ROM and CPM Flashcards
muscle ROM
functional excursion of muscles
joint ROM
full arc of motion that can occur between 2 bones, measure by a goniometer and recorded in degree
function excursion of muscles
the distance that a muscle is capable of shortening after it has been elongated to its maximum
1 joint muscle excusion
equal to its ROM
2 or multi-joint muscle excursion example (biceps brachii)
measure from short to long
short - supination, elbow & shoulder full flexion
long - pronation, elbow & shoulder full extension
structures that are affected by ROM
all structures in the region:
- muscle
- joint surfaces
- joint capsule
- ligaments
- fascia
- blood vessels
- nerves
- skin
factors that affect ROM
- joint structure and integrity
- soft tissue flexibility
- disease process
- trauma
- surgery
- inactivity/immobilization
PROM
- motion produced entirely by an external force
- should be little to no voluntary muscle contraction of muscles that normally move the joint
PROM is NOT
stretching!!!
when stretching you want to go beyond the point of resistance
indications for PROM
- acute inflamed tissue
- pt unable/not supposed to move on own
- part of examination process
- demonstration of correct movement pattern
PROM goals
- maintain joint & connective tissue mobility
- minimize/prevent formation of contracture
- maintain mechanical elasticity of muscle
- assist circulation & vascular dynamics
- enhance synovial movement for nutrition of cartilage & diffusion of materials within the joint
- decrease or inhibit pain
- assist with healing process after injury/surgery
- help maintain pt’s awareness of movement
AROM
Movement within the unrestricted ROM for a segment that is produced by active contraction of the muscles crossing the joint. May be performed against gravity or in gravity-minimized positions, depending on pt’s strength & treatment goals.
indications for AROM
- whenever pt is able to actively contract the muscles & move a segment either with or without assistance
- for weaker muscles, can be used as strengthening exercise
- aerobic conditioning program
- used on the regions above & below an immobilized segment
A-AROM
active-assisted ROM
a type of AROM where assistance is provided by an external force
indications for A-AROM
when pt has weak musculature & is unable to move a joint thru the desired range
AROM/A-AROM goals
Same as PROM and:
- maintain physiological elasticity & contractility of active muscles
- provide sensory feedback from contracting muscles
- provide a stimulus for bone & joint tissue integrity
- increase circulation & prevention of DVT
- develop coordination & motor skills for functional activities in movement patterns used
limitations of PROM
- true, relaxed ROM may be difficult to obtain when muscle is innervated & pt is conscious & has active control
- will not prevent muscle atrophy
- will not increase muscle strength or endurance
- will not assist circulation as much as active muscle contraction
limitations of AROM
- will not maintain or increase muscle strength in strong muscles
- will not develop skill or coordination except in the movement patterns used
precautions & contraindications to ROM exercises
- ROM should not be done when motion is disruptive to the healing process
- ROM should not be done when pt response or the condition is life-threatening (PROM carefully initiated to major joints and AROM to ankles and feet)
PROM & AROM may be performed in different positions
- anatomical planes of motion
- antagonistic to line of pull of the muscle
- diagonal patterns or combination of different planes of motion
- functional patterns
principles & procedures for applying ROM
- examine & evaluate
- determine pt’s ability and what amount of motion is safe
- monitor any changes in vital signs, pain, ROM, quality of movement
- prepare the patient
- prepare the PT
- grasp & support body segment(s) appropriately
- perform motions smoothly & rhythmically
- for AROM/A-AROM demonstrate proper pattern to pt and give assistance only when needed
- document & communicate findings & intervention
- re-evaluate & modify the intervention as necessary
continuous passive motion (CPM)
passive motion performed by a mechanical device that moves a joint slowly & continuously thru a controlled ROM
indications for CPM
- to maintain articular cartilage nutrition
- to decrease pain (this is controversial)
application of CPM
- controls of the system (arc of motion and speed)
- dosage
- speed of movement based on pt comfort
- duration of treatment
contraindication for CPM
- unstable fractures
- unstable joints
- very resistive patient
