At the completion of this chapter, the reader will be able to:
List the different types of physiologic motions
Describe the differences among active motions, active-assisted motions, and passive motions
Describe the purpose of range of motion exercises
List the different types of diagonal patterns of motion that can be incorporated therapeutically
Interpret the findings of active and passive range of motion testing
Perform a range of motion examination using a goniometer
Apply passive range of motion techniques to the upper extremity
Apply passive range of motion techniques to the lower extremity
Physiologic motions are joint and soft tissue movements that can be produced actively or passively. Active motions are those that can be produced by the patient alone, whereas passive motions are those motions that require assistance to complete. Active-assisted motions are those that are combination of active and passive motions (see Chapter 4).
RANGE OF MOTION EXERCISES
Range of motion exercises are designed to move the joint and soft tissues through the available physiologic ranges of motion.
The purpose of range of motion exercises is to prevent the development of adaptive muscle shortening, contractures, and shortening of the capsule, ligaments, and tendons. In addition, range of motion exercises provide sensory stimulation.
Active range of motion (AROM): performed by the patient independently. AROM exercises are used when the patient is able to voluntarily contract, control, and coordinate a movement when such a movement is not contraindicated. Contraindications to AROM include a healing fracture site, a healing surgical site, severe and acute soft tissue trauma, and cardiopulmonary dysfunction. The presence of a number of conditions requires caution with AROM exercises. These include acute rheumatoid arthritis, significant pain or joint swelling, or if the symptoms are intensified with the exercise. The benefits of AROM exercises are outlined in Table 11-1.
Active assisted range of motion (AAROM): performed when the patient needs assistance with movement from an external force because of weakness, pain, or changes in muscle tone. The assistance may be applied mechanically, manually, or by gravity while the patient performs a voluntary muscle contraction to the extent he or she is able. AAROM exercises are used in the presence of muscular weakness, fatigue, or pain.
Passive range of motion (PROM): usually performed when the patient is unable or not permitted to move the body segment, and the clinician, or family member, moves the body segment. PROM exercises are typically used where there is paralysis, when the patient is comatose, in the presence of a healing fracture, or if pain is elicited during an active muscle contraction. One of the primary goals of PROM is to counteract the detrimental effects of immobilization. However, it is important to remember that PROM exercises cannot prevent muscle atrophy.
Log In to View More
If you don't have a subscription, please view our individual subscription options below to find out how you can gain access to this content.
Want remote access to your institution's subscription?
Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.
If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.
AccessPhysiotherapy Full Site: One-Year Subscription
Connect to the full suite of AccessPhysiotherapy content and resources including interactive NPTE review, more than 500 videos, Anatomy & Physiology Revealed, 20+ leading textbooks, and more.
Pay Per View: Timed Access to all of AccessPhysiotherapy
24 Hour Subscription $34.95
48 Hour Subscription $54.95
Pop-up div Successfully Displayed
This div only appears when the trigger link is hovered over.
Otherwise it is hidden from view.