The proprioceptive neuromuscular facilitation-concept; the state of the evidence, a narrative review

Abstract

Introduction: The proprioceptive neuromuscular facilitation-concept (PNF-concept) is a widely used rehabilitation concept, and is in many countries part of the undergraduate curriculum of physiotherapy education. It is also offered in postgraduate training worldwide. The modern physiotherapist is confronted with the application of evidence-based practice; therefore, the aim of this review is to summarize the available evidence for this rehabilitation concept.

Method: A search was completed using Pubmed, ScienceDirect, PEDro, Cochrane library and the International PNF Association website. An evidence-based practice approach has been promoted in the field of physiotherapy since the early 1990s, hence we limited the search from 1990 until 2014.

Major findings: Seventy-four sources that were found were categorized in: (A) PNF philosophy, (B) PNF basic principles and procedures, (C) PNF techniques in rehabilitation. In the reviewed publications, a variety of indications and subject populations were identified including: neurological, musculoskeletal, pulmonary, geriatric and mixed disorders. The publications varied in type and quality, ranging from case studies, clinical trials, randomized controlled trials and reviews. This variety of publications, treatment indications and outcome measures in the publications warranted a narrative review

Discussion and conclusion: The scope and diversity of articles in the review make it difficult to study the PNF-concept in a methodical way, since different components of a comprehensive rehabilitation approach may act as confounders when measuring the effects of one specific part of the approach. There is a substantial body of research which supports the use of PNF as a comprehensive rehabilitation concept. The literature also describes that the PNF-concept is applied in clinical practice in a variety of populations and indications; however, efficacy for specific indications and populations requires further investigation.

Keywords:

• Proprioceptive neuromuscular facilitation
• PNF
• Motor learning
• Physical therapy
• Clinical rehabilitation

Acknowledgement

We like to express our gratitude to Mr. Stephen G. Schmidt for guidance and advice in linguistic matters.