Passive ROM Exercises. 9/29/2013 Dr. Enas Elsayed ١

Transcription

1 Passive ROM Exercises 9/29/2013 Dr. Enas Elsayed ١

2 Reference Therapeutic Exercise: Foundations and Techniques. 5 th edition by Kisner and Colby. Range of Motion (Chapter 3),pages: /29/2013 Dr. Enas Elsayed ٢

3 Objectives By the end of the lecture, the student will be able to: 1. Define passive movement. 2. Mention characteristics of passive movement. 3. List the indications of passive movement. 4. Postulate the aims of passive movement. 5. Explain technical principles before performing passive exercises. 6. Identify the benefits and uses of continuous passive movement 9/29/2013 Dr. Enas Elsayed ٣

4 Definition Passive ROM is movement of a body segment within the unrestricted ROM produced by an external force. The external force may be from gravity, a machine, another individual, or another part of the individual s own body. 9/29/2013 Dr. Enas Elsayed ٤

5 Passive shoulder flexion A B 9/29/2013 Dr. Enas Elsayed ٥

6 So, passive ROM exercises are characterized by: 1. No voluntary muscular activation. 2. Performed within the available ROM. 3. Applied by some external force. 4. No pain. 9/29/2013 Dr. Enas Elsayed ٦

7 Indications Acute tissue inflammation after surgery or injury that lasts for 2-6 days as active movement may disrupt the healing process. When voluntary movements are impossible as in cases of coma, or paralysis of the body part. 9/29/2013 Dr. Enas Elsayed ٧

8 Aims Passive exercises are largely preventive in nature and are used to: 1. Maintain ROM. 2. Maintain joint and connective tissue mobility. 3. Minimize the formation and effects of contractures. 4. Enhance synovial movement for cartilage nutrition and diffusion of materials in the joint. 5. Maintain mechanical elasticity of the muscles. 6. Assist circulation and vascular dynamics. 7. Help to maintain the patient s awareness of movement. 9/29/2013 Dr. Enas Elsayed ٨

9 Points to remember Passive ROM exercises will NOT: Build up muscles or make them stronger. Prevent muscle atrophy. Increase strength or endurance. Assist in circulation as active, voluntary muscle contraction will. 9/29/2013 Dr. Enas Elsayed ٩

10 Application of Passive Exercises Before performing passive exercises, some of the technical principles should be remembered: 1. Place the patient in proper comfortable position with proper body alignment and stabilization. 2. The therapist should be in a proper position and effective stance. 3. Free the region from restrictive clothes, splints, and dressings. 4. Cover the patient as necessary. 9/29/2013 Dr. Enas Elsayed ١٠

11 5. Utilize the proper hand grasps by the therapist. 6. Perform the exercise slowly, smoothly with rhythm within the available pain-free ROM without any force behind it. 8. Stop exercises if the person feels pain. The exercises should never cause pain or go beyond the normal movement of that joint. 9. Repeat the exercise 5 to 10 repetitions according to the patient condition and response. 9/29/2013 Dr. Enas Elsayed ١١

12 Passive supination and pronation 9/29/2013 Dr. Enas Elsayed ١٢

13 Passive movement for the knee 12.jpg 9/29/2013 Dr. Enas Elsayed ١٣

14 Continuous Passive Motion Continuous Passive Motion (CPM) refers to passive movement that is performed by a mechanical device that moves a joint slowly and continuously through a controlled range of motion. 9/29/2013 Dr. Enas Elsayed ١٤

15 CPM Device for the Knee 9/29/2013 Dr. Enas Elsayed ١٥

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17 Benefits of CPM Prevention of development of adhesion, contracture and joint stiffness. Providing stimulating effect for healing of tendons and ligaments. Minimizing the effect of immobilization. Increasing the synovial fluid of the joint so increase rate of intra-articular healing. 9/29/2013 Dr. Enas Elsayed ١٧

18 Indications After surgery, including: Anterior cruciate ligament (ACL) Knee arthoroplasty Repair of stable intra-articular or extra-articular fractures Meniscectomy Osteochondral repair 9/29/2013 Dr. Enas Elsayed ١٨

19 Contraindications It is contraindicated in cases for which the device can cause unwanted translation of opposing bones or overstressing the healing process. 9/29/2013 Dr. Enas Elsayed ١٩

20 Precautions The use of CPM in conjunction with anticoagulation therapy may produce an intra-compartmental haematoma. Skin irritation from the straps may develop. 9/29/2013 Dr. Enas Elsayed ٢٠

21 General Principles: Clinical Application The CPM unit is often applied in the recovery room immediately after surgery even when the patient is wearing brace or surgical bandages. The arc of motion for the joint is determined. Often a low arc of 20 to 30 degrees is used initially and progressed 10 to 15 degrees per day. The rate of motion is usually one cycle per 45 seconds or per 2 minutes. 9/29/2013 Dr. Enas Elsayed ٢١

22 The timing on the CPM machine ranges from one hour, three times a day to continuous for 24 hours. After surgery, it is recommended to use it for 6 to 8 hours a day. Physical therapy is provided during the time when the patient is not on the CPM machine. Minimum duration for CPM is usually less than one week when a satisfactory ROM is reached. 9/29/2013 Dr. Enas Elsayed ٢٢

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