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ROM
Is basic technique used for the examination of movement and for initiating
movement into a program of therapeutic intervention.
Movement that is necessary to accomplish functional activities can be viewed, in its
simplest form, as muscles or external forces moving bones in various patterns or
ranges of motions.
Functional excursion (range of a muscle)
is the distance a muscle is capable of shortening after it has been elongated to its
maximum.
directly influenced by the joint it crosses.
Active Insufficiency
muscle shortens to a point where it can shorten no more
Passive Insufficiency
muscle elongates to a point where it can elongate no more
1. Passive ROM
o is movement of a segment within the unrestricted ROM that is produced
entirely by an external force; there is little to or no voluntary muscle
contraction.
External Forces- machine, another individual, another part of
individuals own body
Indications:
Passive motion is beneficial to acute inflamed tissues.
Active motion would be detrimental to the healing process.
Inflammation after injury or surgery usually lasts 2 to 6 days.
When a patient is not able to or not supposed to actively move a
segment or segments of the body, as when comatose, paralyzed, or on
complete bed rest, movement is provided by an external source.
Goals:
Main goal is to decrease the complications that would occur with
immobilization
Maintain joint and connective tissue mobility
Minimize the effects of the formation of contractures
Maintain mechanical elasticity of muscle
Assist circulation and vascular dynamics
Enhance synovial movement for cartilage nutrition and diffusion of
materials in the joint
Decrease or inhibit pain
Assist with the healing process after injury or surgery
Help maintain the patients awareness of movement
Other Uses:
Inert structures examination - determine limitations of motion, to
determine joint stability, and to determine muscle and other soft
tissue elasticity
PROM used for demonstration for active exercise program
PROM before passive stretching techniques
2. Active ROM
TERMS:
MOBILITY
described based on two different but interrelated parameters.
often defined as the ability of structures or segments of the body to move or be
moved to allow the presence of range of motion for functional activities (functional
ROM)
ability of an individual to initiate, control, or sustain active movements of the body to
perform simple to complex motor skills (functional mobility)
HYPOMOBILITY (restricted motion)
caused by adaptive shortening of soft tissues can occur as the result of many
disorders or situations.
Factors:
o prolonged immobilization of a body segment
o sedentary lifestyle
o postural malalignment and muscle imbalances
o impaired muscle performance (weakness) associated with an array of
musculoskeletal or neuromuscular disorders
o tissue trauma resulting in inflammation and pain, and
o congenital or acquired deformities.
FLEXIBILITY
is the ability to move a single joint or series of joints smoothly and easily through an
unrestricted, pain-free ROM.
DYNAMIC FLEXIBILITY
o Referred to as active mobility or active ROM, is the degree to which an
active muscle contraction moves a body segment through the available
ROM of a joint.
PASSIVE FLEXIBILITY
o also referred to as passive mobility or passive ROM, is the degree to
which a joint can be passively moved through the available ROM
o dependent on the extensibility of muscles and connective tissues that
cross and surround a joint. Passive flexibility is a prerequisite for but does
not ensure dynamic flexibility.
SELECTIVE STRETCHING
is a process whereby the overall function of a patient may be improved by applying
stretching techniques selectively to some muscles and joints but allowing limitation
of motion to develop in other muscles or joints.
CONTRACTURE
Is defined as the adaptive shortening of the muscle-tendon unit and other soft
tissues that cross or surround a joint that results in significant resistance to passive
or active stretch and limitation of ROM, and it may compromise functional abilities.
Complete loss of motion; shortness,partial loss of motion
TYPES OF CONTRACTURE
1) Myostatic (myogenic) contracture
the musculotendinous unit has adaptively shortened and there is a significant loss
of ROM, there is no specific muscle pathology present
INDICATIONS and
CONTRAINDICATIONS
STRESS-STRAIN CURVE
TYPES OF STRESS
1) Toe region
considerable deformation without the use of much force is called the toe
region.
most functional activity normally occurs.
2) Elasticity range/linear phase
Strain is directly proportional to the ability of tissue to resist the force.
This occurs when tissue is taken to the end of its ROM, and gentle stretch is
applied
complete recovery from this deformation, and the tissue returns to its
original size and shape when the load is released if the stress is not
maintained for any length of time
3) Elastic Limit
point beyond which the tissue does not return to its original shape and size is
the elastic limit.
4) Plastic range
The range beyond the elastic limit extending to the point of rupture is the
plastic range
5) Ultimate strength
Greatest load a tissue can sustained
increased strain (deformation) without an increase in stress required.
region of necking is reached in which there is considerable weakening of the
tissue, and it rapidly fails.
6) Failure
Rupture of the integrity of the tissue
7) Structural stiffness
Slope of the linear portion of the curve (elastic range) is known as Youngs
modulus of elasticity and represents the stiffness of the tissue
TYPES OF STRETCHING
1) Static stretching
commonly used method of stretching in which soft tissues are elongated just
past the point of tissue resistance and then held in the lengthened position
with a sustained stretch force over a period of time.
2) Static progressive stretching
is another term that describes how static stretch is applied for maximum
effectiveness. The shortened soft tissues are held in a comfortably
lengthened position until a degree of relaxation is felt by the patient or
therapist.
3) Cyclic (Intermittent) Stretching
A relatively short-duration stretch force that is repeatedly but gradually
applied, released, and then reapplied is described as a cyclic (intermittent)
stretch.
applied for multiple repetitions (stretch cycles) during a single treatment
session.
the end-range stretch force is applied at a slow velocity, in a controlled
manner, and at relatively low intensity
4) Ballistic Stretching
rapid, forceful intermittent stretchthat is, a high-speed and high-intensity
stretc
quick, bouncing movements that create momentum to carry the body
segment through the ROM to stretch shortened structures
5) Manual Stretching
a therapist or other trained practitioner or caregiver applies an external force
to move the involved body segment slightly beyond the point of tissue
resistance and available ROM.
therapist manually controls the site of stabilization as well as the direction,
speed, intensity, and duration of stretch.