ACTIVE FREE EXERCISES
Free active exercises are those which are performed by the pt’s own Definition: Free active exercises are those which are performed by the pt’s own muscular efforts without the assistance or resistance of any external force, other than that of the gravity.
Active free ex’s vary widely in character & effect because of: The nature & extent of the movement. The manner in which they are performed. * Active free ex’s can be used to obtain any effects which are produced by ex’s as a whole, if it is performed & used judiciously.
Indications of active free exercises: In cases of m. weakness. After removal of plaster cast following surgical procedures (tendon or m. transplantation). Muscle re-education. Limitation of ROM. Cardiovascular or respiratory disorders. Inability to do basic functional ADL independently.
Goals of active free exercises: To improve circulation. To ↑ rate & depth of respiration. To mobilize stiff joints. To improve ROM. To strengthen weak ms. To improve co-ordination & balance. To achieve ADL independently. To correct deformities. To improve posture. To improve gait & ambulation.
Contra-indications of active free movements: Immediately after cardiovascular disorders e.g. myocardial infarction & angina pectoris. Immediately after recent tear to ligament, m., or injured joints. At the site of #. Recent surgical procedures to tendons, ligaments, muscles, joint capsules or skin. Diseases of bone (e.g. TB) & pathological # (e.g. osteoporosis & tuberculosis of bone). Acute joint inflammation. Acute muscle inflammation. Muscle swelling. Severe joint pain. Acute m. pain.
Localized. General. Classification of active free exercises: It may be classified according to the extent of the part involved into: Localized. General.
Localized: Are designed primarily to produce some local & specific effects. E.g.: a. Mobilization of particular joint or b. Strengthening of particular m. group. E.g.: Pendulum exs. for the shoulder.
2.General: Are free exercises that usually involve the use of many joints & muscles allover the body. Their effect is wide spread. E.g.: a. Coordination exs. b. Respiratory exs.
Instructions: Rules & principles of active free exs. (procedures): Instructions are given in a manner which will gain the interest & cooperation of the pt.
2. Starting position Is selected & taught with care to insure the maximum postural efficiency as a basis for the movement . The P.T. must choose it according to: The pt’s condition Type of active ex. The type of m. contraction desired.
3. Speed of movement The speed at which the exercises are done depends on the effects required. It is usually slow during the period of learning & later the pt. is either allowed to find his own natural rhythm or the speed desired is dictated by the P.T. It often helps the pt to maintain his natural rhythm at home. During practice under the P.T. supervision the pt. is encouraged to count loudly.
4. Progression An active free ex program must be progressive & as soon as the pt. is capable of performing a more difficult task, he should be encouraged to do it. Constant re-evaluation of the pt’s abilities is essential to allow the re-education to be progressive.
The number of times the movement is repeated depends on: 5. Repetitions The number of times the movement is repeated depends on: A- The aim (strengthening or endurance). B - The fatigue of the ms. * The condition which has caused the m weakness must be known & understood as in some conditions m. fatigue can be injurious.
Group Therapy 1. Goals of group therapy. 2. Rules of choosing the members of the group. 3. Location of group therapy. 4. Tools used in group therapy.
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