This document provides an introduction to therapeutic exercise and range of motion techniques. It discusses different types of movements including active, passive, assisted and resisted motions. The goals and indications for range of motion exercises like passive and active are explained. Principles, procedures and applications of range of motion techniques are outlined. Different types of assisted and resisted exercises are also described along with their uses.
Goniometry is the measuring of angles created by the bones of the body at the joints.1, 2, 3
The term goniometry is derived from two Greek words, gonia meaning angle and metron, meaning measure. 1, 2, 3, 4, 5,
System to measure the joint ranges in each plane of the joint is termed goniometry. 4
These measurements are done with instrument such as goniometer, a tape measure, inclinometers or by visual estimate.
Joint mobilization refers to a technique of manual therapy by which a therapist applies a brief stretch of 30s or less through traction and gliding along a joint surface.
Goniometry is the measuring of angles created by the bones of the body at the joints.1, 2, 3
The term goniometry is derived from two Greek words, gonia meaning angle and metron, meaning measure. 1, 2, 3, 4, 5,
System to measure the joint ranges in each plane of the joint is termed goniometry. 4
These measurements are done with instrument such as goniometer, a tape measure, inclinometers or by visual estimate.
Joint mobilization refers to a technique of manual therapy by which a therapist applies a brief stretch of 30s or less through traction and gliding along a joint surface.
This Presentation is about Mitchell relaxation technique also known a physiological relaxation technique Mitchell’s physiological relaxation technique is based on reciprocal inhibition and involves diaphragmatic breathing and a series of ordered isotonic contractions.
A technique which uses water as a therapeutic modality. This therapy is usually used by Physiotherapist for healing wound, edema drainage, improving balance and posture and decreasing pain.
The manual muscle testing procedure was described in this power point, indications, contraindications, limitations of MMT was included. the MMT grading system (scale) was explained well in this PPT.
Traction: a basic physiotherapy modality used for inducing space between the joints. this slideshow deals with various types of traction and its application to cervical, thoracic and lumbar spine.
this PPT contain detailed kinetics & kinematics of ankle joint & all joints of foot complex, muscles of ankle & foot complex, plantar arches & weight distribution during standing.
This PPT contains a detailed explanation about resisted exercises, different types of exercise, indications & contraindications, manual & mechanical techniques.
This Presentation is about Mitchell relaxation technique also known a physiological relaxation technique Mitchell’s physiological relaxation technique is based on reciprocal inhibition and involves diaphragmatic breathing and a series of ordered isotonic contractions.
A technique which uses water as a therapeutic modality. This therapy is usually used by Physiotherapist for healing wound, edema drainage, improving balance and posture and decreasing pain.
The manual muscle testing procedure was described in this power point, indications, contraindications, limitations of MMT was included. the MMT grading system (scale) was explained well in this PPT.
Traction: a basic physiotherapy modality used for inducing space between the joints. this slideshow deals with various types of traction and its application to cervical, thoracic and lumbar spine.
this PPT contain detailed kinetics & kinematics of ankle joint & all joints of foot complex, muscles of ankle & foot complex, plantar arches & weight distribution during standing.
This PPT contains a detailed explanation about resisted exercises, different types of exercise, indications & contraindications, manual & mechanical techniques.
Am Papri Das, M. Sc (N) Community Health Nursing faculty with more than 23 yrs of experience working as Vice-Principal at Peerless College of Nursing. Power point presentation on topic "Community Based Rehabilitation" It will be of great help to Nursing student in graduate and post graduate level. as possible in the interest of the students. Hope the topic will be beneficial to the students folk.
CBR is a strategy within general community development for the rehabilitation, equalization of opportunities, poverty reduction and social inclusion of people with disabilities
Active and Passive movements in joints.pptxreeshmapk93
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
Mobility and Flexibility of soft tissues (muscles, tendons, fascia, joint capsule, and skins) surrounding the joint along with adequate joint mobility, are necessary for normal ROM.
Mobility: is the ability of segments of the body to move through range of motion for functional activities.
Flexibility: is the ability to move a single joint or series of joints smoothly and easily through an unrestricted, pain –free ROM.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
Welcome to Secret Tantric, London’s finest VIP Massage agency. Since we first opened our doors, we have provided the ultimate erotic massage experience to innumerable clients, each one searching for the very best sensual massage in London. We come by this reputation honestly with a dynamic team of the city’s most beautiful masseuses.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
2. Therapeutic Exercise
The exercise, which is needed for the treatment purpose, is called as
therapeutic exercise.
Which are performed to come out from ones ailment or disease.
The main goal of the therapeutic exercise is preparing or making the patient
independent or symptom-free movements.
