The Effect of Proprioceptive Neuromuscular Facilitation on Joint Position Sense: A Systematic Review

in Journal of Sport Rehabilitation
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Context: Accurate joint position sense (JPS) is necessary for effective motor learning and high performance in activities that require fine motor control. Proprioceptive neuromuscular facilitation (PNF) can be a promising intervention. Objective: To examine existing peer-reviewed original studies that have investigated the effect of PNF techniques on the JPS in terms of the methodological quality, PNF techniques, outcomes, and participant characteristics. Evidence Acquisition: A systematic literature search was performed using PubMed, EMBASE, MEDLINE, CINAHL, SocINDEX, Scopus, and Cochrane Library from inception to January 2018. The following inclusion criteria were used: (1) assessment of the JPS; (2) peer-reviewed original studies with a randomized controlled trial or quasi-randomized controlled trial design; (3) participants with musculoskeletal disorders or healthy individuals (ie, neither animal studies nor those involving neurological problems); and (4) no cointervention with PNF, except for warm-up procedures. The methodological quality was assessed using PEDro scale and 5 additional criteria. Effect size (η2) was calculated where a positive value indicated an increased JPS after PNF as compared with other approaches including the wait-and-see method. Evidence Synthesis: Nine studies were examined for their methodological quality, and only one study scored >6 on the PEDro scale. Positive and large effect size (η2 > .14) was detected in 2 studies where JPS of the knee with contract-relax and replication techniques was assessed in healthy individuals. However, the methodological quality of these studies was poor (PEDro scores of 3 and ≤5 in the total quality score out of 16, respectively). Conclusions: The current study did not find multiple studies with high methodological quality and similar PNF techniques, outcomes, and characteristics of participants. More high-quality studies are required to achieve a comprehensive understanding of the effect of PNF on the JPS.

Takasaki and Okuyama are with the Department of Physical Therapy, Saitama Prefectural University, Koshigaya, Japan. Okubo is with the Department of Physical Therapy, School of Physical Therapy, Faculty of Health and Medical Care, Saitama Medical University, Iruma, Japan.

Takasaki (physical.therapy.takasaki@gmail.com) is corresponding author.
Journal of Sport Rehabilitation
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References
  • 1.

    Lephart SMPincivero DMGiraldo JLFu FH. The role of proprioception in the management and rehabilitation of athletic injuries. Am J Sports Med. 1997;25:130137. PubMed ID: 9006708 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Mota NRibeiro F. Association between shoulder proprioception and muscle strength in water polo players. Isokinet Exerc Sci. 2012;20:1721. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    van der Esch MSteultjens MHarlaar JKnol DLems WDekker J. Joint proprioception, muscle strength, and functional ability in patients with osteoarthritis of the knee. Arthritis Rheum. 2007;57:787793. PubMed ID: 17530678 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Kaya DCallaghan MJDonmez GDoral MN. Shoulder joint position sense is negatively correlated with free-throw percentage in professional basketball players. Isokinet Exerc Sci. 2012;20:189196. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Lazarou LKofotolis NMalliou PKellis E. Effects of two proprioceptive training programs on joint position sense, strength, activation and recurrent injuries after ankle sprains. Isokinet Exerc Sci. 2017;25:289300. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Cho SILee DYHong JHYu JHKim JS. Effect of hold and relax technique on knee joint position awareness in normal adults. Indian J Sci Technol. 2015;8(19).

    • Search Google Scholar
    • Export Citation
  • 7.

    Padua DAGuskiewicz KMPrentice WESchneider REShields EW. The effect of select shoulder exercises on strength, active angle reproduction, single-arm balance, and functional performance. J Sport Rehabil. 2004;13:7595. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Sharman MJCresswell AGRiek S. Proprioceptive neuromuscular facilitation stretching: mechanisms and clinical implications. Sports Med. 2006;36:929939. PubMed ID: 17052131 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Hindle KBWhitcomb TJBriggs WOHong J. Proprioceptive neuromuscular facilitation (PNF): its mechanisms and effects on range of motion and muscular function. J Hum Kinet. 2012;31:105113. PubMed ID: 23487249 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Peck EChomko GGaz DVFarrell AM. The effects of stretching on performance. Curr Sports Med Rep. 2014;13:179185. PubMed ID: 24819010 doi:

  • 11.

    Behm DGBlazevich AJKay ADMcHugh M. Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: a systematic review. Appl Physiol Nutr Metab. 2016;41:111. PubMed ID: 26642915 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Lial LMoreira RCorreia Let al. Proprioceptive neuromuscular facilitation increases alpha absolute power in the dorsolateral prefrontal cortex and superior parietal cortex. Somatosens Mot Res. 2017;34:204212. PubMed ID: 29096587 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Shuratani TNitta OMatsuda MTada YSenoo AYanagisawa K. The effects of a static contraction of pelvic anterior elevation on the brain activities induced by a fMRI in the normal volunteers. J Jpn Acad Health Sci. 2011;14:205212.

