ROM Flashcards
Cardinal Planes of Motion
- Sagittal: flexion and extension
- Frontal: abduction and adduction, lateral flexion of the spine, wrist ulnar and radial deviation
- Transverse: internal and external rotation, spinal rotation, forearm supination and pronation
- Triplanar: foot inversion and eversion
ROM vs stretching
Stretching moves into overpressure, ROM does not.
We measure ROM in non diagonal ROM, but ____ we do.
functionally
Example:
UE: Reaching for something in the fridge
LE: Kicking, putting on pants, getting in a car
Joint vs Muscle Range
If a muscle crosses more than one joint,
* Lengthen over both joints simultaneously to assess muscle range.
* Slacken over one joint to assess joint range.
- In Picture on Left, hip joint flexion is limited by tightness of the hamstrings.
In Picture on Right, the flexed knee puts the hamstrings on slack and allows the hip joint to reach full flexion.
Active Assisted ROM
requires external force through part of the range
Benefits of ROM - PROM and AROM
PROM
* Stimulates tissue healing
* Prevents adhesions and joint stiffness
AROM
* Helps maintain health, integrity, and elasticity of tissues
* Increases sensory input
* Promotes tissue alignment
* “Skeletal muscle pump” enhances local circulation
PROM Indications
- When the patient’s own muscle force cannot produce safe, effective motion at the joint
- When active muscle contraction would be harmful
- As an assessment technique (Joint mob, joint stability)
- As an intervention (contracture risk, AROM would damage tissue)
PROM - Precautions
- When it temporarily increases patient’s pain
- When it elicits undesired muscle tone
PROM Contraindications
- When motion will interfere with tissue healing
- In the presence of extreme muscle guarding
- When strong muscle guarding is accompanied by increased pain
PROM Dosage
To promote early tissue healing
* Low Intensity (without resistance)
* High Frequency (20-30 reps)
Orthopedic conditions:
* Generally, 5 to 12 repetitions
* Approximately 5 to 10 seconds per cycle (peforming the full range in this time for a rep)
* Generally, 3 to 5 times/week
Some neurological conditions (e.g., cerebral palsy)
* Repetitions tend to be slower, with a sustained hold of 20 to 60 seconds at end range (not overpressure).If you went faster may activate spasticity (counterproductive to ROM)
AROM indications
- As an assessment technique
- As an intervention
- Preferbale when the patient is able to perform the movement safely, effectively, and without pain (AMAP/ANAP)
- Provides more stimulation to the bone, cartilage, and other tissues than PROM
AROM Precautions
- PROM precautions
- Generates undesired movements
- Physiological demands increase patient risk
AROM Contraindications
- PROM contraindications
- Pain throughout motion and/or persisting after the activity
- Development of dysfunctional muscle tone
- Cardiac distress
- Other adverse exercise responses (inflammation, effusion, etc.)
AROM Dosage
- Determined by patient responses
- Watch for:
– Fatigue
– Pain
– Changes in quality or accuracy of movement
– Changes in vital signs
Number of reps can vary from exercise to exercise based on their response/ability
How do you chose a plan of motion?
Straight plane
* More specific and thorough
* Allows isolation of movements
* Appropriate for examination and treatment
* Can combine straight planemotions of 2 or more joints (hip and knee flexion)
Diagonals
* Closer to daily functional movement patterns
* Do not allow for isolation and therefore not appropriate for examination
* Three components, one from each cardinal plane