Chapter 3 of Therapeutic exercise handout https://www.slideshare.net/RijwanBhuiyan/therapeutic-exercise-handout https://doi.org/10.5281/zenodo.6349232

1. CHAPTER- 3
Classification of
Movement

2. CHAPTER: 3 CLASSIFICATION OF MOVEMENT
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Our body is a series of long and short bones connected at junctions or joints. For movement,
the junctions must allow for free movement in the directions that their design allows.
Movement is produced by the internal forces generated by muscle contraction or by
external forces such as gravity and manual or mechanical forces. It occurs at joints and is
contained by ligaments.
DEFINITION OF MOVEMENT
Movement takes place at the joint, & it is brought about by either the patient's muscular
effort or by the application of an external force.
CLASSIFICATION OF MOVEMENT
A. Active movement
 Freely active movement
 Assisted active movement
 Resisted active movement
 Assisted-resisted movement
B. Passive movement
 Relaxed passive movement or passive physiological movement
 Accessory passive movement
ACTIVE MOVEMENT
Definition: The movement, which is performed or controlled by an internal force or by the
voluntary muscular contraction of person/patient
Type:
Active movement is divided into four types. They are:
1. Freely active movement:
This movement is controlled by voluntary action of muscles, without any external force.
2. Assisted active movement:
This movement is performed by the voluntary action of muscles with the help of
external force.

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3. Resisted active movement:
This movement is performed by the voluntary action of muscles against the application
of opposite force or any resistance (weight).
4. Assisted resisted active movement:
This movement is performed or controlled by the voluntary action of muscles with the
help of external force against the application of opposite force.
Freely active Assisted Resisted
PASSIVE MOVEMENT
Definition: This type of movement is performed by external force.
Type:
1. Relaxed passive movement or passive physiological movement:
This is a rhythmic passive movement with the help of external force. This movement is
performed within the unrestricted range by an external force.
Passive physiological movement is performed in three ways:
 Manual relaxed passive movement: This movement is performed by Physiotherapist.
 Auto relaxed passive movement: This movement is performed within the
unrestricted range by the patient themselves. E.g. this type of movement is performed
by the unaffected limb.
 Mechanical relaxed passive movement: Performed by any machine.
Characteristics of passive movement:
 It is a rhythmical passive movement
 Maintain or increase joint range of motion (ROM)
 Maintain or increase muscle strength
 Stimulate blood circulation
 It has 4 grades- I, II, III, IV

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2. Accessory passive movement:
Accessory movement are those movements of the joint which a person cant perform
actively, but which can be performed on that person by an external force, but he can
able to stop or restrict the movement (Maitiand 1986)
OR
Isolated translational movement are known as accessory movement & they cant
normally be produced through volitional effort. These translational movements are
used in manual therapy procedures known as joint mobilization (Huber, F.E & Wells,
C.L, p 63) TE new
Accessory movements are of two types:
a) The first type is seen in the MCP joint when rotate in grasping objects such as a hard
ball. The rotator movement is not possible unless resistance is encountered.
b) The second type of accessory movement can only be produced passively. They are
produced when the muscles acting on a joint are relaxed & are those which can't be
performed actively in the absence of resistance.
Name of accessory movement:
1. Anterior posterior (AP)
2. Posterior anterior (PA)
3. Medial glide
4. Lateral glide
5. Gaping
6. Compression
7. Longitudinal caudal
8. Longitudinal cephalad
AP & PA
Compression Gaping

