Proprioceptive Neuromuscular Facilitation Techniques Research Articles

A COMPARATIVE ANALYSIS OF VARIOUS PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION (PNF) TECHNIQUES ON MUSCLE FLEXIBILITY AMONG EXTENDED SITTING POSTURE INDIVIDUALS

Purpose: The purpose of this research is to compare the effectiveness of different Proprioceptive Neuromuscular Facilitation (PNF) stretching techniques for hamstring muscle tightness, and to find out the best PNF technique for improving hamstring flexibility. Methods: In this quasi-experimental designed study, 30 university students who were between 18-25 years-old, sitting >6 hours per day, and had a Active Knee Extension Test (AKET) >20º were recruited with convenience sampling and equally allocated into Group A, B and C, non-randomly. Hold-Relax (HR), Agonist Contraction (AC) and Contract-Relax-Antagonist-Contract (CRAC) stretching techniques were given respectively, 3 sessions/week, for three weeks. Results: Paired t-test showed significant effect of each technique compared between pre-test value and post-test value of AKET measurements of Hold-relax (HR), AC and CRAC groups (p

Ventilatory Effect of Proprioceptive Neuromuscular Facilitation Patterns in Critically Ill Patients: A Brief Review

Background: The Intensive Care Unit (ICU) plays a crucial role in managing patients with life-threatening conditions, and the mortality rate of mechanically ventilated patients in developed countries is on the rise. Chest complications during ICU stays, such as respiratory failure and pneumonia, pose significant challenges in patient care, requiring continuous and vigilant medical and physiotherapy intervention. Objective: This narrative review explores the role of Proprioceptive Neuromuscular Facilitation (PNF) techniques in chest physiotherapy for mechanically ventilated patients, aiming to assess their impact on respiratory parameters and overall patient outcomes. Method: A comprehensive analysis of relevant literature was conducted, focusing on studies investigating the ventilatory effects of PNF in different patient populations, including neurological injuries, organophosphorus poisoning, and chronic obstructive pulmonary disease (COPD). Results: The reviewed studies demonstrated that incorporating PNF techniques, such as intercostal stretch and anterior basal lift, alongside conventional chest physiotherapy, positively influenced respiratory rates, oxygen saturation, and pulmonary compliance. These findings suggest that PNF can be an effective adjunct in preventing pulmonary complications and improving outcomes in mechanically ventilated patients. Conclusion: The evidence presented in this narrative review supports the integration of PNF techniques into chest physiotherapy for mechanically ventilated patients. The positive outcomes reported in the literature suggest that PNF can be a valuable adjunct to conventional care, contributing to better respiratory function and potentially reducing complications associated with immobility. Keywords: Intensive Care Unit (ICU), Mechanical ventilation, Physiotherapy intervention, Chest complications, Chest physiotherapy techniques, PNF techniques

Effects of proprioceptive neuromuscular facilitation technique on scapular dyskinesis in patients with subacute stroke

Objectives: The objective of this was to compare the effects of the proprioceptive neuromuscular facilitation (PNF) hold-relax technique on pain severity, range of motion (ROM) of the shoulder, shoulder disability, and scapular asymmetry in stroke patients with scapular dyskinesis. Methods: The study used a randomized clinical trial design including 46 patients ranging from 40 to 60 years with at least five months of stroke with type-1 scapular dyskinesia. The participants were divided into two groups, taking the upper limb Diagonal 1 (D1) flexion pattern and Diagonal 2 (D2) flexion pattern, respectively, which were allocated by consecutive sampling using the lottery method. We used a visual analog scale (VAS) for pain, goniometry for shoulder ROM, shoulder pain and disability index (SPADI) for shoulder disability, and lateral scapular slide test for scapular asymmetry. Results: D1 flexion and D2 flexion both improved the ROM in both groups (P < 0.05) and decreased pain and disability, while in-between comparisons did not find a significant difference between the effectiveness of both treatments in terms of pain measured by VAS, ROM, that is, flexion, extension, and abduction (P > 0.05). In terms of external and internal rotation, the D1 flexion pattern of PNF techniques showed more improvement as compared to D2 flexion (P < 0.05). While in terms of SPADI, D2 flexion showed more improvement as compared to D1 flexion (P < 0.05). Conclusion: Scapular PNF substantially influences stroke patients’ shoulder discomfort and ROM.

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.

