What we know today as PNF began as “proprioceptive facilitation,” a term developed by Dr. Herman Kabat in the early 1940s. In 1954. Dorothy Voss added the word “neuromuscular” to complete the current name proprioceptive neuromuscular facilitation.
Dr. Kabat’s conceptual framework for PNF came from his experience as a neurophysiologist and physician. The work of Sister Elizabeth Kenney, an Australian nurse who treated polio patients with specific stretching and strengthening activities, were early influences on Dr. Kabat. Her work was then perceived as a deviation from the usual treatment, but it lacked a neurophysiological foundation. Kabat integrated Sister Kenney’s technique with Serrington’s discovery of successive induction, reciprocal innervation and inhibition, and the phenomenon of irradiation.
Objective of the PNF
Its goal was to develop a hands-on treatment approach that would allow clinicians to analyze and assess patient movement, while allowing for more effective functional movement strategies. That’s why it’s important to understand that PNF is not just a treatment approach, it’s a technique that allows for the simultaneous evaluation and treatment of neuromuscular dysfunction. In the mid-1940s, Dr. Kabat’s new concepts caught the attention of wealthy industrialist Henri Kaiser, whose son was suffering from multiple sclerosis. In 1946, they founded the Kaiser-Kabat Institute in Washington, D.C. 1948. another Kaiser-Kabat Institute opened in Vallejo, California, and a third opened in Santa Monica, California, in 1950.
In the mid to late 1940s, Dr. Kabat began searching for a physiotherapist who would work alongside him, treating patients using his new concepts.
in December 1945. Maggie Knott became the first physical therapist hired by Dr. Kabat. In 1948, Maggie arrived west with Dr. Kabat from Washington, D.C., to Vallejo. After arriving in Vallejo in 1948, Maggie Knott began teaching other physical therapists the patterns and techniques of PNF. That same year, she began a postgraduate training program attended by therapists from all over the world. That same program still exists today, 52 years later, with dedicated medical staff training graduate physiotherapists over 3 or 6 months of specialist residency training. The programs combine didactic and clinical training that honors the legacy of Dr. Kabat and Maggie Knott.
The PNF approach to kinesitherapy treatment is understood as a positive and stimulating integration of physical and psychological factors (central and peripheral fasciation) that facilitates the patient to reach the highest level of function.
The patterns/models of complex movements mimic normal motor activities and are based on the “Beevor’s axiom,” which states that the brain does not know individual muscle functions, but only complex (group) movement. In normal functional-motor activities, different combinations of movements are the result of the activity of a large number of muscles, over several levers, of varying intensity. The patterns of complex movement are diagonal and spiral in character and closely mimic the movements used, for example, in sports and other functional activities. The spiral-diagonal character of the movement maintains the spiral-rotatory peculiarities of the skeletal-ligamentous structures. This type of movement is also in harmony with the position, i.e. topographic alignment of muscles between their attachments and structural features (it is considered that true muscles are almost a rarity – m.rectus abdominis and m.masseter).
The development of PNF is based on the previous work of Sir Carles Schörington, from whose work the following terms are commented:
- Fasting – the stimulus effect – is a prolongation of the effect of the stimulus, which is prolonged in proportion to the strength and duration of the stimulus.
- Temporal summation – repetition to combine and lead to the excitation of a weak, subthreshold stimulus, which occurs within a short period of time,
- Spatial summation – several weak stimuli, simultaneously applied to different parts of the body, can affect each other, i.e. It collapses at the synapses and produces excitation.
- Irradiation – represents the expansion and increase in the strength of the response, as a result of the increased strength or number of stimuli. It is about expanding or increasing the response to other muscles, either in the form of stimulation or inhibition.
- Successive induction – contraction of antagonist muscles, immediately before agonist stimulation, increases the excitation of the agonist.
- Reciprocal innervation – contraction of the agonist is accompanied by simultaneous inhibition of its antagonists. This is a reflex response and the necessity to perform a normal, healthy, i.e. Coordinated movement (relaxation techniques in particular use this principle).
The application of basic facilitation techniques through the PNF philosophy enables therapists to help the patient gain effective motor function and improve motor control. The basic procedures are used to
- Increase the patient’s ability to move and stay stable
- Direct the movement with an appropriate grip and appropriate resistance
- Help the patient achieve coordinated movement through the timely involvement of segments
- Increases the patient’s endurance and prevents fatigue
