Proprioceptive Neuromuscular Facilitation Techniques Research Articles

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) < 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 < 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<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%.

ALÍVIO DA FADIGA ESPORTIVA APÓS CORRIDAS DE MARATONA POR ALONGAMENTO PNF

ABSTRACT Introduction: Marathon running requires stretching practices to relieve fatigue after exercise. The Proprioceptive Neuromuscular Facilitation (PNF) technique is an advanced stretching technique that allows segmenting of a specific muscle group for simultaneous stretching and strengthening. Objective: This paper explores the effect of PNF stretching exercise on relieving sports fatigue after marathon races. Methods: In this paper, 160 marathon runners were selected for the experiment, and randomly divided into experimental and control groups. The experimental group performed the PNF stretching exercise, while the control group remained with traditional stretching without any new intervention. Fatigue was assessed according to the heart rate, collected before, during, and after the experiment. Results: After nine weeks of PNF stretching training, the heart rate in the experimental group changed from 65.35 to 62.46 in the morning; during training, the group’s heart rate changed from 180.79 to 173.04; after recovery, the first group’s heart rate changed from 82.88 to 81.88. In the control group, the heart rate of the group also showed changes from 65.29 to 68.86 in the morning; during training, it changed from 180.7 to 175.49; and after recovery, from 86.23 to 88.4. Conclusion: PNF stretching exercise has a positive effect on relieving sports fatigue after marathon races. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

Proprioceptive neuromuscular facilitation in chronic low back and neck pain and disability: A systematic review and meta-analysis

BACKGROUND: Proprioceptive neuromuscular facilitation (PNF) is one of the neurophysiological techniques aimed at reducing pain and disability. This systematic review objective addresses the current evidence on PNF techniques’ effectiveness in chronic low back and neck pain. METHODS: Literature search in PubMed, Scopus, Cochrane, Wiley and Ovid databases were searched until 2021. The content of the titles and the abstracts were analysed to gather information about the effects of PNF in chronic back and neck pain with outcomes of pain and disability. The quality of the studies was analysed by the Joanna Briggs Institute (JBI) critical appraisal score. Meta-analysis was performed on Visual Analogue Scale (VAS), Numerical Rating Scale (NRS) for chronic low back pain and Oswestry Disability Index (ODI), Roland Morris Disability Questionnaire (RMDQ) for disability. RESULTS: Nine studies addressed the different PNF based interventions on chronic low back pain, with a total of 416 participants. The intervention period ranged 3–6 weeks, and two studies conducted 12-weeks follow-up. Many studies measured pain using a VAS and NRS, whereas the disability through ODI and RMDQ. The JBI score ranged from 6/13 to 11/13. None of the PNF studies treated chronic neck pain. CONCLUSION: PNF might be beneficial for reducing low back pain and related disability. The long term effects of PNF on chronic low back pain, and also to determine its benefits on chronic neck pain are warranted in future studies.

Concepts and Application of Tai Ji in Stroke Rehabilitation: A Narrative Review.

Stroke remains a leading cause of adult disability, and it decreases the health-related quality of life due to functional disability and poor functional recovery in stroke. Tai Ji has been recently introduced to overcome disabilities. This review aims to explain the effects of Tai Ji on functional recovery in stroke patients, linking it to current approaches, concepts and therapies such as Bobath and proprioceptive neuromuscular facilitation techniques. A compilation of recent literature on Tai Ji's use in stroke rehabilitation from Google scholar and PubMed Central (2018 to 2022). The benefits of Tai Ji in stroke functional recovery were studied and explained based on its similarity in concepts to current conventional stroke rehabilitation approaches. There were few randomized controlled trials on Tai Ji in functional recovery among stroke patients. However, all literature identified Tai Ji as beneficial in stroke rehabilitation. However, there was no literature on explaining the Tai Ji movement based on current conventional stroke rehabilitation approaches. Tai Ji carries similar theories to the current neurorehabilitation approach. Tai Ji can be modified and incorporated into stroke rehabilitation programs based on patients' needs to produce promising outcomes.

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.

