SAIFEE HOSPITAL MUMBAI

Organized

 A WORKSHOP ON

PROPRIOCEPTIVE NEURO MUSCULAR FACILITATION (PNF)

IN NEURO REHABILITATION

 On 23^rd  August & 13^th  September 2015

 Course instructor

Dr. Gajanan Bhalerao (PT)

Phd scholor, Master of Physiotherapy (Neurosciences)

Certified Adult NDT (C/NDT) Therapist Associate professor

Sancheti Institute College of Physiotherapy

HOD Physiotherapy Dept Sancheti Hospital

Shivajinagar, Pune.

 

Introduction

 

In this workshop, the PNF techniques will be presented and applied in an analytical manner, on various muscle groups.

Proprioceptive neuromuscular facilitation uses the body’s proprioceptive system to facilitate or inhibit muscle contraction. These techniques are based on Sherrington’s principles of irradiation, reciprocal innervation and inhibition. PNF techniques were developed during the 1940s and 1950s, and are the result of the work of Kabat, Knott and Voss.  Herman Kabat began using PNF techniques on younger individuals with cerebral palsy and other neurological disorders.

Voss defined the PNF as a method of promoting or speeding up the response of the neuromuscular system by stimulating the proprioceptors.    Since the 1980s, PNF techniques have been used in many other areas of physical therapy and sports training besides neuro-rehabilitation. These techniques can be used to decrease tone in the quadriceps, hip flexors, hamstrings, biceps, etc., leading to large gains in range of motion and function, as well as decreasing pain and discomfort.

Many PNF techniques can be included in workout programs, to enhance coordination, movement and stability. PNF is a useful tool that all sports professionals and physical therapists should understand and use depending on their objectives.

Contact hours – 8

Eligibility – Clinical Therapist,

Venue: – Saifee Hospital Mumbai

 

PROGRAM HIGHLIGHTS

	Day 1
	Topics	Timing
1	Definition and neurophysiologic bases of PNF: auti inhibition, receprocal innervation, reciprocal inhibition	9.00am – 10.00am
2	Principals of PNF	10.00am – 11.00am
3	Daigonal Pattern of movement –D1 and D2	11.00am – 3.00pm
3a	Pattern of movement in upper limb – unilateral pattern, bilateral pattern, symmetrical, asymmetric and reciprocal pattern of UL.	11.00am – 1.00pm
3b	Pattern of movement in lower limb – unilateral pattern, bilateral pattern, symmetrical, asymmetric and reciprocal pattern of LL.	2.00pm – 4.00pm
4	Training of use these patterns in patient treatment.	4.00pm – 5.00pm
4a	PNF for improving upper limb control emphasis on shooulder, elbow wrist and hand	4.00pm – 5.00pm

 

	Day 2
4b	PNF for improving upper limb control emphasis on hip, knee and ankle	9.00am – 11.00am
5	Facilitatory and inhibitory PNF techniques	11.00am – 1.00pm
5a	Facilitatory PNF techniques : Slow Reversals (SR), Slow Reversal Hold (SRH), Repeated Contraction (RC), Timing for Emphasis (TE), Agnostic Reversals (AR)
5b	Hold-relax Active Movement (HRAM),Rhythmic Rotation (RR), Hold-Relax (HR), Contract-Relax (CR),
5c	Inhibitory PNF techniques : Rhythmic Stabilization (RS), Rhythmic Initiation (RI), Alternating Isometrics (AI),
6	Use of PNF for facilitation, inhibition or stability. Exercises for stability, mobility and coordination.	2.00pm – 2.30pm
7	PNF for Training of activities of daily living, mat exercises, ambulation and transfers training	2.30-4.00pm
7a	Activities of daily living,
7b	Mat exercises,
7c	Transfers & Transition training
7d	ambulation
8	Examintion Practical assessment	4.00pm – 5.00pm
9	Certificate distribution	5.00pm – 5.30pm

