The Effectiveness of Proprioceptive Neuromuscular Facilitation (PNF) on Balance and Fall Risk in Older Adults: A Systematic Literature Review
Keywords:
Proprioceptive Neuromuscular Facilitation, Berg Balance Scale, Balance Disorders, fall risk, ElderlyAbstract
Introduction: Proprioceptive Neuromuscular Facilitation (PNF) is an exercise method that focuses on improving neuromuscular control through proprioceptor stimulation. PNF is more commonly used in neurological therapy, but further research is needed regarding its ability to address musculoskeletal issues, such as balance and fall risk in the elderly. This study aims to review the PNF approach and analyse its effectiveness in improving balance and reducing the risk of falls in the elderly based on existing literature reviews. Methods: This study uses a simple literature review method. Data were collected through searches in research article databases such as Google Scholar, Crossref, ProQuest, PubMed, Science Direct, Scopus, and Semantic Scholar. Inclusion criteria for this article included studies published between 2015 and 2025, experimental research designs, and the application of Proprioceptive Neuromuscular Facilitation (PNF) in the elderly. Results: A review of six previous studies showed that PNF exercises had a positive effect on improving balance and reducing the risk of falls in the elderly. Conclusion: Proprioceptive Neuromuscular Facilitation (PNF) has been proven effective in improving balance and functional range associated with a reduced risk of falls in the elderly. With these benefits, PNF can be an important component of fall prevention programmes and improving the quality of life for the elderly.
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References
Adler, S. S., Beckers, D., & Buck, M. (2007). PNF in Practice: An Illustrated Guide. Springer Berlin Heidelberg. https://books.google.co.id/books?id=NYvQeja_UGwC
Attar, M., Alsinnari, Y. M., Alqarni, M. S., Bukhari, Z. M., Alzahrani, A., Abukhodair, A. W., Qadi, A., Alotibi, M., & Jastaniah, N. A. (2021). Common Types of Falls in the Elderly Population, Their Associated Risk Factors and Prevention in a Tertiary Care Center. Cureus, 13(5), e14863. https://doi.org/10.7759/cureus.14863
Beckers, D., & Buck. (2021). PNF in Practice. Springer Berlin Heidelberg. https://doi.org/10.1007/978-3-662-61818-9
Burton, E., Lewin, G., O’Connell, H., & Hill, K. D. (2018). Falls prevention in community care: 10 years on. Clinical Interventions in Aging, 13, 261–269. https://doi.org/10.2147/CIA.S153687
Cayco, C. S., Gorgon, E. J. R., & Lazaro, R. T. (2019). Proprioceptive neuromuscular facilitation to improve motor outcomes in older adults with chronic stroke. Neurosciences (Riyadh, Saudi Arabia), 24(1), 53–60. https://doi.org/10.17712/nsj.2019.1.20180322
Chen, X., & Qu, X. (2019). Age-Related Differences in the Relationships Between Lower-Limb Joint Proprioception and Postural Balance. Human Factors, 61(5), 702–711. https://doi.org/10.1177/0018720818795064
Da Silva, C. R., Magalhães, L. F. R., Chaves, F. M. G., Vieira, E. C. do N., Adames, A. P. R., & Brauns, I. da S. D. (2020). Effects of aquatic physiotherapy versus conventional physical therapy on the risk of fall in the elderly: a randomized clinical trial. Fisioterapia Brasil, 21(3), 253–264. https://doi.org/10.33233/fb.v21i3.3459
Ek, S., Rizzuto, D., Fratiglioni, L., Calderón-Larrañaga, A., Johnell, K., Sjöberg, L., Xu, W., & Welmer, A.-K. (2019). Risk Factors for Injurious Falls in Older Adults: The Role of Sex and Length of Follow-Up. Journal of the American Geriatrics Society, 67(2), 246–253. https://doi.org/10.1111/jgs.15657
Ferlinc, A., Fabiani, E., Velnar, T., & Gradisnik, L. (2019). The Importance and Role of Proprioception in the Elderly: a Short Review. Materia Socio-Medica, 31(3), 219–221. https://doi.org/10.5455/msm.2019.31.219-221
Gale, C. R., Cooper, C., & Aihie Sayer, A. (2016). Prevalence and risk factors for falls in older men and women: The English Longitudinal Study of Ageing. Age and Ageing, 45(6), 789–794. https://doi.org/10.1093/ageing/afw129
García-Flores, F. I., Rivera-Cisneros, A. E., Sánchez-González, J. M., Guardado-Mendoza, R., & Torres-Gutiérrez, J. L. (2016). [Correlation between gait speed and muscular strength with balance for reducing falls among elderly]. Cirugia y cirujanos, 84(5), 392–397. https://doi.org/10.1016/j.circir.2015.12.005