Effect of Proprioceptive Neuromuscular Facilitation on Basic Motor Skills in Children with Down Syndrome

Objective: Trisomy 21 is a genetic disorder occurs in 92% individuals. Majority of the skeletal abnormalities are associated with it. Therefore the study had been planned with an aim to determine the effect of PNF on basic motor skills in child Down syndrome children. Methods: The study design was quasi-experimental. 22 children were included on inclusion &amp;exclusion criteria. The data was collected from Rising Sun Institute for Special Children Lahore Group A was treated with conventional physical therapy whereas Group B were treated with PNF technique and conventional physical therapy. Pre-assessment was done by using GMFM. Each subject received 36 treatment sessions with 03 sessions per week. The session continued for 30 minutes for both groups. Post treatment reading for Gross Motor Function Measure was recorded after the end of 12 weeks. The collected data analyzed by using Statistical Package for Social Software (SPSS). Results: It showed that across the group comparison shows both treatments which are applied to both groups shows good results as their mean difference values show it and their P value are not significant. Results also showed that within the group comparison PNF has better results on group B patients as per their mean difference values show it and their p values are significant. Conclusion: The study concluded that the PNF technique has better effect in Down syndrome children as compared to conventional physical therapy treatment in children on gross motor skills like standing, walking, running jumping Keywords: Down syndrome (DS), Proprioceptive Neuromuscular Facilitation (PNF), Gross Motor Function Measure (GMFM).

Effectiveness of Pelvic Proprioceptive Neuromuscular Facilitation Techniques on Balance and Gait Parameters in Chronic Stroke Patients: A Randomized Clinical Trial.

Background Stroke is the second leading reason for death and the third most common reason for disability. Stroke is a source ofpossible substantial harm and is often moredisabling than lethal. Common stroke defects include stiffness, tiredness, loss of balance on the afflicted side, as well as gait impairment, resulting in an inability to sustainpostural alignment. Pelvic proprioceptive neuromuscular facilitation (PNF) is a physical rehabilitation that combines functionally dependent diagonal activity patterns with neuromuscular facilitator strategies to improve motor behaviour, endurance, and muscle activity and control. This protocol was created to describe the experimental study design for evaluating the combined impact of pelvic PNF and task-oriented exercises in chronic stroke patients to improve balance and gait parameters. Aim and objective The purpose of our study is to investigate the effectiveness of pelvic PNF as well as task-oriented exerciseson balance, gait parameters, and in pelvic asymmetry. Methods The participants (n=30) were stroke survivors who fulfilled the inclusion criteria for research and were divided into two groups. The regimen lasted four weeks and took 30 minutes each day. Patients were evaluated at the beginning and end of their treatment. In both groups, pre- andpost-intervention outcome measures were recorded and the data was analyzed. Result Following four weeks of rehabilitation, subjectsshowedremarkableimprovementin balance, gait parameters, and pelvic inclination in both groups, i.e., pelvic PNF and task-oriented exercises in group A and task-oriented exercises in group B, but Group A showed a major improvement in outcome measures.A p-value of less than 0.05 was considered significant. Despite the fact that both treatment regimens were successful for the patient, pelvic PNF combined with task-oriented exercises exhibits a statistically significant difference from task-oriented exercises. Conclusion Pelvic PNF along with task-oriented exercises proved to be beneficial and can help in the restoration of balance and gait parameters as a result of normalisation in the geometry and symmetry of the pelvis in stroke patients. The pelvis, which is a connecting link between the trunk and lower limbs, plays a crucial role in balance and also in lower limb performance exclusively in gait.

Effectiveness of Pelvic Proprioceptive Neuromuscular Facilitation on Balance and Gait Parameters in Children With Spastic Diplegia.

Background Among several variants of Cerebral Palsy, Spastic Diplegic is encountered most commonly in clinical setups. A majority of children with Spastic Diplegia manifest themselves with a disturbance in the geometrical orientation of their pelvis, which imposes an effect on their functional capabilities like walking with independence. This research had an emphasis on the extraction of the efficacy of Pelvic Proprioceptive Neuromuscular Facilitation (PNF) Techniques on Balance and Gait Parameters in children suffering from Spastic Diplegia. Method Participants included in the study were between the age groups of 8 to 12 years who were diagnosed with Spastic Diplegia with an independent sitting and walking ability and who are coming in stages I to III according to Gross Motor Function Classification System. Subjects in group A were given Pelvic PNF techniques for 15 minutes on both sides along with Task-Oriented training for 30 minutes, six days a week and continuously for four weeks, while the subjects in group B were given only Task-Oriented activity for the same duration. The pre- and post-treatment assessments of all 40 subjects were gathered using the Paediatric Balance Scale, Palpation Meter device, and Gait Parameters. Results The study included 40 participants, which were segregated into two groups of 20 subjects in each group. Group A received Pelvic Proprioceptive Neuromuscular Facilitation with Task-Oriented Training, and group B received only Task-Oriented training activities. The contrast of pre- and post-treatment findings of both the groups revealed that group A reported a significant improvement in their outcomes (P>0.0001). Conclusion The present study, which included 40 subjects, has generated evidence regarding the efficacy of Pelvic PNF on Balance and Gait Parameters in children with Spastic Diplegia.

