Académique Documents
Professionnel Documents
Culture Documents
the cellular level. The musculoskeletal changes in available ROM. If the many
components of the joint can actually joints of the hands are affected by
A client’s level of lose their ability to stretch and become arthritis, tasks such as buttoning a shirt,
permanently shortened. This new opening a jar, writing a letter or holding
function will influence alignment of the joint surface is called a
contracture.
a fork challenge the individual. Likewise,
if the knee joints are affected, movement
in and out of a car, on and off a chair or
the way ROM Cellular changes also take place in the toilet, or up and down a staircase or
skin overlying the contracted joint. As sidewalk curb becomes difficult.
problems are addressed. the skin remains folded upon itself for
an extended period of time, it becomes Clearly, any person who maintains
Some of the many moist and malodorous. Eventually,
the skin breaks down and, as healing
a sedentary lifestyle risks ROM
limitations. Health and wellness
occurs, reestablishes to mimic the new professionals can help these
variables that need to musculoskeletal formation of the individuals to maximize movement,
contracture. thereby improving function and quality
be considered when of life.
Typically, splints, positioning and
designing a com- routine ROM are used to prevent
contractures and subsequent skin
Programs to address
diminished range of motion
breakdown. Once decreased ROM is identified, the
prehensive plan of care health or wellness professional should
Functional problems. Limited range of conduct a comprehensive client
include available motion can substantially hinder daily evaluation to determine the root
function such as bathing, dressing or cause(s), in order to design a program
strength, ROM, walking. An example of functional
difficulties as they relate to ROM
that addresses limitations. Is the root
cause for ROM decline due to an
limitations is a change in posture. An individual sitting in a recliner chair all
proprioception, older female client often has forward, day and seldom moving? Has a broken
rounded shoulders. The forward hip prevented a person’s leg from
sensation, current position of the shoulders creates a need bearing weight, and now the joints are
for her to raise her head in order to see painful, swollen and stiff? Or is an
functional level, prior properly. This alignment of the shoulder
joint anatomically prevents her from
independent older adult experiencing
ROM loss from a long-term lack of
completely raising her arm overhead. A physical activity? Once professionals
functional level and ROM limitation such as this can create know the cause of ROM loss, they can
difficulty in retrieving clothes from a create a plan or program to tackle the
cognitive ability. closet, reaching items on a high shelf, or problem.
even putting on an overhead sweater or
shirt. The alignment of the client’s A client’s level of function will influence
head to enable vision, now creates the way ROM problems are addressed.
compression on the joints and nerves in Some of the many variables that need
Contractures and skin breakdown. the back of the neck. This compression to be considered when designing a
Many changes occur when a joint can lead to a variety of symptoms, comprehensive plan of care include
remains immobile for an extended including headaches, and pose available strength, proprioception,
period of time. Most obvious is that the challenges with nerves and muscles ROM, sensation, current functional
joint itself becomes stiff and painful to in the arms. level, prior functional level and
move. The muscles that surround the cognitive ability.
joint become tight and do not slide as Many functional limitations result from
easily upon one another to produce arthritis. Painful, swollen joints limit Regardless of the client’s functional
movement. Eventually, changes occur at movement, eventually leading to level, professionals such as therapists
Pages 2–3
NuStep
Page 5
and fitness specialists specialize in stand to gain much more than Star Trac
developing individualized plans of care improved ROM by participating in
aimed at optimizing functional abilities these programs. Page 7
and improving quality of life. Treatment Technogym
strategies could incorporate stretching, Range of motion and
strengthening, functional mobility quality of life Page 9
training, balance reeducation or other Range of motion is pivotal to FreeMotion
advanced techniques. (See sample optimizing safe functional mobility,
Page 11
exercises on pages 54–55.) especially for older adults. Deficits in
LifeTrail
certain functional mobility skills, which
In addition to working on ROM, can result from ROM loss, can inhibit Page 12
professionals should encourage aging independence, socialization and STOTT Pilates
clients to participate in general fitness or overall quality of life. When ROM
wellness programs, to help them attain diminishes, additional problems may Page 13
their highest level of function. occur throughout the body. The Biodex
resulting ripple effect can debilitate
Preventing range of aging adults. Page 15
motion loss The Core
Health and wellness professionals No matter the setting, programs
Page 19
should aim to prevent ROM limitations established to prevent or address ROM
First Step to Active Health
in older clients. In individuals with low problems can greatly improve the
function, professionals might focus on quality of life for older adults. By Page 21
positioning to ensure proper body helping individuals maximize ROM, HOGGAN Sprint
alignment and joint integrity, and/or health and wellness professionals can
splinting and contracture management help their clients enjoy a full, active life Page 25
to prevent further range of motion loss. at any age. Fit Express
Programs for aging clients with higher
function might focus on improving Lisa Jenkins, M.P.T., is a clinical specialist Page 29
performance in activity-specific tasks. for the Eastern Division of RehabWorks, Miracles
Individualized fitness or wellness the largest contract therapy providers
Page 32
programs help avert ROM problems, in the United States’ long-term care Cooper Ventures
in addition to providing many other industry. She is also a certified clinical
health benefits. instructor. Jenkins has 10 years experience Page 37
in both the physical therapy field and Jazzercise
Fitness or wellness programs that management. She can be reached via
incorporate fun activities using mobility www.rehabworks.com. Page 43
to improve strength, stamina, balance ICAA
and flexibility are typically most References
successful at helping older individuals Page 49
become active. Programs that encourage 1. National Institute on Aging, U.S. Department Med-Fit Systems
adults to get moving include general of Health and Human Services, National
Institutes of Health, 2002. Available at Page 62
fitness, walking, yoga, water aerobics, tai www.nia.nih.gov AARP
chi, golf, line dancing and bowling, 2. National Institute of Neurological Disorders
among others. In fact, health and and Stroke. “NINDS Thoracic Outlet
Page 69
wellness professionals are wise to Syndrome Information Page.” Available at
www.ninds.nih.gov/disorders/thoracic/ Walk 500
incorporate a variety of activities that thoracic.htm
focus on safely improving their older Page 71
clients’ strength, endurance, fitness, Keiser
flexibility and balance. Aging adults
Page 72
Life Fitness
Continued on page 54