PNF are stretches that are used to increase range of motion. Particularly in athletes and fit individuals. In chronic diseased individuals such as COPD PNF may not be as useful due to their physical inactivity and difficulty with normal stretches. PNF requires longer periods of time to complete and you may not have adequate time to assist all patients. Ultimately age, fitness level, time, and stage of COPD will determine how useful PNF will be.
Dear Senthil
PNF have different techniques in it:
1. hold-relax & contract relax that are used for ROM improvement
2. rhythmic stabilization & stabilizing reversals that are used to improve postural activity and patients' ability to sustain a posture
3. rhytmic initiation & replication - for introducing a new movement pattern and improvong muscle coordination
4. dynamic reversals and combination of isotonics - in order to activate different muscles (agonist-antagonist) or to initiate different muscle activity in the same muscle (concentric, isometric, eccentric)
working in different patterns (D1-D2) you can work with short levers (knee/elbow bent) or long levers (knee-elboe extended) and in a such way it may increase the demand for core control and for ventilation
so coming back to your question - whether PNF in helpful for COPD - I suppose that the answer is "it depands"...it depands on patient's needs. For example, for improving balance & postural control which is impaired in moderate-severe COPD (Gait Posture. 2016 Jan;43:101-7. doi: 10.1016/j.gaitpost.2015.09.004. Epub 2015 Sep 11.
Balance recovery is compromised and trunk muscle activity is increased in chronic obstructive pulmonary disease.
Smith MD1, Chang AT2, Hodges PW2.) you can use rhythmic stabilization. For endurance of upper extremities - dynamic reversals
http://journal.publications.chestnet.org/data/Journals/CHEST/21576/688.pdf
remeber - to adjust position for each patient for mechanical advantage of respiratory muscles...
Good Luck
As Irena told us, PNF have a lot of techniques, and of course that it so useful in COPD patients. In the true, using the good sense and criativity, PNF can be useful in almost all patients. We can use hold-relax, contract-relax for the shortened muscles, etc, etc. During the International courses we can observ that PNF is really useful during our daily routine even in neurological, orthopedic and pulmonary diseases patients.
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