1. Range of Motion Exercise(ROM)

2. Type of ROM Exercises

3. Passive ROM(PROM)
is movement of a segment within the unrestricted ROM that is produced entirely by an external force
is little to or no voluntary muscle contraction

4. Active ROM(AROM)
Is movement of a segment within the unrestricted ROM that is produced by active contraction of the muscles crossing that joint

5. Active-Assistance ROM(AAROM)
is a type of AROM in which assistance is produced manually or mechanically by an outside force because the prime mover muscles need assistance to complete the motion

6. Indications and Goals For ROM

7. Passive ROM(PROM)
Primary goal for ROM is to decrease the complication with immobilization
Cartilage degeneration
adhesion and contracture formation
sluggish circulation

8. 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 joint

9. Decrease or inhibit pain
Assist with the healing process after injury or surgery
Help maintain the patient’s awareness of movement

10. 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 (progessively strengthened)

11. 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

12. Increase circulation and prevent thrombus formation
Develop coordination and motor skills for functional activities

13. Limitations of ROM Exercises

14. Limitations of PROM Does not ; Prevent muscle atrophy
Increase strength or endurance
Assist circulation to the extent that active, voluntary muscle contraction does

15. Limitations of AROM For strong muscles, does not ;
maintain or increase strength
develop skill or coordination except in the movement patterns used

20. Principles and procedures for
Applying ROM Techniques

21. Examination, Evaluation and Treatment Planning
Examine and evaluate the patient’s impairment and level of function, determine any precautions and prognosis, and plan the intervention
Determine the ability of the patients ; PROM, A-AROM or AROM
Determine the amount of motion

22. Decide pattern can best the goal
- Anatomic plane of motion ; frontal, sagittal, transverse
- muscle range of elongation
- combined patterns ; diagonal motion
- functional pattern ; ADL

23. 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

24. Patient preparation
Communicate with the patient : descirbe 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

25. 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 resitance
Perform the motions smoothly and rhythmically, with 5 to 10 repetitions

26. Shoulder : Flexion and extension

27. Shoulder : hyper-extension

28. Shoulder : abduction and adduction

29. Shoulder : medial and lateral rotation

30. Shoulder : horizontal abduction and adduction

31. Scapular : elevation, depression,
protraction, retraction,
upward, downward rotation

33. Elbow : flexion and extension

34. Triceps Brachii muscle

35. Forearm : pronation and supination

36. Forearm : supination

37. Hand : cupping and flattening the
arch of the hand at the
Carpometacarpal

39. Elongation of extrinsic muscle of the wrist and hand : flexor and extensor digitorum muscles

41. Combined Hip and Knee : flexion and extension

43. Hip : hyperextension

44. Elongation of the two joint Hamstring muscle group

46. Hip : abduction and adduction

47. Hip : internal and external rotation

48. Ankle : dorsiflexion

49. Ankle : inversion and eversion

50. Joint of toes : flexion and extension abduction and adduction

52. Good luck on your finals!
Thank You!
Good luck on your finals!