Do the health insurance companies pay the PNF? | PNF (Proprioceptive Neuromuscular Facilitation)

Do the health insurance companies pay the PNF?

For the time being, there is sufficient scientific backing for the concept so that it will be paid for by health insurance companies. PNF is a concept recognized by the health insurance companies and is carried out by specially trained physiotherapists if a prescription for treatment on a neurophysiological basis is available. On the prescription is usually noted: KG – CNS according to PNF. The prescription can only be billed if the therapist has a corresponding certified advanced training.

Movement Patterns

The PNF concept is based on certain patterns of movement, which, so to speak, form the basic building blocks of the concept along with the specific stimuli. These are precisely defined movement patterns for the upper and lower extremities, as well as head and trunk patterns. The individual joints each fulfill their own components of the movements.

For example, there are patterns for the upper extremity that begin with the movement of the shoulder blade, continue over the shoulder, the elbow, and continue to the hand with the individual fingers. Through visual control and stimuli, the head can also be included in the pattern. The individual movement patterns are based on diagonals.

The movements of these patterns reflect the spiral structure of the musculature and are intended to promote the most intensive and physiological activity possible. The individual movement patterns can be practiced in isolation, e.g. on the therapy bed, or they can be trained functionally in certain positions and starting positions.The basic movement patterns of the PNF concept can be found in the physiological everyday movements of the patients and can thus also improve everyday activity through targeted training. Exercising a certain movement pattern can also change the muscle activity of the entire body and thus lead to an improvement in the symptoms of spasticity or postural deformity.

Exercises

The exercises of the PNF program are based on the movement patterns. The simplest exercises are the correct and conscious execution of the patterns. The PNF-therapist will compile a selection of exercises for the patient after a precise diagnosis and will actively practice with the patient.

The arm pattern Flexion – AbductionExternal Rotation will serve as an example. This term refers to the movements of the shoulder. It is a three-dimensional movement pattern.

The shoulder blade can be included and would in this case perform a “posterior elevation”, i.e. it would be pulled backwards towards the spine and raised by lifting the arm. To be more specific, the movement will now be described using the command. In everyday therapy, it is combined with the use of a Thera-band, for example, and is used to strengthen the raising muscles.

There is a variety of special techniques that can change, emphasize or strengthen the effect of the exercises. First of all, a distinction is made between exercises in a closed chain and exercises in an open chain. The execution of patterns on the therapy bed or with the therapy band are exercises in open chain.

More physiological are exercises in a closed chain, e.g. in a quadruped position. The therapist can support or encourage the patient by the targeted use of techniques such as the application of resistance, stretching stimuli or light pull/pressure on joints.

  • The patient is asked to open his hand, spread his fingers and stretch his arm outwards from the starting position.

    The gaze follows the fingers. It ends in the final position with the palm of the hand facing the ceiling, the fingertips pointing to the head as the arm is rotated outwards. The elbow can be bent or stretched.

    Now the patient should lower the arm again. He leads it on a diagonal back to the starting position. The hand is led to the opposite thigh, closed to the fist and placed on the hip.

    The shoulder blade moves forward and down (anterior depression). The gaze again follows the movement. This movement can now be performed alternately.