Active Movements Lecture PDF

Active movements By Dr. Erum Naz(PT) Senior Lecturer DIPMR At the end of the lecture, the students should be able to: Differentiate the types of Active exercises in terms of – Principles – techniques – effects – Goals of Exercise – Indicati...

Active movements By Dr. Erum Naz(PT) Senior Lecturer DIPMR At the end of the lecture, the students should be able to: Differentiate the types of Active exercises in terms of – Principles – techniques – effects – Goals of Exercise – Indications – Limitations – Contraindications  WHAT IS EXRCISE???? planned, structured, and repetitive physical activity  Active Movements/Voluntary Movements Movement performed or controlled by voluntary action of muscle, working in opposition to external force.  Free exercises Classification Assisted exercises Assisted-resisted exercises Involuntary movements  Uses RELAXATION JOINT MOBILITY MUSCLE POWER AND TIME NEUROMUSCULAR COORDINATION COFIDENCE Circulatoryand Respiratorycooperation. – A. NEED OF ACTIVE TISSUE – B. PREPARATION FOR ACTIVITY. – C.LOCAL CIRCULATORY CHANGES: Regulation of circulatory and respiratory function  Free / Active Exercise work is performed only against gravity  Advantage CURE Great role in rehabilitation Patient can master the technique once performed  Indication When a patient is able to actively contract the muscles and move the segment with or without assistance Muscle weakness and inability to move segment completely against gravity Aerobic conditioning programs During periods of immobilization, AROM is used in joints above and below the immobilized segment PRECAUTIONS AND CONTRAINDICATIONS OF ROM EXERCISES Should not disrupt the healing process – Excessive movement/wrong performance of movement leads to increased pain and inflammation – Example ? Should not be done if response will be life-threatening to the patien. – Example ?  Limitations 1.maintain or increase strength of already strong muscles 2.develop skill or coordination except in the movement patterns used  Techniques 1. STARTING POSITION 2. Instruction to patient-----this will help to gain the interest and cooperation of the patient 3. Speed of exercises ----- it depend upon the effect required. Usually it is slow in the period of learning later on it is according to patients natural rhythm 4. Duration--- it depend on patients capacity. Usually three bouts with rest interval so as to avoid fatigue  Classification of free exercises Localized General  General exercises Subjective exercises Objective exercises  Assisted Exercises Incorporates help from an outside source (either human or mechanical) to complete the movement.  INDICATIONS OF AAROM Patient unable to complete ROM actively because of weakness due to : TRAUMA  Principle Of Assistance When the voluntary contraction of the muscle is insufficient to produce movement, An external force may be added to complete range.  Principle Of Assistance The magnitude of this assisting force must be sufficient only to augment the muscular action but not allowed to act as a substitute for it. As the muscular power is increasing, the assistance given must be decreased proportionally.  Techniques Of Active Assisted Exercises 1. Starting position: stability of the body is important to ensure that the patient’s attention is concentrated on the pattern of the movement and the effort required to perform it. 2. Pattern of movement: this can be explained to the patient by performing it passively or actively on the sound limb. 3. Fixation:Avoid trick movements to occur by proper fixation.  Techniques Of Active Assisted Exercises Support: the moved part should be supported to reduce the load on the muscle. Traction: preliminary stretching of the weak muscle provides a powerful stimulus to contraction because it stimulate the muscle spindle( Myotatic reflex) which helps in the initiation of movement.  Techniques Of Active Assisted Exercises The assistance force: the force used in assisting the action of the muscle must be applied in the direction of the movement by the PT hands. Repetitions: repetition of the movement depends on the condition of the patients The cooperation of patient: this is essential during this type of exercise. The patient should be encouraged to exert maximum effort.  Resisted Exercise Resisted exercise is performed against a force that tends to oppose the force of muscle contraction.  Reference Practical exercise therapy by Margaret Hollis 4th Ed. illustrated, reprint, Blackwell Scientific The principles of exercise therapy by: M. Dena Gardiner, 4th Edition. Questions ?