Passive Movements - Week 1

Question 1

Where does movement occur in the body?

Answer 1

At joints e.g. flexion of elbow

Question 2

What is required to achieve a joint movement?

Answer 2

Passive structures, muscles, nerves & circulation, spinal cord and brain areas.

Question 3

Define: Passive movement

Answer 3

Movement of a joint without muscle activity from the patient (movement produced by the therapist/mechanical device)

Question 4

Active-Assisted movement

Answer 4

Produced by the patient with help from the therapist (patient is unable to complete the movement without assistance)

Question 5

Active movement

Answer 5

Produced by the patient’s own muscles (assistance not required to produce joint movements)

Question 6

When might a therapist need to use passive movements?

Answer 6

When there is a restriction in the following areas: muscle activation, muscle length, nerves, spinal cord, brain areas, consciousness.

Question 7

Aims of passive movement treatment

Answer 7

Maintenance of:
Joint ROM, muscle length / soft tissue extensibility, circulation

Restoration of:
Joint ROM, muscle length / soft tissue extensibility

Question 8

Passive movements can be used for the assessment of: (4)

Answer 8

Joint ROM, muscle length, muscle tone e.g. Parkinsons, pain e.g. spinal joint movement

Question 9

Contraindications & precautions for passive movements (muscular)

Answer 9

Following tendon reconstruction, myositis ossificans, acute muscle spasm

Question 10

Contraindications & precautions for passive movements (joint)

Answer 10

Infection, carcinoma, acute haemarthrosis

Question 11

Contraindications & precautions for passive movements (bone)

Answer 11

Recent fracture, marked osteoporosis

Question 12

Potential positive effects of P.Ms

Answer 12

Reduce spasticity (high muscle tone), decrease or inhibit pain, maintain awareness of movement, Re-activate brain and CNS circuits e.g. after stroke

Question 13

P.M technique

Answer 13

Performed at a single joint with an isolated movement for 3+ repetitions (reps change dependent on client)

Question 14

Therapist position for P.M

Answer 14

Bed should be at appropriate height, and sufficient eye contact for effective communication.
Good balanced posture, feet in line with direction of movement, allows weight transference, close to the patient

Question 15

Therapist handling PM

Answer 15

Firm, comfortable, lumbrical grip
Position hands to localize the movement to specific joint, hands close to joint, proximal body park stabilised and distal supported.

Question 16

Patient position for PM

Answer 16

Expose the joint you are mobilising, drape as required, comfortable position, allows full ROM, no clothes restrictions, note presence of splints or dressings that may limit ROM

Question 17

Movement technique for PM

Answer 17

Slowly, smoothly & rhythmically
Through full range of available movement
Slight overpressure at end of ROM
Monitor for pain / discomfort throughout