Proprioceptive neuromuscular facilitation (PNF) is a stretching technique developed in the 1940s to enhance both active and passive range of motion. It uses patterns of diagonal and functional movements along with techniques like isometric contractions and combinations of passive stretching and muscle facilitation. The main PNF techniques are rhythmic initiation, repeated contraction, slow reversal, and contract-relax which aim to increase muscle strength and flexibility through repetition. PNF can be used to treat conditions involving muscle weakness or spasticity such as after a stroke.

1. PROPRIOCEPTIVE
NEUROMUSCULAR FACILITATION

2. INTRODUCTION
• Proprioceptive Neuromuscular Facilitation (PNF) is a set of
stretching techniques commonly used in clinical environments to
enhance both active and passive range of motion .
• PNF is considered an optimal stretching method when the aim is to
increase range of motion .
• Herman Kabat developed proprioceptive neuromuscular facilitation
(PNF) in the 1940s and further developed Dorothy Voss and
Margaret Knott.

3. DEFINITION
•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. Muscles
• Facilitation: making easier
Techniques of proprioceptive neuromuscular facilitation
may be defined as "Methods of promoting or hastening
the response of the neuromuscular mechanism through
stimulation of the proprioceptors".

4. PRINCIPLE
• PNF focuses on mass movement patterns that are diagonal and
resemble functional movement. The body does not work in parts,
but instead as a whole. 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. BASIC PRINCIPLES OF PNF
• 1. Resistance
• 2. Irradiation and reinforcement
• 3. Manual contact
• 4. Stretch
• 5. Verbal commands
• 6. Traction and approximation
• 7. Timing
• 8. Body positioning and body mechanics

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

7. USES OF PNF
• 1. PNF treatment has been used to increase strength, flexibility,
coordination and functional mobility..
• 2. The main goal of treatment is to facilitate the patient in achieving
a movement or posture .
• 3. Stretches as well as diagonals and rational exercise patterns are
used to improve ADL's functional mobility and athletic performance

8. CONDITIONS WHERE WE CAN USE PNF !
• PNF is suitable for patients with upper motor neuron lesions
accompanied by spasticity.
• It also may be used to initiate muscle contraction in patients
with partial peripheral nerve damage and extreme muscle
weakness.
CONDITIONS : Stroke

9. PNF TECHNIQUES
STRENGTHENING TECHNIQUES
•Rhythmic initiation
•Repeated contraction
•Slow reversal
•Slow reversal-hold
• Rhythmic stabilization
STRETCHING TECHNIQUES
•Contract relax
•Hold relax

10. STRENGTHENING TECHNIQUES

11. RHYTHMIC INITIATION
• Progression from(agonist pattern)
PASSIVE
◇
ACTIVE ASSISTED
◇
ACTIVE
USED IN
• Limited ROM due to increase tone
• Who are unable to initiate movement

12. REPEATED CONTRATION
• Patient move isotonically against maximumresistance
repeatedly until fatigue is evidenced
• When fatigue is evident then a stretch at that point in the
range should facilitate the weaker muscles and results in
coordinated movement.
USED
• To develop strength and endurance.

13. SLOW REVERSAL
• Involves isotonic contraction of the agonist followed
immediately by an isotonic contraction of the antagonist.
• USED
1. For development of active ROM and
2. 2. Normal reciprocal timing b/w agonist and antagonist

14. SLOW REVERSAL HOLD
• Involves isotonic contraction of the agonist followed
immediately by an isometric contraction, with a hold
command given at the end of each active movement.
• USED
• In developing strength at a specific point in the range of
motion.

15. RHYTHMIC STABILIZATION
• Uses an isometric contraction of the agonist, followed by an
isometric contraction of the antagonist.
• USED
• To increase strength and endurance

16. STRETCHING TECHNIQUES/PNF STRETCHING
• It is often a combination of passive stretching and isometrics
contractions.
• encourage flexibility and coordination throughout thelimb's entire
range of motion.
• PNF is used to supplement daily stretching and is employed to make
quick gains in range of motion to help athletes improve performance.
•Good range of motion makes better biomechanics, reducesfatigue
and helps prevent overuse injuries.

17. CONTRACT-RELAX
• Moves the body part passively into the
agonistpattern.
• Patient is instructed to push by contracting the
antagonist isotonically against the resistance.
• USED
• When ROM is limited by muscle tightness.

18. HOLD RELAX
• Begins with isometric contraction of the
antagonist against resistance, followed by
concentric contraction of the agonist
muscle.

19. PATTERNS OF PNF
• The patterns of movement associated with PNF are composed of
multijoint, multiplanar, diagonal, and rotational movements of the
extremities, trunk & neck.
• There are 2 pairs of foundational movements for the upper
extremities;
• UE D1 flexion & extension, UE D2 flexion & extension.
• There are also 2 pairs of foundational movements for the lower
extremities; LE D1 flexion & extension, LE D2 flexion & extension.

20. PNF PATTERNS
PNF patterning is used for the upper and lower
extremities and is broken into to D1 (Diagonal 1) and D2
(Diagonal 2) patterns.
The upper extremity pattern encompasses the shoulder,
elbow, wrist and fingers.
Similarly, the lower extremity pattern encompasses the
hip, knee, ankle and toes

21. Upper Extremity D1 , D2 Flexion and Extension

22. Lower Extremity D1 , D2 Flexion and Extension
:

23. Lower Extremity D1 , D2 Flexion and Extension

24. THANK YOU !