Kakavas, Malliaropoulos & Forelli (Bioengineering, 2025) propose a complexity-informed framework for rehabilitation after ACL reconstruction (ACLR), integrating PNF concepts into a broader systems perspective.
You can find this article here.
Core idea
ACLR rehabilitation should not be seen as a linear, time‑based sequence (protection → strength → RTS), but as a complex adaptive process where outcomes emerge from interactions between biological, neural, psychological and environmental factors.
The athlete is viewed as a complex adaptive system; variability is not “noise” but information about how the system is adapting.
Relevance for PNF
PNF fits naturally into this model as a tool to modulate neuromuscular control and sensory input within the Control–Chaos Continuum:
–> Early & mid stages: PNF to address arthrogenic muscle inhibition, improve proprioception and controlled ROM.
–> Later stages: integrating PNF concepts (task‑specific resistance, rhythmic stabilization, dynamic reversals) into more variable, reactive, sport‑like drills.
The article reinforces the idea that PNF is not only a stretching method but part of a broader strategy to shape movement variability, coordination and confidence across rehab.