2. The movement,which is performed with
the help of external force whenever the
muscles fails to perform the movement by
its own
3. Relaxation passive movement
Passive manual mobilization
a. Mobilization of joint
b. Manipulation of joint and soft tissue
c. Stretching of soft tissue
Mechanical passive movement
4. Definition :
This is a smooth ,rhythmical and
accurate anatomical movements
performed by the therapist within pain
limited range.
5. The passive movements performed by therapist or
any other medical professional are called manual
passive movements.
Sometimes it shall be performed by patient’s
attenders like relatives.
6. These are small repetitive rhythmical oscillatory
localised accessory or functional movements
performed by therapist in various amplitudes
within the available range and under the
patient’s control. These can be done very gently
or quite strongly and are graded according to the
part of available range in which performed.
7. Performed by-
PHYSIOTHERAPIST: These are accurately
localized, single, quick decisive movements of small
amplitude and high velocity completed before the
patient can stop it.
SURGEON/PHYSICIAN: The movements are
performed under anaesthesia by surgeons or
physician to gain further range. The increase in
movement must be maintained by physiotherapist.
8. Passive stretching of muscles and other soft
tissues can be given to increase ROM .
Movements can be gained by stretching
adhesions in these structures or by
lengthening of muscle due to inhibition of
tendon protective reflex.
9. The passive movements which are performed by mechanical
devices are called mechanical passive movements.
Depending on the type of movements the device may vary,
For EX:
Continuous passive mobilizer(CPM):used for relax passive
movement, joint mobilization and stretches.
Springs, Weights, Pulleys, Splints, Plaster cast: for stretching
and mobilization.
11. Patient has to be positioned in relaxed manner before
starting the treatment procedure. During relaxed state there
will be no muscle work and the total body will be in relaxed,
this will make the patient to cooperate for treatment.
Position plays a crucial role in the treatment process and
shouldn't be modified at any point since if the patient is
uncomfortable in their position, they won't cooperate.
Therapist position also plays a major role ,he should adopt in
walk standing position while treating patients.
12. The proximal joint to joint to be moved
should be fixed, otherwise trick movements
may occur. To prevent it and localized the
movements proximal joint has to be
stabilized /fixed
13. The long axis traction is given to increase the space
between the articular joint.
It reduces intra articular friction as well as breaks
the adhesion formation in joint.
Free passive movements can be performed due to
less friction effect done by long axis traction.
14. Movements should be performed in pain
limited range.
In that joint care should be taken care to
avoid exceeding anatomical movement
In stiff joint ,movements have to be done
forcefully to break adhesion and maintain
muscle property.
15. Speed should be smooth, rhythmic and
same through out the movement, Jerky
movements should be avoided
No of times movement performed varies
on the condition.
16. The sequence is decided before the treating the patient
For flaccid condition ,movement should be proximal to
distal
For spastic condition, to increase the venous and
lymphatic drainage movements should be from distal to
proximal.
17. If patient cannot perform active movement
For restricted ROM
Prolong bed ridden patient to prevent DVT, maintain
muscle properties, to increase venous and lymphatic
drainage.
To break adhesion
Unconscious patient
For relaxation
Edematous limb
18. Recent fracture or dislocation
Recent injuries and inflammation
Hemarthrosis
Immediately after surgery or repair
Hemophilic joints
Precaution must be taken for flial joint
Early burn
Patient with external appliances
Patient with POP plaster cast
DVT
Malignant tumours
Psoriatic arthritis
19. Increase ROM
Increase venous and lymphatic drainage
Maintain muscle properties
Breaks adhesion formation in joint
Prevent DVT
Induces relaxation