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.
Osteoarthritis of the Knee Joint is a quite common condition found in Indian Population. This presentation is made to understand how this condition affects patients and what are the different Physiotherapy measures to make the patient functionally independent.
Manual Muscle Testing (MMT) is a clinical assessment technique used by healthcare professionals to evaluate the strength and function of individual muscles or muscle groups. It involves the systematic application of resistance while the patient contracts specific muscles, allowing the examiner to assess the muscle's ability to generate force and produce movement. Here's a detailed overview:
1. **Purpose**: MMT is used to:
- Identify muscle weakness or imbalance.
- Assess the extent and location of neuromuscular dysfunction.
- Monitor changes in muscle strength over time.
- Guide treatment planning and rehabilitation interventions.
2. **Procedure**:
- **Patient Positioning**: The patient is positioned appropriately to isolate and activate the muscle being tested.
- **Instruction**: Clear instructions are provided to the patient regarding the desired movement and level of effort.
- **Stabilization**: Adjacent joints or body segments may be stabilized to prevent compensatory movements.
- **Resistance Application**: The examiner applies resistance, typically manually, in the direction opposite to the muscle's action, gradually increasing it while the patient contracts the muscle.
- **Observation**: The examiner observes the quality of muscle contraction, noting factors such as initiation, strength, endurance, and any signs of fatigue or compensation.
- **Grading**: Muscle strength is graded on a scale ranging from 0 to 5:
- 0: No contraction detected.
- 1: Muscle flicker, but no movement.
- 2: Movement occurs, but not against gravity.
- 3: Movement against gravity, but not against resistance.
- 4: Movement against some resistance, but not full strength.
- 5: Full strength, normal movement against full resistance.
3. **Applications**:
- **Clinical Diagnosis**: MMT helps identify muscle weakness or dysfunction associated with various conditions, such as neuromuscular disorders, orthopedic injuries, and neurological impairments.
- **Treatment Planning**: Assessment findings from MMT guide the selection of appropriate therapeutic interventions, including strengthening exercises, manual therapy techniques, and functional training.
- **Rehabilitation Monitoring**: Serial MMT evaluations track changes in muscle strength and function during the rehabilitation process, informing progression and adjusting treatment goals as needed.
4. **Considerations**:
- **Reliability and Validity**: MMT results may vary based on factors such as examiner experience, patient cooperation, and testing conditions. Standardized protocols and repeated assessments can enhance reliability.
- **Limitations**: MMT may not be suitable for assessing deep muscles or muscles affected by pain, and results may be influenced by factors such as fatigue, motivation, and neurological impairment.
- **Clinical Judgment**: Interpretation of MMT findings requires clinical judgment,.
199 Flexibility LEARNING OBJECTIVES After comp.docxaulasnilda
199
Flexibility
LEARNING OBJECTIVES
After completing the study of this concept, you will be able to:
▶ Identify and explain several misconceptions about flexibility.
▶ List the health benefits of flexibility and stretching.
▶ Describe the various methods of stretching and their advantages
and disadvantages.
▶ Determine the amount of exercise necessary to improve flexibility, explain the FIT
formulas for the different types of stretching, and describe factors in the “do and
don’t list for stretching.”
▶ Describe a variety of flexibility-based activities for improving flexibility and some
of the advantages and disadvantages of each.
▶ Identify some of the
guidelines for safe and
effective stretching.
▶ Describe several self-
assessments for flexibility,
select the self-assessments
that help you identify
personal needs, and plan
(and self-monitor) a personal
flexibility exercise program.
C
o
n
c
e
p
t 1
0
• Regular stretching exercises promote flexibility,
a component of fitness that permits freedom of
movement, contributes to ease and economy of
muscular effort, allows for successful performance in
certain activities, and provides less susceptibility to
some types of injuries or musculoskeletal problems.
cor22568_ch10_199-224.indd 199 17/08/12 9:24 PM
F
O
S
T
E
R
,
C
E
D
R
I
C
1
6
9
2
T
S
200 Section 3 ▶ The Physical Activity Pyramid
is described by the arc through which a joint moves and is
typically measured in degrees using a tool called a goni-
ometer. The direction of movement at a specific joint is
determined by the shapes of the bony surfaces that are in
contact. Certain types of joints allow for greater move-
ment than others. In fact, flexibility is highly joint spe-
cific. An individual may demonstrate optimal flexibility
in one region of the body but not in others. For example,
a person may have good flexibility of the spine, hips, and
legs in order to reach down and touch the toes, but is
unable to clasp both hands behind the back due to stiff-
ness of the shoulder joints.