5. CHAPTER: 3 CLASSIFICATION OF MOVEMENT
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MOVEMENT THAT OCCURRED IN THE BODY
SHOULDER JOINT
1. Flexion: A forward-upward movement in a plane at right angles to the plane of the
scapula (sagittal plane). If the movement exceeds 180 degrees, it is hyper flexion
2. Extension: Return movement from flexion (sagittal plane).
3. Hyperextension: A backward movement in a plane at right angles to the plane of the
scapula (sagittal plane).
4. Abduction: A sideward-upward movement in a plane parallel with the plane of the
scapula (frontal plane).
5. Adduction: Return movement from abduction (frontal plane)
6. Medial rotation: A rotation of the humerus around its mechanical axis so that when
the arm is in its nor-mal resting position, the anterior aspect turns medially (horizontal
plane). The full range of inward and outward rotation is best observed when the
forearm is held in 90 degrees of flexion and the humerus is held in 90 degrees of
abduction.
7. Lateral rotation: A rotation of the humerus around its mechanical axis so that when
the arm is in its nor-mal resting position, the anterior aspect turns laterally.
8. Horizontal flexion: A forward movement of the abducted humerus in a horizontal
plane (i.e., from a plane parallel to the plane of the scapula to a plane at right angles to
it). Sometimes identified as horizontal adduction in other textbooks.
9. Horizontal extension: A backward movement of the flexed humerus in a horizontal
plane (i.e., from a plane at right angles to the plane of the scapula to a plane parallel to
it). Sometimes called horizontal abduction in other texts.
10. Circumduction: A combination of flexion, abduction, extension, hyperextension, and
adduction per-formed sequentially in either direction so that the extended arm
describes a cone and the fingertips a circle

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7. CHAPTER: 3 CLASSIFICATION OF MOVEMENT
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ELBOW JOINT
1. Flexion: From the anatomical position this is a forward-upward movement of the
forearm in the sagittal plane
2. Extension: Return movement from flexion. A few individuals are able to hyperextend
the elbow joint. This is probably because of a short olecranon process rather than loose
ligaments
PROXIMAL RADIOULNAR JOINT
1. Supination: Fore arm is in anatomical position
2. Pronation: Fore arm rotates as much as possible

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WRIST JOINT
1. Flexion: From the anatomical position, this is a forward-up ward movement in the
sagittal plane, whereby the palmar surface of the hand approaches the anterior surface
of the forearm.
2. Extension: Return movement from flexion.
3. Hyperextension: A movement in which the dorsal surface of the hand approaches the
posterior surface of the forearm—the exact opposite of flexion
4. Radial deviation: From the anatomical position this is a sideward movement in the
frontal plane, whereby the hand moves away from the body with the thumb side
leading. The movement corresponds to abduction of the humerus.
5. Ulnar deviation: From the anatomical position this is a sideward movement in the
frontal plane, whereby the hand moves inward to the body. The movement corresponds
to adduction of the humerus.

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MOVEMENT OF THUMB
1. Abduction: A forward movement of the thumb at right angles to the palm.
2. Adduction: Return movement from abduction.
3. Hyper adduction: A backward movement of the thumb at right angles to the hand.
4. Extension: A lateral movement of the thumb away from the index finger, on level with
the palm.
5. Flexion: Return movement from extension.
6. Hyper flexion: A medially directed movement of the thumb from a position of slight
abduction. The thumb slides across the front of the palm.
7. Circumduction: A movement in which the thumb as a whole describes a cone and the
tip of the thumb describes a circle. It consists of all the movements’ just described,
performed in sequence in either direction.
8. Opposition: This movement, which makes it possible to touch the tip of the thumb to
the tip of any of the four fingers, is essentially a combination of abduction and hyper
flexion and, according to some investigators, slight inward rotation.

