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Therapy and Sports
Medicine Chapter
Apply therapeutic skills for
rehabilitation and injury
prevention
Demonstrate Assistive and
Therapeutic Techniques
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Range of motion
When patients have
limited movement
range of motion
exercise help keep
muscles and joints
functioning
An example of a psychological
benefit of massage therapy is
relaxation
Range of Motion
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ROM
Ordering by physician,
Administered by
physical therapist,
nurse assistant or other
authorized person
Done during daily bath
or at other times.
Using massage on strained muscle
can help increase circulation
ROM is done to avoid
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Contractures
(tightening/shortening of
muscle causing permanent
flexing of joint, for example foot
drop)
ROM exercise are done to
prevent contractures
Muscle atrophy or stiff joints
Circulatory impairment
(leading to blood clots or
decubitius ulcers
Mineral loss
Other problems, poor appetite,
constipation, urinary infections,
respiratory problems, and
hypostatic pneumonia.
Active ROM
Active ROMPerformed by patients who are able to move each joint
without assistance.

The term that describes the ROM movement
when a straight leg is bent at the knee is
flexion.
Passive ROM

Another person moves
each joint for a patient
who is not able to
exercise.
If a person has a cast on their
wrist, the motion that can still
be done to the wrist and hand
is rotation.
Resistive ROM

Performed by a
therapist against
resistance provided by
the therapist
The training a certified
athletic trainer must
have a bachelor’s
degree.
The medical practice
that would use a
massage therapist as an
associate is an
orthopedics office.
Movements
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Abduction
Adduction
Flexion
Extension
Hyperextension
Rotation
Pronation
Supination
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Inversion
Eversion
Dorsiflexion
Plantar Flexion
Principles for Performing ROM
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Movements should be done slow, smooth,
and gentle to prevent injury
Support should be provided to the parts
above and below the joint being exercised
Never force joint beyond range or to the point
of pain
If patient complains of pain, stop exercise
and report it to the supervisor
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Repeat three times or as ordered
Encourage patient to assist as much as
possible
Prevent unnecessary exposure of patient
Close door, provide privacy
Use correct body mechanics at all times
Principles of Ambulatory
Assistance

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Crutches-Usually
prescribed by physician
Therapist or authorized
person fits crutches
Appropriate gait must
be taught
Must be properly fit
(axillary pressure can
cause damage to radial
nerve).
When ambulating a pt. with
crutches, be sure: the pat
supports his/her weight on
the hand bars and not the
axillary support.
When fitting crutches:
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Patient should wear good fitting walking shoes with
low, broad heels
If possible, position patient against wall for support
(use chair for additional support)
Position crutches 4-6” in front and 4-6” to the side of
patient’s foot
Allow 2” space between armpit and axillary bar.
Adjust hand pieces so that each elbow is flexed at
25-300 angle.
Crutches


Gait taught depends
upon condition
Patients must be taught
to support weight on
hand bars, NOT axillary
supports
Cane

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Provides balance and
support
Some have 3 or 4 legs
for additional support
Used on unaffected
(good) side
Walker
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When helping a client’s who is
recovering from a stroke the nurse
aide should assist on the clients
weak side.
4 legged device
Often used for weak
patients without leg
injuries
Must be properly
fitted to the pt.
Patient must lift walker,
place it in front of the
body, and walk into it
Patients must NOT
slide walker
Gait Belt
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Band of fabric or leather around patient’s waist
During transfers or ambulation, health care workers
can hold gait belt to provide additional support
Gait belt must be the proper size-secure fit around
waist but not too tight
Belt may have loop to hold, or use an underhand
grasp to hold below
Grasp belt at the back during ambulation
Grasp the belt on both sides while facing the patient
Apply gait belt over the patient's clothing at the
waist
Safety Checks
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Remain alert when ambulating patient
Walk on weak side and slightly behind patient
If the patient starts to fall, use your body to brace
the patient
Ease the patient to the floor as slowly as possible
Protect the patient’s head and neck
Stay with the patient and call for help
If a patient falls, an incident report must be filled out
in most agencies
Massage
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A traditional backrub uses
primarily friction.
The massage technique
involving making fine,
tremulous movement with the
fingers or the use of a
mechanical device is vibration.
During childbirth the massage
technique that is used when
light, circular strokes over the
lower abdomen done during
controlled breathing is called
Effleurage.
During a massage you should
encourage the pt. to
understand the potential
source of healing in his/her
own consciousness.
Taping an ankle…

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When taping an ankle under
wrap is used to protect the
skin.
When taping an ankle, the
first piece of tape to go on is
a single strip of tape around
the ankle, approximately 5
or 6 inches above the
malleous. The strip of tape
is called an anchor.
Test Your Gray Matter
When you are
ambulating a pt.
with a gait belt,
how should you
hold the gait belt?
Hold the back of the
belt using an
underhand grasp.
Sheena has a
cast on her wrist.
What motion can
she still do with
her lower arm,
wrist and hand?
When ambulating
pt. with crutches,
be sure:
The pt. supports
his/her weight on
the hand bars and
not the axillary
support
A physician wishes
to treat a pts.
Hemorrhoids with
moist heat. Which of
the following
applications might
be ordered?
Sitz bath
You go into a pt.’s
room and note
that the humidifier
attached to the
oxygen is empty.
What should you
do?
Notify your supervisor
immediately
What term
describes the
ROM movement
when a straight
leg is bent at the
knee?
What statement
about the walker
is true?
The walker
should be
properly fitted
to the pt.
A pt. has shallow
respirations, rapid
pulse,
restlessness, and
cyanosis. The
physician will
likely order?
Flexion
Oxygen