Immediate Effectiveness of Chest Proprioceptive Neuromuscular Facilitation (PNF) Technique on Hemodynamic Status in COVID-19 Patients: An Original Research.

IntroductionCOVID-19 is an infectious illness that first appeared in Wuhan, China in December 2019, and subsequently spread over the entire world. Those who were affected suffered from fever, cough, weakness, and breathlessness, along with the probability of developing pneumonia which sometimes leads to respiratory failure. The older population with co-morbidities was at higher risk.MethodsIn this experimental study, 59 subjects with COVID-19 were included according to pre-decided inclusion and exclusion criteria. Pre-vitals before the treatment were noted such as heart rate, respiratory rate, and oxygen saturation (SPO2), and then the chest proprioceptive neuromuscular facilitation (PNF) technique was given as a treatment regime, and its immediate effect was calculated. Post-vitals were noted immediately after the treatment session. The statistical analysis was made using the student's paired t-test.ResultsWe found a mean difference of 9.45±5.27 in heart rate before and after the intervention provided which is suggestive of a statistically significant increase within normal limits. Also, the mean value of respiratory rate immediately after the intervention was shown as 22.91 and pre-intervention was 19.18 with a mean difference of 2.93±3.95, showing a statistically significant increase in respiratory rate. Additionally, the mean value of SPO2 immediately after the intervention was shown as 92.76 and pre-intervention was 94.64 and had a mean difference of 1.88±1.67 suggestive of high improvement in oxygen saturation immediately after the intervention.ConclusionThe present study concludes from the available statistical analysis that chest PNF techniques such as intercostal stretch and anterior basal stretch lift have an immediate impact on improvement in oxygen saturation in COVID-19 patients and can be incorporated as an inpatient treatment regime in the rehabilitation protocol.

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.

The Effect of Scapular Proprioceptive Neuromuscular Facilitation Techniques on Pain and Functionality in Patients with Subacromial Impingement Syndrome: A Randomized Controlled Trial

Abstract Objective To determine the effectiveness of scapular proprioceptive neuromuscular facilitation (PNF) techniques in patients with subacromial impingement syndrome (SIS). Methods 36 patients were randomized and a 6-week exercise program was applied to both groups 2 days a week. PNF group also received rhythmic initiation and repeated stretch PNF techniques in 2 scapula diagonals. Pain and function were primary outcomes. Active range of motion (ROM), pain pressure threshold (PPT), active myofascial trigger points (MTrPs), scapular dyskinesis, anxiety and depression status were secondary outcomes. Results The improvement in function, internal rotation ROM, PPT, active MTrPs and patient satisfaction was significantly greater in PNF group than exercise group (p&lt;0.05). Scapular dyskinesis improved only in PNF group (p&lt;0.05). Significant improvement in pain, function, ROM, PPT, active MTrPs, anxiety and depression was found in both groups (p&lt;0.05). Conclusions Both scapular PNF techniques and standard exercise program are effective in the treatment of SIS. However, scapular PNF techniques can be added to the exercise program to further improve function, ROM, PPT, active MTrPs, scapular dyskinesis, and patient satisfaction.

