PNF facilitation and Kabat technique
Out of the wide range of approaches used in neurological rehabilitation, let us look deeper into the Kabat technique
Facilitation techniques are aimed at improving motor control by enhancing muscle activity.
Origin of all facilitation techniques used today are all based on the Rood approach developed by Margaret Rood in the 1950s.
Proprioceptive Neuromuscular Facilitation (PNF) is a set of stretching techniques commonly used in clinical environments to enhance both active and passive range of motion
It helps in improving motor performance and aids in rehabilitation.
Proprioceptive neuromuscular facilitation(PNF) was developed by Herman Kabat in the 1940s and further developed Dorothy Voss and Margaret Knott.
Reflexive movement are taken as the basics to learn more volitional movements.
Here, the developing sequences of movements and the work of agonists and antagonists are the primary focus.
PNF focuses on mass movement patterns that are diagonal and resemble functional movement by using multi-sensory approach.
The patterns of movement associated with PNF are composed of multi-joint, multi-planar, diagonal, and rotational movements of the extremities, trunk & neck.
It uses 2 sets of foundational movement.
The Kabat method is optimal for strengthening and muscle stretching, for the increase in the width of the joint range, for the reduction of stiffness and spasticity, for coordination and balance.
PNF stretching techniques based on Kabat’s concept are:
Contract Relax:
In Contract Relax method, restricted muscle are placed into a position of stretch passively.
This is followed by isotonic contraction and then relaxation of the restricted muscle.
Now the opposing muscles are activated, leading to movement.
Golgi tendon is the structure that is at work.
Hold Relax Method
Used when the agonist is too weak to activate properly.
The patient's restricted muscle is put in a position of stretch.
This is followed by an isometric contraction of the restricted muscle.
After a minimum of 6 minutes, the restricted muscle is passively moved to a position of greater stretch.
This technique utilizes the autogenic inhibition, which relaxes a muscle after a sustained contraction.
Contract Relax Agonist, Antagonist Contract:
This is usually performed by a passive or active stretch of the target muscle(s) to move the limb into a starting position at first.
This is followed by a sub-maximal isometric contraction of the target muscle.
An active stretch is used to move the limb into a new greater position.
This technique uses autogenic and reciprocal inhibition.
Reciprocal inhibition is the main cause of the greatest effect of this technique versus the other PNF techniques.
Rhythmic Initiation:
This begins with the therapist moving the patient through the desired movement using passive range of motion.
This is then followed by active-assistive, active-resisted range of motion, and finally active range of motion.
Slow reversals:
This technique is based on Sherrington's principle of successive induction, i.e. that immediately after the flexor reflex is elicited the excitability of the extensor reflex is increased.
This technique is used to strengthen and build up endurance of weaker muscles and develop co-ordination and establish the normal reversal of antagonistic muscles in the performance of movement.
Latest Researches:
It has been proven that Kabat techniques when associated with other medical management for patients with Bells Palsy shower better and faster recovery than those in whom only medical treatment was applied.
It has helped patients with functional motor loss improve. Through stimulation of the proprioceptors, the Kabat rehabilitation therapy for facial paralysis can trigger or restore the neuromuscular circuit, restore the normal functionality of nerve terminals in the muscles, gain functional & aesthetic benefits. Patients who were treated with kabat rehabilitation method restored motor capacities of the paralyzed hemifacial.
Laser along with Kabat technique is more effective as compared to laser with facial exercise technique in improving physical and social function. Both techniques showed significant improvement in both treatment groups. But patients with Kabat rehabilitation along with laser therapy showed more significant improvement
At Valley Healing hands, we provide the best physical therapy in neurological rehabilitation using Kabat techniques. We have highly qualified therapists whose proficiency and capability in this field would keep you wanting for our services. We are known for customizing our patients' sessions as per their medical and physical requirements. Our patients are totally satisfied with our services. You may learn about what they have to say about us here and get connected to us here. Our patients love us and you too will.
References:
Physiopedia, Neurology Treatment Techniques.
Role of Kabat rehabilitation in facial nerve palsy: a randomised study on severe cases of Bell's palsy, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5066463/
A Case Study on the Effectiveness of Kabat Rehabilitation in a Patient with Bell’s Palsy, https://jddtonline.info/index.php/jddt/article/view/4951/3992
Comparison of Efficacy of Kabat Rehabilitation and Facial Exercise in Patients with Bell’s Palsy in Loni, https://www.ijsr.net/archive/v11i10/SR221006160503.pdf
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