Physiotherapeutic treatment on a neurophysiological basis according to PNF | Neurophysiological physiotherapy

Physiotherapeutic treatment on a neurophysiological basis according to PNF

The Proprioceptive Neuromuscular Facilitation (movement trajectory via the functional unit of nerve and muscle) was developed in the middle of the 20th century by the neurophysiologist Hermann Kabat and the physiotherapist Maggie Knott in America. The starting point of their research was the then frequent occurrence of poliomyelitis (polio), which was accompanied by paralysis in about 2% of cases. The difference to the treatment methods of that time, which were mainly limited to the isolated, one-dimensional movement of muscles, was the three-dimensionality of the developed movement patterns, which were based on the spiral structure of the muscle chains and the multiple function of individual muscles.

These movement patterns, empirically tested at the time, can be found in our everyday movement sequences (inconspicuous to the untrained eye). For example, in the leg patterns stance and free leg phase, we are trained for the normal course of walking. The PNF method makes use of the fact that the brain remembers complex movement sequences, even if the patient is currently not able to execute them actively and independently.

Implementation of the therapy (PNF)

The initiation of the different movement patterns is done by summing up external (exteroceptive) and internal (proprioceptive) stimuli. Exteroceptive stimuli are applied via the skin by touch, via the eye by eye contact and via the auditory system by commands. Muscle activity is increasingly initiated via proprioceptive stimuli on the body’s own perception system (activation of the muscle spindles, tension and pressure on joints).

From different starting positions from supine to standing, synergistic (cooperating) muscle groups are pre-stretched (= StretchRestretch) by the therapist and then activated against dynamic resistance. The choice of movement patterns and the use of the various techniques depends on the clinical picture, the individual movement findings and the objectives for the respective patient. By repeating the three-dimensional movement patterns (patterns), which are composed of bending/stretching, spreading and rotating movements, the desired sequence of movements is automated in the brain; regulation of muscle tension, muscle strength, endurance, coordination and stability is promoted.

The transfer of the learned movement patterns into everyday life is also important for the motivation and independence of the patient in this therapy. To perform physiotherapy according to the PNF method, an additional qualification of the physiotherapist is required.