Proprioceptive Neuromuscular Facilitation

The PNF stretching ( PNF ) is a three-dimensional physiotherapy / occupational therapy and speech therapy treatment method that is used for patients of all medical fields in which the movement behavior by an illness, injury, surgery or degeneration is disturbed.

definition

The PNF uses both exteroceptors (sensors that process stimuli that hit the body from outside), telereceptors (eyes and ears) and above all proprioceptors to initiate natural, physiological movement. Proprioceptors are muscle, joint and tendon receptors that transmit information about the posture and movement of the body to the central nervous system. The aim of PNF physiotherapy is to promote neuromuscular interaction, i.e. the interaction between nerves and muscles, through increased stimulation of the sensors, and thus to facilitate physiological movement patterns (facilitation) that are stored in the central nervous system. In practical application, the therapist and the patient perform a three-dimensional, physiological movement pattern on a part of the body that is largely healthy against an adapted resistance. This healthy movement pattern is recognized by the central nervous system as part of a complex movement pattern (overall movement pattern), such as a phase of walking. The central nervous system then sends the relevant information for muscle activity to all other parts of the body. This overflow of activity into other parts of the body is called irradiation. One also speaks of a targeted, gait-typical irradiation, since the overall movement patterns of walking are stored in the central nervous system after the sensorimotor development as a child.

history

The PNF was developed between 1946 and 1951 by the neurophysiologist Herman Kabat (1913-1995) and the physiotherapist Margaret Knott (1913-1978) in Vallejo (California, USA). The method claims to build on the basic principles of neurophysiology discovered by Charles Scott Sherrington (1857–1952), Frances Anna Hellebrandt (1901–1992) and others, but it has been developed pragmatically and goes far beyond scientifically established knowledge. Initially, only poliomyelitis patients were treated with their help . However, due to good successes, it was found that it works in all patients in whom healthy exercise behavior is disturbed. Since the optimization and economization of physical activity behavior is a central task for physiotherapists, PNF is now used in all medical fields. In Germany, the PNF was further developed in the 80s and 90s mainly by the PNF instructor Liselotte Ozarcuk, who acquired her knowledge directly from Maggie Knott. Liselotte Ozarcuk differentiated the movement patterns and the treatment techniques in such a way that a targeted irradiation of gait-typical movement patterns was made possible.

The method

The PNF is a physiotherapeutic / occupational therapy analysis and treatment concept. You can analyze the movement behavior of a patient in comparison with physiological movement, then set goals for an improvement in movement behavior together with the patient and then plan the treatment. The aim of PNF is to bring pathologically changed movement sequences back to physiological (healthy) movement sequences. It uses the fact that the physiological movement patterns of the body sections and the overall movement patterns (pattern combinations when walking) are stored in the central nervous system. All movement patterns are characterized by a fixed three-dimensionality. In the movement patterns of the arms and legs, physiological patterns always include a flexing or stretching component of the elbow or knee joint. In practical application, one selects a body section that is as physiologically moving as possible and executes a physiological movement pattern with precisely defined tactile stimuli by letting the patient move from the correct pre-stretching of the pattern against an adapted three-dimensional resistance to the end position of the pattern. During the implementation, contact, pressure, muscle stretching, tendon tension and position sense receptors are specifically stimulated. Furthermore, attention is paid to a physiological sequence of muscle actions in the treated body section. The summed stimuli of the movement pattern are conducted via the peripheral nervous system to the central nervous system (CNS). There, a single movement pattern is recognized as part of an overall movement pattern, whereupon the CNS sends the corresponding orders for a muscular activity to all other body sections involved in the overall movement pattern. Physiological irradiation occurs in those parts of the body that were previously affected by the movement disorder. Physiological movement is facilitated (initiated). As soon as the healthy reactions are visible to a small extent, PNF movement patterns and treatment techniques are used directly on the affected part of the body. The treatment takes place based on the findings in the starting positions that occur in the sensorimotor development of the patient. These are supine, lateral, prone, quadruped, sitting, standing, bear standing, etc.

Treatment goals

• Normalize muscle tension (e.g. reduce spasticity or activate weak or paralyzed muscles) = facilitate
• Promote motor control
• Promote mobility
• Promote dynamic stability, endurance, strength
• Promote skill, coordination
• Restoring healthy physical activity

literature

• Renata Horst: Motor strategy training and PNF. Georg Thieme Verlag, Stuttgart 2005, ISBN 3-13-129291-1 .
• Thomas Einsingbach, Armin Klümper, Lutz Biedermann: Sports physiotherapy and rehabilitation. Georg Thieme Verlag, Stuttgart 1988, ISBN 3-13-711101-3 .
• Patricia E. Sullivan, Prudence D Markos, Mary D. Minor: PNF - A Path to Therapeutic Practice . Gustav Fischer Verlag, Stuttgart 1985, ISBN 3-437-00435-2 . (translated and expanded by Liselotte Ozarcuk)
• Liselotte Ozarcuk: Importance of osteosynthesis and functional further treatment for fracture healing. In: OP-Journal. 1/1992.
• Liselotte Ozarcuk: Follow -up treatment of the lumbar nucleotomy with PNF. In: Lumbar disc disease. W. Zuckschwerdt Verlag, Munich 1994, ISBN 3-88603-475-5 .
• T. Laser: Coxarthrosis and PNF. In: Physiotherapy for coxarthrosis. E.-M. Funke, Gustav Fischer Verlag, Stuttgart 1994, ISBN 3-437-00764-5 .
• HR Weiss: Basics of scoliosis treatment with PNF. In: Hans-Rudolf Weiß (Ed.): Principles and results of physiotherapy methods in scoliosis treatment, possibilities for evaluating the treatment results. (= Spinal deformities. Volume 3). Gustav Fischer Verlag, Stuttgart 1994, ISBN 3-437-11550-2 .
• E.-M. Funke treatment of functional disorders of the cervical spine with the PNF. In: Physiotherapy on the cervical spine. Urban & Fischer, Munich 1999, ISBN 3-437-45280-0 .
• Gretel Schneider: Treatment results of scoliosis treatment after PNF. In: Hans-Rudolf Weiß (Ed.): Principles and results of physiotherapy methods in scoliosis treatment, possibilities for evaluating the treatment results. (= Spinal deformities. Volume 3). Gustav Fischer Verlag, Stuttgart, ISBN 3-437-11550-2 .
• Britta Dietz: Let's sprint, let's skate - innovations in the PNF concept. Springer Medizin Verlag, Heidelberg 2009, ISBN 978-3-540-88897-0 .

Web links

• International PNF Association (English)

Individual evidence

1. ↑ PNF - Proprioceptive Neuromuscular Facilitation. on: neurologie.uni-bonn.de
2. ↑ Proprioceptive Neuromuscular Facilitation (PNF). on: physio.weyh.org

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !