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msk2 > rom > Flashcards

rom Flashcards

1
Q

define ROM

A

full possible motion needed to accomplish functional activities

all about movement - referred as flex-ext, abd-add, rotation)

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2
Q

structures that affect ROM

A

muscles
synovial fluid and joint capsule
ligament
fascia
nerves and vessels

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3
Q

what is functional excursion

A

distance that muscle is capable of shortening after maximally elongated

range of muscle

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4
Q

exp 1 jointed muscle rom

A

muscle that proximal and distal attachments on the bones on either side of one joint - brachialis

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5
Q

exp 2 jointed muscle rom

A

muscles that cross over two or more joints - biceps and hamstrings

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6
Q

where does ideal length-tension relation exist

A

midportion of functional excursion

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7
Q

exp active insuff

A

2 jointed muscle cannot be shortened anymore - hamstrings in knee flexion & hip extension

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8
Q

exp passive insuff

A

2 jointed muscle cannot be elongated anymore - hamstrings in knee extension & hip flexion

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9
Q

factors that can lead to dec ROM

A

Systemic, joint, neurologic (e.g. stroke) or muscular disease

Surgical or traumatic insults (e.g. post-operative, acute stage or inflammatory stage of injury)

Inactivity or immobilization

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10
Q

general rationale of ROM exercise

A

MAINTAIN joint and soft tissue mobility/integrity

MINIMIZE loss of tissue flexibility and contracture formation

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11
Q

what is PROM

A

movement w/in pain-free range produced by external force

NO VOLUNTARY MUSCLE CONTRACTION

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12
Q

indications of PROM

A

acute, inflamed tissue

AROM will impede healing

not able to or not supposed to actively
move a segment - comatosed or bed rest

after surgical repair of contractile tissues

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13
Q

inflammation after injury or surgery
usually lasts

A

2-6 days

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14
Q

goals of PROM

A

maintain joint and tissue mob

minimize contractures/adhesions

maintain elasticity

assist in circulation - AROM > PROM

enhance synovial movement

dec or inhib pain

assist healing process

maintain pt awareness of movement

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15
Q

limitations of PROM

A

hard when pt is conscious or muscle is innervated

does not:
prevent atrophy
inc strength and endurance
assist circulation at same extent of AROM

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16
Q

what is AROM

A

movement produced by active contraction of muscles

info on muscle strength, coordination and function

17
Q

indications of AROM

A

pt is able to actively contract

improving cv and respi responses - done repeatedly

regions above and below of immmob area

aerobic conditioning

relieve stress from sustained postures

18
Q

limitations of AROM

A

strong muscles - does not maintain nor increase strength

does not develop skill or coordination except in the movement patterns used - functional > AROM

19
Q

what is AAROM

A

AROM with external assistance bcs prime mover needs it to complete ROM

either initiation, mid or end range

20
Q

indications of AAROM

A

weak musculature and unable to move joint through desired range against gravity

provide assistance so that muscles could function maximally and progressively strengthened

progressed to AROM then resistance exercises

21
Q

goals of AROM and AAROM

A

maintain elasticity and contractility of muscle

provides sensory feedback

provides stimulus for bone and soft tissue healing

inc circulation and prevents thrombus

develops coordination and motor skills

22
Q

precautions and contraindications of AROM and AAROM

A

if it will cause more trauma, disruptive to healing

signs of too much or wrong motion

not within pain free range

prevent DVT but not if may DVT na

23
Q

exp use of AROM after MI, CABG or PTCA

A

AROM of both UE & limited walking with careful monitoring of symptoms

24
Q

discuss the process for creating ROM program

A

examine and evaluate pt’s impairments and level of functions; precautions and contra

determine ability of pt to participate in ROM - PROM, AAROM, AROM

determine safe range

decide what patterns and techniques to be used

25
Q

what is manual assistance

A

for unilateral weakness or paralysis - pt is taught to use good extremity to assist the bad extremity in ROM

26
Q

discuss wand or t-bar

A

indicated when pt has voluntary muscle control but needs guidance/motivation to complete ROM

for shoulder and elbow

max protection - supine bcs sitting or standing requires more control

27
Q

discuss finger ladder

A

for shoulder flexion and abd - provides visual feedback for height reached

avoid substitute trunk side bending, toe reaching or shoulder shrugging

28
Q

discuss overhead pulleys

A

for shoulder flexion, abd, scaption and elbow flexion

sitting or standing

avoid shoulder shrugging and trunk lean

direct pulley along line of pull of joint

29
Q

discuss skateboard

A

used for horizontal abd-add

30
Q

what is reciprocal exercise unit

A

bicycle for UE and LE - provides flex-ex and matches strength of good extremity

useful for endurance and strengthening of bad extremity

31
Q

what are the benefits of CPM

A

prevents adhesions and contractures

stimulus for healing of tendons and ligaments

enhance healing of incisions over joint

32
Q

usual parameters for CPM

A

imedd after surgery while pt is under anesthesia

20-30° muna tas progress by 10-15° at 1 cycle/45 sec or 2 mins for 24 hrs cont or 1hr TID

minimum of 1 wk or when desired ROM is completed

33
Q

ROM present in brushing or combing of hair

A

○ Shoulder abd & ER
○ Elbow flexion
○ Cervical rotation

34
Q

ROM present in holding phone to ear

A

○ Shoulder ER
○ Forearm supination
○ Cervical lateral flexion (side-bend)

35
Q

ROM in donning and doffing of clothes

A

○ Shoulder extension and external rotation
○ Elbow flexion and extension

36
Q

ROM in sit to stand

A

○ Hip flexion
○ Knee flexion
○ Ankle DF and PF
○ Some Hip rotation

37
Q

frequency of STS to prevent functional decline

A

STS for 1 min twice a day

38
Q

significance of functional ROM

A

helps the patient recognize the purpose and value of ROM exercises and develop motor patterns

msk2 (42 decks)

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