Effect of additional proprioceptive neuromuscular facilitation training to routine stretching exercises on agility in athletes with cerebral palsy

Introduction. Sports and physical activity are increasingly popular among individuals with cerebral palsy (CP), both in professional and rehabilitation contexts. Muscle imbalances, reduced joint mobility, and spasticity increase the risk of limb injuries and generally result in reduced agility in CP athletes. Proprioceptive neuromuscular facilitation (PNF) is a stretching technique that has been shown to improve muscle flexibility, peak torque, and both active (AROM) and passive (PROM) range of motion. PNF is widely used in clinical settings to improve ROM and muscle strength in individuals with CP. Objective. To examine the effect of additional PNF stretching exercises combined with routine stretching on agility in athletes with CP. Methods. The study was conducted at the National Paralympic Committee (NPC) Indonesia Training Center. A total of 24 CP athletes were randomly assigned to two groups: the treatment group (n = 12) received routine stretching plus PNF three times a week for four weeks; the control group (n = 12) received only routine stretching. Agility was assessed using the Modified Agility Test before and after the intervention. Results. Significant improvements in Modified Agility Test times were observed in both groups: treatment group (p = 0.00), control group (p = 0.02). The treatment group demonstrated a greater effect size (Cohen’s d = 1.43) compared to the control group (Cohen’s d = 0.79). The delta difference in agility scores between the groups was statistically significant. Conclusion. The addition of PNF-based stretching exercises significantly improves agility performance in athletes with CP, as reflected in their Modified Agility Test results.