By Courtney Roth, SPT
Proprioceptive neuromuscular facilitation (PNF) is a specific manual technique used by physical therapists to help improve a patient’s functional status. Traditionally, PNF was used to treat patients with neurological conditions such as stroke, multiple sclerosis, and Parkinson’s disease. However, research also supports its use for patients with orthopedic conditions such as back, neck and shoulder pain or muscle imbalances.1-7 PNF is a unique treatment approach because it uses diagonal patterns that incorporate multiple planes of movements, making the task more functional and effective in achieving patient goals.
The philosophy of PNF is based on five concepts8
- The human body moves as a unit, so PNF involves treating the whole person, not just the area of injury. Physical therapists can help identify whether someone has muscle imbalances or compensations in other areas of the body that may be contributing to their symptoms.
- PNF aims to tap into a patient’s underlying potential, by requiring active patient participation in order to mobilize strength, coordination, and range of motion reserves.
- A positive therapeutic environment is a critical component of PNF. Tasks that the patient is successful in performing without provoking symptoms are performed first, and then progress is built on those successes. Treatment avoids any movements that are painful for the patient.
- PNF aims to help patients achieve their highest level of function.
- In order to ensure progress made in the clinic carries over to a patient’s daily life, PNF implements principles of motor learning by using repetition and variability in multiple contexts to achieve retention of motor skill.
Adding PNF techniques to the treatment plan of many orthopedic conditions can help better integrate the nervous and musculoskeletal systems in order to move easier, more efficiently, and without pain.
- Olkzac A, Wlodzislaw K, Domaniecki J. The PNF method in the treatment of intervertebral disc disease. The PNF method in the treatment of intervertebral disc disease. 2008;8(3):241-252.
- Rezasoltani A, Khaleghifar M, Tavakoli A, Ahmadi A, Minoonejad H. The Effect of a Proprioceptive Neuromuscular Facilitation Program to Increase Neck Muscle Strength in Patients with Chronic Non-specific Neck Pain. World Journal of Sport Sciences. 2010;3(1):59-63
- Maicki T, Bilski J, Szczygieł E, Trąbka R. PNF and manual therapy treatment results of patients with cervical spine osteoarthritis. Journal of Back and Musculoskeletal Rehabilitation. 2017;30(5):1095-1101. doi:10.3233/bmr-169718.
- Lee J-H, Park S-J, Na S-S. The Effect of Proprioceptive Neuromuscular Facilitation Therapy on Pain and Function. Journal of Physical Therapy Science. 2013;25(6):713-716. doi:10.1589/jpts.25.713
- Park K, Seo K. The Effects on the Pain Index and Lumbar Flexibility of Obese Patients with Low Back Pain after PNF Scapular and PNF Pelvic Patterns. Journal of Physical Therapy Science. 2014;26(10):1571-1574. doi:10.1589/jpts.26.1571.
- Jain AS, Anandh S, Pawar A. Effectiveness of Proprioceptive Neuromuscular Facilitation as an Adjunct to Eccentric Exercises in Subacromial Impingement. Indian Journal of Physiotherapy and Occupational Therapy – An International Journal. 2017;11(2):141. doi:10.5958/0973-5674.2017.00051.x.
- Voight M, Hoogenboom B, Cook G. The chop and lift reconsidered: integrating neuromuscular principles into orthopedic and sports rehabilitation. North American Journal Of Sports Physical Therapy: NAJSPT [serial online]. August 2008;3(3):151-159.
- Adler SS, Beckers D, Buck M. PNF in Practice: an Illustrated Guide. Berlin: Springer; 2014.