PNF Approaches

Proprioceptive Neuromuscular Facilitation (PNF) is a stretching technique used to increase range of motion, flexibility, and improve muscle performance (Hindle, Whitcomb, Briggs & Hong, 2012).

Initially developed by Kabat, Knott, and Voss, PNF is applied to treat impairments associated with neuromuscular conditions and musculoskeletal conditions. There are multiple theoretical mechanisms proposed for the effects of PNF, largely based on antagonist inhibition with maximum voluntary contraction.

Manual contact enhances the muscular response and faciltates recruitment. This can occur through indirect (distal) and direct facilitation. Manual contact can also influence the direction of force produced; therefore manual contact should be in placed to inform the direction of motion.

Resistance is applied based on the desired action from the patient. For example, if the patient needs to stabilize in a position, the resistance is applied in a slow velocity and in a direction that requires the patient to and "match" the resistance. This is referred to maintained isotonic contraction. Unlike an isometric contraction where there is no movement ("hold"), isotonic contractions is a recruitment pattern where the muscles are trying to prevent external forces from producing movement ("don't let me move you").

Note the manual contact and the appropriopriate resistance demonstrated in the video clip and how hand placement, speed, and verbal cuing influences the motor response.

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