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METACARPOPHALANGEAL JOINTS OF THE FOUR FINGERS
1. Flexion: The anterior surface of the finger approaches the palmar surface of the hand.
2. Extension: Return movement from flexion. Most individuals are able to achieve slight
hyper extension in these joints.
3. Abduction: For the fourth, fifth, and index fingers this is a lateral movement away
from the middle finger. This movement is limited and cannot be performed when the
fingers are fully flexed.
4. Adduction: Return movement from abduction.
PIP joint:
1. Flexion
2. Extension
DIP joint:
1. Flexion
2. Extension

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HIP JOINT
1. Flexion: A forward movement of the femur in the sagittal plane. If the knee is straight,
the movement is restricted by the tension of the hamstring muscles. In extreme flexion
the pelvis tilts backward to supplement the movement at the hip joint.
2. Extension: Return movement from flexion.
3. Hyperextension: A backward movement of the femur in the sagittal plane. This
movement is extremely limited. Except in dancers and acrobats, it is possible only when
the femur is rotated outward and is probably completely absent in many individuals.
The restricting factor is the iliofemoral ligament at the front of the joint. The advantage
of this restriction of movement is that it provides a stable joint for weight bearing
without the need for strong muscular contraction.
4. Abduction: A sideward movement of the femur in the frontal plane so that the thigh
moves away from the midline of the body. A greater range of movement is possible
when the femur is rotated outward. Abduction is limited by the adductor muscles and
the pubofemoral ligament.
5. Adduction: Return movement from abduction. Hyper adduction is possible only when
the other leg is moved out of the way. In extreme hyper adduction the teres femoris
becomes taut.
6. Medial rotation: A rotation of the femur around its longitudinal axis so that the knee
is turned inward. The range of inward and outward rotation is affected by the degree of
femoral torsion, (twisting of the femur on its long axis so that one end is inwardly
rotated with respect to the other). The range of outward rotation usually exceeds that of
inward rotation.
7. Lateral rotation: A rotation of the femur around its longitudinal axis so that the knee
is turned outward.
8. Circumduction: A combination of flexion, abduction, extension, and adduction
performed sequentially in either direction.

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KNEE JOINT
1. Flexion: Move the leg towards the thigh.
2. Extension: Return to the anatomical position.
3. Medial rotation: Rotate the leg towards the midline of the body. No movement in the
ankle
4. Lateral rotation: Rotate the leg in outward direction of the midline of the body. No
movement in ankle.
Flexion & Extension Medial & Lateral Rotation

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ANKLE JOINT
1. Planter flexion: A forward-downward movement of the foot in the sagittal plane, so
that the dorsal surface of the foot moves away from the anterior surface of the leg.
2. Dorsi flexion: A forward-upward movement of the foot in the sagittal plane, so that
the dorsal surface of the foot approaches the anterior surface of the leg.
3. Inversion and Adduction (Supination): A lifting of the medial border of the arch
combined with a medial bending of the front of the foot.
4. Eversion and Abduction (Pronation): A slight raising of the lateral border of the
foot combined with a slight lateral bending of the front of the foot.
Planter & Dorsi flexion Inversion & Eversion
MP joint:
1. Flexion
2. Extension
3. Abduction
4. Adduction
PIP joint:
1. Flexion
2. Extension
DIP joint:
1. Flexion
2. Extension

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CERVICAL SPINE
1. Flexion: Move the face downward so that chin touch the chest
2. Extension: Move the face upward
3. Side flexion: Move the ear towards the shoulder
4. Both side rotation: Turn the face towards the shoulder
Flexion Extension Side flexion Rotation
LUMBAR SPINE
1. Flexion: Move the forward
2. Extension: Return to the previous position
3. Hyperextension: Move the trunk backward
4. Both side flexion: Bent the trunk sideward
Flexion Hyperextension Side flexion

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Study question:
1. Define movement & classify it.
2. Define active movement. Write down the classification of active movement.
3. Define passive movement. Write down its classification.
4. Write down the Characteristics of passive movement.
5. Name of accessory movement.
6. How many types of active movement in shoulder joint? Write down their definition.
7. How many types of active movement in Elbow joint? Write down their definition.
8. How many types of active movement in wrist joint? Write down their definition.
9. How many types of active movement in Hip joint? Write down their definition.
10. How many types of active movement in knee joint? Write down their definition.
11. How many types of active movement in Ankle joint? Write down their definition.
Reference list: