To enhance the ability to Measuring range of mortion

1. For 2nd year Physiotherapy Students
Range of Motion
Dechasa Imiru
Department of physiotherapy
Jimma University
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2. Learning objectives
At the end of this presentation the students will
be able to
Define range of motion/ROM
Describe the purpose of ROM
Discuss the types of range of motion
Discuss the contraindication of ROM
Enlist the point to be remembered while
performing the ROM exercises
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3. Introduction
Clients with restricted mobility are unable to
perform some or all range of joint motion
exercises independently.
The easiest intervention to maintain or improve
joint mobility for client is use of range of motion
exercises.
If joints are not moved periodically, joint may be
become fixed in one position and client loses
normal uses of the joint.
So, range of motion exercises are very important
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4. Definition
Range of motion (ROM) is the maximum
amount of movement available at a joint in
one of three cardinal planes of the body.
The magnitude of rotatory motion that a body
segment moves through or can move through.
The arc of motion may occur either at a single
joint or at a series of joints.
The starting position for measuring all ROM is
either the anatomical or neutral position.
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5. Purposes
To promote health by improving functioning of
the circulatory system and lungs.
To prevent the stiffness of joint
To delay degenerative change
To restore muscle function in diseases, injury or
deformities
To promote physical mobility and improve gait
To prevent deformity
To improve blood supply in vascular disorder
To reduce stress
To rehabilitate the patient
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6. .
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7. Active range of motion/AROM
Exercises are highly independent, performed
solely by client/patient
Unassisted voluntary movement of joint
(Quality of ROM)
The PT may be provide the verbal cues
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8. Passive range of motion/PROM
Attained by the external force by examiner
(quantity of ROM)
Normally, PROM is slightly greater than AROM
because joints have a small amount of motion
at the end range that is not under voluntary
control.
It can help to prevent stiffness from occurring.
It is practiced on a joint that is inactive
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9. Active assisted ROM
Performed by a client with some assistance
Client move a limb partially through its ROM,
but needs help completing the ROM.
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10. END FEEL
Nature of the motion barrier that characterizes
the type of tissue limiting range.
Normal or Physiologic end feels are:
 Hard
Soft
Firm
Capsular stretch
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11. End feel…..
Hard (bony): An abrupt, hard stop to
movement when bone contacts bone; for ex.:
Passive elbow extension. the olecranon process
contacts the olecranon fossa.
Soft (soft tissue opposition): When two body
surfaces come together a soft compression of
tissue is felt, for ex.: in passive knee flexion, the
posterior aspects of the calf and thigh come
together.
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12. End feel….
Firm (soft tissue stretch): Firm or springy
sensation that has some give when a muscle is
stretched. for instance: passive ankle
dorsiflexion performed with the knee in
extension is stopped due to tension in the
gastrocnemius muscle.
Capsular stretch: Hard arrests/stops to
movement with some give when the joint
capsule or ligaments are stretched. The feel is
similar to stretching a piece of leather, for ex.:
passive shoulder external rotation
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16. Indications For Passive ROM
Primary goal for ROM is to decrease the
complication with immobilization
Cartilage degeneration
Adhesion and contracture formation
sluggish circulation
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17. Goal for PROM
Maintain joint and connective tissue mobility
Minimize the effects of the formation of contracture
Maintain mechanical elasticity of muscle
Assist circulation and vascular dynamics
Enhance synovial movement for cartilage nutrition
and diffusion of materials in the join
 Reduction or inhibit pain
Assist with the healing process after injury or
surgery
Help maintain the patient’s awareness of movement
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18. Indication for Active and Active assistive ROM
A patient is able to contract the muscles
actively and move a segment with or without
assistance, AROM is used
A patient has weak musculature and is unable
to move a joint through the desired range, A-
AROM is used to provide enough assistance to
the muscles in a carefully controlled manner
(progressively strengthened)
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19. Goal for AROM
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
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20. Limitations of ROM Exercises
PROM Does not;
 Prevent muscle atrophy
Increase strength or endurance
Assist circulation to the extent that active,
voluntary muscle contraction does
Alters/halts disease progression in chronic
stage like RA, OA etc
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21. Limitations of AROM
For strong muscles, does not ;
maintain or increase strength
develop skill or coordination except in the
movement patterns used
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22. Contraindications
Joint Inflammation/effusion
swelling
Severe/acute pain
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23. Principles and procedures for Applying ROM Techniques
Examination, Evaluation and Treatment Planning
 Examine and evaluate the patient’s impairment
and level of function
Determine any precautions and prognosis
 plan the intervention
Determine the ability of the patients; PROM, A-
AROM or AROM
Determine the amount of motion
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24. Decide pattern can best the goal
 Anatomic plane of motion ; frontal, sagittal,
transverse
 muscle range of elongation
 combined patterns
 diagonal motion
 functional pattern
 ADL
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25. Monitor the patient’s general condition and
responses during and after the examination
and intervention:
Change in vital sign,
Warmth and color of the segment,
ROM,
Pain
Quality of movement
Document and communicate
Re-evaluate and modify
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26. Patient preparation
Communicate with the patient : describe the
plan and method
Free the region from restrictive clothing etc
Position the patient in a comfortable
Position yourself so proper body mechanics
can be used
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27. Application of techniques
 To control movement, grasp the extremity
around the joint
 Support areas of poor structural integrity :
hyper-mobile joint, recent fracture site or
paralyzed limb
 Move the segment through its complete pain
free range to the point of tissue resistance
 Perform the motions smoothly and
rhythmically, with 5 to 10 repetitions
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28. Fire your Questions Now?
Thank U for Ur time
& patience !!!!
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