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TE: ROM
therapeutic exercise
Question | Answer |
---|---|
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" |