LECTURE 2: ROM and Stretching Flashcards
ROM is what?
basic technique for examining movement/initiating movement into purposeful therapeutic intervention
functional excursion
distance muscle is capable of shortening after its been max elongated
passive insufficiency
ROM limited by lengthened muscle
A-AROM
motion combo of external force and active muscle contraction
PROM example in ther-ex technique
myofascial release
AROM example technique in ther-ex
ART
Indications for PROM
- recent repair/Sx
- ton of pain
- ASIA A: maintenance of joint mobility/ROM if pt cannot activate to avoid contracture
Indication for AROM/AAROM
ROM should not be done when
motion is disruptive to healing process!!!!
-follow specific precautions during early phases of healing
-ROM should not be done when PT’S RESPONSE/CONDITION IS LIFE THREATENING
(broken rib)
If you check AROM and PROM, they are similarly limted, they have a
passive limitation
(capsule, ligament
If you check AROM and PROM is much higher, then they have a
muscle problem
what is a CPM?
passive motion mechanical device moving joint slowly and continously through pre-set, controlled ROM
-for when there is a risk of scarring down with contracture
benefits of CPM
-prevent adhesions, contractures
-brings healing through blood (stimulate healing of tendons, ligaments, healing of incisions, increase synovial fluid)
-prevent degrading effects of immob
-quicker return to ROM
-decrease post-op pain
acute general ROM exercise Rx
PROM 3-5 reps within pain tolerance
several x/day
subacute general ROM exercise Rx
PROM–>AAROM–>AROM
gravity eliminated then antigravity (no cheat)
10-15 reps, brief hold periods (3-5 seconds) within pain free range 2-3x/day
chronic AROM
over 30 reps for mm re-ed
maintain ROM
stretching to gain ROM
stretching is
increasing soft tissue mobility to improve ROM by lengthening structures that have shortened and become hypomobile over time
FOR CHRONIC STAGE
flexibility
related to muscle shortness
-dynamic and passive
hypomobility
limited arthrokinematic movement of joint
contractures
designated by location and position the joint is “stuck in”
myostatic contracture
MT unit shortened
pseudomyostatic contracture
hypertonicity due to CNS lesions (CVA, TBI, SCI)
arthrogenic and periarticular contractures
passive structures!
Adhesions, synovial proliferation, joint effusion, osteophytes
fibrotic contracture/irreversible contracture
fibrous changes in connective tissue leads to adhesions
selective stretching
TENODESIS
Purposefully stretch or mobilize certain muscles and joints while letting others become hypomobile to improve function
manual or mechanical stretching
use external force to perform passive stretch
PROM
types of stretching
manual stretching
passive stretching
assisted stretching
indications for stretching exercises
adhesions, contractures, scar tissue
muscle weakness/shortening of muscles
part of total fitness program
pre-post vig exercise
contraindications for stretching exercise
Bony Block
Non-Union Fracture
Acute Inflammation or Infection : will spread it!
Sharp or Acute Pain With Elongation
Hematoma or Tissue Trauma
Hypermobility
Hypomobility Provides Stability or Neuro-muscular Control
benefits and outcomes for stretching exercises
increased flexibility and ROM
general fitness
other benefits: injury prevention (evidence not shown for passive stretching techniques), reduced post-exercise soreness, enhanced performance
elasticity: temporary change in tissue length then return to previous length once force is removed
viscoelasticity
Only non-contractile connective tissue
Non-contractile connective tissue initially resists stress and strain
Tissue lengthens as the stress is repeated to the tissue
Dependent on velocity, direction, magnitude of force, and tissue temperature
plasticity
permanent change in tissue length