 

s. no.	NAME	INSTITUTION
1	Dixita Sampat	–
2	Karishma Virjee	Saifee hospital
3	Swandha Majundar	Saifee hospital
4	Tandel Deepak Ramchandra	MGM
5	Palak Gandhi	SSPTC
6	Jigna Tanna	Saifee hospital
7	Mezba Fakih	Saifee hospital
8	Sanjyot Harshe	Saifee hospital
9	Shailesh Gardar	Saifee hospital
10	Priti Shingade	Saifee hospital
11	Shilpa Arya	Saifee hospital
12	Pallavi Kasture	Saifee hospital
13	Richa Shah	Manav Seva Sangh
14	Reepa Shroff	Saifee hospital
15	Sakina Rangwala	Saifee hospital
16	Hasan Sayed	Seth.GMC
17	Raahatara Trean	–
18	Muniva Palitanawala	Saifee hospital
19	Sadia Kazi	Saifee hospital
20	Neha Shah	Saifee hospital
21	Rangwala	Saifee hospital
22	Fatema Kalyanwala	Saifee hospital
23	Mohini Mishra	Shree swaminarayan phyiotherapy college
24	Rajesh Shah	SNEH RERC
25	Pradnya Girdhar	Saifee hospital
26	Mansi Khochare	Saifee hospital

Feedback of delegates of PNF workshop

Day 1

Delegate no 1 :

What did i learned today?

• How to apply in patients
• Techniques of PNF – manual hold, resistance
• Stance of therapist

What was good in the workshop?

• It cleared a lot of confusion about the names of PNF patterns
• Easy way to remember and use it

What was bad in the workshop? more time should given for practice.

Delegate no 2 :  Munira

 What did i learned today?

• I learnt the exact neurophysiology taught, also the importance of bio mechanics and how to improve skills to on it.
• The method of combining different techniques which can work so well

What was good in the workshop?

• To call the patients in workshop and apply PNF technique on them which helped in better understanding.
• Very well explained by the instructor
• Interesting ways of teaching

What was bad in the workshop?

• More time to practice

 

Delegate no 3 : Hasan Sayed

 What did i learned today?

• Techniques and hands on training of PNF
• Though processing when assessing and treating a neuro patient
• How to do more functional exercises specific to patient needs

What was good in the workshop?

• Teaching
• Answers to queries

What was bad in the workshop?

• Less practical
• Deviation from topic (PNF)

 Delegate no 4 :

What did i learned today?

• How to do problem solving
• How to use overload & irradiation at different places
• Using integrated approaches along with PNF
• To treat dysfunction & not disease

What was good in the workshop?

• Practical & hands on approach
• Problem solving
• Patient demo’s
• Instructor’s encouragement & positive feedback

What was bad in the workshop?

• The f low of consent, sometimes it was going slight haphazard

 

Delegate no 5 : Palak

 What did i learned today?

• I am really happy for not getting boring theoretical lecture.
• Learnt more of hands on skills, which is really appreciable . now I don’t need to mug up the components of diagonal patterns of PNF (thankfully).
• Come to know about a wider aspect if PNF .
• And the main thing … I have started liking neuro. At least now I don’t hate it and that’s just because of the way you taught us in my favorite way … Dance !
• Thank you

What was good in the workshop?

What was bad in the workshop?

Delegate no 6 : Mohini Mishra

What did i learned today?

• With PNF you made us learn other approaches too.
• Learned PNF neurophysiological principals with its application

What was good in the workshop?

• Your interaction with us
• Application of technique which you modify and make patient do.
• What was bad in the workshop? Nothing bad. But didn’t get time to practice diagonal patterns for lower extremity.

Delegate no 7 : Sadiya Kazi

What did i learned today?

• New techniques like rhythmic rotation

What was good in the workshop?

• It was an amalgamation of all techniques pertaining to a case, not only pertaining to the subject of today’s workshop.
• Overall approaches to a patient were taught well, in a fun way.

What was bad in the workshop?

• As the topic is very confusing & volatile, it required a lot of time to absorb the things taught in one day.

Delegate no 8 : Dr. Rangwala HOD physio dept Saify hospital

What did i learned today?

• Different patterns of movements.
• Walk along theory of muscle contraction
• Timing of emphasis
• Inhibition techniques
• Facilitation techniques
• Rhythmic stabilization

What was good in the workshop?

