Proprioceptive Neuromuscular Facilitation Group Research Articles

Impact of PNF and MET technique on hamstring flexibility among university students with hamstring tightness

Background. Hamstring tightness affects pelvic posture, contributing to symptoms such as low back discomfort and improper lumbar-pelvic area motions. The purpose of this study is to determine the immediate effectiveness of both Proprioceptive Neuromuscular Facilitation (PNF) and Muscle Energy Technique (MET) interventions on hamstring tightness. A paucity of literature has left a research gap on this topic. Thus, my study aims to compare the effects of these two interventions on improving hamstring flexibility among university students with hamstring tightness. Methods. Group I, consisting of 20 subjects, received PNF for 30 minutes. Group II, also consisting of 20 subjects, received MET for 30 minutes. The study was conducted for 4 weeks. Results. The ROM variables were examined using an independent ‘t’ test with a significance level of 0.05. The mean ± SD of the difference in hamstring ROM for the PNF group was 9.77 ± 4.01° and 10.7 ± 5.21° for the MET group. This indicates that a marked difference was obtained between Group I and Group II, as well as a substantial variation between both the pre-intervention and post-intervention values. Conclusion. The findings demonstrated that both PNF and MET significantly improved (p = 0.000) ROM. Meanwhile, no significant difference (p > 0.05) was found between these two interventions.

Proprioceptive neuromuscular facilitation stretching exercises for treatment of temporomandibular dysfunction in patients with forward head posture: A double-blinded, randomized, controlled trial.

Proprioceptive neuromuscular facilitation (PNF) stretching exercises have been widely advocated for the management of patients with different musculoskeletal conditions. However, its effect on the treatment of temporomandibular dysfunction (TMD) in patients with forward head posture (FHP) has not been fully investigated. To investigate the effect of PNF stretching exercises on the treatment of TMD in patients with FHP. A prospective, randomized, double-blinded clinical trial. Twenty-four patients with TMD and FHP aged from 18-40 years were randomly assigned to PNF or control group. The PNF group composed of 12 patients received PNF stretching exercises of masticatory muscles in addition to routine physical therapy treatment (FHP correction exercises and ultrasound for the temporomandibular joint); the control group composed of 12 patients received routine physical therapy treatment only. Interventions were conducted twice a week for six weeks. Craniovertebral angle, pain threshold, pain intensity, temporomandibular joint ROM, and temporomandibular joint function were assessed for all participants before and after the intervention. The outcomes were analyzed using Two-way mixed MANOVA. For further multiple comparisons, post-hoc tests with the Bonferroni correction were performed. There was no significant difference between both groups pre-treatment (p> 0.05). Comparison between groups post-treatment revealed statistically significant differences in all outcome measures (p< 0.05) in favor of the PNF group. Adding PNF stretching exercises of masticatory muscles to routine physical therapy programs is an effective method for management of TMD in patients with FHP more than routine physical therapy programs alone.

Do proprioceptive neuromuscular facilitation techniques improve respiratory parameters and swallowing in people with multiple sclerosis: A randomized-controlled study

AimThis study aims to investigate the effects of Proprioceptive Neuromuscular Facilitation (PNF) techniques on respiratory parameters, swallowing, functional capacity, fatigue, and quality of life in people with Multiple Sclerosis (PwMS). MethodThirty-four PwMS were included and randomized into the PNF Group (mean age: 43.23±10.55/years) or Control Group (mean age:38.47±8.18/years). In the PNF group, head-neck, upper extremity, trunk, and breathing techniques were applied three days/eight weeks. The control group continued home-based breathing exercises. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1/FVC, peak expiratory flow (PEF), forced expiratory flow 25–75 % (%FEF 25–75), peak cough flow (PCF), maximal inspiratory (MIP) and expiratory pressures (MEP) were and two minutes walking test (2MWT) were measured. Dysphagia in Multiple Sclerosis (DYMUS), Eating Assessment Tool (EAT-10), Fatigue Severity Scale (FSS) and Multiple Sclerosis Quality of Life (MusiQoL) were questioned. ResultsAfter treatment, MIP, MEP,%FEV1/FVCpred,%PEFpred,%FEF 25–75pred, PCF, DYMUS, EAT-10, FSS, and MUSIQoL were improved in the PNF group while MIP, MEP, PCF, DYMUS, EAT-10, MUSIQoL, and 2 MWT were improved in the control group (p < 0.05 for all). In the between-group analysis of the mean differences, the%FEV1pred was significantly different in favor of the PNF Group (p = 0.011), and MIP was significantly different in favor of the Control Group (p = 0.013). DiscussionThe PNF techniques can improve respiratory muscle strength, respiratory functions, cough efficiency, swallowing functions, and quality of life in mild to moderate PwMS. However, these improvements were not superior except for%FEV1pred compared to home-based breathing exercises.

