Proprioceptive neuromuscular facilitation is a therapeutic concept in which the patient is stimulated in a targeted manner in order to recall physiological muscle activities and movement sequences. Such stimuli are precisely placed and applied in certain phases of a movement or posture in order to strengthen and support certain muscle groups in their activity. The stimuli are the tactile stimulus, the verbal and the visual stimulus.
On the one hand, tactile stimuli are specifically set by the therapist, but contact with the support or suitable aids can also enhance this tactile stimulus. The visual stimulus is provided by asking the patient to follow the movement with his eyes or to fixate on a certain prominent object. The command comes from the therapist and should always be concrete, precise and always the same, so that it is memorized by the patient. Furthermore, the self-perception (proprioception) of the patient is promoted.
Goals
The aim of the PNF concept is to improve the patient’s strength and mobility, but also his coordination. Particular emphasis is placed on the physiological movement sequence and the maintenance or improvement of the patient’s independence. Special emphasis is placed on physiological and everyday movements.
The training can be performed on a therapy couch, on a mat (mat program according to PNF) or directly in the position and posture that the patient needs in everyday life. PNF is based on certain pattern movement patterns. These are three-dimensional and follow the spiral arrangement of the muscles.
By stimulating the proprioceptors (sensors that provide our brain with information about the position of our joints and muscles), certain muscle activities are promoted. This results in continued muscle activity in other muscles as well and physiological contraction of certain related muscle groups. Similar to Proprioceptive Neuromuscular Facilitation, Spiral Dynamics takes place in three-dimensional movement patterns.
Does the PNF make sense and when should it be made?
Originally, PNF is a therapeutic concept for the treatment of neurological patients, but today, parts of it are also used for the treatment of orthopedic diseases (e.g. clubfoot). Neurological clinical pictures, which are often treated with PNF, are for example stroke, paraplegia, other cerebral pareses, multiple sclerosis or Parkinson’s disease and many more. Orthopedic clinical pictures are joint prostheses, diseases of the spinal column with or without nerve lesions or other restrictions of mobility.
The PNF concept was first introduced in the 1950s and has evolved over the years. There are some studies that prove the effectiveness of PNF, as with many physiotherapeutic techniques, the evidence base is still expandable. Evidence for the effectiveness of PNF is based on practical experience and success rather than on scientific studies.
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