Range of motion chap 3
- 1. By: Dr Khazima asif
- 2. • Range of motion is a basic technique used for the examination of movement and for initiating movement into a program of therapeutic intervention. The full motion possible is called the range of motion (ROM). • FUNCTIONAL EXCURSION: Functional excursion is the distance a muscle is capable of shortening after it has been elongated to its maximum. • Range of a muscle, is directly influenced by the joint it crosses.
- 4. • The range for the brachialis muscle is limited by the range available at the elbow joint. This is true of one-joint muscles (muscles with their proximal and distal attachments on the bones on either side of one joint). For two-joint or multi joint muscles (those muscles that cross over two or more joints), their range goes beyond the limits of any one joint they cross. • Active insufficiency occurs when a multi-joint muscle reaches a shortened length where it can no longer apply a good effective force. Passive Insufficiency: When a muscle cannot stretch anymore, occurs with the antagonist
- 6. Passive ROM. Passive ROM (PROM) is movement of a segment within the unrestricted ROM that is produced entirely by an external force; there is little to no voluntary muscle contraction. The external force may be from gravity, a machine, another individual, or another part of the individual’s own body. Active ROM. Active ROM (AROM) is movement of a segment within the unrestricted ROM that is produced by active contraction of the muscles crossing that joint. Active- Assistive ROM. Active-assistive ROM (A-AROM) 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
- 8. Passive ROM • Indications for PROM: acute, inflamed tissue, When a patient is not able to or not supposed to actively move a segment(s) of the body, as when comatose, paralyzed, or on complete bed rest, movement is provided by an external source. • Goals for PROM: ■ Maintain joint and connective tissue mobility. ■ Minimize the effects of the formation of contractures. ■ Maintain mechanical elasticity of muscle. ■ Assist circulation and vascular dynamics ■ Enhance synovial movement for cartilage nutrition and diffusion of materials in the joint. ■ Decrease or inhibit pain. ■ Assist with the healing process after injury or surgery. ■ Help maintain the patient’s awareness of movement Limitations of Passive Motion: ■ Prevent muscle atrophy. ■ Increase strength or endurance. ■ Assist circulation to the extent that active, voluntary muscle contraction does.
- 9. Indications for AROM: When 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 the desired range (usually against gravity), When a segment of the body is immobilized for a period of time. • AROM can be used for aerobic conditioning programs and is used to relieve stress from sustained postures.
- 10. • Maintain physiological elasticity and contractility of the participating 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 Active ROM • For strong muscles, active ROM does not maintain or increase strength. It also does not develop skill or coordination except in the movement patterns used.
- 11. • ROM 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.
- 12. • ROM should not be done when patient response or the condition is life-threatening. • PROM may be carefully initiated to major joints and AROM to ankles and feet to minimize venous stasis and thrombus formation. • After myocardial infarction, coronary artery bypass surgery, or percutaneous transluminal coronary angioplasty, AROM of upper extremities and limited walking are usually tolerated under careful monitoring of symptoms