3. TYPES OF MOVEMENTS
1. Active movement
i. Assisted
ii. Free
iii. Assisted and resisted
iv. Resisted.
4. TYPES OF MOVEMENTS
2. Passive movement
i. Relaxed passive movement
ii. Passive manual mobilization techniques
iii. Mobilization
iv. Manipulation
v. Stretching.
6. Passive ROM
Indications for PROM
In the region where there is acute, inflamed tissue,
passive motion is beneficial.
Inflammation after injury or surgery usually lasts 2 to 6
days.
When a patient is not able to or not supposed to actively
move a segment or segments of the body, as when
comatose, paralyzed, or on complete bed rest, movement
is provided by an external source.
7. Passive ROM
Goals for PROM
Maintain joint and connective tissue mobility
Minimize the effects of the formation of contractures
Maintain mechanical elasticity of muscle
Assist circulation and vascular dynamics
Enhance synovial movement for cartilage nutrition and
diffusion of materials in the joint
Decrease or inhibit pain
Assist with the healing process after injury or surgery
To maintain the patient’s awareness of movement
8. Other Uses for PROM
When a therapist is examining inert structures, PROM is
used to determine limitations of motion, to determine joint
stability, and to determine muscle and other soft tissue
elasticity.
When a therapist is teaching an active exercise program,
PROM is used to demonstrate the desired motion.
When a therapist is preparing a patient for stretching,
PROM is often used preceding the passive stretching
techniques.
9. Active ROM
Indications for AROM
If a patient is able to contract the muscles actively and move a
segment with or without assistance,AROM is used.
If a patient has weak musculature and is unable to move a
joint through the desired range (usually against gravity),A-
AROM is used.
AROM can be used for aerobic conditioning programs
During immobilization, AROM is used on the regions above
and below the immobilized segment to maintain the areas in
as normal a condition as possible and to prepare for new
activities, such as walking with crutches.
10. Active ROM
Goals 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
12. Limitations of Passive Motion
True passive, relaxed ROM may be difficult to obtain
when muscle is innervated and the patient is conscious.
Passive motion does not:
Prevent muscle atrophy
Increase strength or endurance
Assist circulation to the extent that active, voluntary muscle
contraction
does
Limitations of Active ROM
For strong muscles, active ROM does not maintain or
increase strength.
It also does not develop skill or coordination except in the
movement
15. Examination, Evaluation, and
Treatment Planning
1. Examine and evaluate the patient’s impairments
and level of function, determine any precautions and
prognosis, and plan the intervention.
2. Determine the ability of the patient to participate in
the ROM activity and whether PROM,A-AROM, or
AROM can meet the immediate goals.
3. Determine the amount of motion that can be safely
applied for
the condition of the tissues and health of the
individual.
16. 4. Decide what patterns can best meet the goals. ROM
techniques may be performed in the
a. Anatomic planes of motion:frontal,sagittal,transverse
b.Muscle range of elongation:antagonistic to the line of pull of
the muscle
c. Combined patterns:diagonal motions or movements
that incorporate several planes of motion
d.Functional patterns:motions used in activities of daily living
(ADL)
5. Monitor the patient’s general condition and responses during
and after the examination and intervention; note any change in
vital signs, any change in the warmth and color of the
segment, and any change in the ROM, pain, or quality of
movement.
17. Patient Preparation
1. Communicate with the patient. Describe the plan and
method of intervention to meet the goals.
2. Free the region from restrictive clothing, linen, splints, and
dressings.
Drape the patient as necessary.
3. Position the patient in a comfortable position with
proper body alignment and stabilization but that also
allows you to move the segment through the
available ROM.
4. Position yourself so proper body mechanics can be used.
18. Application of Techniques
1.To control movement, grasp the extremity around the
joints. If the joints are painful, modify the grip, still providing
support necessary for control.
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, with 5 to
10 repetitions.The number of repetitions depends on the
19. 1. During PROM the force for movement is external, being
provided by a therapist or mechanical device.When
appropriate, a patient may provide the force and be
taught to move the part with a normal extremity.
2. No active resistance or assistance is given by the
patient’s muscles that
cross the joint. If the muscles contract, it becomes an
active exercise.
3. The motion is carried out within the free ROM, that is,
the range that is available without forced motion or
pain.
Application of PROM
20. Application of AROM
1. Demonstrate the motion desired using PROM; then ask
the patient to perform the motion. Have your hands in
position to assist or guide the patient if needed.
2. Provide assistance only as needed for smooth
motion.When there is weakness, assistance may be
required only at the beginning or the end of the ROM, or
when the effect of gravity has the greatest moment arm
(torque).
3. The motion is performed within the available ROM.
21. ACTIVE MOVEMENTS
(ACTIVE—BY HIS /HER OWN)
Assisted Exercise:
• If the strength or the coordination of the muscle is insufficient to perform
an activity, the external force is utilized to compensate the lack.
