PNF MAT USED IN FUNCTIONAL
REHABILITATION ..... FILLING IN THE
BLANKS
Robyn Smith
Department of Physiotherapy
UFS
2011
PRINCIPLES OF MAT WORK:
Synonymous with term “functional strengthening”
 Key PNF principles are still to be applied – namely
stretch, resistance and the use of diagonals
 PNF special techniques may also be used to
address specific aims e.g. Strengthening,
endurance etc.
 During PNF mat work the patient is involved in
functional activities or positions
 Mat work activities incorporate both the elements of
mobility & stability

PRINCIPLES OF MAT WORK:
Normal developmental sequencing forms the basis
for PNF mat work activities – certain components
are required for certain levels of motor tasks e.g. In
supine, sitting, standing.
 A functional task needs to be broken down into
components which can be practiced and
strengthened before entire activity can be done
 Proximal control and stability before distal mobility
Central control involves the spine/trunk (including
the cervical thoracic and lumbar spine), the
shoulder girdle and the pelvis
 Functional goals and the patients functional level
will determine your choice of activities

WHERE DO I START?

Where does one start?
 Subjective interview with patient regarding his functional
abilities & difficulties
 Objective examination of how patient does functional activity

Where do I start with therapy?
 Identify functional problems and underlying causes and
components that are problematic
 Set a functional goal for patient/therapy sessions
 start in a position initially that patient can get into
independently or with help
 Work for stability and balance in position (rhythmical
stabilization NB here)
 Work then for functional motion into and out of the position into
another
TAKE PATIENTS CURRENT STRENGTH INTO
ACCOUNT

Make use of your grading of muscle strength to decide on the
techniques one could potentially use to address the muscles
weakness
Grade
3-5
Grade 02
Tapping
ice brushing
Strengthening weights
/theraband
Facilitation
Suspension & reeducation board
Functional
strengthening
TAKE PATIENTS CURRENT STRENGTH INTO
ACCOUNT

PNF can be used across the strength spectrum through
making use of special techniques and addressing the specific
requirements patient and any precautionary measures
Grade 0-2
Grade 3-5
Rhythmic
initiation &
stabilization
Dynamic reversal endurance
Active patterns
in diagonals
Repeated stretch
strengthening
Combination
isotones eccentric
control
WHAT ARE FUNCTIONAL POSITIONS AND HOW
DO I DECIDE WHICH ARE APPROPRIATE?

Use of functional activities are often age dependant e.g.
C=child crawling and using prone are appropriate but
often with an 80 year old they do not make use of these
positions in ADL.

Positions used for PNF therapy may therefore include :
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Supine
Side lying
Sideling or reverse on elbows
Crook lying
Puppy
Four-point kneeling
Kneeling or high kneeling
Sitting on mat or high sitting on chair
Standing
WHAT ARE FUNCTIONAL TASKS THEN ?
Rolling over in bed to reach for a glass on bedside
table
 Being able to sit up over side of bed
 Being able to move forward to point chair and stand
up
 Being able to stand up and sit out in chair
 Being able to walk from bed to a chair in the room
 Being able to do pressure relief
 Being able to climb a stair
 Being able to walk safely and independent with
crutches

COMPONENTS ANALYSIS AND IDENTIFICATION OF
SUITABLE PNF PATTERNS AND SPECIAL
TECHNIQUES

Standing up from chair requires:
Adequate UL strength to push up on chair (mm.
Latissimus- extension adduction ER using chairs
armrests )
 Sufficient trunk strength, anterior weight transfer and
balance in sitting (chop/lifting in sitting position)
 Being able to bum shuffle forward to point chair (anterior
pelvis elevation resistance can be given pelvis/shoulder)
 Weight transfer and initiate standing walking
stance(rhythmic initiation, anterior depression shoulder
or anterior elevation pelvis)
 Sit down slowly (combination isotones eccentric control)
 Standing (rhythmic stabilization) –balance and stability
in standing
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REFERENCES
Smith, R. 2011. PNF dictate, learning material UFS.
(unpublished)
 Old PNF notes (UFS)
 Adler, S.S, Beckers, B. & beck, M. 1993. PNF in
Practice. An illustrated guide pp169-231