• The participation of the candidates
• Recourse person and candidates

What was bad in the workshop? So far nothing bad.

Delegate no 9 : Tandel Deepak Ramchandra

What did i learned today?

• I am taking lots of things from today’s workshop like new concepts of treatment and how to incorporate that in application of patient treatment.
• Even for therapist – How to enjoy treating patients

What was good in the workshop?

• Everything was good
• Your smiling face was superb sir
• Learned lot, no words to explain
• Laughed a lot and enjoyed a lot. Thank you

What was bad in the workshop?

• it was hangover of seminar

Delegate no 10 :

What did i learned today?

• Practical application of PNF
• New concepts in treating patients
• Combinations of various therapies to treat patients

What was good in the workshop?

• The knowledge of instructor
• the good way of teaching concepts
• More interactive & problem based
• Basic concepts explained & queries solved
• Hands on treatment in treatment

What was bad in the workshop? Nothing

Delegate no 11 : Priti Singhade

What did i learned today?

• I learnt about rhythmic rotation its effect on spasticity. I learnt that whatever works is treatment and whatever doesn’t work is assessment.
• Also I liked the concept of inviting muscle for contraction.

What was good in the workshop?

• The lecture and practical was very informative.
• Cleared basic concepts.
• Very useful for application in patients

What was bad in the workshop? Nothing was bad in workshop

Delegate no 12 : Sanjyot

What did i learned today?

What was good in the workshop?

• I really liked the way you teach sir! The very fact that you used less of PPT and explained the neurophysiology of each technique is good.
• Plus your method of teaching is very good, especially with all the jokes and the correlation of pattern with dances makes it very easy to remember.

What was bad in the workshop? Nothing

Delegate no 13 : Pallavi K

What did i learned today?

• Neurophysiology in a more explanatory way
• Neuro is all about dance and understand the normal behavior and follow it to treat the abnormal pattern.
• Always move with the patient as an one unit.
• PNF can used and incorporate in any condition with other approaches as long as it serves the purpose and improves the muscles function (it is not only restricted to neuro) and most importantly i learnt to think multi directional towards a problem.

What was good in the workshop?

• The presentation was excellent.
• The workshop was self-explanatory and fun.
• Not at all boring
• Excellent practical & examples

What was bad in the workshop?

• Nothing specifically I feel more time is required to understand it in more details and practically on patients.

Delegate no 14 : Reepa Shroff

What did i learned today?

• I learnt how to increase the complexity in mat exercises.

What was good in the workshop?

• I like the way upper extremity pattern was explained & good sense of humor.

What was bad in the workshop?

• I wanted more hands on under supervision & certain topic’s pace should be slow.

Delegate no 15 : Neha Shah

What did i learned today?

• I learnt “ whatever works is treatment and whatever doesn’t work is a assessment”.
• Phenomenon of Flexion extension bias for rhythmic rotation
• Different PNF patterns

What was good in the workshop?

• It was a combination of various techniques with principals of PNF.
• Techniques & PNF patterns were simplified & now easy to remember

What was bad in the workshop?

• Everything was good except that the topic it self is very volatile.

Delegate no 16 : shailesh

What did i learned today?

• Practical application of PNF on specific dysfunction to gain functional output

What was good in the workshop?

• The best take home message was “ teach, treat and training”.
• The best part of approval was to understand the neurophysiological basic technique.

What was bad in the workshop? Everything was good.

Delegate no 17 : Dixita

What did i learned today?

• I learnt to believe in my treatment & gain more confidence in treating patients with PNF. (something which I sound very volatile in BPTh).

What was good in the workshop?

• It gave more insight to the technique.
• The way you taught was great.

What was bad in the workshop? I am an ortho elective, if you can add a little of PNF use in musculoskelatal cases.

Delegate no 18 :Pradnaya Girdhan

What did i learned today?

• We (therapist) treat movement dysfunction and not the disease
• Learnt application of PNF in various conditions
• Learnt new techniques of releasing the stiffness and strengthening concepts.
• Learnt to explore new concepts and apply them in rehab

What was good in the workshop?

