From The Deep End · ATU Blog

Pattern Treatments: Aquatic PNF

How Herman Kabat's PNF patterns, first built for polio patients, became the Bad Ragaz Ring Method and the freer aquatic PNF patterns used today.

By Andrea Salzman, MS, PT1 min read

  • PNF
  • Bad Ragaz
  • Technique
  • Equipment
First published December 25, 2023 on atuseminars.com

Two pool techniques grew from the same land-based roots. This post traces how PNF moved into the water and how the Bad Ragaz Ring Method and aquatic PNF went separate ways.

Want to go deeper? Explore the Introduction to Aquatic Therapy for Adult Neurological Conditions course →

Illustrations of an arm pattern performed with hand floats.
Traditional PNF arm patterns can be performed in the water with hand floats.

Aquatic PNF offers another take on resistance therapy

In the early 1950s, physicians and therapists were scrambling to find treatments that might work for a new crop of polio patients. Dr. Herman Kabat first developed a technique called “proprioceptive facilitation” to address the paralysis caused by this dreaded disease. (“Neuromuscular” was added to the name in 1954.)

Within a decade, Kabat’s PNF spiral and diagonal movement patterns were modified and exported to Bad Ragaz, Switzerland, where they further morphed into an aquatic specialty technique known today as the Bad Ragaz Ring Method.

Full article link or continue reading below.

Illustrations of a standing arm pattern performed with hand floats.

In this new Ring Method, clients were trained to perform spiral and diagonal movements while a therapist provided a fixed external resistance. The patterns were performed horizontally, making use of the concept of a “floating treatment table.”

However, all PNF did not transform into Bad Ragaz patterns. Many aquatic providers continued to experiment with traditional PNF patterns (D1/D2 flexion and extension) without providing a fixed distal resistance. These movements were performed in all positions, including horizontal, standing, sitting, kneeling and quadrupedal.

Over time, these traditional-looking PNF patterns ... Continue Reading Article Here.

Frequently asked questions

How did PNF patterns become the Bad Ragaz Ring Method?

Kabat's spiral and diagonal patterns were adapted in Bad Ragaz, Switzerland, within about ten years and became an aquatic specialty technique, the Bad Ragaz Ring Method (Salzman, 2023).

How does the Bad Ragaz Ring Method work?

The client performs spiral and diagonal movements while floating, and the therapist provides a fixed external resistance (Salzman, 2023).

Is traditional PNF still used in the pool?

Yes. Many aquatic providers use D1/D2 flexion and extension patterns without a fixed distal resistance, in horizontal, standing, sitting, kneeling and quadruped positions (Salzman, 2023).

How to cite this article

First published December 25, 2023 on atuseminars.com · Last updated October 19, 2026 · Permanent URL: https://www.aquatictherapyuniversity.com/blog/pattern-treatments-aquatic-pnf

How to cite

Salzman, A. (2023, December 25). Pattern Treatments: Aquatic PNF. Aquatic Therapy University Blog. ATU Educational Services, LLC. https://www.aquatictherapyuniversity.com/blog/pattern-treatments-aquatic-pnf

Permissions: You may quote and cite this article with attribution. Reproducing or adapting the full article requires written permission from ATU Educational Services, LLC.

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