Proprioceptive neuromuscular facilitation training reduces pain and disability in individuals with chronic low back pain: A systematic review and meta-analysis

Abstract

Background: and purpose: Although proprioceptive neuromuscular facilitation (PNF) exercises are used in rehabilitation practice, their effects in patients with low back pain (LBP) remain unclear. This study aimed to investigate the efficacy of PNF training for pain and disability in patients with LBP.

Methods: In this systematic review, we searched five databases from the earliest date available to October 2020. Three comparisons were performed: PNF versus control, PNF versus core strengthening, and PNF versus conventional physical therapy.

Results: Sixteen studies met the eligibility criteria (722 patients). PNF training improved pain (standardized mean difference [SMD]: -2.6; 95% confidence interval [CI]: -4.2 to -0.9, n = 174) and disability (SMD: -3.29; 95% CI: -5.3 to -1.3, n = 144) compared to the control. PNF training also yielded a greater benefit for pain reduction (mean difference [MD]: -1.8, 95% CI: -2.2 to -0.3, n = 177) and disability improvement (MD: -6.6, 95% CI: -9.3 to -3.8, n = 113) than did core strengthening.

Conclusion: PNF training seems to be a useful strategy for decreasing pain and improving disability in patients with LBP. However, the quality of evidence for the outcomes of both pain and disability was low to moderate.

Keywords: Exercise; Meta-analysis; Pain management; Physical impairment; Proprioceptive neuromuscular facilitation; Rehabilitation.