Effects of proprioceptive neuromuscular facilitation and both sides up ball exercise on pain level, range of motion, muscle function after total knee arthroplasty.

Knee osteoarthritis (OA) is a degenerative joint disease caused tearing and progressive wear of articular cartilage, and total knee arthroplasty (TKA) is recommended to patients with OA. The purpose of this study was to investigate the effect of proprioceptive neuromuscular facilitation (PNF) and both sides up ball (BOSU) exercises on pain, range of motion (ROM), and muscle function in patients following TKA. Ten participants who have limitation of the knee joint from TKA were divided into two groups: the continuous passive motion (CPM)+PNF exercise group (n=5) and the CPM+BOUS exercise group (n=5). Exercise rehabilitation program consisted of PNF and BOSU exercises, and both exercises were performed twice a day for 2 weeks. To examine effect of exercise rehabilitation, visual analogue scale (VAS), sit and reach flexibility, knee ROM, and Timed Up and Go test (TUG) were measured before and after exercise intervention. A two-way repeated analysis of variance was used to confirm the main effect. If there was a significant interaction effect, an independent t-test between groups or a paired t-test between times was applied. VAS, sit and reach flexibility, knee ROM and TUG did not show interaction between the PNF and BOSU exercise groups, but all measured variables showed significant differences over time. Present findings provide information that PNF and BOSU exercise rehabilitation after TKA might be an important part of ensuring successful surgical outcomes as they have a positive impact on reducing pain, increasing ROM, improving muscle strength, and enhancing daily life movements.

Effectiveness of Myofacial Release versus Proprioceptive Neuro Facilitation Technique on Pain and Range of Motion in Patients with Cervicogenic Headache

Background: Cervicogenic headache is a prevalent condition characterized by headaches caused by cervical musculoskeletal impairments. The effectiveness of Myofascial Release (MFR) and Proprioceptive Neuromuscular Facilitation (PNF) in managing this condition has been explored, with varying outcomes on pain intensity, cervical range of motion (ROM), and functional disability. Objective: To compare the efficacy of MFR and PNF techniques in reducing pain and improving ROM in patients with cervicogenic headache. Methods: This randomized control trial included 30 female participants diagnosed with cervicogenic headache. Participants were randomly assigned to receive either MFR or PNF treatments over a period of 4 weeks, with sessions conducted twice weekly. Outcome measures included pain intensity assessed by the Visual Analog Scale (VAS), cervical ROM measured using a universal goniometer, and functional disability evaluated through the Neck Disability Index (NDI). Data were analyzed using SPSS version 25, employing t-tests for within-group comparisons and ANOVA for between-group analyses. Results: Both MFR and PNF groups showed significant improvements post-treatment. The MFR group demonstrated a reduction in VAS scores from 6.73 ± 0.593 to 4.26 ± 0.703 (p&lt;0.001), and the PNF group from 6.73 ± 0.593 to 5.26 ± 0.432 (p&lt;0.001). Cervical ROM and NDI scores also significantly improved in both groups. Comparative analysis revealed MFR to be more effective in enhancing cervical rotation (MFR: 70.13 ± 3.020 to 80.20 ± 2.840; PNF: 60.33 ± 2.690 to 64.06 ± 2.548; p&lt;0.05) and reducing NDI scores (MFR: 48.33 ± 5.56 to 17.53 ± 5.46; PNF: 10.00 ± 2.267 to 8.93 ± 1.667; p&lt;0.001). Conclusion: Both MFR and PNF are effective in treating cervicogenic headache, significantly reducing pain intensity and improving cervical ROM and functional disability. MFR, however, exhibited a superior efficacy in enhancing cervical rotation and reducing NDI scores, suggesting it may offer additional benefits in the management of cervicogenic headache.

Effectiveness of Constraint Induced Movement Therapy and Proprioceptive Neuromuscular Facilitation on Upper Extremity Functions in Stroke

Background: Stroke is the quickly developing clinical indication of a focal disruption of brain function that lastsmore than 24 hours or results in death, with no discernible cause other than vascular origin. Despite the fact thatthe majority of patients are able to walk again, 30% to 60% of survivors are no longer able to use the arm that wasinjured. CIMT aims at improves both the motor and functional capacities of a paretic arm. PNF exercises alter theorder in which muscles are stimulated, increases the efficiency of joint movement.Purpose: To compare the effectiveness of Constraint Induced Movement Therapy and ProprioceptiveNeuromuscular Facilitation for treating upper extremity functions in stroke.Materials and Methods: A total of 30 participants were selected from Sree Annai Physiotherapy Clinic Chennai.According to the inclusion and exclusion criteria. Subjects willing to participate were allocated into two groupsConstraint Induced Movement Therapy group and Proprioceptive Neuromuscular Facilitation group. Theparticipants underwent Pre-test measurement with Fugl-Meyer Assessment Upper Extremity FMA-UE and wererepeated for Post-test measurement. Study period : November 2022 to April 2023.Results: When comparing the mean differences of the two groups, Constraint Induced Movement Therapygroup displays a greater difference than Proprioceptive Neuromuscular Facilitation group. Therefore, it can besaid that Constraint Induced Movement Therapy is more advantageous for the upper extremity functions thanProprioceptive Neuromuscular Facilitation.Conclusion: The study concluded that Constraint Induced Movement Therapy is found to be more effective thanProprioceptive neuromuscular facilitation technique for upper extremity function recovery.

