ROM Exercises and Techniques in Rehabilitation

ROM Exercises

• Definitions

  • ROM: Basic technique for examining movement.
  • ROMEx: Initiating therapeutic movement.
  • Functional excursion: Maximum muscle shortening after elongation.
  • Immobility: Physical restriction due to disease or treatment.

• Passive vs. Active Insufficiency

  • Active insufficiency: Multi-joint muscle shortens across all joints simultaneously, reducing its ability to generate optimal tension.
    • Example: Full shoulder flexion limits elbow flexion because biceps brachii assists with shoulder flexion.
  • Passive insufficiency: Multi-joint muscle lengthens across all joints, limiting range of motion.
    • Example: Finger extension is limited when the elbow is extended.

Precautions and Contraindications

• Should not disrupt healing.
• If response is life-threatening, discontinue.

Examination, Evaluation, and Treatment Planning

• Determine impairments and function level.
• Determine precautions, prognosis, and intervention plan.
• Determine participant's ability to perform ROM exercises.
• Decide on exercise patterns (anatomical plane, muscle range of elongation, combined patterns, functional patterns).
• Monitor patient condition and response.
• Document and communicate findings.
• Re-evaluate and modify intervention as needed.

Patient Preparation

• Communicate intervention plan.
• Remove restrictive clothing.
• Position patient comfortably, maintaining alignment and stabilization.

Application (L Posture)

• Stabilize and support appropriate joint areas.
• Perform movements smoothly and rhythmically (5-15 repetitions).
• Adjust as needed.

Passive Range of Motion (PROM)

• Movement of a segment within unrestricted ROM entirely by an external force.
• Little to no voluntary muscle contraction.
• Applications include when active motion disrupts healing, patient is unable or not supposed to actively move body part, assessment purposes, and preparation for stretching.

Limitations of PROM

• Difficulty obtaining true passive ROM when muscles are innervated and patient is conscious.
• Does not prevent muscle atrophy, increase strength/endurance, or assist circulation.

Active-Assistive Range of Motion (AAROM)

• Assistance provided by an outside force (manual or mechanical) when prime mover muscles cannot complete motion.

Active Range of Motion (AROM)

• Movement produced by active contraction of muscles.
• Within unrestricted ROM.

Continuous Passive Motion (CPM)

• Passive motion performed by a mechanical device, moving a joint slowly and continuously.
• Developed for healing effects on joint structures and soft tissues.

Indications and Benefits for Various Techniques

• Detailed information on specific indications and benefits of each technique, such as PROM, AROM, and CPM, and their use in different situations is available in the text.