Proprioceptive neuromuscular facilitation (PNF) is a stretching technique that can improve your range of motion. Many therapists use PNF to help people regain their range of motion after injury or surgery. However, it can also be used by athletes and dancers to improve their flexibility

1. PROPRIOCEPTIVE NEUROMUSCULAR
FACILITATION (PNF)
DEVENDRA SINGH
MPT NEUROLOGY
(devendrasingh112221@gmail.c
om

2. Definition
Proprioceptive neuromuscular facilitation (PNF) is a concept of treatment. Its underlying
philosophy is that all human beings, including those with disabilities,
have untapped existing potential (Kabat 1950).
Proprioceptive – Having to do with any of the sensory receptors that give information
concerning movement and position of the body
Neuromuscular – Involving the nerves and the muscles
Facilitation – Making easier

3. Philosophy
In keeping with this definition, there are certain basics that are part of the PNF philosophy: PNF is an integrated
approach: Each treatment is directed at the total human being, not just at a specific problem or body segment.
Mobilizing reserves: Based on the untapped existing potential of all patients, the therapist will always focus on
mobilizing the patient’s reserves. Positive approach: The treatment approach is always positive, reinforcing and using
what the patient can do, on a physical and psychological level.Highest level of function: The primary goal of all
treatments is to help patients achieve their highest level of function. Motor learning and motor control: To reach this
highest level of function, the therapist integrates principles of motor control and motor learning.This includes treatment
on the level of body structures, on the activity level, as well on the participation level (ICF, International Classification of
Functioning, WHO 1997).The PNF philosophy incorporates certain basic thoughts, which are anchored in the treatment
concept shown below.
The philosophy of the PNF treatment concept:
1. Positive approach: no pain, achievable tasks, set up for success, direct and indirect treatment, start with the strong
2. Highest functional level: functional approach and use ICF, include treatment of impairments and activity levels
3. Mobilize potential by intensive active training: active participation, motor learning, and self-training
4. Consider the total human being: the entire person with his/her environmental, personal, physical, and emotional
factors
5. Use motor control and motor learning principles: repetition in different context, respect stages of motor control,
variabilityof practice

4. Basic principles are:
1. Tactile stimulation
2. Visual stimulation
3. Resistance
4. Traction
5. Approximation
6. Stretch (stimulus or reflex)
7. Procedures are:
8. Patterns
9. Timing
10. Body mechanics
11. Irradiation

5. Techniques
1. Rhythmic Initiation
2. The combination of isotonic
3. Reversal of Antagonists
4 . Dynamic Reversals (Incorporates Slow Reversal)
5. Stabilizing Reversals
6. Rhythmic Stabilization
7. Repeated Stretch (Repeated Contractions)
8. Repeated Stretch from Beginning of Range
9. Contract–Relax
10 .Contract–Relax: Direct Treatment
11. Contract–Relax: Indirect Treatment
12. Hold–Relax
Hold–Relax: Direct Treatment
Hold–Relax: Indirect Treatment

6. Combination of Isotonics: coming forward with eccentric contraction of trunk extensor muscles
Description
1 The therapist resists the patient’s moving
actively through a desired range of motion
(concentric contraction).
2 At the end of motion the therapist tells the
patient to stay in that position (stabilizing
contraction).
3 When stability is attained the therapist tells the
patient to allow the part to be moved slowly
back to the starting position (eccentric contraction).
4 There is no relaxation between the different
types of muscle activities and the therapist’s
hands remain on the same surface

8. Bilateral patterns.
a Symmetrical: both arms in flexion–abduction. b Asymmetrical: right arm in flexion–abductionand left arm in flexion–adduction.
c Symmetrical reciprocal: right arm in flexion–abduction and left arm in extension–adduction.d Asymmetrical reciprocal: right arm
in flexion–abduction and left arm in extension–abduction

9. The direction of the resistance is an arc (posterior depression of the scapula)
Resistance to scapular anterior elevation

10. Pelvic diagonal: a neutral position; b anterior elevation; c
posterior depression
Resistance to pelvic anterior elevation

11. RESISTANCE TO PELVIC ANTERIOR DEPRESSION.
A- THE GRIP ON THE TROCHANTER.
B, C- THE GRIP ON THE ANTERIOR SUPERIOR
ILIAC SPINE AND THE KNEE.
D -THE GRIP ON THE ANTERIOR SUPERIOR ILIAC SPINE
AND THE ISCHIAL TUBEROSITY.
POSITION THE LEFT LEG IN EXTERNAL
ROTATION TO GET THE CORRECT ARC

12. THE UPPER
EXTREMITY
Upper extremity diagonals: with each of the four patterns, the
elbow can flex, extend or maintain a position

13. Flexion–abduction–external rotation with elbow extension. a, b Standard grips
Extension–adduction–internal rotation

14. THE LOWER EXTREMITY
Lower extremity diagonals (Courtesy of V. Jung): with all four
patterns, the knee can flex, extend, or maintain aposition

15. Flexion–abduction–internal rotation
Flexion–abduction–internal rotation with knee flexion. a, b
Usual position of the therapist; c, d alternative position on the
opposite side of the table

16. EXTENSION–ADDUCTION–EXTERNAL ROTATION WITH
KNEE EXTENSION. A, B USUAL POSITION OF THE
THERAPIST; C, D ALTERNATIVE
POSITION ON THE OTHER SIDE OF THE TABLE

17. Extension–abduction–internal rotation with knee extension
Bilateral symmetrical pattern combination of flexion–abduction
with knee extension in sitting
Bilateral symmetrical pattern combination of flexion–abduction
with knee extension in sitting

18. THE NECK

19. Diagonal of flexion to the left, extension to the right. a, b Active
motion through range; c, d neck flexion to the left

21. The Trunk
Chopping to the left in supine

22. Lifting: a, b lifting to the left in supine;
c lifting to the right in prone;
d, e lifting to the left in sitting

23. Trunk combination: chopping to the left with bilateral leg
flexion to the right