This document discusses passive movements in physical therapy. It defines passive movements as smooth, rhythmic movements performed by a therapist or device on a patient, within their pain-free range of motion, to help increase range of motion when muscles cannot move a joint on their own. It describes different types of passive movements including manual techniques by therapists and mechanical techniques using devices, and provides guidelines for properly performing passive movements.

1. - DR SADHIKA N.S TALAULIKAR

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.

10. Relaxation
Fixation
Traction
Range
Speed and duration
Sequence

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