11 Proprioceptive Neuromuscular Facilitation

Proprioceptive Neuromuscular Facilitation (PNF) is a dynamic approach to the evaluation and treatment of neuromusculoskeletal dysfunction with particular emphasis on the trunk. Over the past couple of decades substantial progress has been made in the conservative care of spinal problems.1-5 The shift towards evaluating and treating them from a functional or neuromuscular perspective enhances and complements the symptomatic and structural approaches.6-14 A functional or neuromuscular approach looks beyond the classical diagnosis, identifying their habitual patterns of posture and movement; their dynamic strength, flexibility, and coordination; and the specific muscle recruitment and motor control of the symptomatic region, as well as contributing factors in the patients' environment. PNF applies neurophysiological principles of the sensory/motor system to manual evaluation and treatment of neuromuscular skeletal dysfunctions. PNF provides the therapist with an efficient means for evaluating and treating neuromuscular and structural dysfunctions.15-19 Structural dysfunctions (myofascial and articular hyperand hypomobilities) affect the body's capacity to assume and perform optimal postures and motions and often are associated with symptoms.2,5,15,20-22 Neuromuscular dysfunctions (inability to coordinate and efficiently perform purposeful