    • Search Google Scholar
    • Export Citation
  • 14.

    Moher DLiberati ATetzlaff JAltman DGPRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8:336341. PubMed ID: 20171303 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Ghogomu EAMaxwell LJBuchbinder Ret al. Updated method guidelines for Cochrane Musculoskeletal Group systematic reviews and metaanalyses. J Rheumatol. 2014;41(2):194205. PubMed ID: 24293581 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    de Morton NA. The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study. Aust J Physiother. 2009;55:129133. PubMed ID: 19463084 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Maher CGSherrington CHerbert RDMoseley AMElkins M. Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther. 2003;83:713721. PubMed ID: 12882612

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Sherrington CHerbert RDMaher CGMoseley AM. PEDro. A database of randomized trials and systematic reviews in physiotherapy. Man Ther. 2000;5:223226. PubMed ID: 11052901 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Takasaki HMay S. Mechanical diagnosis and therapy has similar effects on pain and disability as ‘wait and see’ and other approaches in people with neck pain: a systematic review. J Physiother. 2014;60:7884. PubMed ID: 24952834 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Boyles RToy PMellon J JrHayes MHammer B. Effectiveness of manual physical therapy in the treatment of cervical radiculopathy: a systematic review. J Man Manip Ther. 2011;19:135142. PubMed ID: 22851876 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Coppola SMCollins SM. Is physical therapy more beneficial than unsupervised home exercise in treatment of post surgical knee disorders? A systematic review. Knee. 2009;16:171175. PubMed ID: 18851916 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Takasaki HLim ECWSoon B. The effect of shoulder muscle fatigue on active repositioning acuity and scapulothoracic resting alignment: a systematic review with meta-analysis. Phys Ther Sport. 2016;20:6178. PubMed ID: 27080109 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Takasaki HMiki T. The impact of continuous use of lumbosacral orthoses on trunk motor performance: a systematic review with meta-analysis. Spine J. 2017;17:889900. PubMed ID: 28323240 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Altman DG. Practical Statistics for Medical Research. London, UK: Chapman & Hall; 1991.

  • 25.

    Cohen J. Statistical Power Analysis for the Behavioural Sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates, Inc.; 1988.

  • 26.

    Bjorklund MDjupsjobacka MCrenshaw AG. Acute muscle stretching and shoulder position sense. J Athl Train. 2006;41:270274. PubMed ID: 17043694

  • 27.

    Streepey JWMock MJRiskowski JLVanwye WRVitvitskiy BMMikesky AE. Effects of quadriceps and hamstrings proprioceptive neuromuscular facilitation stretching on knee movement sensation. J Strength Cond Res. 2010;24:10371042. PubMed ID: 20300021 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Minshull CEston RBailey ARees DGleeson N. The differential effects of PNF versus passive stretch conditioning on neuromuscular performance. Eur J Sport Sci. 2014;14:233241. PubMed ID: 23688197 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Sookhee BHohee S. The effects of proprioceptive neuromuscular facilitation and stabilizing exercise on trunk repositioning errors. J Phys Ther Sci. 2012;24:10171020. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30.

    Furuya HIto TSumiya KTomoshige STanaka T. The effect of PNF techniques with replication for the joint position sense in patients undergoing knee arthroplasty. PNF Res. 2009;10:2832.

    • Search Google Scholar
    • Export Citation
  • 31.

    Ito TSaito TSato HShinoda M. The influence of replication on knee joint kinesthetic sense. PNF Res. 2007;7:3943.

  • 32.

    Relph NHerrington L. Knee joint position sense ability in elite athletes who have returned to international level play following ACL reconstruction: a cross-sectional study. Knee. 2016;23:10291034. PubMed ID: 27712856 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Friden TRoberts DAgeberg EWalden MZatterstrom R. Review of knee proprioception and the relation to extremity function after an anterior cruciate ligament rupture. J Orthop Sports Phys Ther. 2001;31:567576. PubMed ID: 11665744 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Relph NHerrington LTyson S. The effects of ACL injury on knee proprioception: a meta-analysis. Physiotherapy. 2014;100:187195. PubMed ID: 24690442 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Kim HJLee JHLee DH. Proprioception in patients with anterior cruciate ligament tears: a meta-analysis comparing injured and uninjured limbs. Am J Sports Med. 2017;45:29162922. PubMed ID: 28060536 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
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