Effect of proprioceptive neuromuscular facilitation versus low level laser therapy on shoulder adhesive capsulitis post-neck dissection surgery

IntroductionNeck dissection (ND) operations are performed to treat known metastatic neck illness. These operations have been associated with chronic neck and shoulder problems. In patients who have had a ND, adhesive capsulitis (AC) is one of the causes of shoulder dysfunction.MethodsForty patients with AC following modified radical neck dissection (MRND) surgeries were chosen at random and divided into two groups of equal size. The low-level laser therapy (LLLT) group (group A) received LLLT with: wavelength – 830 nm, output – 50 mw, maximum frequency – 5000 Hz, pulse duration – 50 ns, and average dose – 9 J/cm2 for 20 min, plus traditional physical therapy (mobilisation technique, myofascial release, range of motion (ROM), and strengthening exercises) for 30 min. The proprioceptive neuromuscular facilitation (PNF) group (group B) received PNF for 25–30 min in addition to traditional physical therapy. The treatment period was 3 times each week and lasted for eight weeks. The discomfort in the shoulder was measured using the visual analogue scale (VAS). Shoulder impairment and pain were assessed by the SPADI scale and the shoulder ranges of motion were assessed using the universal goniometer technique. All measures were taken before and after the intervention.ResultsThe findings reveal that there was a significant enhancement in all variables in both groups A and B after therapy compared to before the treatment (p &lt; 0.001). After therapy, there were no obvious changes in the VAS and SPADI values among the groups (p &gt; 0.05). However, statistical analysis showed significant improvement in the PNF group (group B) in shoulder flexion, abduction and external rotation in comparison to that of the LLLT group (group A) after treatment (p &lt; 0.001).ConclusionsPNF proved to be more effective than LLLT in increasing ROM but was as effective as LLLT in decreasing shoulder pain and dysfunction in AC post ND surgery.

Revitalizing performance: Exploring the influence of sports massage and PNF stretching on lactic acid recovery in females futsal athletes

Elevated levels of lactic acid in the blood and muscles following intense training or competition can have detrimental effects on physical performance and increase the likelihood of injury. Therefore, it is crucial to identify effective recovery techniques to mitigate fatigue promptly. The objective of this study was to assess the impact of sports massage and the Proprioceptive Neuromuscular Facilitation (PNF) method on the recovery of lactic acid in athletes. This study employed a true-experimental design using a pretest-posttest without a control group. A sample of 20 female futsal athletes was divided into two groups: the sports massage group (SM) consisting of 10 participants, and the PNF method group also comprising 10 participants. Lactic acid levels were assessed before exercise, immediately after completing the anaerobic exercise, and immediately after the recovery intervention based on the respective group allocation. The results showed an increase in lactic acid after anaerobic exercise in both groups. The SM group experienced a significant decrease compared to the PNF group which did not experience a significant decrease. A significant disparity was observed in the mean lactic acid levels between the two groups in the post-test data. In conclusion, the application of sports massage following anaerobic exercise proves to be effective in reducing lactic acid concentrations in futsal athletes compared to the PNF method. The findings of this study are anticipated to yield advantages for coaches, sports medical teams, and athletes by lowering lactic acid levels, enhancing sports performance, and mitigating injury risks. Practically, the findings underscore the potential benefits of incorporating a 15-minute sports massage into the recovery routine of female futsal players.

Effects Of Core Strengthening And Proprioceptive Neuromuscular Facilitation Technique On The Barthel Index And Balance In Patients With Hemiplegic Stroke: A Quasi-Experimental Study.