Effectiveness of Proprioceptive Neuromuscular Facilitation Technique on Balance and Mobility in Chronic Stroke Patient

This comprehensive review explores the multifaceted impact of stroke, a cerebrovascular disorder, on individuals, emphasizing the physical, emotional, and cognitive dimensions of its aftermath. Stroke is a major global health concern, contributing significantly to mortality and disability. The immediate consequences involve neurological impairments such as paralysis, speech difficulties, and impaired vision, while the emotional toll includes coping with loss and adjusting to new realities. Long-term cognitive implications affect memory, attention, and executive function, adding complexity to the recovery journey. Communication challenges, physical limitations, and the risk of secondary complications are discussed, highlighting the importance of a continuum of care. The role of caregivers is explored, emphasizing the emotional, physical, and financial burdens they face. Technological innovations, such as virtual reality and robotics, are introduced as promising tools in stroke rehabilitation. The focus then shifts to balance and mobility issues in stroke survivors, particularly the impact of proprioceptive neuromuscular facilitation (PNF) techniques. Proprioceptive neuromuscular facilitation emerges as a dynamic and versatile therapeutic approach, offering promise for improved functional outcomes and enhanced quality of life in the evolving landscape of stroke care and rehabilitation. The review delves into the neurophysiological ballet of PNF, emphasizing neuromuscular stimulation, neuroplasticity, and motor learning. Clinical applications of PNF in orthopaedic, neurological, geriatric, and paediatric rehabilitation are discussed, highlighting its versatility.

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.

The Mechanisms, Effects, and Outcomes of Manual Therapy in the Treatment of Adhesive Capsulitis: A Literature Review

Purpose of the Study: Adhesive capsulitis, commonly called frozen shoulder, is frequently treated with manual therapy. This pathology cycles through three stages and usually resolves itself; however, many patients will use traditional treatments to expedite their recovery. The researchers theorize that a variety of manual therapy techniques improve the adverse effects of this condition, greater than that of traditional treatments. This literature review aimed to explore various manual therapy techniques that are beneficial in preventing and minimizing lifelong symptoms associated with adhesive capsulitis and analyze which ones are most effective in treating this pathology. Methods: The mechanisms of orthopedic manual therapy for adhesive capsulitis are vast. This literature review examined the following techniques. The first technique reviewed was Mulligan’s mobilization with movement techniques applied to the GH joint in elevation, internal rotation, and flexion compared with passive stretching. Proprioceptive neuromuscular facilitation (PNF) techniques were reviewed, where specific techniques were picked based on the patient’s dysfunctions and compared to traditional manual therapies. In addition, Maitland’s mobilization techniques were reviewed, and patients were given mobilizations to treat pain or restrictions in the tissue. These were compared to Kaltenborn’s mobilization techniques. Next, Maitland’s mobilization techniques were compared with a myofascial release arm-pull technique. Finally, scapular mobilization was compared to posterior capsular stretching in treating adhesive capsulitis. Discussion: The outcomes of this literature review evaluated various manual therapy techniques for treating adhesive capsulitis, aiming to improve shoulder movement and alleviate pain. Researchers expected manual therapy to outperform traditional treatments like medications and surgery by enhancing ROM and reducing pain. Mulligan’s manual therapy demonstrated significant pain reduction and ROM improvement, particularly in flexion, abduction, and rotation. Combining Mulligan’s technique with other modalities yielded superior outcomes compared to passive stretching. Proprioceptive Neuromuscular Facilitation (PNF) techniques showed better pain reduction, ROM enhancement, and coracohumeral thickness reduction than traditional manual therapy. Maitland and Kaltenborn’s techniques significantly improved shoulder rotation and functional movement, especially with soft tissue mobilization. Scapular mobilization techniques increased joint motions, but ROM improvements varied. Manual therapy techniques like Mulligan’s, PNF, Maitland, and scapular mobilization offer promising results in improving the quality of life for adhesive capsulitis patients by enhancing ROM and reducing pain. As more research is done with this pathology, it was found that Mulligan’s, Maitland’s, PNF’s, and soft tissue mobilizations were effective in increasing ROM and decreasing stiffness in patients with this diagnosis. These are all effective forms of manual therapy, specifically when performed by a skilled clinician, further advocating for education on these techniques. Additionally, understanding the mechanisms, effects, and outcomes of different manual therapies for treating adhesive capsulitis can reduce the risk of life-long symptoms and improve quality of life. Results: Various manual therapy methods, such as Mulligan’s mobilization with movement (MWM), Maitland’s mobilization, and PNF have been used to treat adhesive capsulitis. These manual therapy techniques increased joint range of motion (ROM) and reduced the patients’ perceived pain.

