Active and passive movements in human joints with examples and how it can be utilized with modern exercise principles with resistance to increase strength and flexibility of human joints

2. 2 types of movements
1. Active movement
2. Passive movement

3.  Active movements are the voluntary action of
the muscles
 This can be classified into 4 varieties
1. Assisted
2. Free
3. Assisted and resisted
4. resisted

4. If the strength or coordination of the
muscle is insufficient to perform an activity,
the external force is utilizes to compensate
the lack

5. Assisted exercise manual active
passive
mechanical

6. The patient himself can assist with his
opposite extremity to perform the assisted
exercise

7. It is classified into:
1. Manual assisted exercise
2. Mechanical assisted exercise

8. The passive assistance may be given by
the therapist.
This type of assisted exercise is maximum
passive in nature.
The patient has to try to perform the
movement upto his ability.

9. The assisted exercise is done with the help
of the mechanical devices.
eg: suspension therapy, pulley

10. Range
Command
Concentration
Speed
Repetition

11. Increase the ROM of the joint
Increase the strength and endurance of
the muscles
It breaks the adhesion formation around
the joint
It reduces the spasm of the muscle

12. It stretches the tightened soft tissue
It reminds the coordinated movement of
the joint or a muscle
Increase the blood circulation and venous
return to the joint and muscle

13. These are the exercise, which are
performed by the patient himself without
any assistance and resistance by the
external force except the gravity.

14. There are two types of free exercises:
1. Localized
2. General body

15. The localized free exercises are planned
and perform to improve one particular joint
range or to increase the strength and
endurance of the one group or particular
muscles.
Eg: free exercises for shoulder flexor

16. These types of free exercises are formed
to increase the joint range in multi-joints or
to increase the strength of many group or
the total body muscles.
Eg: jogging relaxed walking

17.  Increase the ROM of the joint
 Increase the strength and endurance of the
muscles
 Increases the neuromuscular coordination
 Increases the circulation and venous
drainage

18.  Increases the relaxation of the muscle by the
swinging movements and the pendular
movements.
 Repeated active movements breaks the
adhesion formation and elongates the
shortened soft tissues.
 Improves the cardiorespiratory function.

19. The activities are performed by opposing
the mechanical or manual resistance is
called as resisted exercise.

20. 2 types:
1. Manual
2. Mechanical

21. In the manual resisted exercise, the
resistance can be given by the therapist.

22.  Mechanical exercises are used to oppose the
active movements of a person.
 Mechanical resistance can be performed by the
the followings:
1. Weights
2. Pulleys
3. Springs
4. Water

23. Increase the resistance by altering:
1. Altering the leverage
2. Increasing the weight
3. By altering speed
4. By changing the duration

24. Increase the strength of the muscle
Increases the endurance of the muscle
Increases the blood flow
Increases the power

25. De Lorme and Watkins formed one
exercise regimen in 1945 to improve the
muscle strength, power and endurance.

26. The maximum amount of weight a person
can lift throughout the range of motion
exactly 10 times

27. 3 types of PRE regimen
1. De Lorme and Walkins
2. Macqueen
3. Zinovieff ( oxford technique)

28. In this exercise regimen, weight is
increased , i.e, first with 1/2 kg followed by
¾ kg and 1kg
Each and every session the patient has to
lift 3 types of weight 10 times each. Daily
30 times

29. In every sessions of 30 times 2 breaks by
the patient
10times1/2kg 10 RM – break - 10times ¾
kg 10 RM – break - 10times1kg 10 RM
4 sessions a week

30.  1 kg is lifted 40 times with 3 breaks per each
session. Same weight is used throughout one
session
 10 times 1 kg – break - 10 times 1 kg – break
- 10 times 1 kg – break - 10 times 1 kg
 3 sessions weekly

31. Each and every 10 lifts break has to be
given the 1 lb also reduced for each 10
lifts.
5 sessions a week

32. The movement which is performed with the
help of external force whenever the
muscles fail to perform the movement by
its own.

33. 1. Relaxed passive movement
2. Passive manual mobilization
• Mobilization of joints
• Manipulation of joints and soft tissues
• Stretching of soft tissue

34. Manual passive movements
Mechanical passive movements

35. The movements performed by the
therapist

36. Passive movements with the help of
mechanical devices
Eg: CPM

37. This is a smooth rythmical and accurate
anatomical movement performed by the
therapist within the pain limited range

38.  Relaxation
 Fixation
 Support
 Traction
 Range
 Speed and duration
 Sequence

39.  Patients who cannot do active movements
 Patients who cannot perform full range of
movements
 Prolonged bed ridden patients
 To break adhesion formation
 Unconsious patients
 For relaxation

40. Recent fractures
Recent dislocations
DVT
Recent injuries and inflammation
Immediately after any joint surgery
Patients with POP

41.  Maintain the muscle property
 Increases the ROM
 Increases the venous and lymphatic drainage
 Break adhesion formation in the joints
 Prevents DVT
 Induces the relaxation

42. It is the elongation of the pathologically
shortened or tightened soft tissues with the
help of some therapeutic techniques

43.  Post traumatic stiffness
 Post immobilization stiffness
 Restrictive mobility
 Congenital or acquired deformity
 Joint pathology resulting in joint stiffness
 Healed burn scars
 Spasticity

44. Recent fracture
Osteoporosis
Sharp pain while doing stretch
Unhealed scars and burns
Malignant tumors

45. Heat
Massage
Active exercise
Joint mobilisation

46. Passive stretching
PNF
Self stretching

47. Manual
o Static stretch
o Ballistic stretch
Mechanical

48. In this slow and prolonged stretch is
applied
In this stretch the muscle is elongated
gently and maintained for long period
without pain

49. It is the bouncing or jerky type of
stretching.
It’s a high velocity and short duration
strengthening
Prone to injury

50. Zachozawski
Slow short end range
Slow full range
Fast short end range
Fast full rtange

51. Long duration
Cyclic