PNF Basics and Principles

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

PNF is an integrated approach: each treatment is directed at a total human being, not just at a specific problem or body segment. Based on the untapped existing potential of all patients, the therapist will always focus on mobilizing the patient’s reserves. The treatment approach is always positive, reinforcing and using that which the patient can do, on a physical and psychological level. The primary goal of all treatment is to help patients achieve their highest level of function. To reach this highest level of function, the therapist integrates principles of motor control and motor learning. This includes treatment on the level of body structures, on the activity level as well as on the participation level (ICF, International Classification of Functioning, WHO).

PNF Philosophy

1. Positive approach: no pain, achievable tasks, set up for success, direct and indirect treatment, strong start.

2. Highest functional level: functional approach, ICF, include treatment on body structure level and activity level.

3. Mobilize potential by intensive training: active participation, motor learning, self training.

Basic neurophysiological principles:

The work of Sir Charles Sherrington was important in the development of the procedures and techniques of PNF. The following useful definitions were abstracted from his work (Sherrington 1947):

Afterdischarge: The effect of a stimulus continues after the stimulus stops. If the strength and duration of the stimulus increases, the after discharge increases also. The feeling of increased power that comes after a maintained static contraction is a result of afterdischarge.

Temporal summation: A succession of weak stimuli (subliminal) occurring within a certain (short) period of time combine (summate) to cause excitation.

Spatial summation: Weak stimuli applied simultaneously to diff erent areas of the body reinforce each other (summate) to cause excitation. Temporal and spatial summation can combine for greater activity.

Irradiation: This is a spreading and increased strength of a response. It occurs when either the number of stimuli or the strength of the stimuli is increased. The response may be either excitation or inhibition.

Successive induction: An increased excitation of the agonist muscles follows stimulation (contraction) of their antagonists. Techniques involving reversal of antagonists make use of this property (Induction: stimulation, increased excitability.).

Reciprocal innervation (reciprocal inhibition): Contraction of muscles is accompanied by simultaneous inhibition of their antagonists. Reciprocal innervation is a necessary part of coordinated motion. Relaxation techniques make use of this property.

“The nervous system is continuous throughout its extent – there are no isolated parts.”

Principles of PNF

All Human beings have potentials that have not been fully developed.
Normal motor development proceeds in cervico-caudal and proximo-distal direction.
Early motor behavior is dominated by reflex activity. Mature motor behavior is supported or reinforced by postural reflexes.
Early motor behavior is characterized by spontaneous movement which oscillates between extremes of flexion and extension. These movements are rhythmic and reversing in characters.
Developing motor behavior is expressed in an orderly sequence of total patterns of movement and posture.
The growth of motor behavior has cyclic trends as evidenced by shifts between flexor and extensor dominance.
Normal motor development has an orderly sequence but lacks a step by step quality. Overlapping occurs.
Locomotion depends upon reciprocal contraction of flexors and extensors and the maintenance of posture requires continual adjustments of nuances of imbalance.
Improvement in motor ability is dependent upon motor learning.
Frequency of stimulation and repetitive activity are used to promote and for retention of motor learning , and for the development of strength and endurance.
Goal directed activities coupled with techniques of facilitation are used to hasten learning of total patterns of walking and self care activities.

References

PNF in Practice : An illustrated guide by Susan Adler, Dominiek Beckers and Math Buck 3rd Edition