Effect of Proprioceptive Neuromuscular Facilitation Technique on Balance in Stroke Patients: A Narrative Review

Effect of Proprioceptive Neuromuscular Facilitation Technique on Balance in Stroke Patients: A Narrative Review

Effectiveness of Thoracic Mobility Exercises and Chest Proprioceptive Neuromuscular Facilitation Technique on Pulmonary Function in Postoperative Breast Cancer Patients: A Randomised Controlled Trial

Effectiveness of Thoracic Mobility Exercises and Chest Proprioceptive Neuromuscular Facilitation Technique on Pulmonary Function in Postoperative Breast Cancer Patients: A Randomised Controlled Trial

The Effect of Proprioceptive Neuromuscular Facilitation Techniques on Muscular Strength in Patients with Knee Osteoarthritis: A Quasi-Experimental Study

Background: Knee osteoarthritis is a prevalent chronic musculoskeletal problem among older people, leading to pain, muscle weakness, and a decline in the quality of life. Objectives: This study aimed to investigate the impact of proprioceptive neuromuscular facilitation techniques on the muscle strength of patients with knee osteoarthritis. Methods: This quasi-experimental study was conducted on all patients with knee osteoarthritis who visited orthopedic offices in Darab City in 2021. A non-probability sampling method was used to select 50 eligible patients, who were then divided into 2 groups: an experimental group and a control group. The allocation of participants into these groups was done by a block randomization method. The experimental group underwent proprioceptive neuromuscular facilitation techniques for eight weeks, with two sessions per week lasting 30 - 45 minutes. In contrast, the control group received only routine care. Muscle strength in both groups was evaluated using the manual muscle test scale before, four weeks, and immediately after the intervention. The collected data were analyzed using SPSS 21, descriptive statistics (such as central tendency and dispersion indices), independent t, chi-square, Fisher’s exact, Mann-Whitney U, Kolmogorov-Smirnov, Wilcoxon, and repeated measures ANOVA tests. A significance level of 0.05 was considered. Results: Fifty patients (24% male and 76% female) with a mean age of 53.6 ± 10 completed this study. There was no statistically significant difference by mean scores of muscle strength parameters, including degree (2.8 ± 0.4 vs. 2.8 ± 0.3), the percentage of normality (45 ± 10 vs. 44 ± 12), and scale (2.8 ± 0.4 vs. 2.8 ± 0.3) between the intervention group and the control group on the before of intervention, respectively. However, a significant difference was observed by degree (3.6 ± 0.6 vs. 2.8 ± 0.3; P = 0.001), the percentage of normality (65 ± 14 vs. 45 ± 9; P = 0.001), and scale (3.5 ± 0.6 vs 2.8 ± 0.3; P = 0.001) between the intervention group and the control group, respectively, at the end of the intervention. Conclusions: The proprioceptive neuromuscular facilitation techniques could improve the muscle strength of patients with knee osteoarthritis. If this finding is confirmed in other studies, healthcare workers should use these techniques for the benefit of these patients.

Evaluation of Proprioceptive Neuromuscular Facilitation (PNF) and Therapy Hand Ball to Improve Motor Dexterity in Post-Stroke Patients

Stroke is the leading cause of disability and can cause various degrees of disturbance, such as decreased muscle tone,loss of sensation in various body parts, and limitations in moving the affected limbs to perform certain activities. This studyaimed to see the effectiveness of the Proprioceptive Neuromuscular Facilitation (PNF) (Contract-Relax) technique and Therapyhandball exercises in improving the motor skill of the affected hand in non-haemorrhagic post-stroke patients. The sample forthis study was 30 patients and were divided into two groups (Group A &amp; Group B), 15 patients each. Both groups were givenconventional physiotherapy before starting with the interventions respectively. Box and Block tests and Bardel index wereperformed pre-treatment and post-treatment to see the changes and for the outcome measurement. PNF(Contract-Relax)technique was given in sets of three, five days a week, and Therapy Hand Ball exercises in three, five days a week for threeweeks. Both interventions were given to every individual in both Groups. This study found that both groups have improvedmotor dexterity of the hand (affected side), with better improvement observed for the group that did the Therapy Hand Ballexercises compared to the PNF(Contract-Relax) technique. From the data analysis of the prolonged treatment Therapy, HandBall exercises showed better results when compared to the Proprioceptive Neuromuscular Facilitation PNF (Contract-Relaxed)Technique, as Therapy Hand Ball exercises can be easily performed at home by the patient himself , whereas the PNF CRtechnique needs a Physiotherapist to perform the treatment.

