PNF Technique Indications Contraindications Techniques for Facilitation
RHYTHMIC INITIATION (RI) Inability to relax Voluntary relaxation* passive movement through
- to improve the ability to Hypertonicity (spasticity, increments of range AAROME AROM MREs (usually
initiate movement rigidity) concentric)
Inability to initiate
movement (apraxia) * Relaxation of muscles using inhibitory techniques
Motor learning deficits * Unidirectional or diagonal
RHYTHMIC STABILIZATION Instability in weight bearing Isometric contraction of agonist isometric contraction of
(RS) & holding antagonist
Poor static postural control
Weakness * Done without rest periods & results in co-contraction of
LOM caused by tightness muscles
Painful muscle splinting
* Emphasizes ROTATIONAL
STABILITY
REPEATED CONTRACTION (RC) Weakness Where sustained Repeated isotonic contractions (induced by quick stretch
Incoordination effort is CI enhanced by resistance performed through the range or part
Muscle imbalance Very acute of a range at a point of weakness)
Diminished muscular situations
imbalance + Isometric hold can be added at the point of severe
weakness
* Unidirectional
SLOW REVERSAL (SR) Muscle imbalance Isotonic contraction (concentric) of agonist isotonic
Muscle weakness contraction of antagonist
* Uses gradual grading of resistance
* Progression can be made by increasing increments in range
SLOW REVERSAL HOLD (SRH) Inability to reverse Isotonic contraction (concentric) of agonist isometric hold
directions at point of weakness or end of ROM isotonic contraction
Muscle imbalance of antagonist isometric hold at point of weakness or end
Weakness of ROM
Incoordination
Lack of endurance
SLOW REVERSAL HOLD RELAX Isotonic contraction of the agonist (tight) isometric
(SRHR) contraction of agonist relaxation isotonic contraction of
agonist
QUICK REVERSAL (QR) Isotonic contraction of antagonist (lengthened position)
quick isotonic contraction of agonist isometric contraction
of agonist
AGONIST REVERSAL (AR) Weak postural muscles - Slow isotonic contraction is introduced
Inability to eccentrically
control body weight during Concentric contraction through the range eccentric
movement transitions contraction of the same muscle group
Poor dynamic muscle
control
* Typically used in SIT-TO-
STAND situation and STEPPING
UP & DOWN
HOLD RELAX (HR) LOM caused by muscle Isometric contraction (tight muscle) relaxation PROM
- Uses AUTOGENIC INHIBITION tightness, muscle spasm,
and pain * Relaxation technique usually performed at the point of
limited ROM in the agonistic pattern
CONTRACT RELAX (CR) Muscle tightness Isotonic contraction passive elongation
* Relaxation technique usually performed at the point of
limited ROM in the agonistic pattern
HOLD RELAX WITH ACTIVE Marked weakness in Isometric contraction in shortened range of pattern
MOTION (HRAM) lengthened range of relaxation PROM in lengthened position isotonic
pattern contraction
HOLD RELAX WITH ACTIVE/ Lack of endurance
AGONIST CONTRACTION Muscle imbalance
(HRAC)
RHYTHMIC ROTATION (RR) Hypertonicity - Completely passive movement
- PT supports the limb or body segment as it rotates
alternately in both directions