Define Range of motion. Write down the types and normal Ranges of motion.

 Range OF Motion:

It is defined as, the full motion which is possible to perform is called ROM.

 It is a basic technique used for the examination of movement and for initiating movement into a program of therapeutic intervention. 

Active Insufficiency:

When a two-joint muscles functioning at elbow is the biceps brachii muscle, if it contracts and moves the elbow into flexion and the forearm into supination while simultaneously moving the shoulder into flexion, it shortens to a point.

Passive Insufficiency:

The muscle is lengthened full range by extending the elbow, pronating the forearm, and simultaneously extending the shoulder.

Types Of ROM Exercises:

1. Passive ROM
2. Active ROM
3. Active-Assistive ROM.

Passive ROM:

Passive ROM 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. The external force may be give with a gravity, machine and other individual. 

Indication for PROM:

• When there is acute inflammed tissue, passive motion is beneficial, active motion would be detrimental to the healing process.
• When a patient is not able to or not supposed to actively move  segment of the body, movement is provided by an external source.

Goals For PROM:

• Maintain joint and connective tissue mobility.
• Minimize the effects of the formation of contracture.
• Maintain mechanical elasticity of muscle.
• Assist circulation and vascular dynamics.
• Decrease or inhibit pain
• Assist with the healing process after injury or surgery.

Limitations of PROM:

Passive range of motion does not :

• Prevent muscle atrophy.
• Increase strength or endurance.

Active ROM:

It is the movement of a segment within the unrestricted ROM that is produced by active contraction of the muscles crossing that joint called Active ROM.

Active Assistive ROM:

Active Assistive ROM is a type in which assistance is provided manually or mechanically by an outside force because the prime mover muscles need assistance to complete the motion.

Indications Of AROM:

• When a patient is able to contract the muscles actively and move a segment with or without assistance, AROM is used.
• When a patient has weak musculature and is unable to move a joint through the desired range , A-AROM is used to provide enough assistance to the muscles in careful manner.
• When a segment of the body is immobilized for a period of time, AROM is used on the regions above and below the immobilized segment.

Goals Of AROM:

• Maintain physiological elasticity and contractility of the participating muscles.
• Provide sensory feedback from the contracting muscles.
• Increase circulation and prevent thrombus formation.

Limitations Of AROM:

For strong muscles, active ROM does not maintain or increase strength.

 

Precautions and Contraindications to ROM Exercises:

• ROM should not be done when motion is disruptive to the healing process.
• ROM should not be performed when patient response or the condition is life-threatening.
• ROM is contraindicated immediately after acute tears, fractures and surgery 

Normal Ranges Of Motion:

Upper Extremity:

SHOULDER:

1. Flexion:   0 to 90 degree.
2. Extension: 0 to 45 degree.
3. Abduction: 0 to 180'
4. External Rotation: 0 to 60'
5. Internal Rotation: 0 to 80'
6. Horizontal Abduction: 0 to 90'
7. Horizontal Adduction: 0 to 130'

ELBOW:

1. Flexion: 0 to 150'
2. Extension: 150' to 0'
3. Supination: 0 to 80'
4. Pronation: 0 to 80'

WRIST:

1. Flexion: 0 to 80'
2. Extension:  0 to 70'

FINGERS:

1. MP Flexion: 0 to 90'
2. PIP and DIP Flexion: 0 to 100'
3. MP Extension: 0 to 45'
4. Abduction: 0 to 20'
5. Adduction: 20 to 0'

THUMB:

1. Thumb MP and IP Flexion: MP( 0 to 50') IP (0 to 80')
2. MP and IP Extension: MP ( 50 to 0) IP ( 80 to 0 )
3. Abduction: 0 to 70'
4. Adduction: 70 to 0'.

Lower Extremity:

HIP:

1. Flexion: 0 to 120'
2. extension: 0 to 20'
3. Abduction: 0 to 45'
4. Adduction: 0 to 20'
5. External Rotation: 0 to 45'
6. Internal Rotation: 0 to 45'

KNEE:

1. Flexion: 0 to 135'
2. Extension: 135 to 0'.

FOOT:

1. Plantar Flexion: 0 to 45'.
2. DorsiFlexion: 0 to 20'.
3. Inversion: 0 to 35'.
4. Eversion: 0 to 25'.
5. Toe MP flexion: 0 to 40'.
6.  Toe DIP flexion: 0 to 60'.

REFRENCES:

Muscle testing by Daniels and Worthingham's.

Therapeutic Exercise By Carolyn Kisner.

AUTHOR:

Tayyba Saleem (PT).

Doctor Of Physical Therapy.