Efficacy of Proprioceptive Neuromuscular Facilitation Technique with Low-Frequency Electrical Stimulation on Facial Disability in Bell’s Palsy

Efficacy of Proprioceptive Neuromuscular Facilitation Technique with Low-Frequency Electrical Stimulation on Facial Disability in Bell’s Palsy

Efficacy of scapular and upper limb proprioceptive neuromuscular facilitation techniques on scapular alignment, upper limb function, and gait in subacute stroke: a randomized controlled trial protocol

Background: Stroke is a neurological disability produced by vascular-related acute focal injury to the central nervous system and is one of the leading causes of disability in adults, and it is frequently accompanied by motor skill loss. Patients suffering from hemiplegia after a stroke are more prone to have fall and are more likely to experience further injury due to irregular gait, diminished muscular strength, and functional impairment. In the affected upper limb of the hemiplegic stroke, spasticity in the shoulder girdle causes scapular malalignment, which reduces the functional mobility and stability of the upper limb. This is reflected as the reduced reciprocal arm swing during walking, which is further reinforced by an abnormal synergy pattern on the affected side. Proprioceptive neuromuscular facilitation (PNF) is a treatment strategy that stimulates motor activity and enhances control and function of the neuromuscular system. This research protocol is intended to assess and evaluate the effects of applying scapular and upper limb PNF along with conventional physiotherapy treatment to subacute-stroke patients on their scapular alignment, upper limb function, and gait. Methods: A total of 40 individuals in total will be allocated equally into two groups, group-A (experimental) and group-B (control). Both groups will be receiving treatment for six weeks with five sessions per week. Each patient will be examined both before and after therapy using the Palpation Meter (PALM), the Fugl-Meyer Assessment of Upper Extremity (FMA-UE), 10-Meter Walk Test, Handheld dynamometer (10MWT), and Dynamic gait index (DGI). After six weeks of therapy, the results will be assessed and the data will be analyzed before and after the intervention using a paired t-test to discover within-group differences in measurements. Conclusions: This physiotherapy method may be used in the management of stroke patients if our study's hypothesis is found to be valid. Registration: CTRI (CTRI/2023/05/052930, 19/05/2023).

Functional Electrical Stimulation in Conjunction With Proprioceptive Neuromuscular Facilitation (PNF) Technique to Improve Upper Limb Function in Traumatic Brachial Plexus Injury: A Case Report

Functional Electrical Stimulation in Conjunction With Proprioceptive Neuromuscular Facilitation (PNF) Technique to Improve Upper Limb Function in Traumatic Brachial Plexus Injury: A Case Report

Effectiveness of Active Releasing Technique Vs Mulligan Bent Leg Raise for Footballers with Hamstring Tightness

BACKGROUND: Hamstring tightness is common among football players, which frequently results in hamstring injuries. Although the exact cause of hamstring tightness is unknown, decreased hamstring extensibility may play a role. Stretching techniques of various types have been used to improve muscle flexibility in rehabilitation and sports. Passive stretching is one of the most commonly used methods, and the recent addition of other techniques such as ballistic stretching, Proprioceptive Neuromuscular Facilitation (PNF) techniques with variants have been effective. The current study aimed to compare the effects of Active releasing technique and Mulligan bent leg raise in footballers with hamstring tightness. AIM AND OBJECTIVE: To determine the effectiveness of Active releasing technique and Mulligan bent leg raise in reducing hamstring tightness among football players. METHOD: STUDY DESIGN: Experimental study. SAMPLING TECHNIQUE: Convenient Sampling technique. SAMPLE SIZE: 20 FOOTBALL PLAYERS. RESULT: The values were statistically analysed using paired ‘t-test and the Unpaired ‘t-test. The statistical analysis made with the quantitative data revealed a statistically significant difference between Group A and Group B and also within the group. The post-test mean value of sit and reach flexibility test of group A was 29.40 and group B was 28.50. This showed that the treatment given for group A is comparatively more effective than group B. CONCLUSION:This study shows that there was an improvement in hamstring flexibility in Active release technique as well as Mulligan bent leg raise among footballers with hamstring tightness. However, Active release technique is better as compared to Mulligan bent leg raise technique to improve hamstring flexibility and range of motion in footballers. KEYWORDS: Hamstring tightness, Active release technique, Mulligan bent leg raise, Footballers.

