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therapeutic exercise

Range of Motion: Basic technique used for examination of movement and as an intervention to initiate movement early in the rehab process.
Range of Motion Exercise does 3 things: 1. Maintains joint and soft tissue mobility; 2. Minimizes loss of tissue flexibility ; 3. Reduces risk of contracture formation
3 Types of ROM: Passive Range of Motion (PROM) ; Active Range of Motion (AROM) ; Active-Assistive ROM (AAROM)
PROM: Movement of a segment within the unrestricted ROM produced entirely by an external force. External force may be: gravity, a machine, another person, another body part.
AROM: Movement of a segment within the unrestricted ROM produced by active contraction of the muscle(s) crossing the joint
AAROM: A type of AROM in which assistance is provided manually or mechanically by an outside force because of weakness in the prime movers
ROM should not be done when motion is __________ to the healing process (Bad) disruptive
During early phases of healing, carefully controlled motion within the limits of _____ ______ _______ is good. pain free motion
____________/____________indicate too much movement or the wrong movement. (bad) Increased pain / inflammation
ROM should not be done when the patient's response or the condition is________________ life threatening. (Bad!)
Careful PROM / AROM to ankles and feet can minimize risk _________________________ of DVT / clot formation (Good!)
After MI (heart attack) or cardiac surgery or procedures, carefully monitored ________of UEs and limited walking to tolerance are o.k. if carefully monitored. (Good) AROM
Determine the ability of the pt. to ___________ in ROM exercise participate
Determine the amount of motion that can be ___________applied safely
Select movement pattern. Potential patterns include: Anatomic Planes, Muscle Range of Elongation ,Combined Patterns (diagonals) , Functional Patterns
Monitor and note changes in : (6 things) vital signs, warmth, color, ROM, pain, or quality of movement.
Document and ______________ communicate.
_____________ intervention within plan of care as necessary. Modify
Tell patient what and_________ why
Properly expose ____________and drape treatment area
Position patient for _____________,_____________ and ___________ without limiting potential motion comfort, good alignment, support
Position yourself for best ____________ – adjust plinth if necessary body mechanics
Grasp ________ joints, or very near joints around
Support __________ areas (hypermobile joint, paralyzed limb, recent fracture) vulnerable
Move segment through its complete ___________ range TO the point of tissue resistance. (NO __________) pain-free - stretching
DO NOT force beyond ________ ____________. available range
____to_____ repetitions, smooth & rhythmic 5 – 10
PROM: force is ___________ external (therapist, machine, normal extremity)
PROM: NO active assistance OR ________ from patient resistance
PROM: Stay within ________ range. pain-free
AROM: Begin with _______ to demonstrate desired motion PROM
AROM:_______only as needed – if weak may need help at beginning or end of ROM only Assist
AROM: Stay within __________ range pain-free
Specific Techniques for UE, LE, C-spine, L-spine, combined patterns see TE videos & TE book ch.3: Upper extremity (pages 47 – 51); Lower extremity (pages 52 – 55) ; Cervical spine (page 55) ; Lumbar spine (pages 55 – 56); Combined patterns of motion (page 56)
(S-AROM) Self-Assisted ROM: Patient uses uninvolved extremity to move involved extremity through ranges of motion. Self-assistance (pages 56 – 59); Wand (T-bar) exercises (page 59 – 60); Wall climbing (page 60);Overhead pulleys (page 60); Skate board/Powder board (page 61); Reciprocal exercise unit (page 61)
(CPM)Continuous Passive Motion- Passive motion that is performed by a _________ device that moves a joint slowly and continuously through a pre-set, controlled range of motion mechanical
CPM can prevent __________and contractures adhesions
CPM stimulates ________ of tendons and ligaments healing
CPM ______________healing of incisions enhances
CPM increases __________ fluid lubrication synovial
CPM prevents degrading effects of ______________ immobilization
CPM facilitates quicker return of ___________ ROM
CPM decreases post-op ___________ pain
CPM may be applied while still ___________ ______________ under anesthesia
CPM-begin with a____ arc of motion, progress gradually low
CPM Rate: 1 cycle per _____ sec > 1 cycle per ____ minutes (Slower than PROM or AROM) 45 - 2
CPM can be used continuously or an __________at a time hour
PT ______________ when CPM unit is off treatments
Usually less than_____________ total duration 1 week
To see examples of CPM: www.medcomgroup.com OR Google Videos – "CPM Knee"
Created by: llacorte