Proprioceptive Neuromuscular Facilitation and Gait Outcomes

Nick Weiss, a second year in my DPT class, presented on proprioceptive neuromuscular facilitation (PNF) and how it influences gait outcomes.

Nick did a great job not only describing what PNF is, but also outlining how it is beneficial to patients who need gait training. Nick emphasized that some outcomes and treatments we use as physical therapists only focus on one perspective of a patient’s health. For myself, this was a big take-home point. He discusses and outlines how the future of health outcomes should be divided into 4 major categories: heath behaviors, clinical care, physical environment, and social and economic factors.

Scope of practice may limit a healthcare providers ability to directly address all 4 of these categories. Specifically, changing a patient’s social and economic factors is often out of our hands as physical therapists. I do think it is important as future or current practicing clinicians that we at least try to address the other 3/4 factors, and have an awareness of social and economic barriers.

Clinical care is the easiest to control in that it stems directly from the clinician. A clinician is responsible for staying up-to-date on current best practices, evidence-based treatments, and overall new healthcare changes. Health behaviors can be tricky, but at the core of the medical system, isn’t the goal to help people achieve health? I think so. It is my ethical and professional responsibility to discuss health with my future patients. Topics such as diet, genetics and even sleep quality can be on the table. Why? These factors affect potential for healing and risk for sustaining new injuries. Lastly, the physical environment is often overlooked. We are taught as students to ask about peoples daily lives; how they get to work, if they have stairs in their home, and more. We explain to people how to work within their environmental constraints, but do not typically help change them. It is simple, we should be doing this more as physical therapists! Helping a patient effectively change their environment so they can function at their best should be a bigger part of our goals, treatment, and practice.