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PT 116 > Kisner Ch 3- ROM > Flashcards

Kisner Ch 3- ROM Flashcards

1
Q

What is functional excursion

A

the distance a muscle is capable of shortening after it has been elongated to its maximum

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2
Q

Types of ROM?

A

Passive ROM
Active ROM
Active Assisted

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3
Q

Indications for PROM?

A

Acute, inflamed tissue, passive motion is beneficial

When are pt. is not able to or not supposed to move actively

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4
Q

Goals of PROM

A

Maintain joint and connective tissue mobility
Minimize the effects of the formation of contractures
Maintain mechanical elasticity of muscle
Assist circulation & vascular dynamics
Enhance synovial movement for cartilage nutrition & diffusion of materials in the joint
Decrease or inhibit pain
Assist w/ the healing process after injury
Help maintain the patient’s awareness

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5
Q

What are limitations of PROM?

A

Passive motion does not:
Prevent muscle atrophy
Increase strength or endurance
Assist in circulation to the extent that active, voluntary muscle contraction does

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6
Q

Indications for AROM & AAROM

A

When the pt. is able to contract the muscles actively

Use AAROM when the patient’s musculature is too weak or unable to move joint through the desired range

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7
Q

Goals of AROM & AAROM

A

Maintain physiological elasticity & contractility of muscles in use
Provide sensory feedback from the contracting muscles
Provide a stimulus for bone & joint tissue integrity
Increase circulation & prevent thrombus formation
Develop coordination and motor skills for functional activities

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8
Q

Precautions & Contraindications to ROM exercises

A

ROM should not be done when motion is disruptive to the healing process
Use carefully controlled motions with in pain free range
Too much wrong motion will increase pain & inflammation
ROM should not be done when pt. response or the condition is life threatening
PROM may be carefully initiated to major joints
AROM to ankles & feet to minimize venous stasis & thrombus formation

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9
Q

What types of activities can be done after myocardial infarction, coronary artery bypass surgery or percutaneous transluminal coronary angioplasty?

A

AROM of the UE & limited walking

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10
Q

Principles & Procedures for applying ROM techniques

A

Evaluate pt. impairments & level of function
Determine ability of pt. to participate in ROM activity and amount of motion that can be safely
Decide what patterns best meet the goals; ADLs, muscle range elongation, anatomical planes, diagonal motions
Monitor pt. response during and after intervention
Document
Re-evaluate and modify intervention, if necessary

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11
Q

How do you prepare the patient for ROM activities?

A

Describe the plan and goals w/ patient
Free the region from restrictive clothing, linen, splints, & dressings
Position pt. in comfortable position w/ proper body alignment & stabilization
PT position to use proper body mechanics

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12
Q

Application of PROM

A

PT moves through ROM
No active resistance or assistance is given by the pt’s muscles
Motion carried out in the free ROM- the range available w/o forced motion or pain

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13
Q

Application of AROM

A

Demonstrate to pt desired motion using PROM, then ask pt to perform motion
PT provides assistance only as needed for smooth motion
Motion performed within available ROM

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14
Q

What are forms of self-assisted ROM?

A

Wand, finger ladder, wall climbing, ball rolling, pulleys, skateboard/ powder board, reciprocal exercise devices

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15
Q

What is continuous passive motion (CPM)?

A

passive motion performed by a mechanical device that moves a joint slowly and continuously through a controlled ROM

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16
Q

Benefits of CPM

A

Prevents development of adhesions & contractures thus joint stiffness
Provides a stimulating effect on the healing of tendons and ligaments
Enhances healing of incisions over the moving joint
Increases synovial fluid lubrication of the joint and thus increase the rate of intra-articular cartilage healing & regeneration
Prevents degrading effects of immobilization
Provides a quicker return of ROM
Decreases postoperative pain

17
Q

Static stretching

A

Place muscle in elongated position
Pt. should feel mild tension (NOT DISCOMFORT)
Hold for 30 sec/ 3-5 times

18
Q

Ballistic stretching

A

Get into elongated position of muscle & bounce into a more elongated position
repeat 10 to 15 times

19
Q

Why is ballistic stretching dangerous?

A

Ballistic stretching may activate the muscle spindle that would in turn cause the muscle to actually resist the stretch
May increase risk of injury or cause microscopic trauma to muscle

20
Q

In what situations would you NEVER use ballistic stretching?

A

Injured muscle or tendon

Sedentary, unconditioned, elderly persons, or persons w/ altered cognitive or sensory systems

21
Q

What is an alternate technique for ballistic stretching?

A

Static stretching that gradually works up to faster oscillations at end range

22
Q

Who is ballistic stretching best used for?

A

In athletes that require rapid end range responses that are ballistic in nature

23
Q

What was PNF designed to influence? How?

A

Muscle performance

By providing input to the kinesthetic and proprioceptive sensors

24
Q

What can PNF be used for?

A

ROM, strengthening, or stretching

25
Q

Describe the PNF technique?

A 
Brief contraction (isometric or concentric) before a brief static stretch
Called contract- relax
26
Q

What is PNF autogenic inhibition?

A

By fatiguing the AGONIST you will get relaxation in the agonist muscle, making it easier to stretch

27
Q

What is the autogenic inhibition technique?

A

Passively move joint to elongated position
ISOMETRIC contraction of AGONIST in elongated position for 10 sec
Followed by instruction to relax
Passively move into a MORE elongated position & hold for 10 to 15 sec
Repeat 3-5 times

28
Q

What is PNF reciprocal inhibition?

A

Fatiguing the ANTAGONIST will cause it to relax so that the agonist can contract and produce motion

29
Q

What is the reciprocal inhibition technique?

A

Passively move joint to elongated position
CONCENTRIC contraction of ANTAGONIST in elongated position for 10 sec
Followed by instruction to relax
Passively move into a static stretch & hold for 10 to 15 sec
Repeat 3-5 times

30
Q

What is Combination PNF?

A

Combines both Autogenic & Reciprocal techniques

31
Q

Combination PNF technique

A

Alternates using Autogenic for 1 repetition then Reciprocal

Repeated for 3 to 5 times

32
Q

Age related considerations

A

Geriatrics decreased soft tissue flexibility
Stretching weakness phenomena- aging and disuse of muscle alters performance
Recommendations: functional flexibility training or dynamic flexibility + AROM to end ROM and static stretching
Pediatrics developing muscles are maximally flexible
Use static and PNF stretching techniques over ballistics

PT 116 (8 decks)

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