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Range of motion II

Range of motion II. By: Dr. Michael Banoub. Application of Techniques . 1. To control movement, grasp the extremity around the joints. If the joints are painful, modify the grip.

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Range of motion II

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  1. Range of motion II By: Dr. Michael Banoub

  2. Application of Techniques 1. To control movement, grasp the extremity around the joints. If the joints are painful, modify the grip. 2. Support areas of poor structural integrity, such as a hypermobile joint, recent fracture site, or paralyzed limb segment. 3. Move the segment through its complete pain-free range to the point of tissue resistance. Do not force beyond the available range. If you force motion, it becomes a stretching technique. 4. Perform the motions smoothly and rhythmically, The number of repetitions depends on the objectives of the program and the patient’s condition and response to the treatment.

  3. 1- RELAXED PASSIVE MOVEMENT • Definition: These are movements performed accurately, rhythmical and smoothly by the physiotherapist through available range of motion( according to anatomy of joints) . The joint is moved through the free range and within the limits of pain.

  4. II- Forced passive movement Definition An exercise performed on a subject by a partner who exerts an external force not only to produce a passive movement, but also to increase the range of movement of a joint. The partner presses the joint into its end-position (i.e. end of range), while the subject's muscles that normally carry out the movements are completely relaxed. There is a danger of overextension beyond the range of movement and damage to the joint if the exercise is not carried out carefully.

  5. Continuous passive motion (CPM) A continuous passive motion device maintains movement of a joint. This device is usually called a CPM. Continuous movement limits stiffness and pain. It is very important to keep joints moving following surgery so that motion will not become limited. The CPM will move the involved leg through its full range of motion. It is only used in bed, but can be used while relaxing, eating, or sleeping.

  6. Benefits of CPM 1-decreasing the complication of immobilization. 2-decreasing the post operative complication and pain. 3-improving the recovery rate and ROM. 4-improving the circulation through pumping action. 5-prevent adhesions and contracture. 6-prevent joint effusion and wound oedema.

  7. Procedure of CPM It is important that you understand the use of CPM. The therapist may adjust the device to fit you before surgery. You will begin to use the CPM right after surgery. Your therapist will give you instructions and monitor how you use the device. The CPM is set to allow 45 degrees of motion right after surgery. Generally, motion will be increased about 15 degrees a day. You will need to use the CPM for about 6 weeks after surgery.

  8. Active Assisted Range of Motion Exercises Exercise in which movement is performed by the voluntary effort of the patient with assistance of external force to complete the range of motion.

  9. Patient is unable to fully activate the muscle and complete the range of motion. • Assistance may be provided throughout the range or mostly just at ends, depending upon the patient. • Motion can be performed against gravity or in a gravity-minimized situation (gravity eliminated).

  10. SELF-ASSISTED ROM • Patient involvement in self-care should begin as soon as the individual is able to understand and learn what to do. • self-assisted ROM (S-AROM) is used to protect the healing tissues when more intensive muscle contraction is contraindicated.

  11. Forms of Self-Assisted ROM Manual

  12. T-bar

  13. Finger ladder, wall climbing

  14. Pulleys

  15. Guidelines for Teaching Self-Assisted ROM • Educate the patient on the value of the motion. • Teach the patient correct body alignment and stabilization. • Observe patient performance and correct any substitute or unsafe motions.

  16. Guidelines for Teaching Self-Assisted ROM • Provide a clear guidelines for number of repetitions and frequency. • Review the exercises at a follow-up session. Modify or progress the exercise program based on the patient response and treatment plan for meeting the outcome goals.

  17. Active Free Range of Motion Exercises Active free ROM exercise is exercise in which movement is performed by the voluntary effort of the patient through full range of motion gravity eliminated or against gravity without external assistance or resistance behind that of the gravity.

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