PNF (proprioceptive neuromuscular facilitation) is a technique that uses stimulation of proprioceptors to facilitate muscle response and increase range of motion. The hold-relax technique is a key part of PNF. It involves isometric contraction of the hypertonic muscle or its antagonist, holding for 15 seconds then relaxing. This lengthens the hypertonic muscle and increases range of motion. To treat right torticollis, the therapist stands behind the patient in sitting and cups one hand under the chin while the other applies resistance to side flexion and rotation to the right. Poor posture is caused by insufficient and unnecessary muscle effort. To re-educate posture, relaxation, mobility,

1. Q no1: Define PNF? What is hold relax technique ? also discuss its
effects ?
Ans: PNF stands for proprioceptive neuromascular facilitation
“ the technique of PNF mainly relay on stimulation of proprioceptors for increasing the
demand made on the neuromascular mechanism to obtain and facilitate the response “
HOLD –RELAX: this is the technique design to obtain a lengthening reaction of the muscle
whose action is antagonistic to the movement limited in the range
APPLICATION: following is the procedure
A) ISOMETRIC CONTRACTION OF THE HYPERTONIC MUSCLE:
Movement in this pattern is in the direction of limitation takes either actively or
passively .the therapist will resist the movement maximally and command the patient to
hold for 15 sec and then relax voluntarily .This technique is repeated often and is usually
followed by repeated contraction
B) ISOMETRIC CONTRACTION OF RECIPROCAL MUSCLE:
The technique is applied on the muscle working antagonistically to the hypertonic
muscle .contract the antagonist muscle isometrically then command the patient to hold
for 15 second and then relax
EFFECTS:
1. It facilitate the action of antagonist
2. It lengthen the hypertonic muscle
3. It increase the ROM of the muscle
4. It is pain free ,simple and effective
USES:
1. It is use to gain successive induction
2. It is use for reciprocal innervation
3. It is use to increase ROM
4. It increases muscle extensibility

2. Q4: how right torticollis can be treated effectively ?
ANS:
TORTICOLLIS:
It is spasmodic condition of sternocleidomastoid muscle which causes the head to
rotate on the other side and downward .
TREATMENT : following is the treatment for right torticollis
 The normal sternocleidomastoid muscle of one side bend the head to the same
side and rotate it to the opposite side
 In right torticollis the head will be bend and rotate to the left side
Patient prepration : patient should be in short sitting position and comfortable
Therapist position: therapist is standing behind the patient
Hand placement : one hand of the therapist is of vertex of the patient’s headand
other hand is cupped under the chin so that the finger extend above the temporo
mandibular joint
Resistance: resistance is given in side flexion with the fingers of above hand and to
rotation with the fingers of the lower hand towards the right side

3. Q no 3: How will you re educate a patient with poor posture ? describe its principle?
POOR POSTURE: it is the posture of a person in which there is minimum efficancy with
maximum effort of the body
Posture is poor when it is insufficient ,and unnecessary amount of muscular effort is
used to maintain it . there is faulty alignment of the body segment .
PRINCIPLE OF RE EDUCATION :
 Therapist should train good posture with efficient postural pattrens
 The posture result of an unsatisfactory mental attitude and un hygienic
conditions can only be corrected by alternation in the mental attitude, person’s
cooperation and improvement of hygienic conditions
 Relaxation mobility exercises is way for improvement
 Fatigue should be treated first
 Restore the muscle strength ,power, edurance and balance of the body
 Occupational strains can be relieved by relaxation methods
 Use mirror for the training
 Correct the faulty pattern of movement
RE EDUCATION: re educate the patient in following ways
RELAXATION: relax the muscles of the body to reduce the unnecessary tension in the muscle
Examples: crook lying, lying prone ;general relaxation
Crook lying; relax shoulder to supporting surface with expiration
Sitting shoulder shrugging and retraction followed by relaxation
MOBILITY: the maintainance of normal mobility is essential it is maintained by general free
exercises which are rhythmical and full range movement
MUSCLE POWER: muscle power is essential for good posture
Power of Following muscles should be maintained
 THE HEAD: crook lying or lying with feet support; body lengthening
Half lying ,sitting or standing ;head stretching upwards
 THE PELVIC TILT : crook lying gluteal and abdominal contraction
Low wing sitting ;pelvis tilting
 THE FEET: sitting bracing of the arch and pressing toes to the floor
Standing ;hip rotation inward