This presentation provides information on range of motion for 2nd year physiotherapy students. It defines range of motion, describes the types and purposes of range of motion, and discusses considerations for performing range of motion exercises. The types of range of motion discussed are active, passive, and active-assisted range of motion. The purposes of range of motion exercises include promoting joint health, preventing stiffness, and restoring muscle function. Contraindications and principles for applying range of motion techniques safely and effectively are also outlined.

1. For 2nd year Physiotherapy Students
Range of Motion
Dechasa Imiru
Department of physiotherapy
Jimma University
12/29/2022 Dechasa I. 1

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
12/29/2022 Dechasa I. 2

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
12/29/2022 Dechasa I. 3

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.
12/29/2022 Dechasa I. 4

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
12/29/2022 Dechasa I. 5

6. .
12/29/2022 Dechasa I. 6

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
12/29/2022 Dechasa I. 7

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
12/29/2022 Dechasa I. 8

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.
12/29/2022 Dechasa I. 9

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
12/29/2022 Dechasa I. 10

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.
12/29/2022 Dechasa I. 11

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
12/29/2022 Dechasa I. 12

13. 12/29/2022 Dechasa I. 13

14. 12/29/2022 Dechasa I. 14

15. 12/29/2022 Dechasa I. 15

16. Indications For Passive ROM
Primary goal for ROM is to decrease the
complication with immobilization
Cartilage degeneration
Adhesion and contracture formation
sluggish circulation
12/29/2022 Dechasa I. 16

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
12/29/2022 Dechasa I. 17

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)
12/29/2022 Dechasa I. 18

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
12/29/2022 Dechasa I. 19

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
12/29/2022 Dechasa I. 20

21. Limitations of AROM
For strong muscles, does not ;
maintain or increase strength
develop skill or coordination except in the
movement patterns used
12/29/2022 Dechasa I. 21

22. Contraindications
Joint Inflammation/effusion
swelling
Severe/acute pain
12/29/2022 Dechasa I. 22

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
12/29/2022 Dechasa I. 23

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
12/29/2022 Dechasa I. 24

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
12/29/2022 Dechasa I. 25

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
12/29/2022 Dechasa I. 26

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
12/29/2022 Dechasa I. 27

28. Fire your Questions Now?
Thank U for Ur time
& patience !!!!
12/29/2022 Dechasa I. 28