Exercise & range of motion exercise

this topic deals with the exercise, various types of exercise, advantages of exercise and how to perform range of motion exercises.

1. Exercise & Range Of Motion Exercises By Mr. M. Shivanandha Reddy

2. EXERCISE - Definition Exercise is physical activity for conditioning the body, improving health, and maintaining fitness.

3. Benefits of Physical Exercise Improved cardiopulmonary function Reduced blood pressure Increased muscle tone and strength Greater physical endurance Increased weight loss Reduced blood glucose level

4. Benefits of Physical Exercise Decreased low-density blood lipids Improved physical appearance Increased bone density Regularity of bowel elimination Promotion of sleep Reduced tension and depression

5. CLASSIFICATION OF EXERCISE

6. BASED ON MUSCLE CONTRACTION Isotonic exercise : cause muscle contraction and active movement. Example : walking, aerobics, moving arms & Legs. Isometric exercise: tightening or tensing of muscles without shortening (there is no movement). This increases muscle tension but do not change the length of muscle fibers. Example : contraction of gluteal muscles.

7. BASED ON MUSCLE CONTRACTION Isokinetic Exercise: Involves muscle contractions with resistance. Resistance is provided by an external source Example: movement of leg against resistance.

8. BASED ON SOURCE OF ENERGY Active exercise is therapeutic activity that the client performs independently. Passive exercise is therapeutic activity that the client performs with assistance and is provided when a client cannot move one or more parts of the body.

9. Range Of Motion Exercises Definition: The movement of a joint to the extent possible without causing pain Purposes: Promote and maintain joint mobility Prevent contractures and shortening of muscles and tendons Increase circulation to extremities. Facilitate comfort for the patient

10. Contraindications To ROM Any illness/disorder where increased use of energy or increased circulation is hazardous. Example: Myocardial infarction. swollen, inflamed joints

11. Types Of ROM Exercises Active ROM exercises – Exercises the client is able to perform independently. Passive ROM exercises – Exercises performed for the client by someone else. Active assisted ROM exercises – Performed by a client with some assistance. Client can move a limb partially through its ROM, but needs help completing the ROM.

12. Guidelines For Performing ROM Exercises Start with the head and move down, always do bilaterally Do not grasp the joint directly Do not grasp fingernail or toenail. Be sure to support the distal and proximal end of the limbs Important joints – thumb, hip, knee, ankle Move joint through movement 5 times/session

13. Guidelines For Performing ROM Exercises Return body part to normal anatomical position Move each joint through full range of motion Move to point of resistance not pain Allow for rest periods whenever required Avoid friction LIFT body part don’t drag Note drastic change in vital signs, extreme fatigue.

14. Guidelines For Performing ROM Exercises Should not disrupt the healing process Warm water relaxes the muscles and joints, bathing is an ideal time to perform ROM

15. Patient Preparation Explain and steps and advantages of ROM exercises. Remove all restrictive clothing, linen, splint, and dressings. Drape appropriately Raise the bed to comfortable height. Position the patient comfortably- preferably supine position.

16. JOINT MOVEMENTS ABDUCTION - MOVING A BODY PART AWAY FROM THE MIDLINE OF THE BODY ADDUCTION - MOVING A BODY PART TOWARD THE MIDLINE OF THE BODY EXTENSION - STRAIGHTENING A BODY PART FLEXION - BENDING A BODY PART ROTATION - TURNING THE JOINT INTERNAL ROTATION - TURNING THE JOINT INWARD

17. EXTERNAL ROTATION - TURNING THE JOINT OUTWARD PLANTAR FLEXION - BENDING THE FOOT DOWN AT THE ANKLE PRONATION - TURNING THE JOINT DOWNWARD SUPINATION - TURNING THE JOINT UPWARD INVERSION - TURNING THE SOLE OF THE FOOT TOWARDS THE MIDLINE EVERSION - TURNING THE SOLE OF THE FOOT AWAY FROM THE MID LINE

18. JOINT MOVEMENTS

19. Range Of Motion Of Various Joints JOINT MOVEMENTS POSSIBLE EXAMPLE Temporo mandibular Open Close Protrusion Retraction Lateral deviation Opening mouth Closing mouth Bringing lower jaw forward Taking lower jaw inside Moving jaw to a side

20. Range Of Motion Of Various Joints JOINT MOVEMENTS POSSIBLE EXAMPLE Neck Flexion Extension Hyperextension Lateral flexion Look @ the toes Look straight ahead Look up @ ceiling look straight ahead, tilt head to shoulder

21. Joint Movements possible Example Shoulder Flexion Extension Abduction Adduction Internal rotation External rotation Circumduction Raise arm forward & overhead Return arm to side of body Raise arm to side to position above head with palm away from head Return arm & bring across chest Elbow flexed, rotate the shoulder by moving arm til thumb is turned inward & toward the back (fingers to the floor) Elbow flexed, move arm until thumb is lateral to head. (Fingers point up) Move arm in full circle

22. Range Of Motion Of Various Joints Joint Movements possible Example Elbow Flexion Extension Hyperextension Bend elbow Straighten elbow Bend lower arm back as far as possible

23. Range Of Motion Of Various Joints Joint Movements possible Example Forearm Supination Pronation Turn lower hand so palm is up Turn lower hand so palm is down

24. Joint Movements possible Example Wrist Flexion Extension Hyperextension Abduction Adduction Bend wrist forward Straighten wrist (fingers, wrist & arm in same plane) Bring dorsal surface of hand as far back as possible Bring wrist medially towards the thumb Bend wrist laterally towards 5 th finger

25. Joint Movements possible Example Fingers & Thumb Flexion Extension Hyperextension Abduction Adduction Circumduction Opposition Bend fingers & thumb into palm make a fist Straighten fingers & thumb Bend fingers as far back as possible Spread fingers apart / extend thumb laterally Bring fingers together/ thumb back to hand Move finger/thumb in circular motion Touch thumb to each finger of same hand

26. Range Of Motion Of Various Joints Joint Movements possible Example Hip Flexion Extension Hyperextension Abduction Adduction Move leg forward Move leg back beside other leg Move leg backwards Move leg laterally away from body Move leg back to medial position & beyond if possible

27. Range Of Motion Of Various Joints Joint Movements possible Example Knee Flexion Extension Bring heel toward back of thigh Return leg to floor

28. Range Of Motion Of Various Joints Joint Movements possible Example Ankle Dorsiflexion Plantar flexion Move foot so toes are pointed upward Move foot so toes are pointed downward

29. Range Of Motion Of Various Joints Joint Movements possible Example Foot Inversion – Eversion – Flexion – Extension – Abduction – Adduction – Turn sole of foot medially Turn sole of foot laterally Curl toes downward Straighten toes Spread toes apart Bring toes together

30. Range Of Motion Of Various Joints Joint Movements possible Example Spine Flexion Extension – Hyperextension – Lateral flexion – Rotation – When standing – bend forward from the waist Straighten up Bend backward Bend to the side Twist from the waist

31. Thank you