Range of Motion and Passive Movement Quiz

Range of Motion (ROM)

• ROM is the amount of movement at a joint.
• Tissue flexibility allows tissues (muscles, tendons) to lengthen for normal joint motion.
• Joint structure and soft tissue integrity affect ROM.
• Maintaining normal ROM requires periodic movement through available ranges.
• Decreased ROM can result from disease, injury, inactivity, or immobilization.
• Therapeutic ROM activities maintain joint and soft tissue mobility, minimizing contractures.
• ROM is limited by joint capsules, ligaments, tendons, bony configuration, and soft tissue bulk.
• Joint surface shape dictates movement direction; disease or trauma can alter this.
• Hypermobility exceeds normal ROM; hypomobility is less than normal ROM.

Passive Movement (PROM)

• PROM is movement produced entirely by external force, without voluntary muscle contraction.
• External forces include gravity, machines, another person, or another body part.
• Relaxed PROM maintains unrestricted ROM.
• PROM for stretching increases restricted ROM to full ROM.
• PROM for mobilization breaks down adhesions and increases ROM.
• Relaxed PROM characteristics: slow, rhythmic, regular, within available ROM.

Goals of PROM

• Maintain joint and connective tissue mobility and unrestricted ROM.
• Minimize contractures and adhesion formation.
• Maintain muscle mechanical elasticity (ability to return to original length and shape).
• Assist circulation and vascular dynamics.
• Enhance cartilage nutrition and synovial fluid movement.
• Decrease or inhibit pain.
• Assist healing after injury or surgery.
• Maintain patient’s awareness of movement.
• PROM exerts mechanical pressure, stretching thin-walled vessels, assisting venous and lymphatic return, reducing edema.

Indications for PROM

• Acutely inflamed tissue (inflammation after injury or surgery usually lasts 2-6 days).
• Coma.
• Paralysis.
• Complete bed rest.
• Muscle re-education.

Other Uses for PROM

• Examination: determining limitations of motion, joint stability, muscle and soft tissue elasticity.
• Demonstrating desired motion during active exercise programs.
• Maintaining ROM and muscle extensibility, preventing adaptive shortening and adhesion formation.
• Preserving memory of movement patterns in paralysis, stimulating kinesthetic receptors.
• When patients can't actively move body segments.
• Complete immobility leads to adhesions, contractures, sluggish circulation, and prolonged recovery.

Limitations of Passive Motion

• Does not prevent muscle atrophy, increase strength or endurance, or assist circulation as effectively as active muscle contraction.
• Muscular strength is maximal voluntary tension or force.
• Muscular endurance is ability to perform repeated contractions or maintain isometric contraction.

Contraindications to PROM

• Immediately after acute tears, fractures, surgery (recent injury).
• Motion disruptive to healing.
• Fever.
• Acute inflammation.
• Increased blood pressure.
• Deep venous thrombosis.
• Open wounds.
• Severe pain.

Precautions for PROM

• Early, continuous PROM within pain-free limits benefits healing and recovery.
• Controlled motion decreases pain and increases recovery rate.
• Monitor patient tolerance; increased pain or inflammation indicates stopping.

Principles and Procedures for Applying PROM

• Therapist needs knowledge of anatomy (joint motions, normal ROM, muscle origin/insertion, function).
• Explain purpose and method.
• Position patient comfortably with proper body alignment, allowing for ROM.
• Position yourself for proper body mechanics.
• Support body part and grasp comfortably near the joint.
• Use both hands to support, grasping above and below.
• Grasp should be firm but not harmful.
• Apply traction to distal segments to reduce friction.
• No active resistance.
• Move through pain-free ROM to tissue resistance, not beyond.
• Movement direction is the same as active movements.
• Relaxed movement is slow and rhythmic, 5-10 repetitions (depending on patient).

Continuous Passive Motion (CPM)

• Mechanical device for slow, rhythmic, continuous movement through a controlled ROM.

Test your knowledge on the concepts of Range of Motion (ROM) and Passive Range of Motion (PROM). Understand the factors that influence joint movement, the effects of inactivity, and the importance of therapeutic activities. This quiz will help solidify your understanding of these essential concepts in physical therapy.