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…
