ROM

Question 1

State the precautions and contraindications for exercises to increase mobility

Answer 1

Mobility: passive ROM and stretching are not benign processes and are contraindicated when motion could disrupt the healing process
Take caution when working with a muscle in which contraction is contraindicated
Stretching: contraindicated in the case of acute inflammation or infection in the tissue being stretched
Caution: patients with recent fractures, osteoperosis, elderly, those with prolonged immobility, or very weak muscles

Question 2

What are the goals for range of motion exercises?

What do we want to prevent or enhance?

Answer 2

• loading of soft tissues to maintain integrity of the tendon, ligament, articular cartilage and muscle
• PROM/AAROM: prevention of negative effects of immobilization, prevention of joint contracture and soft tissue tightness, decrease pain, enhance vascular dynamics and synovial diffusion

Question 3

What is the best means for a patient to maintain ROM gains achieved through
stretching?

Answer 3

Do not get tight

Question 4

What are the effects of reduced mobility on muscle, tendon,
ligament, and bone?

Answer 4

MOB
M: the longer the immob the greater the atrophy
T: reduction in size and number of collagen bundles
L: decrease in collagen mass
B: bone mineral loss may be as high as 8% per month while on bedrest

Question 5

What are the effects of remobilization on muscle, tendon,
ligament, and bone?

Answer 5

REMOB
M: often requires long rehab, less stiffness
T: acceleration of collagen synthesis, less development of adhesions, improvement of tensile strength
L: remob aids with re establishing ligament strength
B: tends to return to normal levels more quickly than soft tissue

Question 6

Individuals with more of which type of fibers are less likely to atrophy

Answer 6

Those with a higher proportion of slow twitch fibers are less likely to atrophy than those with a higher proportion of high twitch

Question 7

Muscles that are immobilized in a shortened position….

Answer 7

show more atrophy than those immobilized in a lengthened position

Question 8

Which is more resistant to immob related changes muscle or tendon”?

Answer 8

Tendon

Question 9

What are the guidelines for static stretching (including age-related parameters).

Answer 9

Stretches should be held for 30 seconds in younger patients and 60 seconds in older

Position patient to allow complete relaxation of muscle

Take limb to the point at which a gentle stretching sensation is felt and hold for required time, relax, repeat