rom Flashcards
define ROM
full possible motion needed to accomplish functional activities
all about movement - referred as flex-ext, abd-add, rotation)
structures that affect ROM
muscles
synovial fluid and joint capsule
ligament
fascia
nerves and vessels
what is functional excursion
distance that muscle is capable of shortening after maximally elongated
range of muscle
exp 1 jointed muscle rom
muscle that proximal and distal attachments on the bones on either side of one joint - brachialis
exp 2 jointed muscle rom
muscles that cross over two or more joints - biceps and hamstrings
where does ideal length-tension relation exist
midportion of functional excursion
exp active insuff
2 jointed muscle cannot be shortened anymore - hamstrings in knee flexion & hip extension
exp passive insuff
2 jointed muscle cannot be elongated anymore - hamstrings in knee extension & hip flexion
factors that can lead to dec ROM
Systemic, joint, neurologic (e.g. stroke) or muscular disease
Surgical or traumatic insults (e.g. post-operative, acute stage or inflammatory stage of injury)
Inactivity or immobilization
general rationale of ROM exercise
MAINTAIN joint and soft tissue mobility/integrity
MINIMIZE loss of tissue flexibility and contracture formation
what is PROM
movement w/in pain-free range produced by external force
NO VOLUNTARY MUSCLE CONTRACTION
indications of PROM
acute, inflamed tissue
AROM will impede healing
not able to or not supposed to actively
move a segment - comatosed or bed rest
after surgical repair of contractile tissues
inflammation after injury or surgery
usually lasts
2-6 days
goals of PROM
maintain joint and tissue mob
minimize contractures/adhesions
maintain elasticity
assist in circulation - AROM > PROM
enhance synovial movement
dec or inhib pain
assist healing process
maintain pt awareness of movement
limitations of PROM
hard when pt is conscious or muscle is innervated
does not:
prevent atrophy
inc strength and endurance
assist circulation at same extent of AROM
what is AROM
movement produced by active contraction of muscles
info on muscle strength, coordination and function
indications of AROM
pt is able to actively contract
improving cv and respi responses - done repeatedly
regions above and below of immmob area
aerobic conditioning
relieve stress from sustained postures
limitations of AROM
strong muscles - does not maintain nor increase strength
does not develop skill or coordination except in the movement patterns used - functional > AROM
what is AAROM
AROM with external assistance bcs prime mover needs it to complete ROM
either initiation, mid or end range
indications of AAROM
weak musculature and unable to move joint through desired range against gravity
provide assistance so that muscles could function maximally and progressively strengthened
progressed to AROM then resistance exercises
goals of AROM and AAROM
maintain elasticity and contractility of muscle
provides sensory feedback
provides stimulus for bone and soft tissue healing
inc circulation and prevents thrombus
develops coordination and motor skills
precautions and contraindications of AROM and AAROM
if it will cause more trauma, disruptive to healing
signs of too much or wrong motion
not within pain free range
prevent DVT but not if may DVT na
exp use of AROM after MI, CABG or PTCA
AROM of both UE & limited walking with careful monitoring of symptoms
discuss the process for creating ROM program
examine and evaluate pt’s impairments and level of functions; precautions and contra
determine ability of pt to participate in ROM - PROM, AAROM, AROM
determine safe range
decide what patterns and techniques to be used