Comparison of Effectiveness of Trunk PNF Versus NDT on Trunk Stability in Stroke Patients

Stroke is the commonest neurological deficit caused by an interruption of the blood flow to the brain and loss of trunk control is commonly observed in patients after stroke. Impaired trunk control has a negative impact on daily activities and quality of life(QOL) in patients after stroke. Proprioceptive Neuromuscular Facilitation (PNF) and Neurodevelopmental technique (NDT), both are effective in improving trunk control in hemiplegic patients by improving trunk muscle endurance, strength, and trunk mobility. This study is aimed to compare the effectiveness of trunk PNF and NDT to improve trunk stability in patients with stroke. The objective of the study was to compare the effectiveness of trunk proprioceptive neuromuscular facilitation and neuro-developmental therapy based on trunk protocol with conventional therapy to improve trunk stability in stroke patients 30 subjects who fulfilled the criteria were taken for the study and was categorised into 2 groups of A and B, each having 15 subjects. Group A received trunk proprioceptive neuromuscular facilitation along with conventional therapy &amp; group B received neuro-developmental therapy based on trunk protocol along with conventional therapy respectively for 4 weeks. Before the study, all the subjects were assessed using a general assessment proforma. Both pre and post-treatment assessments were assessed by using trunk impairment scale and ROM of trunk flexion and extension. The results of statistical analysis were tabulated in terms of mean, standard deviation, variance, t-test, P-value, coefficient of variation in both groups. Paired t-test showed that there was a statistically significant improvement in both groups (P&lt;0.05). The coefficient of variation is significant at the CV of group A (83.34) less than the CV of group B (100.16), therefore group A is more effective compared to group B. In this study, it was found that the trunk PNF technique with conventional exercises and NDT based on trunk protocol with conventional exercises was effective to improve trunk stability in acute or subacute stroke patients. But, the trunk PNF technique with conventional exercises was more effective than NDT based on the trunk protocol conventional exercises technique for improving the trunk stability in acute or sub acute stroke patients.

EFFECTIVENESS OF PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION TECHNIQUES IN IMPROVING MUSCLE STRENGTH IN A PATIENT WITH HEMIPLEGIA

Stroke is a neurological condition that causes damage to the brain tissue caused by the cutoff of normal blood flow due to vessel collapse or thrombosis. Depending on the areas affected, size, and the cause of injury, motor, sense, recognition, language, and perception deficits are common symptoms of the disease. Patients with stroke often presents with problems such as weakness, spasticity and impaired movement patterns along with decreased balance and mobility issues. There are many physiotherapeutic approaches focussing on early recovery of stroke patients. One approach which can be primarily used to improve strength when there are visible voluntary individual movement patterns is Proprioceptive Neuromuscular Facilitation techniques. The present case report is of a 50-year-old male with left hemiplegia who underwent physiotherapy for 4 weeks primarily emphasizing on strength through Proprioceptive Neuromuscular Facilitation. After 4 weeks there was improved strength in left upper and lower limb. The patient even improved in his ADL’s.

Effects of Scapular Proprioceptive Neuromuscular Facilitation Techniques in Addition to Routine Physical Therapy on Clinical Outcomes in Patients with Adhesive Capsulitis: A Randomized Controlled Trial

Background: Adhesive capsulitis is a painful condition comprises of reduced glenohumeral joint movement and the scapular neuromuscular facilitation techniques is considered effective, non-invasive approach for treating this condition. Objective: To compare the effects of neuromuscular facilitation techniques on clinical outcomes in patients with adhesive capsulitis. Methods: This trial was registered in ClinicaTrials.gov (ref: NCT05151783) and approval was taken (IRB No. 818-II). This single-blinded randomized controlled trial was conducted on patients (n=96) having adhesive capsulitis in six months. Non-probability purposive sampling technique was used for randomization via sealed envelope method. Conventional group received routine physiotherapy including ultrasound, hot packs, shoulder range of motion, stretching exercises, and joint mobilization five times per week for four weeks with 40 minutes’ duration of each session. Glenohumeral joint distraction, caudal, dorsal, and ventral glides were given at a rate of 2-3/second oscillations for 1-2 minutes to patients. Visual analogue scale, functional activity was calculated at baseline, 2nd and 4th week. The descriptive statistics (continuous variables) values for each variable in form of means and standard deviations were calculated and their p-values were also calculated using an independent sample t-test. For the qualitative data (categorical variables), frequency and percentage were estimated. Frequencies and percentages of different variables like gender had also been calculated. Repeated measure analysis of variance (ANOVA) was calculated to calculate within-group differences in the mean of each variable between the assessment points. Results: Test of within subject effects showed significant difference for all variables at follow-up and difference between groups also showed significant difference at different follow-ups (p-value≤0.001). Both groups showed statistically significant results (p≤0.001), but scores were higher in experimental group. Conclusion: Scapular proprioceptive neuromuscular facilitation technique along with routine physical therapy are more effective as compared to routine physical therapy alone in patients with adhesive capsulitis.

