PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION (PNF)

PNF or Active Inhibition includes
• Type 1: Agonist Contraction (AC) [Reciprocal Inhibition- Muscle spindle]
• Type 2: Hold-Relax (HR) or Contract-Relax (CR) [Autogenic inhibition- GTO]
• Type 3: Hold-Relax with agonist contraction (HR-AC)

Type 1: Agonist Contraction (AC):
• Agonist refers to the muscle opposite the range-limiting muscle. So antagonist refers to the range limiting muscle.
• The short muscle (antagonist) preventing the full movement of the prime mover (agonist)
• To perform agonist contraction, the client concentrically contract (shorten) the muscle opposite the range-limiting muscle & then holds the end range position at least several seconds (6-10 seconds)
• When the agonist is activated & contracts concentrically, the antagonist (the range-limiting muscle) is reciprocally inhibited, allowing it to relax & lengthen more easily.
• Effective for
o Early subacute condition
o Acute muscle spasm for non-traumatic injury

Type 2: Hold-Relax (HR) or Contract Relax (CR):
Hold-Relax (HR):
• The range limiting muscle is first lengthened to the point of limitation or to the extent that is comfortable for the patient.
• The client then performs a pre-stretch end range, isometric contraction (for 5-10 seconds) followed by voluntary relaxation of the tight muscle (Post-Isometric Relaxation-PIR/Autogenic Inhibition).
• The limb is then passively moved/stretch into the new range as the range limiting muscle is elongated.
• Hold the stretch
• Repeat at least 3 times (whole procedure)
• Isometric contraction should be submaximal.
• Effective for
o Late subacute & chronic condition

Contract-Relax (CR):
• It is a variation of HR.
• Procedures are same as HR except the client performs an isotonic concentric contraction against resistance throughout the ROM before its stretch.
• Resistance should be submaximal.

Type 3: Hold-Relax with Agonist contraction (HR-AC):
Type 3 is the combination of Type 1 & Type 2 (except contract relax)

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