What is the proprioceptive neuromuscular facilitation (PNF) approach to developing motor control in a hemiplegic shoulder?

Updated: Feb 08, 2019
  • Author: Robert Gould, DO; Chief Editor: Stephen Kishner, MD, MHA  more...
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Answer

Answer

Developed by Kabat, Knott, and Voss, proprioceptive neuromuscular facilitation (PNF) involves repeated muscle activation of the limbs by quick stretching, traction, approximation, and maximal manual resistance in functional directions (ie, spiral and diagonal patterns) to assist with motor relearning and increasing sensory input.

Brennan asserts that PNF is based on the principles of normal human development (ie, mass movements precede individual movements, reflexive movements precede volitional movements, developments occur cephalically to caudally, control is gained proximally prior to distally, the timing of normal movements is distal to proximal). [61] Lorish and coauthors have considered it to be an optimal method of stretching in patients with hemiplegia. [47]

In an attempt to relax spastic antagonist muscle groups, rhythmic stabilization can be used, which involves alternating voluntary contractions of agonist and antagonist muscles. However, Brandstater found PNF to be more effective when muscle weakness is not due to upper motor neuron lesions. [60]


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