Impact of cervical mobilization, proprioceptive neuromuscular facilitation and active release technique on neck function, disability and quality of life in a hemithyroidectomy patient: A case report

Impact of cervical mobilization, proprioceptive neuromuscular facilitation and active release technique on neck function, disability and quality of life in a hemithyroidectomy patient: A case report

Effectiveness of PNF stretch of pectoralis major muscle on pulmonary function in COPD patients

COPD is a common and a progressive disorder that is characterised by respiratory symptoms and airflow limitation due to the abnormalities of the airway or alveoli. Proprioceptive neuromuscular facilitation technique can increase the contractive capacity of muscles. The study aimed at assessing the effect of Proprioceptive neuromuscular facilitation stretch of pectoralis major muscle on chest expansion and pulmonary function values in COPD patients. Methods: hold relax PNF of pectoralis major muscle was given for a duration of 6 weeks on the particpants who are met with inclusion and exclusion criteria. Chest expansion was measured at axillary level and xiphisternal level, FEV1, FVC and FEV1/FVC were measured pre and the post intervention. Results: statistical analysis was done using paired t test (p&lt;0.05). the results of the study shows that there is increase in the chest expansion at axillary level and xiphisternal level and increase in the FEV1/FVC ratio following 6 weeks of hold relax PNF stretch of pectoralis major in COPD patients. Conclusion: the study concludes that with hold relax PNF stretch there is increase in chest expansion and pulmonary function values.

Comparison Of Scapular Proprioceptive Neuromuscular Facilitation and Myofascial Release Techniques on Pain and Function in Scapular Dyskinesia Associated with Adhesive Capsulitis

Adhesive capsulitis is frequently recognized as ‘Frozen Shoulder’, which is characterized by primarily painful joint range of motions and later progressively restricted range of motion of the glenohumeral joint. Other common names used for adhesive capsulitis includes ‘Periarthritis and Painful stiff shoulder’ and ‘Shoulder arthrofibrosis’. Objective: To compare the effects of scapular proprioceptive neuromuscular facilitation and Myofascial release techniques on pain and function in scapular dyskinesia associated with adhesive capsulitis. Methods: Quasi Experimental study was conducted on 34 patients of Scapular dyskinesia associated with Adhesive Capsulitis. Subjects were allocated to either to PNF technique group and Myofascial release technique groups. Both were treated for 12 sessions in 6 weeks. NPRS and SPADI scale were used to evaluate the treatment effects at baseline, 2 weeks, 4 weeks and 6 weeks. Results: The mean age of Group A was 43.12± 5.25. The mean age of Group B was 43.0±5.95. There was a significant difference between the mean value of baseline, 2 weeks, 4 week and 6-week NPRS score and baseline, 2-week, 4 week and 6-week SPADI score with P value &lt;0.05 in both study groups. There was more significant mean difference of 6.23 between baseline and week 6 NPRS in Group A but there was less significant mean difference of 4.00 between baseline and week 6 NPRS in Group B. There was more significant mean difference of 70.70 between baseline and week 6 SPADI in Group A but there was less significant mean difference of 46.17 between baseline and week 6 SPADI in Group B. Conclusions: The study concluded that PNF technique and Myofascial release techniques were led to significant difference in NPRS and SPADI score, but PNF technique had shown more significant results than myofascial release technique to improve pain and function in scapular dyskinesia associated with Adhesive capsulitis.

