - Sup Wrist - Rad. Flexion Fingers - flexion SHOULDER

D2 Flexion
Shoulder FLEX, ABD, ER Forearm - Sup Wrist - Rad. Flexion

Fingers - Extension

D2 Extension
Shoulder EXT, ADD, IR Forearm - Pro Wrist - Ulnar ext. Fingers - flexion

D1 Extension
Shoulder EXT, ABD, IR
Forearm - Pro Wrist - Ulnar. extension Fingers - Extension

TECHNIQUES
Strengthening
Rhythmic initiation - initial passive, active assistive, active motion without a quick stretch Repeated contraction - weakness at a point or through a range of motion Rhythmic stabilization - Isometric contraction of the agonist followed by isometric contraction of the antagonist, produces stability