ROM Flashcards

1
Q

Cardinal Planes of Motion

A
  • 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
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2
Q

ROM vs stretching

A

Stretching moves into overpressure, ROM does not.

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3
Q

We measure ROM in non diagonal ROM, but ____ we do.

A

functionally

Example:
UE: Reaching for something in the fridge
LE: Kicking, putting on pants, getting in a car

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4
Q

Joint vs Muscle Range

A

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.
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5
Q

Active Assisted ROM

A

requires external force through part of the range

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6
Q

Benefits of ROM - PROM and AROM

A

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

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7
Q

PROM Indications

A
  • 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)
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8
Q

PROM - Precautions

A
  • When it temporarily increases patient’s pain
  • When it elicits undesired muscle tone
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9
Q

PROM Contraindications

A
  • When motion will interfere with tissue healing
  • In the presence of extreme muscle guarding
  • When strong muscle guarding is accompanied by increased pain
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10
Q

PROM Dosage

A

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)

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11
Q

AROM indications

A
  • 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
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12
Q

AROM Precautions

A
  • PROM precautions
  • Generates undesired movements
  • Physiological demands increase patient risk
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13
Q

AROM Contraindications

A
  • 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.)
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14
Q

AROM Dosage

A
  • 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

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15
Q

How do you chose a plan of motion?

A

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

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16
Q

In order to get from 60-120 degrees of shoulder flexion utilization of the ____ is necessary.

A

Scapula.

If you don’t get it moving can cause an impingement with the acromion.

17
Q

Body Mechanics during ROM

A
  1. Have the patient close to you.
  2. Stand with a wide base of support (BoS), generally facing in the direction of movement
  3. If supervising AROM, position yourself to allow full AROM while still able to monitor the activity and guard as needed.
18
Q

ROM Procedure

A
  • Stabilize the proximal joint.
  • Use a lumbrical grip.
  • Control passive movements centrally (CCDD).
  • Direct active movements distally (CCDD).
  • AMAP/ANAP (as much as possible, as naturally as possible)
  • Use a systematic approach
  • Proximal to distal OR Distal to Proximal
19
Q

PROM Procedure

A
  • Move patient through range slowly and with brief hold at end range (but not beyond).
  • Monitor the patient’s response to activity
20
Q

AAROM Procedure

A
  • Have patient start movement as able
  • Have your hands / body in ready position to assist as needed
  • Assist patient through parts / whole ROM as needed
    – May be that patient is weak throughout range, so needs support throughout
    – May be that patient is weak only at certain points in the range and needs intermittent support
  • Monitor patient response / compensatory movements

Example: Use a towel on a slideboard to decrease friction, using a gait belt, little wheels, bz board.

21
Q

AROM Procedure

A
  • Instruct patient in movement
  • Watch for movement form and quality
  • Be ready to provide support / guidance as needed
  • Monitor patient’s response to activity
22
Q

Codman’s Pendulum Exercise

A
  • Example of shoulder passive or very early active-assisted ROM
  • Patient (prone or standing) allows the arm to hang down and initiates very small shoulder movements, assisted by gravity and lower body movement.

Move lower body to get upper body moving. People with high tone can put a weight in the hand so get them sto straighten out then move into circles.

23
Q

Observations and Findings

A
  • Quantity of movement
  • Quality of movement
  • Patterns of movement
  • End Feel
  • Pain
  • Msucle tone, spasms, guarding
  • Audible sounds