Effect of proprioceptive neuromuscular facilitation technique on the treatment of frozen shoulder: a pilot randomized controlled trial

Background and objectivesFrozen shoulder is a common painful disease of the shoulder joint characterized by structural changes in the shoulder joint, restricting both active and passive shoulder joint activities. Proprioceptive neuromuscular facilitation (PNF) effectively improved and maintained the range of motion; however, it is not clear whether it can improve the shoulder joint structure in patients with frozen shoulder. This pilot study used magnetic resonance imaging (MRI) observation to assess the improvement of the local structure of the shoulder joint upon PNF treatment to elucidate a target based on structure for the treatment of frozen shoulder.Materials and methodsForty-eight patients with frozen shoulder were randomly divided into the traditional manual therapy group and the PNF technique group. Changes in the thicknesses of the coracohumeral ligament (CHL) and capsule in axillary recess (CAR) of the shoulder joint were observed via MRI upon admission and at 4 weeks after treatment. A visual analog scale (VAS) and passive shoulder range of motion (ROM) at abduction, anteflexion and external rotation position were used to evaluate the improvement of shoulder joint pain and function in the initial, mid-term, and discharge of the two groups of patients.ResultsThe primary outcome results shown that the PNF joint mobilization significantly reduced the thickness of the CHL (p = 0.0217) and CAR (p = 0.0133). Compared with simple joint mobilization, The mid-term and discharge rehabilitation assessment results showed that PNF has a better effect on shoulder pain. At the mid-term evaluation, the ROM of the PNF group was significantly better than that of the Control group in the three directions (p < 0.05).ConclusionAs an adjunctive therapy, PNF can improve the shoulder joint structure of patients with frozen shoulder and is an effective treatment strategy for frozen shoulder.

Hold-relax PNF is more effective than unilateral lumbar mobilization on increasing hamstring flexibility: A randomized clinical trial

BackgroundAlthough lumbar mobilization (LM) and proprioceptive neuromuscular facilitation (PNF) are used to increase flexibility in clinical practice, remains unclear which technic is the most effective. This study aims to verify and compare the immediate effect of unilateral LM and hold-relax PNF on hamstring flexibility. MethodA randomized, blinded, crossover trial carried out in university research laboratory. Thirty healthy young adults were randomly allocated to three groups, each group receive unilateral, central posterior-anterior LM grade III to the L4 joint, hold-relax PNF and control intervention in a different order with 48 h of washout period. Hamstring flexibility was measured using photogrammetry before and immediately after intervention through range of motion (ROM) change in the Straight Leg Raise Test. T-tests were used to compare ROM within groups, and ANOVA repeated measure followed by Bonferroni post-hoc tests was used for between groups comparison. ResultsTwo participants were lost to follow-up, leaving 28 for analysis (21.6 ± 2.2 years-old). LM increased 4.5° (95% CI 2.3–6.5°, p = 0.001, d = 0.29) on the straight leg raise test and PNF increased 10.0° (95% CI 7.7–12.2°, p = 0.001, d = 0.7). No statistically significant increase was observed on the control group (p = 0.151, d = 0.08). Further, the technique used significantly influenced ROM (p = 0.001, η²p = 0.37). On the between group analysis, PNF was better than LM (p = 0.005) and control (p = 0.001), whereas LM was no better than the control for hamstring flexibility (p = 0.68). ConclusionsAlthough hold-relax PNF and unilateral LM techniques increased ROM, hold-relax PNF was more effective on increasing hamstring flexibility.

Physiotherapy Management of Migraine Pain: Facial Proprioceptive Neuromuscular Facilitation Technique Versus Connective Tissue Massage.

Physical therapy modalities are often used by patients with migraine pain. The effectiveness of the methods in the treatment of migraine has not been clarified yet. This prospective study was planned to investigate whether facial proprioceptive neuromuscular facilitation is superior to connective tissue massage in the treatment of migraine pain. The study was conducted on 40 female patients with a neurologist-confirmed diagnosis of chronic migraine with non-aura, and who were aged between 18 and 65. They were randomly divided into 2 groups. Facial proprioceptive neuromuscular facilitation techniques were applied to the patients in the study group (Group 1), and connective tissue massage was applied to the patients in the control group (Group 2). The interventions were performed 3 times a week for approximately 20 minutes. Pain and pressure pain threshold scores were recorded on the first day of treatment before starting the session and were reassessed immediately after the end of the 18 treatment (6 weeks) sessions. Pretreatment and posttreatment results were similar in both groups in terms of pain scores and pressure pain threshold values ( P > 0.05). Both groups improved in pain-related outcomes ( P < 0.05). Our results suggest that facial proprioceptive neuromuscular facilitation was no more effective than connective tissue massage for treating migraine for the sample size used in the present study. Both methods can be used in the treatment of migraine pain.