The document is a presentation about Proprioceptive Neuromuscular Facilitation (PNF) techniques in physiotherapy, explaining its definitions and physiological basis. PNF is an advanced flexibility training method that involves muscle stretching and contraction, utilizing principles such as resistance and manual contact to facilitate muscle control and rehabilitation. Various PNF techniques like rhythmic initiation and contract-relax are outlined, emphasizing their application in restoring motor function post-injury.

1. Presented by,
Konok Chandra Barman
BSc in physiotherapy
3rd
year
Session: 2018-19
Roll : 28
BANGLADESH HEALTH PROFESSIONS INSTITUTE
Presented to –
Md. Ershad Ali
Lecturer, Department of physiotherapy, BHPI

2. Topic : Proprioceptive Neuromuscular
Facilitation (PNF) procedures and techniques
with abidance.

3. Definitions of PNF
Proprioceptive
Neuromuscular
Facilitation (PNF) is a
more advanced form of
flexibility training that
involves both the
stretching and
contraction of the
muscle group being
targeted.

4. What is PNF ?
Proprioceptive, means
receiving stimulation
within the tissues of the
body.
Neuromuscular, means
pertaining to the nerves and
muscles.
Facilitation, means the effect
produced in nerve tissue by the
passage of an impulse.

5. Physiology of PNF
- PNF exercises are based on the stretch reflex
which is caused by stimulation of the Golgi
tendon and muscle spindles.
- This stimulation results in impulses being sent to
the brain, which leads to the contraction and
relaxation of muscles.
-When a body part is injured, there is a delay in the
stimulation of the muscle spindles and Golgi
tendons resulting in weakness of the muscle.
PNF exercises help to re-educate the motor units
which are lost due to the injury

6. Principles:
❑Patient must be taught the pattern.
❑Have the patient watch the moving limb moved
passively.
❑The patient must give proper verbal command.
❑Manual contact with appropriate pressure is very
important.
❑ Contraction of the muscle group is facilitated by hand
placement.
❑ Apply maximal resistance throughout ROM.
❑ Resistance will change.
❑ Rotation of movement will change throughout ROM.
❑ Distal movement should occur first.

7. Techniques of PNF
The techniques described are:
❖ Rhythmic Initiation
❖ Combination of Isotonics
❖ Reversal of Antagonists
- Dynamic Reversal of Antagonists (incorporates
Slow Reversal)
-Stabilizing Reversal
-Rhythmic Stabilization

8. Continue…
❖Repeated Stretch (Repeated Contraction)
-Repeated Stretch from beginning of range
-Repeated Stretch through range
❖ Contract-Relax
❖ Hold-Relax
❖ Replication

9. 2. Hold relax technique
1.Contact relax technique

10. The basic procedures for facilitation are:
1. Resistance: To aid muscle contraction and motor
control, to increase strength, aid motor learning.
2. Irradiation and reinforcement: Use of the spread
of the response to stimulation.
3. Manual contact: To increase power and guide
motion with grip and pressure.
4. Body position and body mechanics: Guidance
and control of motion or stability.
5. Verbal (commands): Use of words and the
appropriate
vocal volume to direct the patient.

11. 6. Vision: Use of vision to guide motion and increase
force.
7. Traction or approximation: The elongation or
compression of the limbs and trunk to facilitate
motion and stability.
8. Stretch: The use of muscle elongation and the
stretch reflex to facilitate contraction and decrease
muscle fatigue.
9. Timing: Promote normal timing and increase
muscle contraction through “timing for emphasis”.
10.Patterns: Synergistic mass movements, components
of functional normal motion.
Continue…..

12. Upper Extremity

13. D1.Extension-Abduction-
Internal rotation
Flection-Abduction-
External Rotation with
elbow flexion

14. D2. Extension-Addaction
Internal rotation
Flexion Abduction
External rotation

15. Diagonal One Diagonal Two

16. Lower Extrimity

17. Flexion- Addiction-External rotation
D1.Extension-Abduction -Internal rotation

18. Extension – Abduction – Internal rotation
D2.Flexion-Adduction- External rotation