Medical professionals use a specific vocabulary to
describe the movement of joints. Figure 1 illustrates some
of these movement terms as they relate to hip, knee, or
ankle motion. Similar terms are applied in describing
movement of the spine and upper body. Note that the
same terms (such as flexion/extension ) can be applied to dif-
ferent joints, while other terms (such as dorsiflexion/plantar
flexion ) are unique to a specific joint such as the ankle.
The shape, size, and orientation of a joint greatly
influence the amount of motion available. The
circular surface of the ball-and-socket joint of the hip,
for example, allows for considerable mobility, includ-
ing movement to the side (adduction and abduction),
forward and backward (flexion and extension), and in
F
lexibility refers to the amount of motion that is
possible at a given joint ...
199 Flexibility LEARNING OBJECTIVES After comp.docxherminaprocter
199
Flexibility
LEARNING OBJECTIVES
After completing the study of this concept, you will be able to:
▶ Identify and explain several misconceptions about flexibility.
▶ List the health benefits of flexibility and stretching.
▶ Describe the various methods of stretching and their advantages
and disadvantages.
▶ Determine the amount of exercise necessary to improve flexibility, explain the FIT
formulas for the different types of stretching, and describe factors in the “do and
don’t list for stretching.”
▶ Describe a variety of flexibility-based activities for improving flexibility and some
of the advantages and disadvantages of each.
▶ Identify some of the
guidelines for safe and
effective stretching.
▶ Describe several self-
assessments for flexibility,
select the self-assessments
that help you identify
personal needs, and plan
(and self-monitor) a personal
flexibility exercise program.
C
o
n
c
e
p
t 1
0
• Regular stretching exercises promote flexibility,
a component of fitness that permits freedom of
movement, contributes to ease and economy of
muscular effort, allows for successful performance in
certain activities, and provides less susceptibility to
some types of injuries or musculoskeletal problems.
cor22568_ch10_199-224.indd 199 17/08/12 9:24 PM
F
O
S
T
E
R
,
C
E
D
R
I
C
1
6
9
2
T
S
200 Section 3 ▶ The Physical Activity Pyramid
is described by the arc through which a joint moves and is
typically measured in degrees using a tool called a goni-
ometer. The direction of movement at a specific joint is
determined by the shapes of the bony surfaces that are in
contact. Certain types of joints allow for greater move-
ment than others. In fact, flexibility is highly joint spe-
cific. An individual may demonstrate optimal flexibility
in one region of the body but not in others. For example,
a person may have good flexibility of the spine, hips, and
legs in order to reach down and touch the toes, but is
unable to clasp both hands behind the back due to stiff-
ness of the shoulder joints.
Medical professionals use a specific vocabulary to
describe the movement of joints. Figure 1 illustrates some
of these movement terms as they relate to hip, knee, or
ankle motion. Similar terms are applied in describing
movement of the spine and upper body. Note that the
same terms (such as flexion/extension ) can be applied to dif-
ferent joints, while other terms (such as dorsiflexion/plantar
flexion ) are unique to a specific joint such as the ankle.
The shape, size, and orientation of a joint greatly
influence the amount of motion available. The
circular surface of the ball-and-socket joint of the hip,
for example, allows for considerable mobility, includ-
ing movement to the side (adduction and abduction),
forward and backward (flexion and extension), and in
F
lexibility refers to the amount of motion that is
possible at a given joint.
Osteoarthritis of the Knee Joint is a quite common condition found in Indian Population. This presentation is made to understand how this condition affects patients and what are the different Physiotherapy measures to make the patient functionally independent.