Hindle, K., Whitcomb, T., Briggs, W., & Hong, J. (2012). Proprioceptive neuromuscular facilitation (PNF): Its mechanisms and effects on range of motion and muscular function. Journal of Human Kinetics, 31(1), 105–113. https://doi.org/10.2478/v10078-012-0011-y
Kumar, S., & George, C. M. (2024). Effects of Head and Neck pattern of PNF combined with conventional balance training in older adults with balance impairment - A Randomized control Trial. Journal of Bodywork and Movement Therapies, 40, 552–556. https://doi.org/10.1016/j.jbmt.2024.02.008
Kumari, R., Chaudhary, V., & Sharma, S. (2024). “Comparison Of Pelvic PNF And Lower Limb Strengthening Protocol For Prevention Of Fall In Post Menopausal Women.” Journal of Advanced Zoology, 45(01), 624–630. https://doi.org/10.53555/jaz.v45i1.3520
Lamp, J., Beraldo, L., Santos, V., Giacometti, da, Cadore, E., & Dias, C. (2023). Cute effects of different proprioceptive neuromuscular facilitation stabilization techniques on the balance of elderly women. Journal of Bodywork and Movement Therapies, 35. https://doi.org/10.1016/j.jbmt.2023.04.054
Lee, D., & Bae, Y. (2021). Short-Term Effect of Kinesio Taping of Lower-Leg Proprioceptive Neuromuscular Facilitation Pattern on Gait Parameter and Dynamic Balance in Chronic Stroke with Foot Drop. Healthcare (Basel, Switzerland), 9(3). https://doi.org/10.3390/healthcare9030271
Mamani, A. R. N., Reiners, A. A. O., Azevedo, R. C. de S., Vechia, A. D. R. D., Segri, N. J., & Cardoso, J. D. C. (2019). Elderly caregiver: knowledge, attitudes and practices about falls and its prevention. Revista Brasileira de Enfermagem, 72(suppl 2), 119–126. https://doi.org/10.1590/0034-7167-2018-0276
Mesquita, L. S. de A., de Carvalho, F. T., Freire, L. S. de A., Neto, O. P., & Zângaro, R. A. (2015). Effects of two exercise protocols on postural balance of elderly women: a randomized controlled trial. BMC Geriatrics, 15, 61. https://doi.org/10.1186/s12877-015-0059-3
Nguyen, P. T., Chou, L.-W., & Hsieh, Y.-L. (2022). Proprioceptive Neuromuscular Facilitation-Based Physical Therapy on the Improvement of Balance and Gait in Patients with Chronic Stroke: A Systematic Review and Meta-Analysis. Life (Basel, Switzerland), 12(6). https://doi.org/10.3390/life12060882
Silva, I. A., Amorim, J. R., Carvalho, F. T. de, & Mesquita, L. S. de A. (2017). Efeito de um protocolo de Facilitação Neuromuscular Proprioceptiva (FNP) no equilíbrio postural de idosas. Fisioterapia e Pesquisa, 24(1), 62–67. https://doi.org/10.1590/1809-2950/16636724012017
Solak, S., Yeşil, H., Dündar, Ü., Toktaş, H., Yeşil, M., & Korkmaz, M. (2022). Evaluation of Balance Exercises on Balance, Fall Risk, and Quality of Life in Postmenopausal Women. Turk Osteoporoz Dergisi, 28(1), 32–40. https://doi.org/10.4274/tod.galenos.2021.85866
Song, Q., Zhang, X., Mao, M., Sun, W., Zhang, C., Chen, Y., & Li, L. (2021). Relationship of proprioception, cutaneous sensitivity, and muscle strength with the balance control among older adults. Journal of Sport and Health Science, 10(5), 585–593. https://doi.org/10.1016/j.jshs.2021.07.005
Toosizadeh, N., Ehsani, H., Miramonte, M., & Mohler, J. (2018). Proprioceptive impairments in high fall risk older adults: the effect of mechanical calf vibration on postural balance. Biomedical Engineering Online, 17(1), 51. https://doi.org/10.1186/s12938-018-0482-8
V, R., Arthi, J., Kumar, G. M., N, M., K, B., K, S., & Kavitha, E. (2022). Effects of Dual Task Training Versus PNF Pattern on Balance and Cognition in Geriatric Population. International Journal of Life Science and Pharma Research, 12(4), 1–7. https://doi.org/10.22376/ijpbs/lpr.2022.12.4.l1-7
Xing, L., Bao, Y., Wang, B., Shi, M., Wei, Y., Huang, X., Dai, Y., Shi, H., Gai, X., Luo, Q., Yin, Y., & Qin, D. (2023). Falls caused by balance disorders in the elderly with multiple systems involved: Pathogenic mechanisms and treatment strategies. Frontiers in Neurology, 14, 1128092. https://doi.org/10.3389/fneur.2023.1128092
Xiong, X., Zang, J., Zhu, C., Wei, W., Wang, P., Wang, J., & Gao, Q. (2024). Effects of Proprioceptive Neuromuscular Facilitation Technique on Balance Function and Muscle Health in Older Adults With High Fall Risk. Journal of Gerontological Nursing, 50(8), 37–44. https://doi.org/10.3928/00989134-20240702-03
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