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iMedPub Journals 2017


JOURNAL OF NEUROLOGY AND NEUROSCIENCE
www.imedpub.com ISSN 2171-6625 Vol. 8 No. 5: 220

DOI: 10.21767/2171-6625.1000220

Effect of Proprioceptive Neuromuscular Aditi Chaturvedi*


Facilitation in Functional recovery of JSS College of Physiotherapy, Mysore,
Patient’s with Stroke-A review Karnataka, India

*Corresponding author: Aditi Chaturvedi


Abstract  chaturvedi.adity4@gmail.com
Background: PNF has been used for very long time for the functional improvement of
stroke. In this review functions were selected according to the ICF (International Classifica- JSS College of Physiotherapy, 454 Devi Clinic
tion of Functioning, Disability and Health) corsets in the domain of Activity and Participation. MG Road Landmark Mobile Palace, 570004,
Aim: The purpose of this study is to review the effective- Mysore, Karnataka, India.
ness of PNF in stroke for functional recovery of patients.
Method: PubMed and Google scholar was searched using the following strat-
Tel: 9731580731, 9731580731
egy- Language- English, Time period- all, Keywords- PNF, stroke, gait, bal-
Fax: 9731580731
ance, functional recovery. Inclusion criteria- RCT, meta-analysis, CASP- 80%.
Conclusion: This finding provides important aspects regarding the use of PNF
in functional recovery of stroke, in various functional activities according to the
ICF corsets, as PNF helps in major areas like gait, co-ordination and balance. Citation: Chaturvedi A (2017) Effect of
Implications: There is no enough clear evidence on the use of PNF, although there Proprioceptive Neuromuscular Facilitation
are reviews that state use of specific techniques for specific goals. Further studies in Functional recovery of Patient’s with
are required to see the use of various PNF techniques as a whole or individually. Stroke-A review. J Neurol Neurosci. Vol. 8
Until then PNF technique can be used in clinical practice as there is no report of No. 5:220
adverse events.
Keywords: PNF; Functional recovery; Stroke; Gait

Received: August 05, 2017; Accepted: October 03, 2017; Published: October 05,
2017

Introduction Results
WHO define stroke as "acute onset of neurological dysfunction PNF is a collection of treatment. It includes various patterns and
due to abnormality in cerebral circulation with resultant signs techniques. Rhythmic initiation, rhythmic stabilization, slow
and symptom that corresponds to involvement to focal area of reversal, agonistic reversal, stabilizing reversal is few of the PNF
brain lasting more than 24 hours”. PNF has been used for very Table 1 The ICF corsets in the area of activities and participation.
long time for the functional improvement of stroke. The purpose
Activities and Participation
of this study is to review the effectiveness of PNF in stroke for
• Copying
functional improvement of patients. In this review, functions
• Rehearsing
were selected according to the ICF corsets in the area of activities
• Acquiring skills
and participation are as follows.
• Writing
Methods • Changing basic body position
• Maintaining a body position
Pub med and Google scholar was searched using the following • Transferring oneself
strategy (Tables 1 and 2): • Walking
English articles between 2011-2015. • Moving around in different locations
• Moving around using equipment
Inclusion criteria - RCT, Meta-Analysis. • Toileting
CASP 80% rating. • Caring of body parts

© Under License of Creative Commons Attribution 3.0 License | This article is available in: www.jneuro.com 1
JOURNAL OF NEUROLOGYARCHIVOS DE MEDICINA
AND NEUROSCIENCE 2017
ISSN
ISSN 1698-9465
2171-6625 Vol. 8 No. 5: 220

Table 2 The PNF techniques which are effective in functional recovery according to this review.
Author Subjects and duration Results Conclusion Evidence PNF techniques
PNF-based short neck
flexion exercises appear to
the effects of neck
Sub- 26 3 days a week for be effective at improving
exercises using PNF PNF based short neck flexion
Kim KD et al. [1] 30min each time over a swallowing function of Level 1
showed significant exercises.
period of 6 weeks. stroke patients
improvement
with dysphagia.