• Easy and approachable instructor
• Good teaching with day –to –day examples
• Good way of simplifying complex things
• Practical demonstration of cases

What was bad in the workshop? Too much saturation towards the end

Delegate no 19 : Richa

What did i learned today?

• I actually learnt the proper concedpt of PNF and how is is to be utilized for patients benefit in all the dysfunction

What was good in the workshop?

• The way the workshop was conducted
• It was interactive with loads of new information
• Easy learning

What was bad in the workshop?

• There was nothing bad in the workshop

Feedback of Day 2: 13th September 2015

NAME-Dixita Sampat

What did I learn today?

• Various techniques that can be combined for treating the patient better.
• Better approach of seeing the patient.

What was good about the workshop?

• The instructor

What was bad about the workshop?

• A little knowledge of PNF related to orthopaedics.

PARTICIPANT-2. NAME: Karishma Virjee

What did I learn today?

• Better learning , new techniques.

What was good about the workshop?

• Everything from the presentation of the topic, knowledge and arrangement of workshop.

What was bad about the workshop?

PARTICIPANT-3

NAME- Swandha Majundar

What did I learn today?

• Use of PNF pattern to facilitate weak muscle; Use of good alingnment to improve body/mechanise. Use of functional movement to improve ADL activities.

What was good about the workshop?

• Hands on practice on patients

What was bad about the workshop?

• More time needed to practice all PNF patterns.

PARTICIPANT-4

NAME- Tandel Deepak Ramchandra

What did I learn today?

• How to solve the problems?
• How to solve problems on simple que which patient can understand
• We learned lots of problem solving techniques which are priceless.

What was good about the workshop?

• Everything was excellent .No words.

What was bad about the workshop?

PARTICIPANT-5

NAME- Palak Gandhi

What did I learn today?

• Way of manipulating things to get the best outcome from the patient with less effort by the therapist and aim at KR and not on KP.

What was good about the workshop?

• It helped me think beyond normal basic treatment and assessment and
• How to treat patient more effectively with less effort by the therapist

What was bad about the workshop?

• Did not get enough time for practicing due to shortage of time.

PARTICIPANT-6

NAME- Jigna Tanna

What did I learn today?

• Learned how to use PNF techniques while treating patients.

What was good about the workshop?

• Instructors way of teaching.

What was bad about the workshop?

PARTICIPANT-7

NAME- Mezba Fakih

What did I learn today?

• New techniques, bridging, treating differently, alertness and arousal.

What was good about the workshop?

• Practical and hands on is very important and we did it.

What was bad about the workshop?

PARTICIPANT-8

NAME- Sanjyot Harshe

What did I learn today?

• Trunk, lower limb patterns.
• Practical application techniques.

What was good about the workshop?

• Practical application.
• Correlation between theory and practicals.

What was bad about the workshop?

PARTICIPANT-9

NAME- Shailesh Gardar

What did I learn today?

• Lower limb PNF techniques
• Problem solving.

What was good about the workshop?

• Practical application of techniques on patients.
• Sharing current experiences by instructor

What was bad about the workshop?

PARTICIPANT-10

NAME- Priti Shingade

What did I learn today?

• –

What was good about the workshop?

• Workshop was very practical and helpful in treating patients.

What was bad about the workshop?

• –

PARTICIPANT-11

NAME- Shilpa Arya

What did I learn today?

• How to use integrated approaches in treatment
• Be creative
• Bridge and tentacle principle.

What was good about the workshop?

• How to change treatment approach according to orientation.
• Arousal of the patient
• How to use PNF in various conditions.

What was bad about the workshop?

• Nothing

PARTICIPANT-12

NAME- Pallavi Kasture

What did I learn today?

• How to integrate and apply different principles of PNF to attain a movement using a task specific action by manipulating BOS, COM, LOG and orientation

What was good about the workshop?

• Practical demonstration of all the techniques.

What was bad about the workshop?

• –

PARTICIPANT-13

NAME- Richa Shah

What did I learn today?

• I learnt the irradiation principle with unit the segments to help the patient to achieve the goal.

What was good about the workshop?

