(american doctor and neurophysiologist MUDr. Herman Kabat 1913-1995)
MUDr. Herman Kabat belonged to important american neurophysiologists. Together with physiotherapists Margaret Knott and Dorothy Voss he develop in the 40’s a method for patients suffering from poliomyelitis (infantile palsy). In 60’s was this method for the first time published in Czechoslovakia, where it quickly gained on popularity among the doctors and physiotherapists. The method proved to be relatively fast and effective in a much wider spectrum of movement diagnosis.
Therapist is teaching the patient exercises with the limbs in diagonal position, which leads to activation of the muscles in specific way to activate the correct movement pattern, increased movement range and strengthening the muscle power. Along with that, there is also a reverse in the exercise: stretching-relaxation, action-relaxation, …
The therapist applies a manual contact and pressures in the direction or against the direction of the performed movement, which affects the tension in the muscles which have to be involved in the movement pattern. By verbal instructions can our client concentrate better on the performed movement and at the same time, the verbal stimulation affects the facilitation or relaxation of the muscle groups which are involved in the movement pattern, client has to control the movement by his/her sight to have a full control, it also affects the quality of the performed movement.
WHEN TO USE THIS METHOD:
By clients who suffer from a functional illness of the musculoskeletal system
Neurological illness - transverzalní mišní léze, peripheral neuropathy, multiple sclerosis, condition after stroke, etc…
Orthopedics - condition after operation and injury of the joints, spine, degenerative illness of joints, posture disorders (scoliosis), etc…
WHEN IT IS NOT RECOMMENDED:
In individual cases. In acute phases of painful conditions, illnesses.
HISTORY OF ORIGINS OF THE PNF
Dr. Kabat originally named the method in 1940 as “Proprioceptive facilitation”. He was inspired by a technique of the australian nurse Elizabeth Kenny, who worked with the patients after poliomyelitis. Characteristic feature of her method is specific stretching or exercising of the muscle tissues. However her method lacked neurophysiological reasoning, which was added by Dr. Kabat.
In 1954, his assistant Dorothy Voss added to the name of the method a term “neuromuscular”. From here comes the complete title of the method Proprioceptive neuromuscular facilitation (PNF).
Dr. Kabat wanted to create a manual therapeutic approach, which would allow the doctors to analyse the patient’s movement condition and at the same time provided them with effective therapy for recovery of the functional movement. It is important to realize that PNF is not just a medical treatment, but it is more like a tool which allows to diagnose the specific treatment of the neuromuscular dysfunction.
In 1940 has Kabat’s newly created concept caught attention of a rich industrialist Henry Kaiser, whose son was suffering from multiple sclerosis. Together they established the Kabat-Kaiser institute in Washington, D.C. in 1946. The institute was moved two years later to Vallejo in California, and in 1950 was a new one opened in Santa Monica in California.
In mid 40’s started Dr. Kabat to search for a physiotherapist who would work with him. In 1945 Margaret Knott became the first physiotherapist to work with him. After moving from Washington to Vallejo in 1948, started Maggie Knott to train the PNF method and even created a post-gradual learning program, in which physiotherapists from the whole world were interested about.
In 1952 joined Dr. Kabat also physiotherapist Dorothy Voss. Dorothy and Maggie wrote a first book about PNF in the 60’s. The three of them then expanded and developed the basic concept of the PNF. they developed detailed spiral and diagonal movement patterns for arms and legs, trunk, head and neck.
PRINCIPLE OF THE PNF
PNF involves also a learning and functional keeping of the newly acquired movement patterns. Thanks to repeating and use of the developmental progression of the movement system, can patients again create a strategy of effective, functioning movement with highest biomechanical effect based on the re-taught movement and analysis of the control movement through the central nervous system.
All the activities within the PNF are focused on functional goals (for example: person wants to take a cup from the upper shelve), it is derived from natural movement patterns of each individual who are also in relationship with their environment, in which the goal should be achieved. The muscle activity is spreaded from the tips of your fingers and toes to the joints, trunk, (for example: from the fingers to the shoulder and chest) while there is no emphasis on keeping the stabilization function of the trunk. That is according to Dr. Kabat automatically secured by every neuromuscularly and mentally mature individual.
Example of this method:
source: international PNF association, studying about PNF on university