Trunk Lateral Flexion


PNF technique should
Range of Motion (TLF Rhythmic initiation, slow
be considered in acute
Shinde K et al. [2] 9 months ROM) and Tinetti Test (TT) Level 1 reversal,
and sub-acute stroke
showed results (P<0.05) in Agonistic reversal.
rehabilitation
the PNF training group
PNF techniques have
PNF is a very beneficial
effect on gait parameters
technique for improving Rhythmic initiation, slow
Sub- 30 30 min for 3 days as well as functional
functional independence reversal, agonistic reversal for
Kumar et al. [3] a week for a total duration mobility as compared to Level 1
in patients with strokes pelvis. Each technique was given
of 4 weeks. conventional therapy in
especially in area like for 10 min.
patients with hemiplegia.
locomotion
Temporal parameters
decreased more in the PNF based walking
Sub- 40
Seo KC et al. experiment group. Spatial exercise on a ramp is PNF based walking exercise, PNF
30 minutes, five times a Level 1
[4] parameters increased effective in enhancing gait gait pattern training.
week for four weeks.
significantly in experiment performance.
group.
Experimental group
TSE using PNF performed
showed improvement
Sub- 40 by stroke patients were
on both affected and
Kim Y et al. 10 minutes, effective at improving Stabilizing reversal,
non-affected side, Level 1
[5] Five times a week for six FRT and the muscle Rhythmic stabilization.
control group showed
weeks. activities of the soleus and
improvements only on the
quadriceps.
non-affected side.
The mean total EFAP
PNF is recommended as PNF patterns as described by
was significantly lowered
an effective treatment Knott and Voss,
Sub – 34 (p ≤ 0.05) from 115.10
Akosile Co et al. for functional ambulatory Level 1 D1 flexion and extension
Twice weekly for 8 weeks. seconds pretest to 88.67
gains in stroke D2 flexion and extension for UE
seconds at the post-test
rehabilitation. and LE.
measurement.

techniques which are effective in functional recovery of patients of PNF in functional recovery of stroke, in various functional
with stroke. activities according to the ICF corsets, as PNF helps in major areas
like gait, balance.
Discussion
PNF is a collection of treatment, it includes various techniques Future Implications
and patterns. Rhythmic initiation and stabilization slow reversal, There is no enough clear evidence on the use of PNF, although
agonistic reversal, stabilizing reversal, are few of the PNF there are reviews that state use of specific techniques for specific
techniques which are effective in functional recovery according goals. Further studies are required to see the use of various PNF
to this review. techniques as a whole or individually. Until then PNF technique
can be used in clinical practice as there is no report of adverse
Conclusion events.
These findings provide important aspects regarding the use

2 This article is available in: www.jneuro.com


JOURNAL OF NEUROLOGYARCHIVOS DE MEDICINA
AND NEUROSCIENCE 2017
ISSN
ISSN 1698-9465
2171-6625 Vol. 8 No. 5: 220

References parameters and functional mobility in hemi paretic patients. JESP 8:


67-73.
1 Kim KD, Le HJ, Lee MH, Ryu HJ (2015) Effect neck exercise on
4 Seo KC, Lee JH, Lee SY (2012) Impact of PNF based walking exercise
swallowing function of patients with stroke. J Phys Ther Sci 27: 1005-
on a ramp on gait performance of stroke patients. J Phys Ther Sci 24:
1008.
1243-1246.
2 Shinde K, Ganvir S (2014) Effectiveness of trunk PNF techniques after
5 Kim YH, Kim EJ, Gong W (2011) the effects of trunk stability exercise
stroke: a meta-analysis. NJMS 3: 29-34.
using PNF on the Functional Reach Test and muscle activities of
3 Kumar S, Kumar A (2012) Effect of PNF technique on gait stroke patients. J Phys Ther Sci 23: 699-702.

© Under License of Creative Commons Attribution 3.0 License 3