The document discusses proprioceptive neuromuscular facilitation (PNF) techniques. PNF is a set of stretching techniques used to improve motor performance and aid rehabilitation by focusing on agonist and antagonist muscle coordination during movement. It relies on stimulation of proprioceptors to increase neuromuscular response. PNF incorporates the auditory, visual and tactile systems to promote functional movement patterns. The techniques aim to increase motor learning, reverse antagonist motor patterns, and relax muscles to improve range of motion and decrease spasticity.

1. PNF techniques
Presented to : Dr. Binash Afzal

2. Facilitation Techniques
• Facilitation and enhancement of muscle activity to achieve improved
motor control are the key tenants to many of the techniques used in
neurological rehabilitation, many of which also utilise neuroplasticity
• The Rood Approach, theoretically based on the Reflex and Hierarchical
Model of Motor Control, developed by Margaret Rood in the 1950s,
provides the origin for many of the facilitation techniques used today in
neurological rehabilitation today. Rood developed a system of
therapeutic exercises enhanced by cutaneous stimulation for patients
with neuromuscular dysfunctions
• In addition to proprioceptive maneuvres such as positioning, joint
compression, joint distraction and the general use of reflexes, stretch,
and resistance, the greatest emphasis is given on exteroceptive
applications such as stroking, brushing, icing, warmth, pressure, and
vibration in order to achieve optimal muscular action.

3. Proprioception Neuromuscular Facilitation
Developed by “Herman Kabat”
Proprioceptive Neuromuscular Facilitation (PNF) is a set of stretching techniques commonly used in clinical
environments to enhance both active and passive range of motion in order to improve motor performance
and aid rehabilitation.
PNF helps to restore normal movement by focusing on the developing sequence of movement and how
the agonist and antagonist muscles work together to produce volitional movement.
PNF uses reflexive movement as a basis for learning more volitional movement. The idea is that one must
be able to roll before he can crawl and crawl before he walks
It relies mainly on stimulation of proprioceptors for increasing the demand made on neuromuscular
mechanism to obtain and facilitate its response.c

4. PNF
PNF focuses on mass movement patterns that
are diagonal and resemble functional
movement
In order to promote these mass movement
patterns, PNF uses a multi-sensory approach,
incorporating the auditory, visual and tactile
systems.
PNF allows the patient to understand what
normal movement feels like through the use of
various senses through use of manual contacts
to cue the patient and facilitate movement.

5. Primarily, PNF treatment techniques focus on three
things
• Increase the motor learning of the agonist through repetition of an activity
(repeated contractions) and rhythmic initiation.
• Reverse the motor patterns of the antagonist.
Two techniques are slow reversal and rhythmic stabilisation, both of which use an
isometric contraction.
• Finally, learning to relax muscles helps to increase range of motion and decrease
spasticity

6. Theoretical Mechanisms
Four theoretical physiological mechanisms for increasing ROM were identified
• autogenic inhibition
Autogenic Inhibition is what occurs in a contracted or stretched muscle in the form of a decrease in the excitability because of inhibitory signals sent from
the GTOs of the same muscle
• reciprocal inhibition
Reciprocal inhibition is what occurs in the TM when the opposing muscle is contracted voluntarily in the form of decreased neural activity in the TM .
• stress relaxation
Stress relaxation is what occurs when the musculotendinous unit (MTU), which involves the muscles and the connected tendons, is under a constant stress
• the gate control theory
The gate control theory is what occurs when two kinds of stimuli, such as pain and pressure, activate their respective receptors at the same time. The
inhibition of the pain signals happens in the dorsal horn when the large fibers transmit signals

7. Basic Principles

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