Transcript File
Physical Therapy Range of Motion Range of Motion (ROM) definition: exercising joints through the available motion to maintain available range and flexibility of joint structures Purpose of ROM maintain prevent joint movement and integrity deterioration of joint structures, ankylosis and contractures Indications for ROM patients bed rest on prolonged prevention of contracture stimulates circulation Types of ROM active (AROM) performed by patient patient moves the joints through available ROM maintains muscle strength and joint mobility Types of ROM active assistive (AAROM) performed by patient with assistance from another person or mechanical device patient uses stronger limb to move or support weaker limb practitioner completes movement through full available ROM Types of ROM passive (PROM) performed for patient by healthcare worker or caregiver moves all muscle groups within each plane over each joint does not maintain muscle strength maintains joint flexibility & integrity Types of ROM stretching forcing movement beyond the available ROM contraindicated for most healthcare personnel Principles of ROM Check doctor’s orders Know the patient diagnosis and rationale for ROM Explain the procedure to the patient Principles of ROM use good body mechanics expose limb being exercised support body part proximal to joint use slow smooth rhythmic motion Key Factors for ROM start ROM exercises on the unaffected side start each movement in neutral position use a firm comfortable grip while maintaining support of the extremity avoid forcing beyond range avoid overexerting patient avoid skin friction exercise just below point of pain, NOT beyond Key Factors for ROM if rigidity occurs slightly decrease ROM until it subsides stop if spastic contraction occurs talk to patient to help them relax expect heart rate and respirations to rise exercise 2-3x’s daily, 5-10 movements(see physician’s or Physical Therapist orders) document procedure & patient reaction Basic Terminology - ROM Flexion to bend a joint Extension to straighten a joint Abduction move away from midline of body Adduction move toward midline of body Basic Terminology - ROM Horizontal moving away from body in a transverse plane Horizontal Abduction Adduction moving toward body in a transverse plane Basic Terminology - ROM Rotation internal (medial) pivoting inward along an axis external (lateral) pivoting outward along an axis Basic Terminology - ROM Supination rotate forearm, palm up Pronation rotate forearm, palm down Opposition oppose thumb tip to base of little finger (may be done to each individual finger tip) Basic Terminology - ROM Eversion sole of foot turned outward at the ankle Inversion sole of foot turned inward at the ankle Dorsiflexion an upward or backward motion of the ankle towards the hips Plantar Flexion a toe down motion of the foot at the ankle Example of Flexion Elbow flexion bend Example of Flexion Knee flexion bend Example of Flexion Toes flexion bend Example of Extension Knee extension straight Example of Extension Head & Neck extension straight Example of Abduction Hip abduction away from midline of body Example of Adduction Toes adduction toward midline Examples of Rotation Head and Neck rotation turning part on its axis Left Right Example of Rotation Hip internal rotation pivoting inward Example of Horizontal Adduction Shoulder horizontal adduction toward body in transverse plane Example of Supination Forearm supination rotate forearm, palm up Example of Pronation Forearm pronation rotate forearm, palm down Example of Opposition Thumb opposition oppose thumb tip base of little finger or to finger tip of each individual finger Example of Eversion Ankle eversion sole of foot turned outward at the ankle Example of Inversion Ankle inversion sole of foot turned inward at the ankle Example of Dorsiflexion Ankle dorsiflexion an upward or backward motion of the ankle toward the hips Example of Plantar Flexion Ankle plantar flexion a toe down motion of the foot at the ankle