Wednesday, October 3, 2012

PNF and Neurological Rehabilitation

Wow, the new semester is already flying away from me!  This year, I find myself in a new position: for the first time, I am a lab instructor in the precursor to my Neurological Rehabilitation course.  It has been eye opening so far, since I am witnessing how the students struggle with the basic concepts in neurological rehabilitation.  Usually, I meet them after this semester, when they have got a bit of a handle on fundamentals of neurological physical therapy.

The introductory course covers (somewhat broadly) the various approaches to neurological rehabilitation.  One of those is PNF (proprioceptive neuromuscular facilitation).  I am aware of my personal biases, having trained as physiotherapist in Australia under a strong motor relearning framework; but I have a hard time understanding the rationale for PNF as a neurological rehabilitation approach.  I was taught that PNF is a stretching technique.  A quick scan of recent studies on PNF suggests it is widely used for this purpose.

My colleagues who were teaching the PNF material to the students last week raved about PNF and how effective it is to treat neurological problems, including rigidity.  If this anecdotal evidence, which made PNF sound like magic, is true, then why does the research evidence tell a different story?  Without my own anecdotal evidence of the “magic of PNF,” I rely on the reported empirical evidence, so I am skeptical about PNF for neuro rehab.  I would have thought that in the current age of evidence-based physical therapy, my clinical colleagues would be more on board with the research evidence.  I can understand wanting the students to have the skill set in their tool box, but I am concerned that the (anecdotal) evidence presented was misleading, and that the students will expect magical (and possibly unrealistic) results from PNF.

I appeared to be an island among my colleagues in my views on the topic last week.  I wonder how other neuro physiotherapists (clinicians or scientists) view PNF as a technique for patients with neurological disorders…

1 comment:

  1. Hello there,
    I am a student of bachelors degree in physiotherapy studying in FInland. PNF is not taught in my schools and hardly practiced here. In my previous studys (cerificate in Physiotherapy) i have learnt PNF as a tool in Neurorehab. I am very fond of the concept but sceptical like you in its use for neuro rehab.
    So i decided carry out a literature review for my thesis on the topic of Efficacy of PNF in neurorehab. in the same process i came across with thiy blog of yours. so hereby i humbly would like to request you to help me find the recenct literatures that u have mentioned in this blog (may be by positng the links or names of sources) if it is possible for you. I have to mention that i am not very good in finding articles and literature and just learning. so it would be a great help from you.
    thanks

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