Manual Muscle Testing (MMT) is a clinical assessment technique used by healthcare professionals to evaluate the strength and function of individual muscles or muscle groups. It involves the systematic application of resistance while the patient contracts specific muscles, allowing the examiner to assess the muscle's ability to generate force and produce movement. Here's a detailed overview:
1. **Purpose**: MMT is used to:
- Identify muscle weakness or imbalance.
- Assess the extent and location of neuromuscular dysfunction.
- Monitor changes in muscle strength over time.
- Guide treatment planning and rehabilitation interventions.
2. **Procedure**:
- **Patient Positioning**: The patient is positioned appropriately to isolate and activate the muscle being tested.
- **Instruction**: Clear instructions are provided to the patient regarding the desired movement and level of effort.
- **Stabilization**: Adjacent joints or body segments may be stabilized to prevent compensatory movements.
- **Resistance Application**: The examiner applies resistance, typically manually, in the direction opposite to the muscle's action, gradually increasing it while the patient contracts the muscle.
- **Observation**: The examiner observes the quality of muscle contraction, noting factors such as initiation, strength, endurance, and any signs of fatigue or compensation.
- **Grading**: Muscle strength is graded on a scale ranging from 0 to 5:
- 0: No contraction detected.
- 1: Muscle flicker, but no movement.
- 2: Movement occurs, but not against gravity.
- 3: Movement against gravity, but not against resistance.
- 4: Movement against some resistance, but not full strength.
- 5: Full strength, normal movement against full resistance.
3. **Applications**:
- **Clinical Diagnosis**: MMT helps identify muscle weakness or dysfunction associated with various conditions, such as neuromuscular disorders, orthopedic injuries, and neurological impairments.
- **Treatment Planning**: Assessment findings from MMT guide the selection of appropriate therapeutic interventions, including strengthening exercises, manual therapy techniques, and functional training.
- **Rehabilitation Monitoring**: Serial MMT evaluations track changes in muscle strength and function during the rehabilitation process, informing progression and adjusting treatment goals as needed.
4. **Considerations**:
- **Reliability and Validity**: MMT results may vary based on factors such as examiner experience, patient cooperation, and testing conditions. Standardized protocols and repeated assessments can enhance reliability.
- **Limitations**: MMT may not be suitable for assessing deep muscles or muscles affected by pain, and results may be influenced by factors such as fatigue, motivation, and neurological impairment.
- **Clinical Judgment**: Interpretation of MMT findings requires clinical judgment,.
199 Flexibility LEARNING OBJECTIVES After comp.docxaulasnilda
199
Flexibility
LEARNING OBJECTIVES
After completing the study of this concept, you will be able to:
▶ Identify and explain several misconceptions about flexibility.
▶ List the health benefits of flexibility and stretching.
▶ Describe the various methods of stretching and their advantages
and disadvantages.
▶ Determine the amount of exercise necessary to improve flexibility, explain the FIT
formulas for the different types of stretching, and describe factors in the “do and
don’t list for stretching.”
▶ Describe a variety of flexibility-based activities for improving flexibility and some
of the advantages and disadvantages of each.
▶ Identify some of the
guidelines for safe and
effective stretching.
▶ Describe several self-
assessments for flexibility,
select the self-assessments
that help you identify
personal needs, and plan
(and self-monitor) a personal
flexibility exercise program.
C
o
n
c
e
p
t 1
0
• Regular stretching exercises promote flexibility,
a component of fitness that permits freedom of
movement, contributes to ease and economy of
muscular effort, allows for successful performance in
certain activities, and provides less susceptibility to
some types of injuries or musculoskeletal problems.
cor22568_ch10_199-224.indd 199 17/08/12 9:24 PM
F
O
S
T
E
R
,
C
E
D
R
I
C
1
6
9
2
T
S
200 Section 3 ▶ The Physical Activity Pyramid
is described by the arc through which a joint moves and is
typically measured in degrees using a tool called a goni-
ometer. The direction of movement at a specific joint is
determined by the shapes of the bony surfaces that are in
contact. Certain types of joints allow for greater move-
ment than others. In fact, flexibility is highly joint spe-
cific. An individual may demonstrate optimal flexibility
in one region of the body but not in others. For example,
a person may have good flexibility of the spine, hips, and
legs in order to reach down and touch the toes, but is
unable to clasp both hands behind the back due to stiff-
ness of the shoulder joints.