• The muscle has the strength or endurance but is not sufficient to perform an
activity or control an action.
23. Active assistance
• The patient himself can assist with his opposite extremity to perform the
assisted exercise.
For example,
a. The opposite leg is used by the patient to increase the flexion movement of
the knee in high sitting.
• The main advantage is the patient, he himself only knows the pain limit and
availability of range of movement.
• So, that he can perform the exercise conveniently within the pain limit.
24. Passive assistance
It is classified into:
1. Manual assisted exercise
2. Mechanical assisted exercise.
26. Uses
• Increase the ROM of the joint.
• Increase the strength, power and the endurance of the muscles.
• It breaks the adhesion formation around the joint.
• It reduces the spasm of the muscles.
• 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.
27. Free Exercise
• There are two types of free exercises.
1. Localized
2. General body.
28. Characteristics of the Free Exercises
• Subjective
• Objective
• Example: Bending and touching the great toe with the middle finger. Here the
goal is set to touch the toe.
29. Uses
• Increases the joint range.
• Increases the muscle strength, power and endurance.
• Increases the neuromuscular coordination.
• Increases the circulation and venous drainage.
• Increases the relaxation of the muscle by the swinging movements and the pendular movements.
• Repeated active movement breaks the adhesion formation and elongates the shortened soft
tissues.
• Regulating the cardiorespiratory function, and the active exercise increases the respiratory and
venous return so that the O2 supply to muscles and blood circulation to the muscle increases.
30. Resisted Exercises
• Performed by opposing the mechanical or manual resistance is called as
resisted exercises.
• Types of Resisted Exercises
1. Manual
2. Mechanical
31. Manual Resisted
• These exercises can be operated by:
1. The therapist
2. Patient himself
3. Relatives and friends
33. Mechanical Resisted
• These resisted exercises can be stated when the muscle power is 2., i.e. from
gravity eliminated position.
• We can increase the resistance;
• By altering the leverage
• By increasing the weight
• By altering the speed
• By changing the duration.
34. Uses of Resisted Exercises
• Resisted exercises increase the strength of the muscle earlier.
• The weak muscle can be strengthened much earlier than the any other exercise
regimen.
• Can be started from the muscle power 2 onwards.
• Strength of the muscle is directly proportional to the tension created inside the
muscle.
• The resisted exercise can create the more amount of intramuscular tension.
Strength α Tension
35. Uses of Resisted Exercises
• Increases the endurance of the muscle.
• Powerful muscle contraction increases the blood flow of the muscle fiber
and it gets nutrition and the O2.
• Resisted exercise increases the muscular power.
• Power is related to the strength of the muscle and the speed.
Power = Force × Distance / Time
36. Progressive Resisted Exercise
• Repetition Maximum :
The maximum amount of the weight a person can lift throughout the range
of motion exactly 10 times.
3 types of progressive resisted exercise regimens are available.
1. DeLorme and Watkins
2. MacQueen
3. Zinovieff (Oxford technique).
37. De Lorme and Watkins
• 10 times with 1/2 10 RM.
• 10 times with 3/4 10 RM.
• 10 times with 10 RM.
Progression
i. 30 times weekly 4 sessions
ii. Every week 10 RM progression.
38. De Lorme and Watkins
• a. For example:
Consider 10RM—1 kg
First week.
1/2 of 10 RM—1/2 kg.
3/4 of 10 RM—3/4 kg
Full of 10 RM—1 kg
Exercise regimen is 10 times with 1/2 kg, 10 times with 3/4 kg, 10 times with 1 kg
39. De Lorme and Watkins
• Second week
Progression 10 RM
= 10 RM + 10 RM
= 1 kg +1 kg
= 2 kg
Exercise Regimen is
10 times with 1 kg
10 times with 11/2 kg
10 times with 2 kg
40. De Lorme and Watkins
• In this exercise regimen, the weight is increased, i.e. first with 1/2 kg
followed by 3/4 kg and 1 kg.
• Each and every session the patient has to lift the above said three types of
weights 10 times each.
• So, that daily 30 times lifting been done.
41. De Lorme and Watkins
• In each and every session 30 times the exercise should be done with 2
breaks by the patient. i.e. 10 times 1/2 10 RM (1/2 kg) → Break → 10 times
with 3/4 10 RM (3/4 kg) → Break→ 10 times 10 RM (1 kg)
• Weekly 4 sessions the exercise has to be practiced.
For example:
Monday, Wednesday, Friday, Sunday (i.e. every alternative day’s) exercise has to
be practiced and remaining days, i.e. Tuesday, Thursday, Saturday given rest.