To determine the effectiveness of core strengthening exercises and proprioceptive neuromuscular facilitation techniques on functional performance and balance among patients with hemiplegic stroke. The quasi-experimental study was conducted from March to August 2021 at Imran Idrees Hospital, Sialkot, Pakistan, and comprised stroke patients of either gender who were divided into proprioceptive neuromuscular facilitation group A and core strengthening group B. In both groups, the treatment was given for 6 weeks with 5 30-minute sessions per week. Functional performance and balance were measured using Barthel Index and Berg Balance Scale. Data were collected at baseline, 3 weeks and 6 weeks. Data was analysed using SPSS 22. Of the 48 patients, 24(50%) were in each of the 2 groups. There were 39 (81.25%) male and 9(18.75%) female subjects with an overall mean age of 45±4.919 years. Mean Barthel Index score in group A was 62.50±7.22 at baseline and 74.79±7.14 after 6 weeks. Mean Berg Balance Score was 25.04±2.15 at baseline and 41.66±6.04 after 6 weeks (p<0.05). In group B, Barthel Index score was 61.45±6.33 at baseline and 80.83±7.61 after 6 weeks. Mean Berg Balance score was 25.33±3.38 at baseline and 47.08±5.99 after 6 weeks (p<0.05). There was a significant difference in group B scores compared to group A (p<0.01). Core strengthening programme was more effective than the proprioceptive neuromuscular facilitation programme in terms of activity of daily living and balance in patients with stroke.

Comparison of Respiratory Proprioceptive Neuromuscular Facilitation and Segmental Breathing on Pulmonary functions, Dyspnoea and Exercise Tolerance in COPD Patients: A Comparative Study

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable disease marked by airflow limitation, destruction of lung parenchyma and other associated respiratory symptoms (e.g., dyspnoea and coughing). Pathological changes and symptoms do not appear altogether, symptoms may not appear but pathological changes are likely to be present. Segmental breathing and Proprioceptive Neuromuscular Facilitation (PNF) techniques are both effective techniques in improving pulmonary functions in COPD patients. Aim: To compare PNF and Segmental breathing with respect to pulmonary functions to relieve dyspnoea and improve exercise capacity in COPD patients. Materials and Methods: This was a comparative study conducted from July 2020 to June 2021 at Department of Physiotherapy, SGT University, Gurugram, Haryana, India. On 30 in-patient aged between 40-60 years with Forced Expiratory Volume in 1st second/Forced Vital Capacity (FEV1/ FVC) &lt; 0.7, hospitalised clinically stable patients . Out of these, 15 were allocated in the segmental breathing group and another 15 participants were allocated into the respiratory PNF group through the sealed envelope. The session was of 10-15 minutes under the protocol of 18-20 repetitions of each technique in segmental breathing and respiratory PNF in either respective group. The dyspnoea was assessed by Modified Borg Scale, pulmonary functions was done with spirometry, followed by the 6-Minute Walk Test (6-MWT). The data was statistically analysed using Statistical Package for Social Sciences(SPSS) version 24.0. Paired t-test was used to compare the means of measurements within the groups. The independent t-test was used to compare the means of all the variables between the groups. Results: Both of these techniques improved SpO2 (change in mean from 81.27 to 86.20 and 82.13 to 90.67 in segmental and PNF group, respectively) and relieve dyspnoea post-exertion (8.33 to 6.60 and 8.0 to 5.67 in segmental and PNF groups) within 1-week of intervention (p &lt; 0.01). There was improvement seen in pulmonary functions (FEV1 from 0.87 to 0.95 and 0.78 to 1.02 in segmental and PNF groups) and exercise tolerance (6- Minute Walk Test (MWT) from 149.47 to 204.80 and 151.77 to 242.20 in segmental and PNF groups) as well. And out of both, respiratory PNF is more efficient in improving pulmonary function, dyspnoea and exercise tolerance in a week (p&lt;0.01) which makes the master improvement and pulmonary rehabilitation can proceed with further advancement. Conclusion: Segmental breathing and respiratory PNF are effective techniques for patients with COPD admitted to hospital whose modified Borg’s dyspnoea score is higher even at rest and intolerant to physical exercise and peripheral capillary oxygen saturation is lower than 88%.

Comparison of Proprioceptive Neuromuscular Facilitation with other exercises on Pain and Disability in patients with Non-specific Chronic Low Back Pain: A Meta Analysis

