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ProprioceptiveNeuromuscular Facilitation 

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WHAT IS PNF?

• PNF - Propriocpetive

neuromuscular facilitation is

exercise based on the principles of 

functional human anatomy and

neurophysiology.

 – Proprioceptive

 – Cutaneous

 – Auditory imput

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EARLY RESEARCH

• Sharrington..

 – Concepts of facilitation and inhibition

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FACILITATION

• Facilitory - an impulse causing the

recruitment and discharge of additional

motor neurons in the spinal cord – Results in increased excitability in the muscles.

 – Weak muscles would be aided through

facilitation

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INHIBITION

• Inhibitory - any stimulus that causes

motor neurons to drop away from the

discharge zone and away from the spinalcord.

 – Inhibition results in decreased excitability of 

motor neurons. – Muscle spasticity can be decreased

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NEUROPHYSIOLGOICAL

BASIS• Stretch Relfex

 – Muscle spindles

• Change in length

• Rate of change in length

 – Golgi tendon organs = tension

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NEUROPHYSIOLGOICAL

BASIS• Autogenic Inhibiltion - inhibition

mediated by afferent fibers from a

stretched muscle.

 – Stretching the hamstrings

• Excitatory and inhibitory information

• Stretch is extended, inhibitory impulses take

over.

• Protective mechanism

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NEUROPHYSIOLGOICAL

BASIS• Reciprocal Inhibition

 – Agonist/antagonist muscle pattern

• Biceps and Triceps

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RATIONAL FOR USE

• Techniques used for… 

 – Increasing strength

 – Flexibility

 – Range of motion

 – Increase coordination

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PRINCIPELS OF PNF

• Patient must be taught the pattern

• Visual stimulus is need early

• Use specific verbal cues

 – “PUSH”, “HOLD” “PULL”, “RELAX” 

• Appropriate pressure with manual

contact

• Body positioning

• Resistance should be constant

• Rotational movement is critical

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PATTERNS

SHOULDER  

D1 Flexion Shoulder FLEX, ADD, ER 

Forearm - Sup

Wrist - Rad. Flexion

Fingers - flexion

D2 Flexion Shoulder FLEX, ABD,

ER 

Forearm - Sup

Wrist - Rad. Flexion

Fingers - Extension

D1 Extension Shoulder EXT, ABD, IR 

Forearm - Pro

Wrist - Ulnar. extension

Fingers - Extension

D2 Extension Shoulder EXT, ADD, IR 

Forearm - Pro

Wrist - Ulnar ext.

Fingers - flexion

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TECHNIQUES• Strengthening

 – Rhythmic initiation - initial passive, active

assistive, active motion without a quick stretch

 – Repeated contraction - weakness at a point or 

through a range of motion

 – Rhythmic stabilization - Isometric contraction

of the agonist followed by isometric contractionof the antagonist, produces stability