Download THERAPEUTIC EXERCISE - 1 ( ) RHPT 246, 224

THERAPEUTIC EXERCISE - 1
(RHPT 246, 224 )
DEFINITION
Range of motion is a basic technique used for
examination of movement and for initiating
movement into a program of therapeutic
intervention.
Bone moves with respect to each other at
connecting joints.
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The structure of joints ,integrity and flexibility
of soft tissues that pass over the joints,
affects the amount of motion that occur
between any two bones. The full motion
possible is called the range of motion.(ROM)
When moving a segment through its ROM, all
structures in the region are affected: muscles,
joint surfaces, capsules, ligaments, fascia,
vessels and nerves.
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FUNCTIONAL EXCURSION : It is the
distance a muscle is capable of shortening
after it has been elongated to its maximum.
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In some cases Functional excursion or ROM is
directly influenced by the joint it crosses.
 Passive range of motion.
 Active range of motion.
 Active assissted range of motion.
1. Passive range of motion – It is a movement of
a segment within the unrestricted ROM that
is produced by a external force. There is little
or no voluntary muscle contraction. The
external force may be from gravity, a
machine, other individual or another part of
individual’s body.
2. ACTIVE RANGE OF MOTION – It is a
movement of a segment within the
unrestricted ROM that is produced by active
contraction of the muscles crossing the
joints.
3. ACTIVE ASSISSTED RANGE OF MOTION – It is
a type of AROM in which assistance is provided
manually or mechanically by an outside force
because the prime mover muscles need
assistance to complete the motion.
INDICATIONS
AND
GOALS FOR ROM
 In case of acute, inflamed tissue passive motion
is beneficial. Active motion would be
detrimental to the healing process.
Inflammation after injury or surgery lasts for 2 to
6 days.
 When a patient is not able to move the segment
actively as when comatose, complete bed rest
then movement is provided by external force.
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Maintain jt. and connective tissue mobility.
Minimize the effects of formation of
contractures.
Maintain mechanical elasticity of muscle.
Assist circulation and vascular dynamics.
Enhance synovial movement for cartilage
nutrition.
Decrease or inhibit pain.
Assist in healing process after injury.
Help maintain the patient’s awareness of
movement.
 If a patient is able to contract the muscles
actively and move a segment with or without
assistance AROM is used.
 When a patient has weak musculature and is
unable to move a joint through desired range, AAROM is used to provide enough assistance to
the muscles can function at its maximum level
and be progressively strengthened.
 AROM can be used for aerobic conditioning
programs.
 Maintain physiological elasticity and
contractility of the participating muscles.
 Provide sensory feedback from the the
contracting muscles.
 Provide sensory feedback from the contracting
muscles.
 Provide a stimulus for bone and joint tissue
integrity.
 Increase circulation and prevent thrombus
formation.
 Develop coordination and motor skills for
functional activities.
Limitations of Passive ROM :
1. Prevent muscle atrophy.
2. Increase strength or endurance .
3. Assist circulation to the extent that active,
voluntary muscle contraction does.
Limitations of Active ROM :
1. For strong muscles , active ROM does not
maintain or increase strength.
2. It does not develop skill or coordination except in
the movement patterns used.
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Range of motion should not be done when motion is
disruptive to the healing process.
Carefully controlled motion within the limits of pain free
motion during early phases of healing has been shown to
benefit healing and early recovery.
Signs of too much or the wrong motion include increased
pain and inflammation.
ROM should not be done when patient response or condition
is life threatning.
PROM may be carefully initiated to major joints and AROM
to ankles and feet to minimize venous stasis and thrombus
formation.
Examination.
Evaluation.
Treatment planning.
Patient preparation.
Application of techniques.
Application of PROM.
Application of AROM.