Background: Low back pain (LBP) is encountered in both developed and developing countries. It has becomeone of the commonest health threats. Proprioceptive Neuromuscular Facilitation (PNF) exercises are designed toenhance stimulation of proprioception in neuromuscular junction, thereby leading to greater reduction in painand disability score along with increase in ROM and core strength. Therefore, the present study is intended tocompare the role of PNF and other exercise approach.Objectives: To compare the effect of Proprioceptive Neuromuscular Facilitation (PNF) and other exerciseapproaches in Non-specific low back pain.Methods: In this review, Pub Med, Google Scholar, Cochrane CENTRAL databases were searched for prospectivestudies fulfilling inclusion and exclusion criteria. Randomized controlled trials comparing PNF with othertreatment techniques to treat chronic non-specific low back pain were included in this review. Data was extractedand assessed for the quality of the trials by two independent reviewers. The results were presented in form offorest plots.Results: 11 studies were included in the review for qualitative analysis and meta-analysis. All the studieshowever,relatively little study has been undertaken examining the effects of massage on women in labour. Methods. Arandomized controlled study was conducted between September 1999 and January 2000. Sixty primiparouswomen expected to have a normal childbirth at a regional hospital in southern Taiwan were randomly assignedto either the experimental (n=30 were included in the meta-analysis of pain and eight of the studies were includedin the meta-analysis of the functional disability due to back pain. Overall, there was a small reduction in painintensity of low back pain in patients receiving PNF treatment as compared to other treatment techniques (SMD:-1.41 [95% CI: -1.97, -0.84], I2= 82.9%; p&lt;0.000). ). There was marked improvement in functional disability in lowback patients after PNF than other treatment techniques (SMD: -1.63 [95% CI: -2.28, -0.98], I2= 80.8%; p&lt;0.000).Conclusion: PNF group was more beneficial than other treatment techniques in decreasing pain and functionaldisability scores in 4- to 6-week intervention. This meta-analysis suggests publication bias.

Exercise-Induced Hypoalgesia Following Proprioceptive Neuromuscular Facilitation and Resistance Training Among Individuals With Shoulder Myofascial Pain: Randomized Controlled Trial.

Various exercises can attenuate pain perception in healthy individuals and may interact with the descending pain modulation in the central nervous system. However, the analgesic effects of exercise in patients with myofascial pain can be disrupted by the pathological changes during chronic pain conditions. Thus, the exercises targeted on the facilitation of the sensory-motor interaction may have a positive impact on the restoration of the descending pain modulation and the analgesia effects. This paper estimates the effect of proprioceptive neuromuscular facilitation (PNF) and resistance training on exercise-induced hypoalgesia (EIH) and conditioned pain modulation (CPM) among patients with myofascial pain syndrome. A total of 76 female patients with myofascial pain syndrome (aged 18-30 years), with the pain in the upper trapezius and a visual analog scale score of greater than 30/100 mm, were enrolled in the study. Participants were randomly assigned into 3 intervention groups, including isometric (n=18, 24%), isotonic (n=19, 25%), and PNF (n=20, 26%) exercises, as well as 1 control group (n=19, 25%) with no intervention. Pressure pain threshold and the CPM responses at the myofascial trigger point, arm, and leg sites were assessed before and after the exercise session. The effective EIH response was reflected in the improvement of pressure pain thresholds. There was an increase in pressure pain thresholds and CPM responses at trigger point (P<.001 and P<.001), arm (P<.001 and P<.001), and leg sites (P<.001 and P=.03) in participants who performed PNF and isotonic exercise, while the isometric exercise only increased pressure pain thresholds at leg sites (P=.03). Compared with the control group, both the isotonic (P=.02) and PNF (P<.001) groups showed greater EIH responses at the trigger points. In comparison to the control group, only the PNF exercise (P=.01) significantly improved pressure pain thresholds and CPM responses at arm and leg sites compared to the control group. PNF, isotonic, and isometric exercises could lead to local and global EIH effects. The improvement in CPM response following PNF and isotonic exercises suggested that the EIH mechanisms of different resistance exercises may be attributed to the enhancement of the endogenous pain modulation via the motor-sensory interaction from the additional eccentric and dynamic muscle contraction. Chinese Clinical Trial Registry ChiCtr202111090819166165; https://tinyurl.com/2ab93p7n.

Роль пропріоцептивної нейром’язової фасилітації у фізичній терапії пацієнтів з адгезивним капсулітом плечового суглобу

The purpose of the study was to perform an analysis of the results of studies devoted to the study of the effectiveness of proprioceptive neuromuscular facilitation in patients with adhesive capsulitis of the shoulder joint. Materials and methods. This work is the result of an analysis of studies devoted to the study of the effect of proprioceptive neuromuscular facilitation as monotherapy and as a part of a complex physical therapy or rehabilitation program on the range of motion in the shoulder joint, pain on the visual analog scale, and the shoulder pain and disability index. During the search in scientific databases, the data of 11 studies, which are devoted to the specified issues, were selected. Results and discussion. Studies examining the immediate effects of interventions have found both benefits and no benefits on amplitude measures in groups of patients who received proprioceptive neuromuscular facilitation in addition to physical therapy or as a component of adjunctive therapy. Thus, it is not possible to draw unequivocal conclusions in the question of advantages regarding the immediate effect. Analysis of the effectiveness of programs and courses of treatment for adhesive capsulitis of the shoulder joint established that in the vast majority of studies, the results in the proprioceptive neuromuscular facilitation groups were better at the end of the treatment (3-4 weeks). At the same time, in most studies, scientists noted a significant improvement in pain, amplitude, and functioning indicators in control groups, that is, without the use of proprioceptive neuromuscular facilitation. All of the reviewed papers that analyzed the effectiveness of adding only proprioceptive neuromuscular facilitation to physical therapy programs or adding proprioceptive neuromuscular facilitation as a part of adjunctive therapy found advantages in such groups in terms of pain improvement on a visual analog scale or a pain subscale in questionnaires. Only one such study did not indicate a benefit of proprioceptive neuromuscular facilitation in external rotation. In addition, in most cases, proprioceptive neuromuscular facilitation or combined therapy with proprioceptive neuromuscular facilitation had a better effect on the amplitude of abduction and flexion at the shoulder joint. Conclusion. The developed Ukrainian versions of the questionnaires can be used to assess the level of therapeutic alliance and patient satisfaction in the field of physical therapy and occupational therapy

