EASY PNF™ Revealed

WHAT IS PNF CONCEPT?

NAME

Name of concept tells us which part of human body we should use during treatment for improvement of function.

P– Means proprioceptor (receptor which perceives changes in human body), through which the muscular contracting is stimulated (contraction). Main receptors used by PNF treatment are in muscle (muscular spindle and free nervous end), in tendom (Golgi's tendom organ), and in joints (corpuscles of Vater Pacini, Ruffini's corpuscles and free nervous ends). But beside proprioceptors we use also exeteroceptors (receptors which perceive changes in skin, eye, and ear). Proprioceptors and exteroceptors could be differently activated through basic PNF's principles, by contraction or relaxations of muscle/muscles.

N– Means neuromuscular connection and symbolizes motor unit. During the treatment we try to include optimal number of motor units (neuromuscular connections), because only in this way we could make movement light, coordinated, exact, strong,…

F– Facilitation means that the inflow on motor cell in spinal cord is from every direction and so strong, that optimal muscular activity become possible.

HISTORY

Proprioceptive neuromuscular facilitation (PNF) was developed in late 40’s. Primarily was used by treatment of children with infantile paralysis, but later PNF expanded also on treatment of patients with different diagnoses (orthopedic, traumatologic, neurological,…).

Beginners were dr. Herman Kabat, dr. med. and physiotherapists Margaret Knott and Dorothy Voss. Their aim was development of medical treatment that was based on neurophysiologic researches of Charles Sherrington.

PNF is a philosophy of medical treatment. Its basis is that have all human beings, including handicapped, unexploited chances for recovery or improvement of their medical condition (Kabat, 1950). In treatment is included whole body: first we do what the patient can do and through that we use stronger parts of body for strengthening the weaker parts (irradiation), we follow the normal motor development and in this way we caused none pain to a patient.

With appropriate revolt and use of different technique we could stimulate different ways of muscular work: dynamic (concentric and excetric) and static (isometric). One of important basic principles is treatment of patient in function, because in function is always included the whole body. We work against revolt from two reasons: firstly the muscles are strengthened, and secondly sensual stimulus is enlarged (because of enlarged inclusion of motor units) – in this way the patient is more aware of movement. We try to stimulate effective and coordinated movement in patterns. Movement goes three-axial, diagonal, and spiral.

MOVEMENT PATTERNS

Movement in patterns and in diagonal: healthy people in everyday life move in diagonal (spiral-diagonal), explicitly we can see that by sportsmen, when they want to develop the biggest strength, speed, persistence, and explosiveness. Movement goes in the same direction that lays muscular fibers in muscle. In human body are two body’s diagonals (from shoulder girdle towards opposite lying hip’s joint). Through shoulder girdle goes also parallel of second body’s diagonal, which means that are in each proximal joint four patterns of movement (picture 1).

Rotation is the smallest and the most important movement: it superior extends the muscles and gives us the best stability, because rotators are short muscles. Muscles of one joint can be moved in diagonal because of the rotators.

IRADIATION

Irradiation means overflow of stimulus. It is always happening in the body, when we activate one part of it, for example upper limb and activations appears also in trunk. When we work with more power, also other parts of body are included. In therapy we could foresee irradiation and so, with help of different positions and patterns of movement in diagonal, we stimulate activity in weaker or more distant parts of body. Irradiation is challenged first of all with static muscular contraction as a response on proper revolt. By including motor cell of handicapped muscle or kinetic chain, the sensoric influence is diffuse expanded on the whole body (5). That influence could be expanded in diagonal of movement in the same muscular chain. We usually get the strongest answer in the diagonal of movement, but the response could be changed with regard to state of patient. When we expect appearance of irradiation, we must create the conditions in which a patient could push himself away from the grounding.

In therapy is the use of irradiation very successful in improvement of functional problems. For understanding irradiation we must consider that it expands in neuromuscular system and that it above all the answer on stimulation with revolt. Its purpose is to stimulate defined activities with inclusion of motor synergists. It develops easier with help of stronger parts of the body and it could include any other part of the body.

For example: movement of shoulder blade and/or pelvis is constantly present, when we turn, get up, walk, put on our shoes, comb or dress ourselves,… Part of dimensions of movement patterns we find in everyday life, the whole patterns we se by sport, dance,…

TIMING FOR EMPHASIS

By use of Freestyler we take advantage of time emphasis. When we move in a pattern, a defined part of movement could come out and the pattern is no longer correct. In that case we use time emphasis and take advantage of strong muscles in single pattern for activity of each muscle.

Example: with grasping handle of elastic, all muscles in hand are immediately stretched and prepared for movement. If you had fracture of upper arm and your problem is rise of hand, try both ways.

1. release elastic and rise the hand.

2. squeeze a fist or stretch fingers and wrist and rise the hand. You will convince yourself that the second way is more effective, because strong muscles of fingers and wrist help to activate weak muscles in area of healed fracture. The purpose of time emphasis is to strengthen part of movement, which is worse in the pattern.

By time emphasis we distinguish:

Usually we pick a pattern somewhere in the middle part of dimension, in that way the patient could also follow the movement also with eyes (spatial summation).