Introduction to PNF Basic Procedures for Facilitation

PNF Therapeutic Goals

The basic facilitation procedures provide  tools for the therapist to help the patient gain efficient motor function and increased motor control.

Their effectiveness does not depend on having the conscious cooperation of the patient. These basic procedures are used to:

–Increase the patient’s ability to move or remain stable.

–Guide the motion by proper grips and appropriate resistance.

-Help the patient achieve coordinated motion through timing.

-Increase the patient’s stamina and avoid fatigue

The basic facilitation procedures overlap in their effects. For example, resistance is necessary to make the response to a stretch effective 

The effect of resistance changes with the alignment of the therapist’s body and the direction of the manual contact.

The timing of these procedures is important to get an optimal response from the patient. 

For example, a preparatory verbal command comes before the stretch refl ex. Changing of the manual contacts should be timed to cue the patient for a change in the direction of motion.

We can use these basic procedures to treat patients with any diagnosis or condition, although a patient’s condition may rule out the use of some of them.

The therapist should avoid causing or increasing pain. Pain is an inhibitor of effective and coordinated muscular performance and it can be a sign of potential harm Other contraindications are mainly common sense: for example, not using approximation on an extremity  with an unhealed fracture.

In the presence of unstable joints, the therapist should take great care when using traction or the stretch reflex.

The basic procedures for facilitation are:

Resistance: To aid muscle contraction and motor control, to increase strength, aid motor learning.

Irradiation and reinforcement: Use of the spread of the response to stimulation.

Manual contact: To increase power and guide motion with grip and pressure.

Body position and body mechanics: Guidance and control of motion or stability.

Verbal (commands): Use of words and the appropriate vocal volume to direct the patient.

Vision: Use of vision to guide motion and increase force.

Traction or approximation: Th e elongation or compression of the limbs and trunk to facilitate motion and stability.

Stretch: Th e use of muscle elongation and the stretch refl ex to facilitate contraction and decrease muscle fatigue.

Timing: Promote normal timing and increase muscle contraction through “timing for emphasis”.

Patterns: Synergistic mass movements, components of functional normal motion.

Combine these basic procedures to get a maximal response from the patient.