Feasibility of Chest Wall and Diaphragm Proprioceptive Neuromuscular Facilitation (PNF) Techniques in Mechanically Ventilated Patients

Abstract

Physical therapy is part of the treatment for patients admitted to ICU. Proprioceptive neuromuscular facilitation (PNF) is one of the physiotherapy concepts including manual techniques and verbal stimulation. The purpose of this paper is to examine the feasibility of PNF techniques in mechanically ventilated (MV) ICU patients. Another aim is to verify whether the technique using resistance during the patient’s inhalation will have a different effect than the technique used to teaching the correct breathing patterns. Methods: Patients admitted to tertiary ICU were enrolled in this study, randomly divided into two groups, and received four 90-second manual breathing stimulations each. The following vital signs were assessed: HR, SBP, DBP, and SpO2. Results: 61 MV ICU adult patients (mean age 67.8; 25 female and 36 male) were enrolled in this study. No significant differences in HR, SBP, and DBP were observed both for two techniques measured separately and between them. Statistically significant differences were noticed analysing SpO2 in the rhythmic initiation technique (RIT) group (p-value = 0.013). Conclusions: Short-term PNF interventions did not influence clinically relevant vital parameters among MV patients and seem to be feasible in this group of ICU patients.

Effects of proprioceptive neuromuscular facilitation combined with threshold inspiratory muscle training on respiratory function in neurocritical patients with weaning failure: a randomized controlled trial

“…Proprioceptive neuromuscular facilitation (PNF) has gained considerable interest in the field of neurophysiological facilitation of respiration. The presumed physiological mechanisms of PNF include autogenic inhibition, reciprocal inhibition, stress relaxation, and the gate control theory [ 10 , 11 ]. PNF is believed to stimulate proprioceptive receptors in perioral, thoracic, and abdominal muscles as well as sensory inputs from peripheral organs by influencing motor outputs of the central nervous system and stimulating the corresponding nerve reflex, which may help patients develop correct movement patterns [ 12 , 13 ] and induce physiological reactions, such as cough and expectoration.…”

“…PNF has been an effective strategy for stimulating active breathing, rhythmic initiation, and stabilization [ 10 , 11 ]. Seo and Cho [ 14 ] showed that PNF respiration exercise is effective in increasing expiratory reserve volume and vital capacity and suggested that PNF can improve pulmonary function.…”

Immediate Effectiveness of Chest Proprioceptive Neuromuscular Facilitation (PNF) Technique on Hemodynamic Status in COVID-19 Patients: An Original Research

“…It gives the respiratory muscles proprioceptive feedback, which triggers reflex respiratory movement responses and enhances the rate and depth of breathing. Repeated compressions are performed to promote an improvement in inspiratory volume, while a stretch response is used to facilitate the onset of inhalation [9]. This effect could lead to a beneficial effect in COVID-19 patients with reduced functional capacity and chest wall mobility.…”