Medical professionals use a specific vocabulary to
describe the movement of joints. Figure 1 illustrates some
of these movement terms as they relate to hip, knee, or
ankle motion. Similar terms are applied in describing
movement of the spine and upper body. Note that the
same terms (such as flexion/extension ) can be applied to dif-
ferent joints, while other terms (such as dorsiflexion/plantar
flexion ) are unique to a specific joint such as the ankle.
The shape, size, and orientation of a joint greatly
influence the amount of motion available. The
circular surface of the ball-and-socket joint of the hip,
for example, allows for considerable mobility, includ-
ing movement to the side (adduction and abduction),
forward and backward (flexion and extension), and in
F
lexibility refers to the amount of motion that is
possible at a given joint ...
199 Flexibility LEARNING OBJECTIVES After comp.docxherminaprocter
199
Flexibility
LEARNING OBJECTIVES
After completing the study of this concept, you will be able to:
▶ Identify and explain several misconceptions about flexibility.
▶ List the health benefits of flexibility and stretching.
▶ Describe the various methods of stretching and their advantages
and disadvantages.
▶ Determine the amount of exercise necessary to improve flexibility, explain the FIT
formulas for the different types of stretching, and describe factors in the “do and
don’t list for stretching.”
▶ Describe a variety of flexibility-based activities for improving flexibility and some
of the advantages and disadvantages of each.
▶ Identify some of the
guidelines for safe and
effective stretching.
▶ Describe several self-
assessments for flexibility,
select the self-assessments
that help you identify
personal needs, and plan
(and self-monitor) a personal
flexibility exercise program.
C
o
n
c
e
p
t 1
0
• Regular stretching exercises promote flexibility,
a component of fitness that permits freedom of
movement, contributes to ease and economy of
muscular effort, allows for successful performance in
certain activities, and provides less susceptibility to
some types of injuries or musculoskeletal problems.
cor22568_ch10_199-224.indd 199 17/08/12 9:24 PM
F
O
S
T
E
R
,
C
E
D
R
I
C
1
6
9
2
T
S
200 Section 3 ▶ The Physical Activity Pyramid
is described by the arc through which a joint moves and is
typically measured in degrees using a tool called a goni-
ometer. The direction of movement at a specific joint is
determined by the shapes of the bony surfaces that are in
contact. Certain types of joints allow for greater move-
ment than others. In fact, flexibility is highly joint spe-
cific. An individual may demonstrate optimal flexibility
in one region of the body but not in others. For example,
a person may have good flexibility of the spine, hips, and
legs in order to reach down and touch the toes, but is
unable to clasp both hands behind the back due to stiff-
ness of the shoulder joints.
Medical professionals use a specific vocabulary to
describe the movement of joints. Figure 1 illustrates some
of these movement terms as they relate to hip, knee, or
ankle motion. Similar terms are applied in describing
movement of the spine and upper body. Note that the
same terms (such as flexion/extension ) can be applied to dif-
ferent joints, while other terms (such as dorsiflexion/plantar
flexion ) are unique to a specific joint such as the ankle.
The shape, size, and orientation of a joint greatly
influence the amount of motion available. The
circular surface of the ball-and-socket joint of the hip,
for example, allows for considerable mobility, includ-
ing movement to the side (adduction and abduction),
forward and backward (flexion and extension), and in
F
lexibility refers to the amount of motion that is
possible at a given joint.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
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Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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Range of Motion - Copy.pptx
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
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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.
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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
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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
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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
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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.
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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
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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.
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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
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16. Indications For Passive ROM
Primary goal for ROM is to decrease the
complication with immobilization
Cartilage degeneration
Adhesion and contracture formation
sluggish circulation
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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
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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)
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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
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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
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21. Limitations of AROM
For strong muscles, does not ;
maintain or increase strength
develop skill or coordination except in the
movement patterns used
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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
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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
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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
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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
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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
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28. Fire your Questions Now?
Thank U for Ur time
& patience !!!!
12/29/2022 Dechasa I. 28