A Combination Effect of Sensory Motor Training and Proprioceptive Neuromuscular Facilitation in a Case of Peripheral Polyneuropathy Manifested by Foot Drop in Type II Diabetes Mellitus – A Case Study

Peripheral neuropathy is one of the common complications in patients with diabetes Mellitus (DM) which leads to disrupting the peripheral nervous system resulting in reduce sensory inputs and motor outputs. Patients with foot drop (FD) will have weakness in dorsiflexor muscles of ankle and toe and sensory loss due to disruption of small myelinated and unmyelinated nerve fibers. Sensory motor training (SMT) will facilitate sensory inputs, correcting muscle imbalance, and ensuring correct program at the level of central nervous system whereas Proprioceptive Neuromuscular facilitation techniques (PNF) not only helps facilitating the weaker group of muscles also improve strength . Hence the purpose of the study to combine the effect on use of SMT along with PNF in a case of peripheral polyneuropathy manifested by foot drop in patient with type II DM. The case report study of 72 year old male patient diagnosed with diabetic polyneuropathy manifested by foot drop in type II diabetes mellitus on medication. Intervention of patient received Sensory motor training and Proprioceptive Neuromuscular Facilitation in foot drop for 5 days a week for 4 weeks and outcome measures used were Stanmore Assessment Questionnaire (SAQ) , Diabetic Neuropathy Examination (DNE) score for diabetic neuropathy which were taken on day one and after 4 weeks of intervention and results shown improved on both the outcome measures which concluded that on combination of SMT and PNF techniques have shown efficacy on improving ankle range of motion and strength , sensory discrimination , thereby implementing these combination techniques, will reduce functional dependence and improve quality of life.

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.

The Early Initiation Advantages of Physical Therapy in Multiple Sclerosis-A Pilot Study.

(1) Background: Multiple sclerosis (MS), a chronic progressive neurological disorder which affects the central nervous system (CNS), can result in disorders of all the functions controlled by the CNS: motor, sensory, cognitive and emotional. Physical therapy (PT), conducted through proprioceptive neuromuscular facilitation (PNF) techniques, can be customized to the individual patient's needs and has the potential to improve the patient's evolution. This study aims to establish if PT based on PNF techniques has a beneficial role in MS treatment. (2) Methods: We performed a prospective study on 40 patients who were diagnosed with MS and previously treated only with MS drug treatment (DT). These patients have participated in a PT program throughout one year. At the beginning and at the end of our study, after one year, we have assessed the following parameters: timed walk for 25 feet (Timed 25-Foot Walk test- T25FW test), dexterity of the upper limbs (9-Hole Peg Test-9HPT), disability level (Expanded Disability Status Scale-EDSS) and cognitive function (Paced Auditory Serial Addition Test-PASAT. (3) Results: In subjects in the early stages of MS, lower limb mobility improved significantly, T25FW decreasing from 6.46 to 5.80 (p < 0.001) and upper limb ability increased significantly in the dominant hand, 9HPT decreasing from 17.73 to 16.97 (p = 0.006) and not significantly in the non-dominant hand, 9HPT decreasing from 17.73 to 17.50 (p = 0.255). Furthermore, among these subjects, cognitive performance improved; their PASAT increased from 52.14 to 54.14 (p = 0.036), while the level of disability of these subjects improved only slightly, the EDSS scale evolving from 3.08 to 2.91 (p = 0.650). (4) Conclusions: In patients with early forms of MS, combining DT with a PT program based on PNF techniques results in: regaining muscle strength in the lower limbs, improving coordination while walking, correcting dexterity in the upper limbs and increasing the ability to concentrate.

Effects of Scapular Proprioceptive Neuromuscular Facilitation Techniques in Adults with Calcific Tendinitis of the Supraspinatus

Effects of Scapular Proprioceptive Neuromuscular Facilitation Techniques in Adults with Calcific Tendinitis of the Supraspinatus

New methodological aspects in rehabilitation after proximal humerus fracture

Proximal humerus fracture ranks third in the elderly after femoral neck fractures and distal radius fractures, and seventh in adults, and the risk of occurrence is related to advancing age. In this study we aimed to analyze the efficacy of a 24-weeks physical therapy programme based on a particular methodology consisting of the reprogramming of the specific proprioceptive neuromuscular facil-itation techniques added to the classical physical therapy and by introducing modern interactive therapies and technologies: Capacitive Resistive Electric Transference, Instrument Assisted Soft Tissue Mobilization, kinesiological tapes and PRAMA system, compared with classical physical therapy. Our study included 26 patients, aged between 18 and 55 years, with proximal humerus fracture, who complete the 24-weeks rehabilitation programme. We assessed pain, shoulder range of motion, muscle strength and the ability to perform activities of daily living. The statistical analysis was performed using IBM SPSS and Excel 2021. The results showed statistically significant im-provement in all shoulder motion, increased muscle strength, decreased pain, and a better ability to perform daily activities. The physical therapy programme based on the proposed particular methodology has proven to be more effective than classical physical therapy, both regarding the improvement of the movement parameters compared to the physiological values, as well as the symmetry of both shoulders.