Proprioceptive Neuromuscular Facilitation and Mirror Therapy Methods Are Comparable Methods of Rehabilitation after a First-Ever Ischemic Stroke: A Randomized Study

Stroke is a serious cause of premature death among adults and the reason for much long-term disability. Understanding the mechanisms of disability and the potential for recovery of stroke patients should be one of the highest priorities of the health care system. Neurorehabilitation of post-stroke patients focuses on functional recovery by activating mechanisms of natural reorganization. Proprioceptive neuromuscular facilitation (PNF) and mirror therapy (MT) are neurorehabilitation methods activating brain plasticity, and their clinical utility for stroke survivors is still under studied. This study compared two neurorehabilitation methods using PNF or MT on functional recovery in patients after a first-ever ischemic stroke. This prospective and interventional randomized clinical study involved a group of 50 patients (34 males and 16 females) with first-ever ischemic stroke, aged 48–82 years being in the recovery-compensation stage and admitted to the unit for early post-stroke rehabilitation. Patients were randomly enrolled into two groups in terms of rehabilitation method used: PNF (n = 26) or MT (n = 24). Barthel Index (BI) was used for assessing functional status at baseline (M0), and 3 (M1) and 6 weeks (M2) after intervention), and modified Rankin Scale (mRS) was used for assessing a disability level at baseline (M0), and 6 weeks (M2) after the intervention. Statistically significant differences were noted in the two study groups in BI (main effect: &lt;0.05). There was an improvement in the MT group between M1 and M2 by 3.6 points, M1 and M3 by 6.9 points, and M2 and M3 by 6.9 points. For the PNF group, there were differences between M1 and M2 by 4.1 points, M1 and M3 by 7.2 points, and M2 and M3 by 3.1 points. Moreover, statistically significant differences were noted in both groups in mRS (main effect: p &lt; 0.05). There was a decrease of 2.2 points in the MT group between M1 and M2 measurements. For the PNF group, there were differences between M1 and M2 by 2.3 points. There were no statistically significant differences between the MT and PNF groups in both BI and mRS scores (p &lt; 0.05). In conclusion, both PNF and MT neurorehabilitation methods could be useful for improving functional status and reducing disability level in patients after first-ever stroke during the regenerative-compensatory stage.

Efficacy of proprioceptive neuromuscular facilitation in improving shoulder biomechanical parameters, functionality, and pain after axillary lymph node dissection for breast cancer: A randomized controlled study

PurposeAxillary lymph node dissection and radiotherapy have been associated with pain, physical symptoms, and decreased functional abilities in the upper extremity. This study aimed to evaluate the potential effects of the proprioceptive neuromuscular facilitation (PNF) technique on muscle strength, pain and functionality in this patient group in comparison with progressive resistance training (PRT). MethodsThe study was conducted with a randomized clinical trial design. Sixty-six women were included in the study and randomly divided into three groups: the PNF group (n = 22), the PRT group (n = 22), and the control group (n = 22). The participants were evaluated at the baseline and after eight weeks of treatment. Outcome measures were determined as pain (the Visual Analog Scale), upper extremity strength (isokinetic dynamometer), functionality (the Disabilities of the Arm, Shoulder and Hand questionnaire), and perception of change (the Global Rating of Change Scale). Trial registrationClinicalTrials.gov identifier: NCT05288036. ResultsThe results showed statistically significant changes in both treatment groups in terms of shoulder flexors/extensors, abductor/adductors, internal/external rotators strength/power/endurance measurement, pain, and functionality (p < 0.05). Concerning functionality and perception of change, the PNF group had a statistically significantly higher improvement compared to the remaining two groups (p < 0.05). ConclusionPNF is an effective technique in increasing upper extremity muscle strength, reducing pain during rest and activity, and improving functionality in patients receiving breast cancer treatment.

