Therex Lecture 2 Flashcards
If biceps brachii contracts and moves elbow into flexion and the forearm into supination WHILE moving SHOULDER into flexion, what is this called?
Active insufficiency.
Biceps brachii shortens to the point where it cannot shorten anymore
If you extend the elbow, pronate the forearm, and extend the shoulder, what is this called?
Passive insufficiency.
The biceps brachii become fully elongated to the point where it cannot elongate anymore
What is passive range of motion?
PROM is movement of a segment within the unrestricted ROM that is produced entirely by an external force; there is little to no voluntary muscle contraction
What are the indications for PROM?
The indications for PROM are:
- if tissue is acutely inflamed (because active motion would be detrimental to the healing process)
- if a patient is not able to or not supposed to actively move a segment (comatose, paralyzed, complete bed rest) - movement has to be provided by an external source
What are the goals of PROM?
The primary goals of PROM:
- decrease complications from immobilization
- maintain joint and connective tissue mobility
- minimize the effects of the formation of contractures
- aintain mechanical elasticity of muscle
- assist circulation and vascular dynamics
- enhance synovial movement for cartilage nutrition and diffusion of materials in the joint
- decrease or inhibit pain
- assist with the healing process after injury or surgery
- help maintain patient’s awareness of movement
What are other uses for PROM?
The other uses for PROM are:
- determine limitations of motion, joint stability, muscle flexibility and other soft tissue elasticity for unmoving structures.
- used to demonstrate motions for active exercise programs
- precedes stretching techniques
What are the limitations of PROM?
The limitations of PROM are:
- does not prevent muscle atrophy
- does not increase strength or endurance
- does not assist circulation to the extent of AROM
What is active range of motion?
AROM is movement of a segment within the unrestricted ROM that is produced by active contraction of the muscles crossing that joint
What is active-assisted range of motion?
A-AROM is a type of AROM in which assistance is provided manually or mechanically by an outside force because the prime mover muscles assistance to complete the motion
What are the indications for AROM and A-AROM?
The indications for AROM and A-AROM are:
- if patient is able to contract muscles actively and move a segment with or without assistance (AROM)
- when a patient has weak musculature and is unable to move a joint through desired range (usually against gravity) (A-AROM)
- used on regions above and below an immobilized segment (that is immobilized for periods of time) to maintain the areas in as normal condition as possible to prepare for new activities such as walking with crutches (AROM)
- can be used for aerobic conditioning programs and is used to relieve stress from sustained postures (AROM)
What are the goals for AROM?
The goals for AROM are:
- same goals of PROM
- maintain physiological elasticity and contractility of the participating muscles
- provide sensory feedback from the contracting muscles
- provide a stimulus for bone and joint tissue integrity
- increase circulation and prevent thrombus formation
- develop coordination and motor skills for functional activities
What are the limitations for AROM?
The limitations for AROM are:
- it does not maintain or increase the strength for strong muscles
- it does not develop skill or coordination except in the movement patterns used
What are the precautions and contraindications to ROM exercises?
The precautions and contraindications to ROM exercises are:
- ROM should not be done when motion is disruptive to the healing process
- ROM should not be done when patient response or the condition is life-threatening
- – PROM may be carefully initiated to major joints and AROM to ankles and feet to minimize venous stasis and thrombus formation
- – After MI, CABG, or percutaneous transluminal coronary angioplasty, AROM of upper extremities and limited walking are usually tolerated under careful monitoring of symptoms
What is self-assisted range or motion?
S-AROM is used to protect the healing tissues when more intensive muscle contraction is contraindicated. A variety of devices as well as use of a normal extremity may be used to meet the goals of PROM or A-AROM. Incorporation of S-AROM then becomes a part of the home exercise program
What are the guidelines for teaching S-AROM?
The guidelines for teaching S-AROM are:
- Educate the patient on the value of the motion
- Teach the patient correct body alignment and stabilization
- Observe patient performance and correct any substitute or unsafe motions
- If equipment is used, be sure all hazards are eliminated for application to be safe
- Provide drawings and clear guidelines for number of repetitions and frequency
