Preparation for ROM

• Examine and evaluate patient

• Obtain information from medical record

• Determine goals and type of exercise to use

• Introduce yourself and explain the purpose, risks, and desired outcomes

• Obtain patient permission

• Position the patient and yourself

 

Principles of PROM Exercise

• Provide gentle, firm support and proper stabilization

• Move through entire unrestricted, normal ROM of a joint (end feel)

• Give special consideration to multijoint muscles

• Give special considerations to how the patient's diagnosis affects the exercise program, e.g., SCI, THR, CVA
• 
  Value: 1

  After a posterior approach total hip replacement, PROM hip flexion should not exceed 90 degrees

   

  True

  
   

  False

  
  
• 
  Value: 1

  In which condition is full lengthening of the extrinsic finger flexors contraindicated?

   

  a. SCI with C6 nerve root sparing

  
   

  b. Radial head fracture

  
   

  c. Inflammation in finger flexors

  
   

  d. Inflammation in shoulder rotator cuff muscles

  
  

• Position patient properly

• Perform passive movement in the direction opposite to the movement that the muscle would produce

• Determine purpose (goals) and sequence

• Perform exercise slowly and smoothly

 

Joint End-Feel

Normal	Abnormal
hard - normal bone to bone painless	abnormal bone-on-bone indicates advanced degenerative changes
soft - soft tissue compression	spasm (early or late) protective response during motion
firm - springy, elastic resistance	empty pain during motion without mechanical/muscle resistance
	capsular hard or soft - tissue stiffness occurring earlier than expected in the ROM

 

Types of Muscle Contractions

Three types:

• Isotonic: visible joint movement

• Eccentric: fibers lengthen

• Concentric: fibers shorten

 

This video shows examples of upper extremity concentric and eccentric exercises. Approximately 5 minutes

• Isometric: no or little observable joint movement and no significant change in muscle length; with or without external resistance
• these exercises are often called "sets", referring to a muscle setting response. Quad sets, hamstring sets are descriptions of isometric exercises for these respective muscle groups.

Video less than one minute

• Isokinetic: requires specific equipment to control the speed of patient's contractions and produces variable resistance throughout the range

This is a brief description of an isokinetic exercise and isokinetic exercise equipment used to control speed and resistance (Approximately 6 minutes)

 

 

End of Lesson

 

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