Bilateral Asymmetrical Limb Proprioceptive Neuromuscular Facilitation Effects on Pain, Multifidus Activity, Range of Motion, and Disability in Low Back Pain: A Randomized Controlled Trial

ObjectiveThe purpose of this study was to determine the effects of bilateral asymmetrical limb proprioceptive neuromuscular facilitation (PNF) pattern exercises on lumbar multifidus (LM) activity, pain, disability, and lumbar range of motions (ROMs) compared to Swiss ball exercises in patients with chronic low back pain (CLBP). MethodsA randomized controlled trial was conducted at the Sindh Institute of Physical Medicine and Rehabilitation, Karachi, Pakistan, between March 2020 and January 2021. A sample size of 150 patients with CLBP was randomized into 2 groups. Participants in the intervention group (n = 75) received bilateral asymmetrical limb PNF, while the comparison group (n = 75) received Swiss ball exercises. The scores of the visual analog scale, Oswestry Disability Index, Modified-Modified Schober's test, and percentage of the maximum voluntary contractions of LM (%MVC LM) through surface electromyography were recorded before and after 15 sessions of exercises. The Wilcoxon signed rank and Mann-Whitney U tests were employed for within-group and between-group comparisons of all outcomes, respectively. The considered level of significance was 0.05. The trial was registered with ClinicalTrials.gov (NCT04206137). ResultsPain (in sitting, standing, and walking), disability on the Oswestry Disability Index, and left side %MVC LM were significantly improved (P < .001) in the PNF group compared to the comparison group except for right side %MVC LM and ROMs on the Modified-Modified Schober's test (P > .05). ConclusionBilateral asymmetrical limb PNF exercises showed improvement in pain, disability, and LM activity of patients with CLBP more than those who used Swiss ball exercises.

Effects Of Proprioceptive Neuromuscular Facilitation On Obstacles Crossing Strategies Among Older Adults With Knee Osteoarthritis

PURPOSE: To investigate the effects of an 8-week proprioceptive neuromuscular facilitation (PNF) intervention on pain and biomechanical characteristics during stepping over obstacles among older adults with Knee Osteoarthritis (KOA). METHODS: Thirty-two participants were randomly allocated into PNF or control groups. The participants in the PNF group received PNF stretching and those in the control group partook in the health lecture series for eight weeks, with three one-hour sessions a week. The Visual Analogue Scale (VAS) was used to assess the pain score. Each subject stepped over an obstacle with a height of 20% leg length. The spatiotemporal variables of the more affected leg were collected using a motion analysis system with two force platforms before and after the intervention. Joint angles and moments were calculated. Two-way (group by intervention) ANOVA with repeated measures was used to compare the differences. RESULTS: Data analysis included 13 participants in the PNF group (8 female, 65.77 ± 4.69 years, 165.46 ± 6.78 cm, and 71.53 ± 8.89 kg) and 14 in the control group (7 female, 63.00 ± 2.77 years, 161.41 ± 6.75 cm, and 69.06 ± 9.59 kg). Significant interactions were detected in the following variables, the pain score (week0: 4.30 ± 1.45, week9: 1.32 ± 1.25, p < 0.001, d = 2.189), foot clearance (week0: 0.27 ± 0.04, week9: 0.25 ± 0.03, p = 0.036, d = 0.555), knee external rotation (week0: 16.14 ± 7.80, week9: 11.08 ± 7.86, p = 0.017, d = 0.646) angles, and first (week0: 0.40 ± 0.10, week9: 0.24 ± 0.10, p < 0.001, d = 1.583) and second peaks (week0: 0.36 ± 0.12, week9: 0.17 ± 0.12, p < 0.001, d = 1.583) of the knee adduction moment were significantly decreased, while the crossing velocity (week0: 0.30 ± 0.04, week9: 0.33 ± 0.03, p = 0.003, d = 0.832), hip flexion angle (week0: 76.16 ± 6.94, week9: 82.51 ± 5.75, p = 0.004, d = 0.996), hip flexion (week0: 0.79 ± 0.23, week9: 0.95 ± 0.17, p = 0.007, d = 0.774) and extension (week0: 0.49 ± 0.09, week9: 0.61 ± 0.14, p < 0.001, d = 0.977) moments were increased after the intervention in PNF group, but not in the control group. CONCLUSION: PNF could relieve pain, improve dynamic joint flexibility and gait strategies among older adults with knee osteoarthritis during stepping over obstacles. Funding was provided by Shandong Province Young Innovative Talent Introduction and Cultivation Program (2019-183).