• The demos on the patient.

What was bad about the workshop?

• Too many demos with short periods of practice.

PARTICIPANT-14

NAME- Reepa Shroff

What did I learn today?

• Different principles
• Techniques of PNF.

What was good about the workshop?

• Orator’s presentation and sense of humor is very good

What was bad about the workshop?

• Maybe it should have been three days workshop with more hands on practice.

PARTICIPANT-15

NAME- Sakina Rangwala

What did I learn today?

• How to treat different conditions of neuro patients.
• Use of different techniques for achieving goals of patients.

What was good about the workshop?

• Instructor’s knowledge
• Humour
• Group participation

What was bad about the workshop?

• Only a little fast.

PARTICIPANT-16

NAME- Hasan Sayed

What did I learn today?

• How to progress in neurological cases
• How to approach a patient

What was good about the workshop?

• Different approaches for different patients.

What was bad about the workshop?

• No individual practice time for specific techniques
• Many techniques taught at one time so created confusion
• No focus.

PARTICIPANT-17

NAME- Raahatara Irean

What did I learn today?

• Along with PNF a lot of practical, patient-related knowledge.

What was good about the workshop?

• Perspective is very refreshing
• Way of teaching is far from boring

What was bad about the workshop?

• Time management.

PARTICIPANT-18

NAME- Munira Palitanawala

What did I learn today?

• To incorporate functional activities in good ways which brings about the mass movements.
• What was good about the workshop?
• Clinical treatment shown on patients
• The instructor sharing a lot of knowledge.Way of teaching is far from boring

What was bad about the workshop?

• Time frame to practice patterns were less
• Also each technique should be given time to practice in front of trainer.

PARTICIPANT-19

NAME- Sadia Kazi

What did I learn today?

• Clinical applications of PNF, verbalization with patient to perform a task.
• Task-oriented approach
• What was good about the workshop?
• Techniques taught, everything was good
• What was bad about the workshop?
• Time constraints, too many things to grasp.

PARTICIPANT-20

NAME- Neha Shah

What did I learn today?

• Different PNF techniques , how to design a treatment protocol depending on patient status.

What was good about the workshop?

• Instructor’s technique of teaching, different treatment techniques of PNF which can be used for not only neuro patients but all types of patients

What was bad about the workshop?

• Too many things to grasp.

PARTICIPANT-21

NAME- Zoeb Rangwala

What did I learn today?

• Revision of the previous day workshop.
• Management of hemi patients.
• Lower limb-PNF

What was good about the workshop?

• Hands on

What was bad about the workshop?

• –

PARTICIPANT-22

NAME- Fatema Kalyanwala

What did I learn today?

• Application of PNF technique on patients

What was good about the workshop?

• Explanation and presentation was upto the core.

What was bad about the workshop?

• Less time for practice
• Little confused

PARTICIPANT-23

NAME- Mohini Mishra

What did I learn today?

• One is giving target to the patient
• Organizing a task for movement playing with gravity BOS, not to treat condition but to treat a function

What was good about the workshop?

• Made every activity with some task and had fun and learned a lot

What was bad about the workshop?

• Did not get much time to practice.

PARTICIPANT-24

NAME- Rajisha Shah

What did I learn today?

• PNF techniques with better hands on application and better decision making on what technique to use in what cases.

What was good about the workshop?

• The approach of the workshop conductor towards was excellent

What was bad about the workshop?

• Some more time is needed to be alloted.

PARTICIPANT-25

NAME- Pradnya Girdhan

What did I learn today?

• Difference between conventional strengthening of PNF and its application to varied weaknesses of any origin.

What was good about the workshop?

• The instructor was to the point and the techniques demonstrated were excellent .
• Made a difference in the approach of rehabilitation.

What was bad about the workshop?

• Too many demos done at a stretch.
• Need to space out the demos.

PARTICIPANT-26

NAME- Mansi Khochare

What did I learn today?

• Multi-segmental cultivation
• Knowledge of results
• Bridge and tentacle principles

What was good about the workshop?

• Interactive
• Problem solving
• Practicals

What was bad about the workshop?

• –