ROM and CPM

Question 0

muscle ROM

Answer 0

functional excursion of muscles

Question 1

joint ROM

Answer 1

full arc of motion that can occur between 2 bones, measure by a goniometer and recorded in degree

Question 2

function excursion of muscles

Answer 2

the distance that a muscle is capable of shortening after it has been elongated to its maximum

Question 3

1 joint muscle excusion

Answer 3

equal to its ROM

Question 4

2 or multi-joint muscle excursion example (biceps brachii)

Answer 4

measure from short to long

short - supination, elbow & shoulder full flexion
long - pronation, elbow & shoulder full extension

Question 5

structures that are affected by ROM

Answer 5

all structures in the region:

• muscle
• joint surfaces
• joint capsule
• ligaments
• fascia
• blood vessels
• nerves
• skin

Question 6

factors that affect ROM

Answer 6

• joint structure and integrity
• soft tissue flexibility
• disease process
• trauma
• surgery
• inactivity/immobilization

Question 7

PROM

Answer 7

• motion produced entirely by an external force

- should be little to no voluntary muscle contraction of muscles that normally move the joint

Question 8

PROM is NOT

Answer 8

stretching!!!

when stretching you want to go beyond the point of resistance

Question 9

indications for PROM

Answer 9

• acute inflamed tissue
• pt unable/not supposed to move on own
• part of examination process
• demonstration of correct movement pattern

Question 10

PROM goals

Answer 10

• 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

Question 11

AROM

Answer 11

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.

Question 12

indications for AROM

Answer 12

• 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

Question 13

A-AROM

Answer 13

active-assisted ROM

a type of AROM where assistance is provided by an external force

Question 14

indications for A-AROM

Answer 14

when pt has weak musculature & is unable to move a joint thru the desired range

Question 15

AROM/A-AROM goals

Answer 15

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

Question 16

limitations of PROM

Answer 16

• 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

Question 17

limitations of AROM

Answer 17

• will not maintain or increase muscle strength in strong muscles
• will not develop skill or coordination except in the movement patterns used

Question 18

precautions & contraindications to ROM exercises

Answer 18

• 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)

Question 19

PROM & AROM may be performed in different positions

Answer 19

• anatomical planes of motion
• antagonistic to line of pull of the muscle
• diagonal patterns or combination of different planes of motion
• functional patterns

Question 20

principles & procedures for applying ROM

Answer 20

• 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

Question 21

continuous passive motion (CPM)

Answer 21

passive motion performed by a mechanical device that moves a joint slowly & continuously thru a controlled ROM

Question 22

indications for CPM

Answer 22

• to maintain articular cartilage nutrition

- to decrease pain (this is controversial)

Question 23

application of CPM

Answer 23

• controls of the system (arc of motion and speed)
• dosage
• speed of movement based on pt comfort
• duration of treatment

Question 24

contraindication for CPM

Answer 24

• unstable fractures
• unstable joints
• very resistive patient