The effects of pain relief on proprioception and muscle strength for tibial plateau fractures: A randomized controlled trial

ObjectivesTo investigate the effect of transcutaneous electrical acupoint stimulation (TEAS) combined with proprioceptive neuromuscular facilitation (PNF) on postural stability, muscle strength and pain in patients with tibial plateau fracture. MethodA 3-arm randomized controlled trial was conducted in 60 patients with tibial plateau fracture. Participants received one of the following interventions: standard treatment (ST group, n = 20), ST + PNF training (ST + PNF group, n = 20), ST + PNF training + TEAS intervention (ST + PNF + TEAS group, n = 20). All treatments lasted for six weeks. Participants’ postural stability, muscle strength and pain were evaluated at baseline, after 3 and 6 weeks of intervention. ResultsAfter 3 weeks of intervention, Between-group comparisons showed that both the ST + PNF group and ST + PNF + TEAS group showed significantly greater performance than the ST group in the postural stability measure (P < 0.02) and pain score(P < 0.05). The peak torque of quadriceps extensors and flexors at the velocity of 60°/s was significantly higher in the ST + PNF + TEAS group than in the ST group (P < 0.02). After 6 weeks of intervention, only the ST + PNF + TEAS group was superior to the ST group in postural stability measure(P < 0.04) and in pain score (P < 0.05). The ST + PNF + TEAS group was significantly higher than the ST + PNF group and the ST group in the peak torque of quadriceps extensors at the velocity of 60°/s and 180°/s (P < 0.01). ConclusionPNF training could improve dynamic postural stability and relieve pain at three weeks, while TEAS combined with PNF was more effective in relieving pain, strengthening muscle strength and improving dynamic postural stability at six weeks post-intervention.

Efficacy of Single Stretching Session of Iliopsoas Using Proprioceptive Neuromuscular Facilitation Versus Muscle Energy Technique on Low Back Pain in Patients With Lumbar Hyper-Lordosis.

Background and objectivesOne of the most frequent conditions for which people seek physiotherapy treatment is low back pain (LBP). When the aetiology of low back pain is whittled down to mechanical factors, pelvic tilting becomes apparent. The iliopsoas muscle is the key to relieving LBP in such circumstances, and since it is tightened, we concentrated on stretching it adequately in this study. Proprioceptive neuromuscular facilitation (PNF) and muscle energy technique (MET) are two stretching techniques that we have compared for this purpose. There are many other stretching techniques available, but the evidence has proven these two to be the most effective.MethodsThe participants in the study were those between the ages of 18 and 60 who had exaggerated lumbar lordosis, or LBP, and met the inclusion criteria. There were two groups created: A and B. PNF and traditional physiotherapy was used to manage the participants in group A, and MET and traditional physiotherapy were used to manage the participants in group B. Each group underwent the same pre-and post-tests, which included the Numerical Pain Rating Scale (NPRS) to assess pain intensity; a universal goniometer to measure hip joint extension range of motion (ROM) to assess iliopsoas flexibility; and a side-lying X-ray to measure the lumbosacral angle (LSA) to determine the angle of lumbar lordosis.ResultIn both the stretching interventions, i.e., PNF and MET, there were statistically significant differences in pain, hip extension range of motion, and lumbar lordosis angle (P > 0.0001). However, for the PNF group, the difference between the pre-and post-test was greater than that for the MET group.ConclusionThe current study, which included 100 participants, demonstrated that both PNF and MET are remarkably effective for loosening the tight iliopsoas. A comparison of both techniques showed that the PNF group had benefited significantly more than the MET group.

Proprioceptive Neuromuscular Facilitation compared to usual resistance exercise therapy in individuals with knee osteoarthritis: a randomized clinical trial protocol

Background/Aims: Knee osteoarthritis (KOA) is characterized by functional impairment in performing of daily life activities. Proprioceptive Neuromuscular Facilitation (PNF) is a treatment concept that recommends performing exercises within a context of functionality. To develop a protocol to evaluate the efficacy of (PNF) compared to conventional physiotherapy (CPT group) on pain reduction and improvement in physical functioning and quality of life in individuals with KOA. Methods: A protocol for a randomized controlled trial was proposed to evaluate the effectiveness of the PNF protocol in pain reduction, improvement physical functioning, quality of life and evaluation of adverse effects, according Consolidated Standards of Reporting Trials. Participants will be randomly assigned (1:1) to PNF or CPT group and twelve weekly sessions will be carried out for three months. To assess primary outcome measures are knee pain severity (Numeric Rating Scale) and physical functioning (The Western Ontario and McMaster Universities questionnaire). The outcomes will be performed at baseline, 12th session (6 weeks), 24th session (12 weeks) and three-month follow-up. Intention-to-treat will be performed. Results: A PNF protocol was developed for KOA, consisting of seven illustrated exercises. Biomechanical objectives, observations, positions of individuals and therapists, load progression, PNF principles, procedures and techniques have been described. Conclusion: The detailed elaboration of a physical therapy treatment protocol based on the PNF-concept allows a treatment approach based on the principles of learning and motor control, favoring the mitigating and improving physical functioning and quality of life of the individuals with KOA.